RESUMO
Thirteen years of activities in the field of quality assurance in the health care field in The Netherlands bring to life the many ups and some downs in this intriguing endeavour. Back in 1974, quality assurance was in the minds of few individuals and in the hands of nobody. This has changed dramatically: not only are there now functioning programmes carried out by knowledgeable and dedicated health care providers, there is legislation that suits the convenience of quality assurance, and a firm delineation of responsibilities. At the same time there is flexibility which enables the various actors to interpret their roles according to their capabilities and tastes. The various contributions in this issue are part of this national development.