care. The definition of quality of care consists of three elements: effectiveness, efficiency and client-centeredness. This definition is used as a basis for several laws. I will mention three of them. (Klik) Tile first one is the 'Law on the Professions in Individual Health Care'. The aim of this law is to influence the quality of the practice of individual professionals. An important feature is that the patient can choose which professional he wants to be treated by. The second law is the 'Quality Law for Institutions' which was enforced last year. This law says that institutions have to make plans to resolve and enhance their quality. They may do this in their own way. But they need to do it in a systematic way, for instance by asking patients what they think of the quality. The results of these investigations have to be put down in an annual report.
The third law that I mention is the 'Law on the Agreement of Treatments', This law regulates the rights of patients, especially the right to be informed and the right to agree or disagree on a treatment. It also takes care of matters as privacy of patients, the rights of minors and of patients who can't decide for themselves. Aside from these three laws, there are laws concerning complaints by patients: in what cases and in what way can a patient file a complaint; and furthermore there is a law that regulates the way in which patients can influence health care organizations. All of these laws have been enforced in the last few years.
As a result many health care institutions in the Netherlands have some kind of quality programme, (klik) It depends very much on the organization what the quality programme consists of. For the general practitioners it meant that they started developing and implementing protocols for the way in which certain diseases and situations should be handled by GPs. The home care organizations have their own quality programmes, for instance to make sure certain procedures are followed. In the VU hospital, 'my' hospital so to speak, there are several programmes, for instance IKG (this is: integral quality programme) or PACE, which involves the organization of a department. There are also medical audits, in which
