The Netherlands - HEPA Policy Making
The prevention cycle
The policy making process in the Netherlands follows a 4-year prevention cycle based on the Dutch Public Health act (WPG). The national policy could be based on the main results coming from the four yearly Public Health status and Forecast report (VTV) of the National Institute for Public Health and Environment (RIVM) on national level.
The prevention cycle is as follows: the process and outcomes of the national policy cycle and the local policies are evaluated and monitored by the Health Inspectorate (IGZ). Then the public health status and forecast report (VTV-report) in which all relevant research evidence on health and health determinants is integrated, is composed by the department VTV of RIVM. The departments of Public Health (PG) and Nutrition Health Prevention (VGP) at the Ministry of Health, Welfare and Sport (VWS) write the four year national policy document, based on the VTV report and the report of IGZ. The following step is that on local level every municipality writes their own local policy document based on the national policy document (its main priorities and recommendations) and on the epidemiologic information collected by the Community Health Services (GGDs) of the local health situation. The municipality then starts to implement this local health policy. This is again evaluated and monitored by IGZ, which results then form the starting point for the new prevention cycle (Loket Gezond Leven, 2014). During the development process the accountable departments within the Ministry of Health might also be informed by working committees and a specific Board of Research, as part of the VTV.
Dutch National Public Health Act and health policy ‘Health close to People’
The purpose of the policy ‘Health Close to People’ (May 2011) can be found in the ideological change to make citizens feel more responsible for their health. The cabinet would like to see that citizens take responsibility for their own health. The policy is focusing on physical activity which gives a positive twist to communicate about health and healthy behavior. Physical Activity is incorporated in as many aspects of the policy as possible. It is mentioned that all information and facilities to live a healthy life should be easy available and accessible for all citizens. Municipalities and local authorities are seen as strong stakeholders and actors within this vision.Within the policy ‘Health Close to People’ (May 2011), research evidence is used to support and underline values and the priorities chosen. One of the political values mentioned for instance was a clear presence of a community value. Community based approaches were valued as effective approaches and were mentioned as such in the policy.
The use of research and epidemiological information is explicitly mentioned in the policy; the municipalities need to use the existing research-evidence infrastructure to know where the focus should be in each municipality. For the ‘Health Close to People’ policy the previous national policy has been taken into account, for example effective interventions were taken into account. With respect to prevention and health promotion the policy builds on the priorities of the 2006 national prevention policy: overweight, diabetes, depression, smoking, alcohol abuse.
Another aspect is that the Dutch Government has the ambition to develop professional sports (top sport) in the Netherlands. With the recent policy the cabinet and ministry of health is striving for a country where everybody is able to sport, move and play in a safe environment. Within the policy document ‘Sport and Physical Activity’ this is translated to three priorities:• At a local level smart combinations will be made between sport, care, school, welfare and the business sector;
• Stimulating to disseminate successful experiences and knowledge, initiatives and entrepreneurship;
• To take away possible barriers which inhibit dissemination.These priorities are integrated in the national policy document and municipalities need to consider these priorities in their health policy.
The municipalities are accountable for the local health policy in their municipality. In addition to these priorities, a couple of Action plans are developed with a specific focus on improving physical activity in other sectors such as environment and trade and industry. Examples are the ‘National Approach Environment and Health’ and ‘Action Plan Healthy companies (Hämäläinen RM et al., 2013; Rijksoverheid, 2011).
Hämäläinen RM, Villa T, and the Repopa Consortium. Evidence-informed policy making to enhance physical activity in six European Countries: WP 1: Internal reporting for REPOPA Consortium. REPOPA; 2013 (not published)
Loket gezond leven, Loketgezondleven.nl Bilthoven: RIVM, http://www.loketgezondleven.nl versie 2.29 http://www.loketgezondleven.nl/gemeente-en-wijk/gezonde- gemeente/gezondh... Retrieved 2012.