[Abundance and shortage. The distribution of medical assistance in the Netherlands during the nineteenth century]

Besides the usual divisions among medical men the nineteenth century Dutch medical laws also recognised a separate class of 'rural practitioners'. These plattelandsheelmeesters were licensed to practice all types of medicine yet only in rural areas. During the 1860s and 1870s all medical men were integrated into one class of academically trained general practitioners. The combination of the number of medical practitioners dropping rapidly for a while and the plattelandsheelmeester becoming obsolete drained some rural areas of medical assistance. Acting on the advice of the medical profession the government attempted to solve this problem by training more midwives and by granting subsidies to municipalities in order to enable them to raise the salaries of medical officers. These measures made a difference but the problem would really be solved during the twentieth century as the number of practitioners rose again and means of communication and collective arrangements were developed which were beyond the wildest dreams of most nineteenth-century citizens. In the mean time, however, the midwife had become an ally of the Dutch medical profession and collectivisation had been suggested as the main vehicle of solving problems concerning access to health care, both with lasting effects.