Health care institutions and professionals are morally and legally obliged to deliver accountable care, but have to decide themselves how to meet this obligation.

Recent incidents in the Netherlands, such as the occurrence of a fire in an operating room at the Twenteborg Hospital in Almelo, and the problems concerning heart surgery in the Radboud University Nijmegen Medical Centre, show that the control mechanisms for guaranteeing the quality and safety of patient care may fail.

After analysis of these incidents, the Dutch Health Care Inspectorate and the Dutch Safety Board formulated a number of important suggestions concerning the interpretation of the concept of ‘responsible care’.

The recommendations are clear: improve the structure, process and management of care, the checking of medical equipment, and monitoring of quality and patient safety.

Managers and professionals must make agreements on their responsibilities and then go on to substantiate and implement them.