The bill, put forward by Minister of Health Edith Schippers of the VVD (Liberals), was adopted on September 13. It is now under consideration by the Senate.

The bill regulates the authority of health insurers to check declarations. As a last step, health insurers may access medical files without patients' consent. The originally proposed law was changed by the House of Representatives on two points. First, health insurers will be obliged to inform patients about accessing their files within three months after they were accessed. Second, the House of Representatives will have the possibility to adjust the specific requirements for accessing medical files.

The minister's aim with the bill is to fight fraud in health care, which totaled 11 million euros in 2015, or 0.015 percent of the annual health care budget. The fraud that was committed by patients equalled 1.4 million euros; the other 9.6 million euros' worth of fraud was committed by health care providers or intermediaries.

A house divided

Debate on the bill in the Dutch House of Representatives began on September 8. The Socialist Party (SP) and the liberal-democratic party Democrats 66 (D66) opposed the proposal. SP called it disproportionate that fraud, only 0.015 percent of the annual health care budget, could result in the abolition of medical confidentiality for all Dutch citizens. As an alternative to avoiding fraud, SP preferred a simplification of the declaration process.

D66 also found the measure disproportionate and stated that there are sufficient alternatives to detect fraud. According to D66, the government is repeating itself: 'There is a problem. Let's collect more data. Although that is rarely effective.'

The People's Party for Freedom and Democracy (VVD), the Labour Party (PvdA), the Christian Democratic Appeal party (CDA), and the populist Party for Freedom (PVV) support the bill. PvdA and CDA were worried about securing privacy, but generally agree with the proposal. PVV would rather see a request to patients "for collaboration" before their medical files are accessed, but does not believe that there is a majority for such a proposal. That is why the party suggested an amendment to the bill to inform patients after their files are accessed by health insurers.

Minister Schipper agreed with that suggestion and said she would will also look into the possibility of informing a patient before his or her medical files are accessed, provided that this does not hamper the investigation.

Citizens want right of refusal

Before the debate, Patiëntenfederatie Nederland surveyed Dutch citizens and concluded that patients should be able to refuse health insurers access to their medical files. Patients want to cooperate, but they do want to be informed beforehand, and they want to have the right to refuse access.

Privacy Barometer wrote a letter (with press release) about the bill to the House of Representatives.