A court in Arnhem has sentenced three people to community service orders and jail for working in healthcare without the necessary qualifications, while a fourth person was found not guilty.

The severity of the sentences depended on the length of time the fraud had been perpetrated and if the person admitted responsibility for their behaviour, the court said.

The most serious case was that of a man from Renswoude who worked for four years in a senior post in a department for the mentally disabled. He was given the highest sentence of six months in jail.

The man had been administering medication to extremely vulnerable patients needing complex care. “This is not an administrative error but wilful and drawn-out deception,” the public prosecutor said.

The public prosecution office combined the cases to warn about rampant diploma fraud in healthcare, which, it said, is “putting at risk the safety and well-being of extremely vulnerable people”. It also undermines public trust in the care sector as a whole, the department said.

Earlier this year, a major investigation by health ministry inspectors uncovered a jobs agency which employed over 60 care workers who had fake qualifications or no documents at all.

Health inspectors as well as the police have been airing their concerns over an increase in fake diplomas for some time. Some agencies were found to have ties with organised crime, providing lucrative jobs in care to people involved in violent crime and the drugs trade, while some were connected with terrorist organisations.

Some €10 billion of the total €100 billion health budget is pocketed by fraudsters and that includes millions raked in by criminal gangs, a police report from 2024 said.

“Healthcare involves a lot of money but checks and balances are fragmented because of the complexity of the system,” the department said.

Experts have put much of the blame for diploma fraud on care providers themselves. “Care providers are responsible for good care; that is their legal duty. It is very simple: the human resources department needs to do thorough background checks in advance to see if people are qualified or not,” health law professor André den Exter said.