Introduction

Quality control has become a familiar word in health care in the Netherlands in the last ten years, as it has elsewhere in the Western world. The self-evident way in which medical practitioners meet their obligations towards their patients on the strength of the Hippocratic oath is apparently no longer a sufficient guarantee of the best possible treatment. There would appear to be pressure to keep a critical eye on the work of medical practitioners, both within the profession itself and also on the part of representatives of patients or those who regard themselves as such. Such a state of affairs has probably arisen not so much as the result of any failing on the part of medical practitioners, but because of a changed cultural pattern in the Western world. Regulated quality control in medicine is a phenomenon typical of those parts of the world where medical care is in abundant supply. Where medical care is scarce, doctors few, and work done on a more individual basis, there is neither the opportunity nor the funds and consequently perhaps not even the inclination to make arrangements to monitor doctors. Similarly, quality control is an issue that arises more commonly in (intramural) hospital care where groups of consultants work, rather than in general practice where medical practitioners operate on an individual basis.