The political and administrative structure

The Netherlands is a Parliamentary Democracy, which allows the Dutch citizens to choose their representatives in the Parliament every four years. The Parliament consists of the Senate and The House. The King, the Prime Minister and the other ministers form together the Dutch Government. The King has very limited power and the Ministers are the only ones who can be held responsible. The Cabinet, all Ministers and State Secretary, regulates and runs the country and carries out policy. On its turn, the Parliament follows and calls to account the Cabinet.

The Cabinet is led by a Prime minister and a minister is assisted by one or more State Secretary. This Secretary receives tasks from the Minister. The Prime Minister of the Netherlands is often the leader of the largest party of the coalition. The Cabinet and each individual minister are accountable to the Parliament and need to have the confidence of the majority of the Parliament. A law can only be applied if the Senate and the House adopted the draft law. These authorities develop and present national planning policies and provide guidance and limits to lower levels of administration, i.e. the regions and municipalities. The Netherlands has 12 provinces, each under a Commissioner of the King. The regions are accountable for planning, health care and recreation. The local government, the municipalities, consists of 408 municipalities (2013) and is accountable for education, planning, health, welfare and social affairs. Also the City Councils of municipalities are elected every fourth year and Aldermen are appointed by the City Council (Government of the Netherlands, 2013). The administrative structure on the 3 BES islands, also known as the Caribbean Netherlands, is different. These islands have the status of public bodies and are generally referred to as special municipalities. They are not part of a province.

Present cabinet

The VVD (liberal party) and PvdA (labor party) were the winners of the last national elections (2012). Since 5 November 2012 they have formed the second Cabinet Rutte. Dutch politics and governance are characterized by an effort to achieve broad consensus on important issues, within both the political community and society as a whole. Because of the multi-party system, no single party has held a majority in parliament since the 19th century, and coalition cabinets had to be formed.

Division of tasks
In the Netherlands, the system of proportional representation is used to elect representatives at various levels:

  • National: the members of the House of Representatives; the members of the Senate and the House of Representatives examine the work of the government (ministers and state secretaries);
  • Provincial: the members of the provincial council (who elect the members of the Senate); the members of a provincial council outline policy in the province and examine its implementation by the provincial executive;
  • Municipal*: the members of the municipal council; the members of a municipal council outline policy in the municipality and examine its implementation by the municipal executive.

*in March 2014 municipal elections have taken place

The task division will be further explained within the context of good governance and the current developments in the Netherlands with respect to decentralization of tasks.

Good governance as part of the coalition agreement

On the website of the government of the Netherlands is stated that good governance is part of the coalition agreement 2012-2016 (Government of the Netherlands,2012). They state that a strong service-oriented government requires a clear division of tasks and responsibilities within and between its different levels.

For a clear division of tasks and responsibilities the national Government is transferring a large number of tasks from central government to municipalities to enable more customized services. The idea is that these services will enhance citizens’ involvement. They state that municipalities will be a better place to coordinate and carry out their tasks with more efficiency. To this end they will offer municipalities’ ample freedom in several policy areas such as Youth Care, Health Promotion and Special Education.

As a consequence in this cabinet period tasks are decentralized to a high degree. This asks for reorganization on regional and local level. In the long term this current government works towards a reduction of the twelve provinces into five regions and the municipalities should consist of a minimum of 100,000 inhabitants.

Not only reorganization on geographical level will take place, it will also have consequences for the way consultations, decentralization and funding arrangements are organized. Decentralizing funding will have consequences for the municipalities and might affect the development of PA and health policies. The most important decentralized tasks and funding will be listed in the next subparagraph in regards to REPOPA.

Decentralization of tasks

In the Coalition Agreement (2012) changes in Governmental funding are mentioned which affect health- and PA policies on national and local (municipal) level. At this moment (2014) the municipalities are preparing and reorganizing to be able to carry out these new assigned tasks (Government Coalition Agreement, 2012).

