Working at the new regulator
Since 2005 I work in and around health care. I have worked with the new regulator, the Dutch Healthcare Authority In a team I developed the strategy and accompanied the Chair of the Managing Board, Frank de Grave, when he gave presentations in the field to put the NZa on the map. In addition, I was a projectmanager of projects with major political pressure and stakeholder’s attention.
As chair I monitored the process in which pharmacists and dispensing GP’s took a cut of 600 million euro’s in their bonuses and rebates. I chaired the first enquiry into practise costs of GP’s. GP’s were not accustomed to regulators opening their books, so they were enticed into participating by paid help of an accountant (by the Ministry of Health). At the same time there were measures to force GP’s to cooperate. This enquiry clarified, that GP’s on average earned 50% more than was assumed.
What energized me was the development of innovation policy. The policy rule innovation allowed health care providers and insurers to develop new formas of health care. After three years the NZa together with the Dutch Health Care Institute evaluates ex-post if the developed care is truly innovative and can be converted into regular care, possibly insured in the insured package of the public health insurance (ZvW).
The first four and a half years at the Health Care Authority, I still lived in Sevenoaks, UK and travelled backwards on Thursday evening and forwards on Sundays. It wasn’t the easiest of times; I missed my husband and kids so much. Fortunately, at the end of 2009, we all moved back to Amsterdam and I was ready for a next step. I had been interested in politics since the mid 90’s when I worked in Parliament as a advisor on public finance and taxes. I wanted to include more of politics in my daily work. As chair of the finance committee of the local VVD I introduced the rule that the first drink was on the association and afterwards every member had to fork out. In my opinion that’s very normal, but in the liberal Amsterdam climate, it was sometimes seen as a niggardly manner. But everyone agreed that money of members of a political association is to commit to the association’s purpose and that is to win elections! You have to celebrate successes and pay gratitude to active members, but the weekly drinks are on your own account!
In 2010 the VVD won the general elections and Rutte I was formed.
In 2009 and 2010 I was part-time seconded to the Ministry of Justice in The Hague to separate the different roles of this department in forensic care and to ensure independent price setting of forensic care.
In oktober 2010 I received a phone call whilst working in The Hague…if I wanted to come to the House of Representatives for a chat. In the Netherlands a cabinet member is allowed to choose only one advisor him- or herself. All the civil servants have sworn loyalty to whoever is in government. Edith Schippers was appointed Minister with the portfolio Health Care and Sport. We had been colleagues as policy advisors in parliament in the 90’s. The same afternoon I had the talk and did not have to overthink it. At the NZa I had to hand-over my projects and within two week after the first conversation, I started as political advisor of Minister Schippers.