Family doctors may stop fitting women with IUD contraceptives from next year because their fee is being slashed to just €18, the Volkskrant reports on Tuesday.

The paper says doctors are currently paid €55 to fit an IUD but the decision by the government to change the way family practitioners are funded means many doctors will refer patients to hospital instead. A hospital fitting costs around €500.

The two main doctors’ associations, the LHV and VPH, point out that their members have been encouraged to take over the role of fitting IUDs from gynaecologists. ‘This measure will have the opposite effect,’ Bram Stegeman of the LHV told the Volkskrant. ‘It is plain stupid to think you can stimulate people to do something by paying them less.’

From next year, doctors will only be able to charge a ‘double consultation’ fee for fitting an IUD – or €18.08. The health ministry says IUDs should form part of the basic healthcare package, changing the basis of the funding. Other treatment which used to be charged separately is also affected, such as post-operation aftercare and injections for joint problems.

To compensate for the change in funding for IUDs, doctors will be able to claim four cents per registered patient per quarter, whether or not they provide the service.

‘So if you don’t fit IUDs you get rewarded and if you fit a lot you are punished,’ Heerhugowaard doctor Hans Gimbel told the paper. ‘Why should I do this for €18 while a gynaecologist says it costs at least €500.’