Those changes are:

  • The Exceptional Medical Expenses Act (AWBZ) will be transformed into a new national provision, with residential care for people with severe physical, social and/or intellectual disabilities being organized on a national level with a budget ceiling based on contracting scope.
  • The existing regional care purchasing system, each with its own budget ceiling, will remain intact, but residential care criteria will be stricter. It is expected that elderly should stay home for a longer period of time and receive more tailor-made care based on the use of personal budget.
  • In 2017 home care will be transferred from the Exceptional Medical Expenses Act (AWBZ) to the Healthcare Insurance Act (ZVW), placing it in the same system of population-based funding as GP care, and will be subject to a care needs assessment.
  • Reasons for the change is that it is supposed to take away the divisions between different types of treatment and providers, will boost district nursing, discourage overtreatment and ensure solid primary care in which GPs play a key role.
  • From 2015 on, funds released from secondary medical care (substitution) will be used to invest in extra district nurses, with at least €250 million invested in 2017. This will help bring care closer to home.
  • Municipalities will become full responsible for support, assistance and home care. Care entitlements will be strictly limited and service provision slimmed down, with a focus on those who need it most. All this will be incorporated into the Social Support Act (WMO). Entitlements to home care will be replaced by tailor-made care for those in need and cannot afford it themselves. In the coalition agreement is described that an income-related care funding system and care close to home will enable the government to limit, simplify and decentralize such arrangements as compensation of the high health insurance costs deduction of specific care costs and the Chronically Ill and Disabled Persons (Allowances) Act (Wtcg).
  • Municipalities will be given more autonomy to decide how these decentralized provisions will be implemented.
  • In 2015 all youth care tasks will be delegated to municipalities: provincial youth care, secure youth care, currently assigned to the Ministry of Health, Welfare and Sport. This is also the case for youth mental health care, covered by the Healthcare Insurance Act, care for those with minor mental disabilities under the Exceptional Medical Expenses Act and youth protection and youth probation and aftercare services carried out by the Ministry of Security and Justice. This decentralization will be coordinated by the Ministry of Health, Welfare and Sport (Government Coalition Agreement, 2012).

The mentioned changes give more tasks and responsibilities to the municipalities. The municipalities are preparing and reorganizing to be able to carry out these new assigned tasks.

Other references

     Garssen, Joop, Han Nicolaas and Arno Sprangers (2005). "Demografie van de allochtonen in Nederland" (PDF) (in Dutch). Centraal Bureau voor de Statistiek. Retrieved 2 July 2011.
     Government of the Netherlands. Central government, provinces, municipalities and water authorities". (Retrieved 3 April 2013).
     Government. Coalition Agreement. Central government; 2012. (Retrieved 3 April 2013).
     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)
     Hendriksen I, Bernaards C, Hildebrandt V, Hofstetter H.Lichamelijke inactiviteit en sedentair gedrag in Nederland 2000-2011. In: Trendrapport Bewegen en Gezondheid 2010/2011. Leiden: TNO, 2013.
     In ’t Panhuis-Plasmans M, Luijben G, Hoogenveen R. Zorgkosten van ongezond gedrag. Kosten van ziekten notities 2012-2. RIVM,2012.
     Kreijl CF van, Knaap AGAC, Busch MCM, Havelaar AH, Kramers PGN, Kromhout D, Leeuwen FXR van (eds), et al. Ons eten gemeten. Gezonde voeding en veilig voedsel in Nederland. RIVM-rapport nr. 270555007. Houten: Bohn Stafleu Van Loghum,2004
     Loket gezond leven, Bilthoven: RIVM, versie 2.29 Retrieved 2012.
     CBS Statistics Netherlands. Population and population dynamics; month, quarter and year Retrieved 12 June 2013.
     Rijksinstituut voor volksgezondheid en milieu. Ministerie van Volksgezondheid, Welzijn en Sport. . Nationaal Kompas Volksgezondheid : Retrieved February 2014.
     Rijksoverheid. Gezondheid Dichtbij. Landelijke nota gezondheidsbeleid; mei 2011

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