Introduction

In this chapter we describe the regulatory structure and the monitoring of quality of long-term care in The Netherlands. Firstly an introduction to long-term care for older people is provided, together with some basic information on the position of the long-term care sector within the overall healthcare system, including its capacity, some basic service user characteristics, the services offered and the way the long-term care sector is financed and regulated. In addition, we highlight selected policy and political issues that have emerged over the last decade which have challenged the traditional approach to judging the quality of services. Secondly, we outline the most relevant legislation and regulations related to the rights of long-term care clients as well as those related to the long-term care sector itself, finishing with the most relevant regulatory measures on the quality of care. This is followed by a section on integral quality systems fulfilling ISO 9001 criteria (an internationally accepted standard for quality management systems and certification). Special attention is given to the Dutch Healthcare Inspectorate and its role in the external monitoring of quality of care and to the use of nationally established quality indicators for long-term care. Finally, we focus on the issue of transparency and how the performance of long-term care organizations is communicated to society in general (including service users themselves and insurance companies) through public reporting. In this context, the increasing strength of the role of service users will be addressed. Although this chapter focuses on long-term care for older people, the information provided generally holds for long-term care for young people and for people with chronic somatic, mental or psychiatric diseases as well as for people with mental health disabilities who need chronic care.