Case study: Geneesmiddelenbulletin, The Netherlands
The monthly Dutch bulletin Geneesmiddelenbulletin (Gebu in short) was first published in 1967 under the auspices of the Directorate of Public Health at the former Ministry of Social Affairs and Public Health, and distributed free of charge to doctors and pharmacists. In 1988 Gebu was threatened with closure because of cost-cutting proposals by the Government. Combined action by many of those involved with the bulletin prevented its closure and in 1990 the bulletin was privatised with the formation of the independent Geneesmiddelenbulletin Foundation. This foundation, which consisted of a board of governors, an editorial board and an advisory council, received an annual grant from the Department of Health that covered all expenses. The mission statement of the foundation defined the independent position of the bulletin: members of the editorial and advisory board were obliged to declare relationships with pharmaceutical companies, and advertising by such companies in the bulletin was not allowed. However, in the autumn of 2003 the Minister of Health proposed to withdraw all financial support to the bulletin, but thanks to the supportive actions of the readers and colleagues from ISDB this ministerial decision was cancelled. Other problems were that the editing office was a very small organization (1.7 full-time-equivalent editors and 2.4 full-time equivalent administrative support) doing highly specialised work. The expertise of the editors was difficult to replace and in times of illness or other times when the editors' work was impaired the continuity and quality of the bulletin was seriously endangered. Furthermore, such a small organization meant limited prospects for career development.
Strategy for change
Considering these problems, the foundation board decided to approach possible future partners for cooperation, and as a first step formulated some conditions for such an alliance.
1. A possible partner should not pose a threat to the editorial independence of the bulletin.
2. Such a partner should have expertise to match that of the editors, in order to better guarantee the continuity and the quality of the bulletin.
3. The organization of the partner should be solid and financially sound.
4. The future partner should be acceptable to both pharmacists and doctors.
On the basis of these conditions a small number of possible future partners was consulted. The results of these contacts were discussed with members of the editorial and advisory boards. During this process board members of the foundation kept in contact with representatives of the Department of Health as its consent was necessary to guarantee continuation of the annual financial support to the bulletin.
After some consideration the College of Health Insurances was chosen as the future partner. This organization initiates activities that focus on quality of care by reporting on medical technology and pharmacotherapy. Among other products, it produces the Farmacotherapeutical Compass, a kind of national formulary. This last activity in particular provides an opportunity for cooperation and exchange of expertise.
Since January 2005, the bulletin has been published by the College of Health Insurances (the foundation Geneesmiddelenbulletin having been liquidated), with the editorial office housed in the building of the College in Diemen. The members of the editorial office have a working contract with this College. Both parties have signed a declaration of editorial independence for the bulletin; the editorial board and advisory board will continue to function as they did within the former organization, with the title of ‘external experts’.
Contributed by Jan Schuling, former Chair of the Advisory Council, Geneesmiddelenbulletin.