Sickness absence in the Netherlands stood at 5.8 per cent in the first quarter of 2025, according to figures from Statistics Netherlands. That means 58 out of every thousand working days were lost to illness. For employers that is a concrete reason to look at how occupational health support is arranged in their company, and whether the current set-up is still the best one. Because the way you organise expert support lays a firm foundation under your absence policy and your approach to prevention.
The Working Conditions Act requires every employer to obtain support in carrying out statutory occupational health tasks. For that you can choose between two routes: the standard arrangement (vangnetregeling) or the tailored arrangement (maatwerkregeling). Both are anchored in law, but they differ considerably in who holds the reins, what has to be arranged and which conditions apply. Even so, many employers do not know exactly what that choice involves, or think they have no choice at all.
In this article we set the two arrangements out side by side, name the pitfalls and give you concrete handles for a well-considered decision. That way you will know exactly which route suits the size, structure and ambition of your organisation.
What the Act asks of you as an employer
The basis is clear: under the Act, every company must obtain support from one or more experts in carrying out its occupational health and absence policy (in Dutch). That support goes further than guiding employees who are ill. Think of reviewing the risk inventory and evaluation (RI&E), carrying out periodic occupational health examinations (PAGO) and, in specific cases, pre-employment medical assessments. For all those tasks you have to take out a basic contract with an occupational health provider. That basic contract is compulsory, whichever arrangement you choose.
The standard arrangement: everything through one certified service
Under the standard arrangement you take out a contract with one certified occupational health service that handles all the statutory work. That service has the four core experts authorised to carry out statutory tasks: the occupational physician, the work and organisation expert, the occupational hygienist and the safety expert. You do not have to assemble that expertise yourself.
The big advantage is simplicity: you have only one point of contact and the service coordinates between the various experts. That saves time and administration. At the same time the works council or staff representation has a right of consent: they have to agree to the choice of service and to the content of the contract. If you have neither a works council nor staff representation, the standard arrangement applies automatically, and then there is no choice to make.
The tailored arrangement: keeping the reins yourself
The tailored arrangement gives the employer the flexibility to take the lead on occupational health tasks and contract different experts or services (in Dutch). You are then not tied to one service, but can bring in the best-suited party for each task or specialism. That makes it possible to respond better to risks specific to your sector or company.
What remains compulsory is contracting at least one certified occupational physician for absence guidance, periodic examinations and pre-employment medical assessments. Without that physician a tailored arrangement is not valid. Beyond that, you as the employer carry the responsibility of showing that the measures taken are effective. Good documentation is indispensable for that.
Conditions for the tailored arrangement
You cannot simply decide to move to the tailored arrangement. Two conditions apply: the possibility of tailoring must be expressly laid down in the collective labour agreement, or there must be agreement with the works council or staff representation. Note: agreement is stronger than consent. Without agreement there is no tailored arrangement, and going to the subdistrict court offers no way out either. On top of that, the agreement has to be renewed every five years.
Companies without a works council or staff representation can only apply the tailored arrangement if the collective agreement explicitly makes it possible. If it does not, the organisation falls back automatically on the standard arrangement. That sounds like a limitation, but it also offers clarity: you know exactly where you stand.
A common mistake
A persistent misconception among employers is that the tailored arrangement is always cheaper or better than the standard one. That is not automatically true. The tailored arrangement calls for internal management and coordination: you arrange the alignment between employer, employee and the various contracted experts. That takes time and requires enough capacity within your own organisation. Larger organisations with their own HR department or prevention officer can absorb that well. Smaller companies run the risk that prevention slips, because the focus lands too heavily on absence.
The other way round, the standard arrangement is not necessarily more expensive or less flexible. With a well-composed contract at a certified service, even a small employer can give proper shape to prevention and sustainable employability without having to do all the coordinating.
Practical tips for making your choice
- First map whether your collective agreement permits the tailored arrangement, or whether you have a works council or staff representation to reach agreement with.
- Assess honestly how much internal capacity your organisation has for coordinating several experts.
- Under the standard arrangement, check that the service is certified and that the basic contract matches the specific risks in your sector.
- Under the tailored arrangement, ask explicitly how prevention is safeguarded, because absence guidance and prevention both need attention.
- Involve your employees or works council early in the process, so that consent or agreement does not become a stumbling block.
Whichever route you choose, the basic contract is compulsory in both cases and forms the written basis for the working arrangements with your provider or physician (in Dutch). Make sure the contract is cut to the situation in your company, and is not a standard text that you sign unread.
How Dokter Beter supports both routes
Dokter Beter works with Arbo Concern, a certified occupational health service, and works both for employers who choose the standard arrangement and for organisations that have set up a tailored one. Under the standard arrangement we act as the certified service and handle all statutory tasks from one point of contact. Under the tailored arrangement you can bring Dokter Beter in as the contracted occupational physician, while you keep the lead on the other experts. Our physicians stay close to the floor, know your organisation and give advice you can apply straight away, whether that is absence guidance, a second opinion or a preventive clinic.
It is not the arrangement that makes the difference, but how well it fits your organisation and your people.
The choice between the standard and the tailored arrangement is not about which is better in theory, but about which fits the size, capacity and ambitions of your organisation best. Both routes are anchored in law and, done well, offer a solid basis for healthy and safe work.
Key takeaways
- Every employer is legally required to have a basic contract with an occupational health provider or physician, whichever arrangement applies.
- Under the standard arrangement you contract one certified service that handles all statutory tasks. That offers simplicity and takes work off your hands, but gives you less of the lead.
- The tailored arrangement gives you more flexibility and the chance to choose the best expert per task, but calls for internal coordination capacity and good documentation.
- The tailored arrangement is only possible if the collective agreement permits it, or if there is written agreement with the works council or staff representation. Without that you fall back automatically on the standard arrangement.
- Under the tailored arrangement, watch whether prevention is sufficiently safeguarded: in practice the focus often falls too heavily on absence and too little on preventing it.
- Dokter Beter supports employers under both arrangements, together with certified occupational health service Arbo Concern, close to the floor and aimed at practical, applicable advice.
Not sure which arrangement fits your organisation, or want to know how to set the basic contract up properly? Get in touch with Dokter Beter. We will gladly think along, without detours.