14 Flemish Hospitals Risk Closure in Consolidation Push

Flemish health ministers have reached a principled agreement to consolidate the region’s fragmented hospital landscape, identifying 14 hospitals and campuses across Flanders that risk closure or significant downsizing. The decision, announced the week of June 22, 2026, follows an expert report commissioned by Federal Minister of Health Frank Vandenbroucke (Vooruit) and aims to address critical pressures including staff shortages, an aging population, and unsustainable fragmentation in the sector.

Under the new criteria, hospitals must have at least 200 beds, of which 150 must be sufficiently occupied by acute-care patients to qualify as a regional general hospital. Hospitals that fall short face four options: merge with another institution, convert to a day hospital, transform into a rehabilitation center, or phase down operations entirely. The first phase of the reform must be completed by 2031, with a transition period and subsequent evaluation.

A Fragmented System Under Pressure

Belgium currently operates 132 different hospitals and rehabilitation clinics — a density that experts and officials alike describe as unsustainable. According to Het Laatste Nieuws, the reform is driven by multiple converging crises: a critical shortage of nurses and healthcare personnel, an aging baby boomer generation placing rising demand on services, and the increasing cost of medical equipment that requires economies of scale to remain viable.

“The staff shortage, the aging population, and the many doctors who no longer want to work full-time in hospitals: hospital directors realize that this cannot be sustained much longer,” said Margot Cloet, CEO of Zorgnet-Icuro, the Flemish hospital umbrella organization, as reported by Zorgnet-Icuro. “If we do nothing, the sector will collapse. This is the way forward.”

The 14 At-Risk Hospitals

The affected hospitals span all five Flemish provinces. In West-Vlaanderen, three campuses are at risk, including AZ Delta’s sites in Menen and Roeselare (Brugsesteenweg) — though AZ Delta is the third-largest hospital in Flanders, its individual campuses do not meet the bed threshold. AZ West in Veurne, while on the list, is considered geographically isolated and likely to receive an exception.

Oost-Vlaanderen faces the heaviest impact with five hospitals or campuses identified. AZ Oudenaarde (179 beds) has already initiated merger talks with AZ Glorieux in Ronse, with the merger expected in the course of 2027. “We want to offer the residents of the Flemish Ardennes quality care, close to home,” said Ine Cruypelinck, communications officer at AZ Oudenaarde, as quoted by HLN. “We chose to bundle our expertise and continue to guarantee that good care here.”

In Antwerpen, three AZ Rivierenland campuses in Bornem and Rumst are affected, while Vlaams-Brabant has two and Limburg one: ZOL campus Sint-Barbara in Lanaken, which will be converted into a specialized day center.

A Four-Tier Hospital Model

The reform envisions a restructured landscape with four types of healthcare institutions: university hospitals offering full-service, research-oriented care; regional general hospitals meeting the 200-bed minimum; day hospitals for planned surgeries and consultations without overnight stays; and rehabilitation centers for specialized post-acute care.

Exceptions are made for hospitals in remote or geographically isolated areas, where the bed threshold will be lowered. The Interministerial Conference on Public Health reached the principled agreement in consensus on June 24, 2026, as confirmed by Zorgnet-Icuro’s summary of the IMC decision. Final decisions are expected after the summer, in September 2026.

Reactions and Concerns

Minister Vandenbroucke has emphasized that the goal is not to close hospitals but to make the system more efficient. “It is absolutely not the intention that hospitals will close,” he stated in a video interview with HLN. “The reform is a necessity: everything must be more efficient.”

Hospital directors broadly support the need for reform but have raised concerns about implementation. Joost Baert, CEO of AZ Delta, told HLN: “I am a big believer in more efficient healthcare. Care is complex and equipment has become more expensive: that requires scaling up. Only, for all the infrastructure adjustments, financial support will also be needed, but I haven’t heard anyone talk about that yet.”

Political opposition has emerged, particularly from the Vlaams Belang party. MP Dominiek Sneppe framed the reform as “pure destruction,” arguing that closing or hollowing out emergency services “plays with people’s lives and undermines the foundation of an accessible healthcare system,” as reported by Vlaams Belang.

What’s Next

The principled agreement will be formalized into a definitive plan after the summer of 2026, following consultations with respective regional governments. The first mergers are expected as early as 2027, with AZ Oudenaarde and AZ Glorieux leading the way. The first phase of the reform must be completed by 2031, with a subsequent evaluation to assess its impact on access to care, particularly in rural areas.

For residents of Flanders, the coming years will bring significant changes to the healthcare landscape. While officials stress that the reform is designed to preserve and strengthen the system for the long term, questions remain about financial support for infrastructure changes, the impact on ambulance response times in rural areas, and how healthcare employment will be affected as hospitals consolidate.

As Minister Vandenbroucke put it: “We have a strong health system, but we must change in order to preserve it.”