One in five Dutch hospitals is in serious financial trouble, according to the annual survey of hospital finances carried out by accountants group BDO.

The research shows 22% of hospitals are in the financial danger zone, partly due to reduced demand for their services. In particular, small hospitals are in a difficult position, BDO said.

‘It would appear to be a question of time before more hospitals go bankrupt,’ accountant Chris van der Haak told broadcaster RTL. ‘If they are unable to get their financial affairs in order, they have no future.’

For years hospitals have been bailed out by the government when they run into financial problems but two years ago health minister Edith Schippers said she would no longer do this.

Since then, a hospital in Spijkenisse and one in Dokkum have gone bust.

Hospitals can boost their financial position by merging and closing down unprofitable departments, Van der Haak told RTL.