Focus on shortage of general practitioners
‘There are concerns about the continuity of GP care in the Netherlands. (…) Increasingly, People are being let down, care insurers cannot buy enough care and GPs are overworked. (…) More and more disabled, elderly and chronically ill people will need curative care. Their number is expected to grow and exert even more pressure on GPs. (…) A further problem is the waning interest in GP training programmes and the falling intake to train for general medical practice’ (VWS, 2003).
The quotation above would neatly summarise the content of this report, but it was written by the Minster of Health, Welfare and Sport (VWS) in 2003. Repeated warnings of shortages of general practitioners (GPs) in 2018 prompted the minister to commission Nivel, the Netherlands Institute for Health Services Research, to examine the situation. A shortage of GPs is not an isolated problem. Shortages in the care sector as a whole are growing The Netherlands Scientific Council for Government Policy (WRR) also pointed out this in 2021. In that year, 1 in 7 of the working population in the Netherlands worked in the care sector. Without a change in policy, the number will rise to 1 in 3 in 40 years’ time (WRR, 2021). Capacity constraints, moreover, compelled 60% of GP practices to stop registering new patients in 2024, and 56% of GP practices expect staff shortages in the years ahead (Nivel, 2024a).
Background to this investigation
It is not clear whether there actually is a national shortage of GPs. In April 2024, the Minister for Medical Care wrote, ‘Given the number of GPs in the Netherlands, there is no shortage’. The problem, she wrote, was one of distribution, with some regions having fewer GPs than others. Four months later, the Minister of VWS wrote that a GP shortage was imminent and people were already feeling the consequences; some were unable to register with a GP. We therefore decided to investigate whether there was a shortage of GPs, nationally and regionally.
Besides being of vital importance, good GP care comes at a high cost: in the 10 years from 2015 to 2024 expenditure on GP care provided under the Health Insurance Act (ZVW) has risen from €2.5 billion to €4.4 billion.
Conclusions
Shortage of GPs
We conclude that there is a national shortage of GPs in the Netherlands and it is expected to increase further in the years ahead. As a matter of policy, the Minister of VWS believes that everyone in the country should be able to register with a GP practice. If we look at the numbers, 1 in 20 people are currently seeking to register with a GP or to change their GP. Yet no fewer than 60% of GP practices stopped registering new patients last year. Data from Capaciteitsorgaan (the Advisory Committee on Medical Manpower Planning), Nivel and the Prognosemodel Zorg en Welzijn (Healthcare and Wellbeing Forecasting Model, the PMZW) also indicate that the GP shortage will intensify. It is uncertain, however, which regions have the most acute shortage.
1 in 20 people seeking to register with a GP or to change their GP
The Minister of VWS has not set an absolute or relative target for the required number of GPs. It is therefore difficult to state unequivocally whether or not there is a shortage and, if so, how pressing it is. The Minister of VWS writes, ‘Everyone in the Netherlands should be able to register with a local GP’ (VWS, 2025). An estimated 45,000 to 194,000 people do not have a GP. The most common reasons for not being registered are a patient’s change of address and the closure of a practice. In addition, an estimated 732,000 people are registered with a GP but are looking for a new one, for instance if they have moved home or are dissatisfied with their current GP. In total, therefore, between 777,000 to 926,000 people (1 in 20) do not have a GP or are looking to change their GP, see figure 1.
777,000 to 926,000 people seeking to register with or change GP
Health insurance records reveal that 6,892 people were actively but unsuccessfully seeking a GP in December 2024 (NZa, 2025). The number is probably a serious underestimation of the actual number of people who wish to register with a GP or to change their GP. Several stakeholders we interviewed said people probably did not know that their health insurer could help them find a GP.
Many practices have stopped accepting new patients
Finding a local GP is more difficult in some regions than in others because many GPs are not accepting new patients. About 60% of GP practices stopped registering new patients in the past year. Furthermore, the number of GPs with their own practice is declining. More and more GPs are working as locums or are employed by another GP. But practice owners are needed: without practice owners there is no practice to accept patients. It is therefore increasingly difficult to register with a GP practice or to change from one practice to another.
Other studies also conclude there is a shortage
Other studies have also concluded that there is a shortage. Capaciteitsorgaan calculated in 2022 that there was a shortage of about 8%. The PMZW has forecast that the shortage in the GP care sector will rise from 3% in 2024 to 16% in 2034.
Causes of shortages
Owing to the shortage, care demand is higher than care provision. The various factors at play are summarised in figure 2. Population growth and demographic ageing are the main drivers of the growing demand. GPs’ workloads, moreover, have been increased in recent years by the transfer of secondary care tasks to primary carers.
An estimated 25% of GPs leave the profession within 15 years of qualifying, with pressure of work being named as one of the main causes. If retirement is also taken into account, Capaciteitsorgaan expects 56% of GPs to leave the profession in the next 20 years. In addition, fewer people are training to become GPs than are needed.
Care demand is higher than care provision
The Minister of VWS aiming to reduce care demand and locums
For the Minister of VWS, future shortages of care staff, including GPs, are beyond doubt. She is prioritising measures to reduce demand for care and encourage GPs to work with their own patients rather than as temporary locums. A fixed relationship between GP and patient improves care quality and life expectancy and reduces the number of referrals. The Schoof government’s Government Agreement states, ‘The government is committed to having enough practice-owning GPs’.