In Canada, we talk a lot about how things should work in primary care.
Patients should be able to get timely access.
Family doctors should offer after-hours care.
There should be a clear system of accountability when that doesn’t happen.
But in many parts of the country, those expectations aren’t backed by real structures or systems. So we’re left with millions of people struggling to access care — and no one clearly responsible.
In our final episode from the Netherlands, I look at what happens when there is accountability built into the system — and what Canada could learn from that model.
Throughout this series, we’ve explored how Dutch family doctors — or huisarts — are responsible for their patients 24/7. In this episode, we ask: Why do they take that responsibility so seriously? And who (or what) makes sure they follow through?
To answer those questions, I visited CZ – one of the country’s largest health insurers. But before you imagine American-style private insurance, let me reassure you: this system is nothing like that.
In the Netherlands:
Pretty much everyone has insurance coverage.
Most insurers are non-profit cooperatives.
They’re required to offer the same standard benefits to everyone.
And yes — they are legally obligated to ensure every person they cover has access to a family doctor.
It’s all part of a system grounded in social solidarity, with structures that reward accountability, transparency, and coordinated care.
And it was extra special to make this visit alongside my colleague Rosemary Hannam, who joined me on this trip just before starting her new role as Strategic Advisor on Primary Care at Ontario Health.
In this episode, Rosemary and I reflect on:
👩⚕️ What the Dutch model gets right — and why
📈 Which numbers stunned the Dutch about Canada’s primary care gaps
🧭 Why a single GP contract, clear access standards, GP leadership and an empowered public create system-wide consistency and accountability.
💡 And why this system was both eye-opening and inspiring for both of us
Missed the series on The Netherlands?
🎧 Head back to the first episode in the series to catch up
📸 View the photo gallery from my trip
📻 Hear me on CBC’s White Coat, Black Art
📰 Read my reflections in the Medical Post series
💌 Got feedback or ideas? Email me anytime at primary.focus@unityhealth.to
Thanks for coming on this journey with me! And, special thanks to my wonderful hosts in the Netherlands - Tim Olde Hartman, Suzanne Ligthart, Eric Moll Van Charante, Ralf Harskamp Jettie Bont, Bart Knottnerus and Joel Gizen - and the many other Dutch people who took time out of their day to share their insights.
With gratitude,
Tara
Dr. Tara Kiran
Host, Primary Focus
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