'No one is alone anymore'

On September 2, 2024, the Covenant on Medical Generalist Care (MGZ) was signed at the Ministry of Health, Welfare and Sport. With this covenant ActiZ, InEen, LHV, NVAVG, Verenso, VGN and ZN guarantee the availability and accessibility of MGZ for people with an indication for long-term care (Wlz). The initiative for this covenant was taken against the background of developments such as the increasing ageing population, the growing demand for care and the shortage of doctors and other professionals in the care and welfare sector.

MGZ is "the entirety of medical care that general practitioners, geriatrics specialists and doctors for the mentally handicapped (doctors VG) tend to provide together, both during the day and for emergency care during evening, night and weekend (ANW) hours. More and more Wlz clients continue to live at home or choose a small-scale or clustered living arrangement. Treatment' as part of the entitlement under the Wlz occupies a special place, because in many situations treatment is reimbursed partly under the Wlz and partly under the Health Insurance Act (Zvw). In all these situations, cooperation between specialists in geriatrics, doctors for the disabled, general practitioners and other primary care is necessary. In practice, agreements about this cooperation and appropriate care procurement do not always come about naturally.

This covenant provides a framework for regionally cooperating parties to reach appropriate agreements. Such that MGZ is accessible and available to all Wlz clients. And such that doctors, professionals, care organizations, care offices and health insurers can make working and (financially) feasible cooperation agreements.

In the covenant, care offices, health insurers, providers and physicians agree on how the joint responsibility can be fulfilled. The demand for care is central; MGZ is accessible to every care recipient with a Wlz indication - both during the day (regular care) and for emergency care during ANW hours. Moreover, the care is provided by the best-equipped doctor, who is supported in this to work as effectively and efficiently as possible.

The agreements in the covenant are the basis for concrete agreements between care providers and professionals in the region. If they encounter problems in reaching appropriate agreements, they turn to the regional consultation structure, which is convened under the responsibility of the health care office and health insurer. Each region is free to develop or maintain the most appropriate solutions for that region. The handbook accompanying the covenant will follow shortly with additional information about the intended working method and how to get there together. 

Parties involved in the covenant are of course accountable for the relevant (national) preconditions regarding, for example, appropriate funding, ICT/data exchange and the specific situation of non-contracted care (including PGB) and will, if necessary, also call the system parties to account on this. In addition, national parties will make an effort to link regional consultations about MGZ with existing programs and regional consultation and collaboration forms.