The rules for new youth care providers must become stricter. This is what both the Dutch mental health services and the Ministry of Health (VWS) say. The BOOS broadcast about the Yes We Can Clinics in Hilvarenbeek prompted Omroep Brabant to ask questions about the admission of new healthcare providers. Concerns about this appear to have existed for some time. According to the mental health services, it sometimes even seems ‘easy’ to start as a healthcare provider. A permit requirement should solve this problem.
In the broadcast of BNNVARA’s BOOS, dozens of former clients and employees talk about their experiences in the clinic for young people with psychological problems and addiction problems. They talk about mental pressure, peer pressure and bullying, among other things.
At the same time, the broadcast raises a broader question: how can a healthcare provider that works with vulnerable young people actually enter the market, and who checks in advance whether the quality is in order?
Different rules per type of care
According to the Ministry of Health, Welfare and Sport, the rules for healthcare providers differ per type of care. An organization that offers regular mental health care is often subject to different laws than a provider of youth care. As a result, other requirements sometimes apply before an organization can start.
Municipalities are responsible for purchasing care and may impose additional conditions on providers themselves. Since the decentralization of youth care in 2015, the number of providers has grown significantly. Municipalities therefore have to deal with large numbers of healthcare organizations, which can make it difficult in practice to intensively monitor every provider.
After the BOOS broadcast about Yes We Can Clinics, the Association of Dutch Municipalities (VNG) already indicated that it was in favor of stricter controls and a licensing requirement for new youth care providers.
No permit requirement
The Ministry of Health, Welfare and Sport (VWS) recognizes that the current admission of new healthcare providers could be improved. An important point is that there is no licensing requirement yet for youth care providers, while this does exist for many other forms of care, including parts of regular mental health care.
Such a licensing requirement means that a healthcare institution must obtain prior permission from the government before it can provide care. In youth care, providers now only have to report and register in advance. “With the reporting obligation, there is no option to screen or stop a provider if risks are seen,” says a spokesperson for the Ministry of Health, Welfare and Sport. The ministry emphasizes that new providers must meet various requirements under the Youth Act before they join and that municipalities test them in advance in contract agreements.
Inspections often only take place after an organization is already active, for example through supervision by the Healthcare and Youth Inspectorate (IGJ). The inspectorate has now started an investigation into the clinic in Hilvarenbeek.
Not clearly arranged
Yes We Can Clinics is affiliated with the Dutch Mental Healthcare Association, which emphasizes that the discussion about stricter admission of healthcare providers has been going on within the sector for some time and does not arise from the situation surrounding the clinic.
The Dutch mental health service confirms that due to the lack of a permit requirement, the same rules do not apply everywhere before an organization can start. “What you see is that the admission of new healthcare providers to the market is not clear and sometimes seems easy,” says a spokesperson for the Dutch mental health service.
The Dutch mental health care sector is therefore also in favor of the licensing requirement announced by VWS.
Stricter rules on the way
The ministry says it is now working on stricter rules for new healthcare providers, especially in youth care. Minister Sterk of Health, Welfare and Sport therefore decided on April 15 that there should be a licensing requirement for youth care providers. In doing so, she responds to the wishes of, among others, the VNG and the Dutch mental health service, which have been advocating for this for some time. With this measure, the government wants to be able to better check providers in advance for quality, governance and integrity.
Here you can read more stories about the Yes We Can Clinic in Hilvarenbeek.