The NMa has approved the merger between two hospitals in Zeeland after an extensive Phase II investigation, subject to strict conditions.2 In its decision the NMa took account of the opinions of the Dutch Healthcare Authority and the Dutch Healthcare Inspectorate.

The merger will result in there being only one general hospital in the entire region, which will significantly limit patients’ options. The NMa nevertheless approved the merger, since its investigation proved that a merger was necessary to guarantee the continuity of hospital care in this region.

In order to have a guarantee that the efficiencies will materialise and will be passed on to the patients, the NMa has imposed a number of conditions on the parties. These include an obligation to create and maintain a (level 2) intensive care unit and emergency room and a price cap for non-regulated medical services based on a national price average. In addition, the merged hospital has to facilitate the possible entry of new providers of specialist medical care in the region.

This is the first time that the NMa has cleared a merger solely on an efficiency defence.