Looking ahead at the financial situation in 2026

The main challenges in healthcare 

Healthcare in the Netherlands faces major challenges, while our ambitions remain high. The demand for healthcare is increasing, partly due to a growing number of people with multiple chronic diseases. This development is reinforced by a dual aging phenomenon: not only is the number of older people increasing, but also the proportion of older employees in healthcare. At the same time, technological and medical developments make more treatments possible, which further increases the demand for healthcare. 

In contrast, there is a persistent shortage in the labor market. This makes recruiting and retaining healthcare professionals challenging and keeps the workload high. Sick leave remained stable at 5.7% in 2025, but is still above our benchmark. Financial capacity in healthcare is also under national pressure. In the Integral Healthcare Agreement (IZA), it was agreed that the growth of healthcare expenses should remain limited. This requires careful choices and a different way of organizing and funding healthcare. 

Through research, we work on better care and on reducing the burden on healthcare workers, patients, and the living environment. This requires a broad transformation: of our own organization, of regional collaboration, of the services we provide, and of preventing disease. Training new professionals and applying innovations from research are also important in this context. 

We will continue the planned investments in renewing our facilities, with a focus on sustainability. We can finance this from our own resources in the first years.  In the longer term, we will also attract external financing, for example in the form of loans. To achieve our ambitions, maintaining adequate staffing levels and controlling cost developments remain essential. Therefore, we remain committed to the efficient use of resources and a more efficient organization of our business operations. 

Staffing development 

The development of our staffing depends on the healthcare demand, our research and education activities, and developments in the labor market. In the current tight labor market, it is not always possible to keep our staffing levels optimal. 

We aim to work as much as possible with employees in permanent positions and to limit the use of external hires. The combination of limited funds and a shortage on the labor market requires targeted management of staffing levels and a further downsizing of external staff.