The Healthcare Professions Act: revised decision-making frameworks for professions and reserved procedures

The Health Council of the Netherlands has reviewed the decision-making frameworks for the regulation of professions and reserved procedures under the Healthcare Professions Act (Wet BIG). These frameworks represent an important step towards clarifying the decision-making process around such regulation.

Changes in healthcare and society have led to a growing number of requests submitted to the Ministry of Health, Welfare and Sport (VWS) to include new professions in the Healthcare Professions Act. This increase has revealed several bottlenecks. Notably, it is often unclear on what grounds decisions are made—whether to regulate a profession or to grant authorisations for performing reserved procedures. In response, the Minister has requested the Health Council to advise on a future-proof decision-making framework. The Council’s permanent Committee on Ethics and Law took up this request.

The Committee proceeded from the assumption that the purpose and function of the Healthcare Professions Act are not under debate. In its view, there is no need to develop new criteria. Instead, the Committee believes that clarifying the function of the regulation and the criteria already in use will help make the decision-making process more transparent and consistent. The decision-making frameworks developed by the Committee articulate the ethical-legal criteria that are often applied implicitly: necessity, subsidiarity, effectiveness and proportionality. 

The frameworks are intended to serve as guidance—for example, by indicating how the government should justify regulatory decisions. Further specification and interpretation will be necessary when applying the frameworks in practice. The Committee recommends that this be carried out by an independent review body that can advise the Minister on decisions regarding the regulation of professions and reserved procedures under the Healthcare Professions Act.