Dutch community healthcare faces a crisis after a confidential police report revealed that criminal gangs have infiltrated the system on a large scale, exploiting vulnerable patients and siphoning millions from the healthcare budget. Criminals have reportedly set up fake care agencies or used falsified qualifications to infiltrate the sector, preying on elderly individuals, troubled youth, and people with severe mental disabilities. These groups are particularly vulnerable, often unable or slow to report poor treatment or abuse.

The report highlights a serious issue: €10 billion of the annual €100 billion health budget is lost to fraud, with a portion funneled to these criminal operations. Many of these fraudulent agencies exploit the personal care budget (PGB) system, which allows patients to directly buy the care services they need. Thousands of small companies across the Netherlands offer such services, from community nursing and psychiatric support to youth and residential care, funded largely by local authorities and insurance companies. 

Healthcare Minister Fleur Agema, who had previously announced measures to counteract this issue in response to parliamentary questions, reacted with outrage. She described feeling “her blood boiled” after reading the report, vowing to take decisive action. Agema reiterated her commitment to launching a healthcare fraud information center and a licensing system for care providers, both set to go into effect on January 1, to “remove the rotten apples.” However, she acknowledged that the problem is complex, noting that “these people are ruthless and certain to find new ways and means” to exploit the system.

The call for immediate action has been echoed by care organizations, with Shamir Ceuleers of the human trafficking prevention group CKM stressing the need for urgent collaboration among politicians, healthcare institutions, and monitoring bodies. “We cannot afford to abandon vulnerable patients in institutions where they are meant to be safe,” Ceuleers emphasized.

This infiltration of criminal activity within healthcare is not new. A 2021 investigation in Twente exposed several care agencies that had forced vulnerable clients, often young people with psychological or addiction issues, into illegal activities such as working on marijuana plantations and even sex trafficking. The CKM report also found that, from 2019 to 2023, one in five cases of sexual and criminal exploitation involved victims recruited through care institutions.

The national audit office warned in 2022 that fraud prevention efforts within healthcare were falling short, with low chances of perpetrators being caught. Board member Ewout Irrgang noted that little progress has been made since, calling the situation dire. With the implementation of Agema’s planned reforms and additional oversight, the government aims to better protect those who depend on community healthcare and restore integrity to the sector.