The need for private capital is a new phenomenon in Dutch hospital care and provokes questions about a potential conflict of interest between profit and safety. Entrepreneurs provide capital, take risks and determine control over administration and production. They establish the rewards or sanctions that administrators and medical specialists may earn. The use of ‘safety cases’ is common in aviation. A combined business and safety case may give insight into whether safety goals have been defined, and if indeed a reasonable outlook for profit by safety exists.