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Fragmented Dutch healthcare landscape can make good use of technology

Last week, the Federation of Medical Specialists published an interesting report on the increasing opportunities for diagnostic care provided by technology. In that report, the increasing importance of effective networks is emphasised, among other things. Jeroen van Roon, partner Healthcare at Boer & Croon, writes that he supports that message and would like to go a step further.

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This is a much-debated topic, because we all feel that the Netherlands is a highly decentralised country. This is true for municipalities, but also for healthcare. This complexity is especially noticeable in times of crisis, such as the coronapandemic or the refugee crisis. In both cases, the conclusion seems to be that 'the minister needs to have more persuasive instruments'.

This decentralised control is part of a very long Dutch tradition, which is really different from that of other Northern European countries. It has brought us many good things, but also fragmentation. And that makes structural cooperation in the region difficult. There is no 'quick fix' but medical technology does indeed offer various new opportunities. For example, the Federation emphasises the opportunities for home diagnostics and better patient involvement in their own health. But it also stresses that this need not lead to "large regional centres".

From becoming healthy to staying healthy

The concerns about mergers and scale increases are understandable, in light of the many difficult attempts to do so in healthcare and beyond. Technology makes it possible to preserve the human dimension for both the patient and the healthcare professional. However, we should also be able to 'dream big' when it comes to the extent to which we want to use technology to really redesign healthcare. The care sector now has such capacity problems due to labour shortages that we cannot escape it.

"We are moving from a world where, for example, a hospital patient goes to the hospital for regular check-ups to a world where he (or she) keeps a constant eye on his (or her) own health, together with the medical professionals who support him, so that he remains more focused on staying healthy and hopefully has to go to hospital far less often. And certainly not for a serious incident that they could have avoided, through proper monitoring. This can lead to better care, but only if all those involved are prepared to fundamentally redesign their roles. In an era of scarcity, this places a great responsibility on those who shape regional cooperation in care. The classic hospital and the classic doctor's practice are no longer adequate. Networks are becoming dominant and may lead to new organisations. Not necessarily big organisations, but new ones."

"It is not easy to go through that transition, in a de-centrally organised country with a large number of parties, each with their own vested interest and starting point. Unlike in crises, the minister will not be able to solve this with 'extra perseverance'. People will have to find each other per region. There are also different opportunities per region. Because the shore of a tight labour market is turning the ship around, this will also happen. But it will take some time."