NMa confirms dawn raid at National Association of General Practitioners

The Netherlands Competition Authority (NMa) has confirmed that it carried out dawn raids at several regional offices of the Dutch National Association of General Practitioners (LHV) this week. The NMa launched its investigation in part based on tip-offs and indications it has been receiving from clients and general practitioners about possible customer sharing and about obstructing general practitioners that wish to set up their businesses in certain (new) areas.

The NMa has been receiving numerous tip-offs and indications from patients that are unable to switch general practitioners. One of the reasons that general practitioners allegedly are giving for refusing to accept new patients is that they have made patient-sharing agreements with other general practitioners in the area. In addition, the NMa has also been receiving tip-offs and indications about a so-called 'location policy' that general practitioners seem to be following. It appears that new general practitioners who wish to set up their businesses in certain areas first need to get permission from general practitioners in the direct vicinity of their prospective business location. If a new general practitioner sets up his business without this 'approval,' he/she runs the risk of being excluded from that area's collaborative networks.

All of these tip-offs and indications seem to indicate that clients are seeing their options be restricted when trying to choose a general practitioner. The NMa takes these kinds of indications very seriously. If it turned out to be true that general practitioners are not respecting their patients' freedom of choice and are actually forcing patients to go to a pre-selected general practitioner, such practices should be dealt with. General practitioners play a crucial role in the health care system. Patients should be able to have good doctor-patient relationships with them. But if, for some reason, that connection is not there or if a patient does not have enough confidence in his/her general practitioner, that patient should be able to switch general practitioners. The indications the NMa has been receiving seem to suggest that general practitioners wish to prevent their patients from switching. Such indications are enough reason for the NMa to find out whether this is true.

Dawn raids
The NMa carries out dawn raids when it suspects the Dutch Competition Act is violated, for example, by market-sharing agreements. The fact that the NMa has carried out these dawn raids does not automatically mean that LHV nor the general practitioners are guilty of anti-competitive behavior, and therefore does not prejudge the possible outcome of the investigation. The NMa cannot comment on the estimated length of the current investigation. In general, the length of an investigation depends on various factors, such as the complexity of the case, as well as the level of cooperation of the undertakings and individuals involved.

The investigation's procedure is as follows: should the NMa's investigation lead to the conclusion that a violation of the Competition Act can be reasonably presumed, the NMa will draw up a report against the undertakings and/or the natural persons involved. In that case, the undertaking or natural person has the opportunity to defend itself/himself, both in writing or orally (at a hearing). Once the parties involved have been heard, the NMa will decide whether the presumed violation can be established as fact, and if so, what sanction should be imposed on the undertakings or natural persons involved. These sanctions can be as high as ten per cent of the global turnover for undertakings, or EUR 450,000 for natural persons.

Applying for leniency
Under the NMa's leniency program, cartel participants may qualify for fine reduction. In addition, cartel facilitators or natural persons that have been involved in a cartel can also apply for leniency. More information on the NMa's leniency program can be found online.

Indications and tip-offs
Indications and tip-offs that the NMa receives from individuals and undertakings concerning possible violations of the Dutch Competition Act, and preferably accompanied by supporting evidence, are highly appreciated. These will enable the NMa to increase its knowledge of the health care industry and to track down possible violations.

General practitioners facing difficulties when attempting to set up their businesses in a new area can submit their tip-offs to the NMa Information Line by calling +31-70-330-1306, or by sending an email to info [at] acm [punt] nl (info[at]acm[dot]nl).

Patients who have experienced difficulties when attempting to switch general practitioners can submit their tip-off or indication to Dutch consumer information portal ConsuWijzer by calling +31-88-0707070. ConsuWijzer is jointly operated by the Netherlands Competition Authority, the Independent Regulator of Post and Electronic Communications in the Netherlands OPTA, and the Dutch Consumer Authority.