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NMa to Conduct a Further Investigation into the Merger of Hospitals in Zeeland

After an initial investigation, the Netherlands Competition Authority (NMa) has concluded that a dominant position may emerge or be strengthened on the market for clinical and non-clinical general hospital care, due to the merger of two hospitals in Zeeland, namely Ziekenhuis Walcheren and Oosterschelde-ziekenhuizen. This may restrict competition. For this reason, NMa has decided that a licence is required for the realisation of this merger.

On the basis of the investigation carried out up until now, NMa deems it plausible that the regional market for general hospital care is not broader than the region of Mid-Zeeland (Walcheren, North and South Beveland and Schouwen-Duiveland). This is due, for instance, to the special geographical characteristics of the area, an analysis of patients' travelling times and patient flows. NMa's concerns focus on restrictions on the choice of patients in Mid-Zeeland due to the fact that only one general hospital will remain.

The hospitals have argued that the merger will result in efficiency advantages which outweigh the possible disadvantages of the merger. NMa has concluded that for the time being this has not been made sufficiently plausible. The hospitals have also referred to the compensating buyer power of health insurers. On the basis of the available information, in NMa's opinion for the time being this claim is not sufficiently plausible.

As a result of the conclusion drawn by NMa, the hospitals have to apply for a licence for the proposed merger. If they do so, NMa has to decide within 13 weeks whether the merger is or is not permitted.

In assessing mergers in the health sector this year, NMa has taken decisions in 21 cases. These related to 15 cases on the market for exceptional medical care covered by the Exceptional Medical Expenses Act (AWBZ), four health insurance cases and two hospital mergers.