--- title: "How Dutch primary care works (for international residents) | HeyDoc" description: "GP gatekeeper, registration, HAP, insurance, your record and rights, from a Leiden practice perspective." url: https://heydoc.nl/en/kennisbank/how-dutch-primary-care-works lang: en source: heydoc.nl generated: 2026-04-24T20:58:57.849Z --- # How Dutch primary care works (for international residents) Updated24 Apr 2026 GP gatekeeper, registration, HAP, insurance, your record and rights, from a Leiden practice perspective. # How Dutch Primary Care Works: A Complete Guide for International Readers The Netherlands has one of the strongest primary care systems in the world, and one of the most confusing for people arriving from abroad. The mechanics feel unfamiliar in ways that only become obvious when you actually need care. This guide explains how the system works: registration, the role of the GP, out-of-hours care, digital records, and your rights. It is written from the perspective of a practising GP at HeyDoc, Lammenschansweg 15b, Leiden. ## The central role of the GP In the Netherlands, the huisarts (GP) is not just a first point of contact but a structural gatekeeper. With very few exceptions, you cannot access secondary care - hospital specialists, outpatient clinics, most diagnostic services - without a GP referral. This is not bureaucracy. It is a deliberate design choice that keeps primary care strong and reserves specialist capacity for cases that genuinely need it. The result is a system in which the GP knows you over time. The average Dutch GP has around 2,100 registered patients, and many patients have been with the same practice for years or decades. That longitudinal relationship is clinically valuable in ways that are hard to replicate in fragmented, specialist-first systems. The GP who sees you for a sore throat also knows about the anxiety diagnosis from five years ago. That context matters. ## Registration: how to join a practice To use GP services you must be registered (ingeschreven) at a practice. You cannot simply walk in and be seen as a general rule. Exceptions exist for urgent situations and for people temporarily in the Netherlands (passanten). Finding a practice with open capacity can be challenging in urban areas, particularly in Amsterdam, Rotterdam, Utrecht, and Leiden. Practices have a maximum list size, and when they are full, they are full. There is no national assignment system. Your gemeente (municipality) or zorgverzekeraar (health insurer) can help. Once registered, you pay nothing extra per visit: the abonnementstarief is billed automatically to your insurer and included in your basic premium. ## The appointment system Consultations are typically ten minutes. That is the national standard, not a quirk of any individual practice. For complex or multiple issues, a dubbel consult (double appointment) can be booked. Mention at booking that you have several things to discuss. The practice assistant allocates accordingly. Requesting a double slot is correct use of the system. Telephone and video consultations are part of routine Dutch GP care. Many practices handle a significant proportion of contacts by phone: follow-up, medication renewals, straightforward queries where examination is unnecessary. ## The practice assistant: first point of contact When you call, you first speak with a praktijkassistente. She is trained in clinical triage using the NHG triage protocol - a standardised system that determines urgency based on presenting symptoms. She will ask about your symptoms, assess urgency, and either book an appointment, connect you to the GP by phone, or tell you to call 112 if the situation is acute. This triage function is genuinely clinical. ## Out-of-hours care: the HAP When your practice is closed - evenings, nights, weekends, public holidays - urgent care goes through regional huisartsenposten (HAPs). Call the HAP number for your region, not your own practice number, describe your symptoms, and get triaged by telephone. The HAP is for urgent but non-emergency situations. If you suspect a heart attack, stroke, or any immediately life-threatening condition, call 112. The HAP does not do acute resuscitation. The duty doctor at the HAP does not know you. Access to your medical history depends on whether you have consented to data sharing through the Landelijk Schakelpunt (LSP). If you have, the HAP doctor can see your current medications and relevant history. If you have not, they work only with what you tell them. ## Prescriptions and medications Prescription medications require a physician's prescription. Chronic medications are managed through the repeat prescription process: you request a renewal, the GP reviews and approves, and the prescription is sent electronically to your pharmacy. The G-Standaard - updated weekly and integrated into every GP and pharmacy system - automatically checks each prescription against your full medication list for interactions. You are free to register with any pharmacy. Using one pharmacy consistently is advisable so your complete medication list is in one place. ## Health insurance: what you need to know Health insurance is mandatory for all residents. The basic package (basisverzekering) is standardised by law: every insurer must offer the same basic coverage. GP care is included at no additional cost beyond the monthly premium. There is a mandatory annual deductible (eigen risico) - €385 in 2026 - which applies to most healthcare costs except GP consultations. GP visits do not consume your deductible. Hospital care and specialist consultations do. Supplementary insurance (aanvullende verzekering) covers services not in the basic package: adult dental care, physiotherapy beyond limited sessions, alternative medicine. Optional. ## Your digital health record Your medical record at a Dutch GP practice is maintained in a huisartsinformatiesysteem (HIS), structured around SOAP notes coded in ICPC-2. Every contact is documented. Problem lists, medication lists, allergy records, specialist letters, and laboratory results are all in the same system. Under the WGBO, you have the legal right to view your complete record, receive a copy, and request corrections. HeyDoc stores records in FHIR R4, the international standard for structured health data exchange. Your record is in a format readable by other compliant systems, nationally and internationally. ## Frequently asked questions **Can I see a specialist without a referral?**Generally no. The GP gatekeeper system requires a referral for specialist care. Emergency departments are accessible without referral for genuine emergencies. **Is GP care free?**GP consultations do not count toward your annual deductible (eigen risico) and are effectively free at point of contact if you are registered with a practice and have basic health insurance. **Can I register at HeyDoc if I live in Leiden?**Contact the practice via heydoc.nl to check current availability. **What if I need urgent care at night?**Call the regional HAP. Do not call your own practice number outside office hours. **How do I give consent for the LSP?**Via volgjezorg.nl, or ask the practice assistant. *New to the Netherlands: register with a GP practice as soon as possible, before you need care. Check whether you have given LSP consent at volgjezorg.nl. And keep a list of your current medications accessible in a language your GP can read.* --- Written by**HeyDoc**· HeyDoc GP practice, Leiden. This article is general information and does not replace a personal consultation. Questions?[Register with HeyDoc](https://heydoc.nl/patient-worden)or[get in touch](https://heydoc.nl/contact).