OVERLEGEN 3-2014 33 healthcare chain between various different healthcare providers and stakeholders, ensuring the right care can be provided. The more than 400 Dutch local authorities are legally obliged to improve citizens’ health and protect them from illnesses and calamities. This task is carried out by the local Community Health Services (GGD’s) under the direction of the local authorities. Flexibility by all those involved is a prerequisite. Both patients and healthcare professionals need to travel in order to be able to receive or provide all types of healthcare. Training/Education All these developments require adaption of the healthcare professionals’ training and education. Their training needs to seamlessly integrate with all changes. Discipline surpassing training is necessary to ensure the healthcare professionals are prepared for all possible forms of collaboration. LAD’s vision of the Dutch healthcare system in 2025 The developments in healthcare have changed the way in which doctors work. The broad spectrum of doctors in employment – young and old, inexperienced and experienced – will notice this. The LAD shares the politicians’ vision that healthcare can and must be provided more effectively. Doctors certainly also need to take responsibility for this. The LAD feels it’s of the utmost importance that doctors think along and discuss the changes in healthcare in the current negotiation culture. Because a doctor as an individual isn’t a discussion partner for, for example, health insurers, it’s important that they take up a position at institution level as a group. The input provided by well organised doctors means the healthcare institutes are well prepared for negotiations with stakeholders. Input by doctors is absolutely essential for safeguarding good patient care. Agreements entered into between politicians, health insurers and healthcare institutes are often not supported until healthcare professionals feel partly responsible for these. This is often not the case if they have been informed of what third parties have decided on afterwards. Doctors have final responsibility in the primary care process. It’s therefore quite disappointing that many decisions about healthcare are made without consulting doctors, who know what is good for the patient and for the healthcare organisation as a result of the content and their experience. The LAD believes that the involvement of doctors in employment via the employer must be organised by including preconditions in the CLA’s. In addition to the patient related activities, the doctor must be given scope to carry out policy tasks, for example focussed on management of his work environment. The fact that doctors don’t have a great deal of influence at the moment isn’t just down to the employers; doctors need to take action themselves too. For example, doctors could have seats in a works council or an association within which doctors in employment are organising themselves as the employer’s discussion partner. • The Netherlands Association of Salaried Doctors (LAD) for short, is the largest and most influential employers’ organisation for (prospective) doctors in employment in the Netherlands. We have more than 16.000 members and are a partner which the healthcare sector can’t ignore. The LAD stands up for the interests of all (prospective) doctors in employment – from co-assistant to junior doctors, from basic doctors to medical specialists, from paediatricians to psychiatrists and from company doctors to specialists in geriatric medicine. Plus we also look after the interests of physician assistants and pharmacists in employment. The LAD is committed to good working conditions and terms of employment for (prospective) doctors in employment, for example by entering into CLA agreements. In addition to this collective representation of employees’ interests, the LAD also advises its members at individual level. Members can contact the LAD with questions about their employment. The LAD will also provide advice about employment and working conditions, like performance appraisals and pensions. At European level, the LAD is affiliated with the European Junior Doctors (EJD) and the Fédération Européenne des Médecins Salariés (FEMS).
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