Explanation of disciplinary measures

Competency limitation order (Bevoegdheidsbeperkend bevel)

The body responsible for supervising the BIG Act, the Health Care Inspectorate IGZ, can issue the healthcare professional a written order, when the inspector decides that the healthcare professional has failed to meet the requirements relating to professional quality. The healthcare professional is required to comply with the competency limitation order within the term stipulated.

The competency limitation order from IGZ can mean a full or a partial limiting of competency. In the case of a full competency limitation it is possible that work experience gained during the order will not count towards re-registration in the BIG-register. This is dependent on the conditions in the order.

Example of a full competency limitation: A doctor must stop all his medical activities until the Health Care Inspectorate is convinced the doctor is competent to give care responsibly.

Consequences for re-registration

This order may restrict re-registration on the basis of work experience. Re-registration on the basis of education is always possible.

Reprimand (Berisping)

The disciplinary commission can reprimand a healthcare professional. In that case, the commission is judging the conduct of the professional. The professional has committed a serious and culpable act and is reproved for this. The healthcare provider remains authorised to carry out their profession.

Consequences for re-registration

A reprimand does not restrict re-registration on the basis of work experience. Re-registration on the basis of education is always possible.

Monetary fine (Geldboete)

The disciplinary commission can impose a monetary fine on the healthcare professional of up to € 4,500. The healthcare provider remains authorised to pursue their profession.

Consequences for re-registration

A monetary fine does not restrict re-registration on the basis of work experience. Re-registration on the basis of education is always possible.

Conditional suspension (Voorwaardelijke schorsing)

The conditional suspension only takes effect if during a probationary period of 2 years the healthcare professional fails to comply with specific conditions. During this probationary period the healthcare professional can continue to use their title and carry out restricted actions where applicable. The healthcare professional retains all rights connected to a BIG registration. Occasionally, an imposed condition may be restricting the competency of the healthcare professional.

Example: the disciplinary commission may require a general practitioner to have weekly interviews with a psychotherapist during the probationary period.

Consequences for re-registration

A conditional suspension does not restrict re-registration on the basis of work experience. It may however restrict the hours that count towards work experience. Re-registration on the basis of education is always possible.

Suspension (Schorsing)

The registration of a healthcare professional in the BIG-register can be suspended for up to 1 year. During this period the healthcare professional is not allowed to use their title or to carry out their profession. The healthcare provider loses the rights associated with a BIG registration.

Consequences for re-registration

The work experience that is gained during a suspension may not be counted towards re-registration. Has the healthcare professional gained enough hours of relevant work experience outside the suspension, and without a work stoppage of 2 years or more? Then they can re-register on the basis of work experience. Re-registration on the basis of education is always possible.

Limited disqualification (Gedeeltelijke ontzegging)

Under this measure the healthcare professional remains registered in the BIG-register. But they are no longer allowed to perform certain acts. The disciplinary commission determines which acts the healthcare provider is no longer allowed to perform. A note of this limited disqualification is inserted in the BIG-register alongside the registration of the healthcare professional.

Example: a general practitioner is no longer allowed to supervise births.

Consequences for re-registration

With a limited disqualification, part of the work experience can count towards re-registration in the BIG-register. This depends on which competencies are denied. Re-registration on the basis of education is always possible.

Suspension as a provisional measure (Schorsing als voorlopige voorziening)

Pending a decision on appeal, the registration of a healthcare professional can be suspended temporarily. This so-called ‘suspension as a provisional measure’ can only be imposed by a regional disciplinary commission in combination with the measure: ‘cancellation of the registration (in the BIG-register)’. In this case, the registration of the healthcare professional is suspended until the decision to cancel the registration in the BIG-register has either become irrevocable or has been nullified.

During this period the healthcare professional is not allowed to use their title or carry out their profession. The healthcare professional loses the rights associated with a BIG registration.

Consequences for re-registration

The work experience that is gained during a suspension may not be counted towards re-registration in the BIG-register. Has the healthcare professional gained enough hours of relevant work experience outside the suspension, and without a work stoppage of 2 years or more? Then they can re-register on the basis of work experience. Re-registration on the basis of education is always possible.

Cancellation (Doorhaling)

The registration of a healthcare professional in the BIG-register can be struck on the basis of a decision from a Dutch or foreign court. The courtcan be a disciplinary court, in the case of a cancellation; a criminal court in the case of a removal; or a civil court in the case of a legal restraint (‘ondercuratelestelling’).

The healthcare professional loses their title and is no longer allowed to carry out the profession under this title. If the healthcare provider does use this title or exercises the rights associated with a registration in the BIG-register? Then they are committing a criminal offence.

Consequences for re-registration

The healthcare professional with a cancellation cannot re-register on the basis of work experience nor education. See also below: Measures with regard to re-registration.

Disqualification of registration after cancellation (on demand or not) (Ontzegging van het recht wederom ingeschreven te worden)

Has the registration of a healthcare professional been cancelled at their own request, during the ruling of the disciplinary commission? Then the disciplinary court can impose the measure ’disqualification of registration after cancellation’. The healthcare professional has already lost their title due to the cancellation and they are not allowed to carry out the profession under this title. Does the healthcare professional still use this title or exercise the rights associated with a BIG registration? Then they are committing a criminal offence.

Consequences for re-registration

The healthcare professional with a cancellation cannot re-register on the basis of work experience nor education. See also below: Measures with regard to re-registration.

Disciplinary measures and re-registration

When a disciplinary court imposes a measure on a healthcare professional this can have consequences for re-registration. The consequences for both the criteria work experience and education are listed above, per measure.

It is important to realize that a published measure will remain published until the period of publication has expired. This is the case even when a healthcare professional is up for re-registration.

Healthcare professionals with the measures ‘cancellation’ and ‘disqualification of registration after cancellation’ in principle cannot be registered in the BIG-register through re-registration. This is only possible when there are no more competency limitations, for example:

• after a Royal Decision;
• after a criminal removal has been terminated, or
• after a full competency limitation imposed abroad is cancelled.

Of course, the health professional must also meet the other criteria for re-registration in order to be able to re-register.