NMa: merger Limburg health organisations cleared

The Netherlands Competition Authority (NMa) concludes after thorough investigation that the merger of three health organisations in the region of Noord and Midden-Limburg is to be cleared. The merger involves the Zorggroep Noord-Limburg (ZgNL), Thuiszorg Midden-Limburg (TML) and Land van Gelre en Gulick (LvGG).

The organisations concerned offer care services in convalescent and nursing homes, home care services and maternity care services. In an earlier phase of the investigation, the competition authority pointed out potential restrictions to competition in the field of home care. The already strong position of TML in the market for home care services in the region of Midden-Limburg would be further enhanced after the merger with LvGG. The NMa did not foresee any problems resulting from the merger in the region of Noord-Limburg.


TML offers regular home care services at clients' homes, whilst LvGG limits its home care activities to sheltered accommodation and extra care housing. The NMa's further investigation focused on the question to what extent LvGG would be able to offer regular home care services in the area of Midden-Limburg, while operating from its sheltered accommodation and extra care housing. The investigation shows that the addition of LvGG to TML has little effect on the market for home care services. In practice, LGG's opportunities for providing regular home care services are limited to the area surrounding its sheltered accommodation and extra care housing. These are situated in part of the region of Midden-Limburg only. It is also relevant that in the region of Midden-Limburg other health organisations are active, which are better equipped to further develop their activities in regular home care.


Healthcare is an important area of attention for the NMa in 2006, as set out in the NMa Agenda 2006. In assessing mergers in the health sector, the competition authority has since 2004 completed 41 cases by drawing up a decision. These involve 29 cases under the Exceptional Medical Expenses Act [AWBZ], 8 cases involving health insurance and 4 cases involving hospitals.