Population perspectives on health system performance: preliminary findings from the Netherlands
E Aydin, J De ZeeuwAbstract
Background
Despite mandatory insurance and a strong primary care system, people’s perceptions of Dutch healthcare are rarely captured systematically. The People’s Voice Survey (PVS) was implemented to generate population-level evidence on access, care quality, and system confidence.
Methods
A cross-sectional online survey was conducted in August 2025 via a nationally representative panel. In total, 1,347 adults aged 25 and older responded (response rate 45%). Survey weights from Statistics Netherlands (CBS) were applied for national representativeness. The results covered access to care pathways, care quality experiences, system trust and overall ratings.
Results
Preliminary results show most respondents (92.3%) having a usual provider, primarily a GP (95.3%). Individual care experiences were generally positive: 61.4% rated their last visit as very good or excellent, and 82.3% would recommend the facility. Yet unmet needs were reported across physical, mental, and sexual health domains. At the system level, only 5.1% felt the system was improving; 49.7% perceived it as staying the same and 45.2% as getting worse. Regarding reform, 52.7% called for major changes and 4.5% for complete rebuilding. System-level confidence was particularly low for mental healthcare, with only 7.3% rating it as very good or excellent.
Conclusions
Dutch residents rate their personal providers well but are considerably more critical of the system overall. The gap between positive individual experiences and widespread pessimism about system trajectory, combined with majority support for reform, is a clear call for action. Population perspectives, including those of adolescents and migrants not yet captured in this wave, must actively inform health policy.