Except for precautions against plague, disease prevention policies on a national scale were non-existent in the Netherlands until the turn of the 18th/19th century. The political constellation of the Republic of the United Provinces was a serious obstacle for the development of an active health policy. The government of the Dutch confederation lacked the power to take charge and initiate a campaign to contain epidemics.

Medical Police

Then the Batavian Revolution (1795) put an end to the old Republic and paved the way for the formation of a national state after the Napoleonic model. The Republic of the Free Bataves (1796-1806) came into being. In quick succession it was followed by the Kingdom of Holland (1806-1810) as a French puppet state, then annexation by the French empire (1810-1813), and finally in 1813 the restoration of the House of Orange and the establishment (1814) of an independent, constitutional Kingdom, which still exists today. The new form of government, in accordance with the French administration, was highly centralized. Health now became a political issue (Batavian Constitution 1798, art. 62). Bearing the primary responsibility for protecting the public health, the state had the right to regulate hygiene and sanitation to improve the public good. The concept of medical police as conceived originally by the Prussian medical reformer Johann-Peter Frank (1745-1821) found a strong advocate in doctor Jan van Heekeren (1773-1803), Secretary of State for Public Health in the Batavian Republic.

As in most European countries this strategy was not fully implemented in the Netherlands until the late 19th century. The budgetary allocations for Medical Police formed only a very small part of the budget of the Ministry of Home Affairs. Nonetheless, establishing the medical police and instituting civil registration to be administered by civilian officials were major achievements matching other reforms of the Batavian-French era (monetary unification, unification of weights and measures, military conscription). Van Heekeren saw the value the registration of births, marriages, and deaths, combined with regular censuses, would have for understanding patterns of disease and assisting the medical police in carrying out their duties (Heederik 1973: 54-75; 247-249).

In 1804 the first government medical regulation (Geneeskundige Staatsregeling 1804) came into being, soon (1806) to be completed by a set of Additional Articles.