Self-employment and flexible work rules in dental care: what’s changing.

The four pieces of legislation

1. The More Security for Flexible Workers Act — passed

The Dutch Senate has approved this act. The three biggest changes for employers: on-call contracts (including zero-hours contracts) disappear and are replaced by the bandwidth contract, the interruption period in the chain rule goes from 6 months to 3 years, and agency workers get at least the same terms of employment as your own staff. It comes in in stages: the agency-work part on 31 December 2026, the rest on 1 January 2028. The KNMT (the Dutch dental association) is adapting its model agreements before the new rules take effect.

What this means for your rota in practice, and which five steps you can take now, is in On-call contracts are going: how to prepare your practice.

2. Statutory presumption of an employment contract based on the hourly rate — from 31 December 2026

Part of the same package of labour-market reforms is the act on a statutory presumption of an employment contract based on the hourly rate, which takes effect on 31 December 2026. The bill has been debated in plenary session in the Dutch House of Representatives. The core: a statutory presumption that an employment contract exists, tied to the hourly rate. For practices that hire locums or self-employed contractors this is the first concrete date to plan around — well before the Self-Employment Act.

3. The Self-Employment Act — in the making, target 2028

The Dutch Ministry of Social Affairs and Employment is working on the Self-Employment Act, with two main tests: the self-employment test (does the contractor genuinely qualify as self-employed?) and the working-relationship test (can the work be carried out freely, without authority and supervision?). On 1 July 2026 the ministry held a stakeholder session with the healthcare sectors as part of the legislative process.

The KNMT made substantive proposals there and argued that no employment relationship should be presumed for a self-employed dentist who works on site and within the practice’s usual opening hours — and that the new act should make it easier for a self-employed dentist to take on locum work and collaborate freely. The minister’s target is to bring it in by 2028.

4. The DBA Act — the current framework

Until the new legislation is in place, working relationships are assessed within the existing framework of the DBA Act. The Dutch tax authority publishes on how exactly it enforces that; we deliberately don’t cover it here — for that, go to your tax or legal adviser. What is visible everywhere: all the legislation above points the same way. If you hire, you have to be able to explain why a contractor really is self-employed.

The timeline

• NowCurrent framework (the DBA Act). Good preparation: take stock of your arrangements and make them explainable.
• 31 December 2026Equal terms of employment for agency workers, and the statutory presumption based on the hourly rate takes effect.
• 1 January 2028End of on-call contracts, new chain rule (interruption period 3 years).
• 2028 (target)Intended introduction of the Self-Employment Act with the self-employment and working-relationship tests.

What does this mean for practice owners?

• Take stock of your flexible workforce. On-call, fixed-term, agency, locum, self-employed — who does what, for how many hours, on what terms?
• Do the maths on the alternatives. The bandwidth contract and plain fixed hours will be the options; work that through now and you decide calmly instead of under pressure.
• Make every locum arrangement explainable. Not because someone will be on your doorstep tomorrow, but because every new act is going to ask the same question.
• Weigh security as a benefit. In a tight market a permanent contract or a fixed number of hours also binds people to you — it is not only a cost.
• Follow the KNMT model agreements. They are being adapted before the rules take effect.

What does this mean for locums and self-employed contractors?

• Your arrangement matters more than your title. The tests look at how you work — freedom, authority, supervision — not at the heading on your invoice.
• The sector is lobbying for freedom to do locum work. The KNMT is pushing for on-site work within opening hours not to count automatically as employment.
• Security becomes negotiable. Practices will offer permanent arrangements more often; it pays to know what you want yourself — carry on as a locum, one fixed day, or salaried employment.

Not sure what makes sense in your situation? Have a look at for applicants or for practices, or simply give us a call.

The full decision for clinicians — with the worked example, the insurance and your pension — is in our guide to self-employment or salaried employment in dental care.

Frequently asked questions

Until when can I still use a zero-hours contract?

The part of the More Security for Flexible Workers Act that abolishes on-call contracts (including zero-hours contracts) takes effect on 1 January 2028. There will be an exception for students, school pupils and people of state pension age. After that the bandwidth contract is the alternative.

What is a bandwidth contract?

A contract in which you agree a minimum number of hours and may call your employee in up to 130 per cent of that minimum (so with a 10-hour minimum, up to 13). Above that the employee may refuse; the bandwidth always applies for at most one quarter.

When does the Self-Employment Act come in and what does it test?

The Self-Employment Act is still in the making; the minister's target is to bring it in by 2028. The act has two main tests: the self-employment test (is the contractor genuinely self-employed?) and the working-relationship test (can the work be carried out freely, without authority and supervision?).

What is the statutory presumption of an employment contract based on the hourly rate?

An act from the same package of labour-market reforms that takes effect on 31 December 2026. At its core is a statutory presumption that an employment contract exists, tied to the hourly rate. Exactly how it will work follows from the text of the act; ask your legal adviser to brief you on it.

Do I need to do anything yet as a practice owner?

Yes: map out who works on an on-call, agency or self-employed basis, do the maths on the alternatives (bandwidth, fixed hours) and make sure you can explain for every locum arrangement why it is not employment. That way you have nothing to repair in 2027. The five concrete steps are in this article.

Can I still hire a self-employed dental hygienist from 2027, or is secondment safer?

You can, as long as the work is genuinely independent: their own schedule, their own rate and several clients. From 31 December 2026, though, there will be a statutory presumption of an employment contract, tied to the hourly rate, and the Self-Employment Act is in the works. If the dental hygienist will be on fixed days in your rota structurally, secondment is the safer route: the dental hygienist is then on our payroll and works at your practice.

What is the difference between secondment and hiring a self-employed professional?

With a self-employed professional you hire an entrepreneur who sets their own rate and has several clients. With secondment, the professional is our employee and works at your practice; that is also allowed if someone is on fixed days in your rota structurally. The employer role then lies with us, and the payroll runs through a partner that is SNA-registered and NEN 4400-1 certified.