The health service has reached a critical point, the Dutch Health Authority (NZa) warns. As the demand for care increases, the supply becomes ever scarcer. Access to care is therefore no longer a matter of course. This is stated in the annual report De Stand van de Zorg, in which the NZa analyzes the functioning of our healthcare system.

So the analysis is anything but rosy. “People no longer always receive the care they need,” writes CEO Marian Kaljouw. “The waiting lists in specialist mental health care are irresponsibly long. There is a lack of medical professionals. General practitioners are assigned more tasks than they can handle. The hospitals are struggling with waiting lists and more than 100,000 treatments postponed due to the corona pandemic.”

Kaljouw assumes that the waiting lists and waiting times will become longer in the coming years. This is not only due to the high absenteeism and the tight job market. There are regional differences, but the NZa sees tensions rising across the country. “If we do nothing, we are heading towards an unbridgeable supply gap,” predicts Kaljouw.

Health gap already visible

According to the NZa, this supply gap is already becoming apparent. Of course, there are people who are knowledgeable and have the resources to get the right care when needed. But there are also many people who do not have these resources and this knowledge and are left out. The gap is not the same everywhere in the Netherlands, due to the different care offers per region.

The NZa is asking the Department of Health to create a list of conditions for healthcare providers, healthcare providers and healthcare buyers from insurers and local authorities across the country to decide, based on the same rules, why certain care services are or are no longer being provided.

Apart from that, the regional “supply networks” of healthcare providers, health insurance companies and municipalities themselves must also make plans from the NZa to turn the tide. Exactly how this is supposed to happen is unclear. An important cause of the problems is the structural lack of personnel, which cannot be solved in the short term.

Of course, the corona pandemic has made the bottlenecks with the high absenteeism even more extreme. But cutting back on staff has been a policy for years to curb high health care costs. Budget constraints forced healthcare providers to do more with fewer staff. The fact that this system was unsustainable in the long term was ignored until it collapsed under the pressure of Corona.

Care limits have been exceeded

In the medical world, there are therefore doubts as to whether the Netherlands can still solve this supply infarction on its own. Some health economists believe that European countries need to pool their health care capacities to meet the increasing demand for health care. Health Minister Kuipers rejected an offer from German hospitals at the beginning of the summer to help on a large scale to catch up with the need for care. According to Kuipers, the Dutch healthcare system itself had to “shift up a gear”.

But this latest NZa report makes it clear that the Dutch healthcare system has already pushed the boundaries. And the reality is that the availability of care that the Dutch used to take for granted is no longer a given.