Drafting a self-employed contract for healthcare

The healthcare sector has been designated by the Tax and Customs Administration as a sector subject to special scrutiny in the fight against bogus self-employment. There is a reason for this: healthcare professionals often follow fixed schedules, work according to protocols, and are deeply embedded in the organization. It is precisely these characteristics that point to a hierarchical relationship, and thus to a possible employment relationship rather than an independent assignment.

For a healthcare organization, this is a real risk, because in cases of bogus self-employment, the client is initially held liable for the payroll taxes and contributions that should have been paid. An agreement tailored to healthcare practice, and a working method that aligns with it, are therefore more important than in many other sectors.

The core question is whether a relationship of subordination exists. In the Deliveroo judgment, the Supreme Court provided viewpoints that are weighed in conjunction: the nature and duration of the work, how the work and working hours are determined, the integration within the organization, the obligation to work personally, the remuneration, and whether the worker acts as an entrepreneur.

In the healthcare sector, these perspectives raise specific questions. Free substitution conflicts with BIG registration and quality requirements, while rotation within rosters indicates integration. At the same time, an independent healthcare provider bears their own professional and disciplinary responsibility, which actually points to independence. It is about the big picture, and our legal experts translate these perspectives to your specific healthcare situation.

Many healthcare organizations and self-employed professionals work with a model agreement. Good to know: as of September 2024, the Tax and Customs Administration no longer approves new model agreements. Existing, approved model agreements remain valid until the end of 2029 at the latest, even if a different end date is stated on them.

However, a model agreement offers only limited certainty. The Tax Authorities and the courts look primarily at how work is performed in practice. The agreement is only meaningful if the actual implementation fully aligns with what is on paper. Therefore, we do not draft a standard document, but an agreement that fits how you actually collaborate, and we assess whether the paper and practice align.

If the Tax and Customs Administration determines that there is a bogus self-employment, an additional assessment of payroll taxes will follow, which can be imposed retroactively to the moment enforcement is resumed. For a healthcare organization, these amounts can add up significantly, especially if self-employed professionals are used structurally to fill rosters.

In addition, employment law implications may apply, such as claims for continued payment of wages or pension. Because the rules and enforcement in this area are evolving, and healthcare is receiving extra attention, it is advisable to have your hiring and agreements reviewed to keep them up to date, rather than relying on a previously drafted document.

An employment relationship in healthcare can change along a sliding scale. What begins as a clearly defined assignment can, over time, resemble a permanent position: the self-employed professional becomes more embedded, works regular shifts, and is managed like a team member. Therefore, a one-off assessment at the start is not sufficient.

Periodically check whether the actual situation still aligns with the agreements, especially in cases of long-term assignments. Look for signs of integration, such as a fixed spot in the schedule, a company email address, or participation in team meetings on the same footing as staff. Our legal experts will help you set up a working method that allows you to keep hiring structurally manageable.

We draw up a self-employed professional agreement for customized care at a fixed price starting from 99 euros, with clarity regarding costs upfront. You will receive a draft document first and only pay afterwards. The final price depends on the complexity: the type of care, the nature of the services provided, and whether you also wish to have existing contracts or the working method reviewed.

During the free intake, we discuss how the collaboration proceeds in practice and where the risks lie, so that the agreement aligns with the reality of care and you know exactly which points require attention.