Private, for profit ambulatory and specialist healthcare centres are taking off in Belgium and are having a big impact on the plans for the private, not for profit hospitals which dominate the country’s healthcare services. Dr Jan Van Emelen says the for profit clinics are popping up everywhere: “there are about sixty now across the country. Specialists have set them up because if they work in hospitals they have to give 50-60% of their fees to the hospital. This way they keep the money.” He says that the new clinics are sometimes multi-disciplinary, sometimes carry out day surgery and are very flexible. “They will see you immediately and you can go when you want at 6 o’clock after work, for instance.” They cover everything from cataracts or orthopaedic surgery through to treating depression with range of specialists working part time in the clinics. Patients can be reimbursed by their insurer but also pay an extra premium for the private treatment.

Van Emelen says the clinics are perceived as a threat by the private not for profit hospitals. “The hospitals are changing their approach. For instance, a very conservative hospital in Antwerp has opened a stress clinic. And they are starting to think about how they can win and keep the fidelity of patients and family doctors.”

Our Analysis: In the Netherlands we have seen a similar explosion in private clinics but there it appears that the hospitals, all but one of which are not for profit, are fighting back by successfully opening their own clinics. Indeed, most new clinics are now attached to hospitals.

These developments highlight the potential for ambulatory day surgery as a sector where new private healthcare providers can enter the market unencumbered by attitudes, technology and outdated procedures which often hold back the public or not-for-profit sector.