Society is running as usual, hospitals do not. 100,000 to 120,000 more people are still waiting for surgery than before the pandemic. And that number has not fallen since March, the Dutch Healthcare Authority (NZa) warned on Monday.
Many hospital operating rooms are still out of use.
There is no staff for this: nurses have been absent for a long time due to overload, or have left care completely.
The NZa published the Healthcare accessibility monitor on Monday. This shows that waiting times vary considerably by region. Some healthcare providers say they can help more people if they are asked to. It seems that some patients wait unnecessarily long for a procedure. Being on the waiting list for a long time can mean a lot of pain and discomfort and sometimes leads to a higher chance of complications.
The NZa writes that it considers it ‘very important’ that hospitals with waiting times that are too long ‘look up cooperation with other hospitals and independent clinics with shorter waiting times’.
Also read: Waiting for her new hip became ‘hell’ for Nelly
No place in intensive care
In the Queen Beatrix Regional Hospital in Winterswijk, for example, the waiting lists have virtually been resolved. “We are back to normal,” says Inge de Wit, hospital administrator. “I just happened to read that Turkish hospitals offer help. Shouldn’t we start with hospitals in the Netherlands that still have space?”
Nearly 7,000 people are waiting for an operation at the Isala in Zwolle due to delayed care. And the University Medical Center in Utrecht is still not able to perform all urgent operations, which officially have to be performed within six weeks, on time. An important factor here is that space in the intensive care unit must be available for more complex operations. And there is often a lack of it.
Most hospitals still have long waiting lists. Such as the Maasstad Hospital in Rotterdam, where 2,500 people are waiting for an operation. A year ago (during the pandemic) there were 2,100. “There are many people on the waiting list who are waiting for orthopedic operations, such as on knees and hips,” says director Wietske Vrijland. “There are people among them who have been waiting since the autumn.”
Like other hospitals, Maasstad is suffering from high absenteeism and staff who have turned their backs on care during the pandemic. Remarkably enough, the NZa has not yet seen a national decrease in long-term absenteeism in health care, which is considerably higher than before the pandemic.
Are we doing everything we can to help people as quickly as possible?
Paulette Timmerman director of Independent Clinics in the Netherlands
Empty operating rooms
Before the pandemic, all twenty operating rooms at the university hospital in Maastricht were in use. The hospital will reopen its seventeenth operating room this week. All twenty open again, that will not work this year, is the expectation. The hospital did manage to reduce the waiting list considerably in recent months, says Esther Peters, capacity director. “For example, by scheduling more patients in an operating room one day.”
Independent treatment clinics – ie centers where relatively simple operations are performed – could treat more people than they do now, says Paulette Timmerman, director of Independent Clinics in the Netherlands. “I have just come from a clinic in Amsterdam. There they said: ‘If we are asked, we can scale up extra’. That applies to many more clinics. Are we now doing everything we can in the Netherlands to help people as quickly as possible?”
Insurers play a major role in distributing patients on the waiting list for a procedure. They have a statutory duty of care and should mediate if it takes too long before an intervention is performed. “Some insurers do more with this than others, says hospital director De Wit. “CZ, for example, asks hospitals every week where there is space. With some other insurers it is much less important.”
Outside your own region
Hospitals often say that patients do not want to be treated outside their own region. “We ask people who have been on the waiting list for a long time how they are doing and sometimes offer them to be treated in other hospitals,” says a spokesperson for the Isala in Zwolle. “Many patients do not choose that, they want to stay with the familiar face of the doctor.”
Timmerman, of the trade association of independent clinics, challenges the image that patients do not want to travel. “That’s possible, but we have to ask them first. Our experience is that many patients really do want to travel if they are helped earlier as a result. We know examples of people who came to Amsterdam from Groningen for a new hip.”
It is not the case that people can always be helped elsewhere, says Vrijland, hospital administrator in Rotterdam. “Not every hospital has the same profile. Some care is best provided by certain hospitals.”
Intensive collaboration is also an option. Surgeons from Maastricht UMC, for example, rent operating rooms with staff in the independent Annadal clinic in Maastricht to perform additional operations. Such a collaboration will also start on Friday with a clinic in Weert. The Isala in Zwolle is also switching to independent treatment centers for some treatments, for example for procedures in plastic surgery and gynaecology.
A version of this article also appeared in the newspaper of May 31, 2022