Health Inspectorate warns of severe underreporting of sexual misconduct in hospitals

The Dutch Health and Youth Care Inspectorate says sexual misconduct against patients in hospitals and clinics is being reported at alarmingly low levels, despite research showing that thousands of patients experience such behavior each year.

The Inspectorate received only five reports this year involving patients who said they were subjected to sexual misconduct in hospitals and clinics, according to figures cited by newspaper Trouw. At the same time, data from the Scientific Research and Data Center show that about 11,000 people experience sexually transgressive behavior every year across the entire Dutch care sector.

Inspector Selini Roozen-Vlachos said the discrepancy is deeply concerning and does not reflect reality. “You would expect the number of reports in this sector to rise at some point,” she told Trouw. “Across society, we have seen an increase for several years in a row, and we also see a clear rise in other care sectors.”

In hospitals and clinics, however, reports have lagged for years. Last year, the Inspectorate received about 20 reports. The year before that, there were roughly 10. This year’s figure of five reports has heightened concern within the watchdog agency.

According to the Inspectorate, many cases never surface because patients are hesitant to report them. The threshold for filing a complaint remains high, and patients may fear they will not be believed because of the power imbalance.

Roozen-Vlachos said the reports that do reach the Inspectorate paint a troubling picture. “They are serious reports involving health care workers who make multiple victims and where there were already earlier signals,” she said. “We have seen convictions in recent years for sexual assault or rape. What often comes up is that the health care provider in question also assaulted colleagues, in addition to patients.”

Uncertainty also plays a role. “In medical examinations, patients often have to search for themselves: has the boundary been crossed here, or does this still belong to the examination? That is not always clear,” Roozen-Vlachos said.

Under Dutch law, care providers have been required since 2016 to report sexual misconduct. But Roozen-Vlachos said behavior that is not recognized or discussed cannot be reported. Clear evidence, such as eyewitnesses, images, or WhatsApp messages, makes it more likely that a case reaches the Inspectorate. When situations are less clear-cut, they often remain hidden.

The Inspectorate is urging hospitals and clinics to investigate why reporting remains so low and to address cultural barriers within institutions. Roozen-Vlachos said many care workers are not even aware that a consensual relationship between a colleague and a patient also falls under the reporting obligation.

She pointed to the disability care sector and mental health care as examples where reporting has increased in recent years. “The disability care sector looks the beast in the mouth,” Roozen-Vlachos said. “They train their people to act and not stay silent when they see something. That is also a duty of care.”