Doctor shortages leave Dutch patients facing months-long waits

Patients across the Netherlands are facing increasingly long delays to see medical specialists, with wait times for gastroenterologists averaging 13 weeks longer than the recommended four weeks, and neurologists averaging seven weeks longer, according to a recent analysis by comparison site Independer. The delays are far from meeting national guidelines, which stipulate that patients should be able to see specialists within four weeks.

The aging population is a significant factor driving the demand for specialist care, according to Manon Spaander, chair of the Dutch Association for Gastroenterologists and Hepatologists. “Nobody is happy about these waiting lists. The situation is becoming increasingly urgent, and we, as doctors, are thinking about how it can be improved,” Spaander said.

An alarming 86 percent of gastroenterology clinics and nearly 80 percent of neurology departments are unable to meet the target, highlighting a nationwide healthcare access problem fueled by shortages of specialists and rising demand.

“There are simply too many patients and too few doctors,” said Robert Chabot, board member of the Dutch Association for Neurology. “For example, a hospital in the northeast is currently looking for five neurologists, while in Zeeland, one hospital only has a single neurologist left.”

Patients with urgent health issues are prioritized, while those with less critical conditions, such as chronic migraines or abdominal complaints, often face months-long delays. “The consequences can be very distressing,” said Tijmen Hendriksen, spokesperson for the Patient Federation. “People are left to endure pain longer, their conditions worsen, and they end up needing more treatment.”

Chabot acknowledged the challenges of balancing care priorities. “It’s, of course, very unfortunate when people have to wait longer, for example, with migraines,” he said. “But migraines are not conditions that suddenly become untreatable after three months. We need to prioritize other patients to ensure we don’t miss conditions that require immediate attention, such as brain tumors.”

The delays underscore mounting pressures on the healthcare system. While there are guidelines requiring patients to be seen within four weeks, these are not legally binding, and hospitals face no penalties for failing to meet them. However, the growing backlog is seen as a critical sign that accessibility to healthcare is under strain.

The problem is particularly acute in the northern and eastern regions of the country, where wait times are significantly longer. The Dutch Healthcare Authority (NZa) advises patients to seek assistance from their health insurers for wait-list mediation. Insurers often help patients find alternative hospitals with shorter wait times, though this process is more challenging in regions with fewer medical facilities.

“In the northern provinces, we’ve noticed that patients increasingly ask for help,” a spokesperson for Zilveren Kruis, a Dutch health insurer, said. “But it’s harder to transfer patients to other clinics in those areas. When it works, though, patients can often significantly reduce their waiting times.”

Another insurer, VGZ, pointed to staffing shortages as the main issue in the northern hospitals. “Unfortunately, this isn’t something we can solve,” a VGZ spokesperson said. CZ, another health insurer, has identified wait times as a key focus for 2025 but admitted it still lacks solutions. “We’re trying to uncover the root causes. At this point, we don’t know how to resolve this,” a spokesperson said.

Health economist Wim Groot highlighted systemic funding issues as a critical driver of the delays. Hospitals are capped at a growth rate of 0.7 percent annually, while patient demand is increasing by 3 percent. “It’s logical that wait times are increasing under these conditions,” Groot said.

Efforts to address the strain, such as providing care at home or through primary care providers, have not gained significant traction. “Years have been spent discussing the idea of the right care in the right place,” Groot noted. For example, blood test monitoring for certain patients at home has been piloted, but widespread implementation remains limited.

Some hospitals have experimented with innovative approaches to alleviate the burden. Chabot cited an example from his neurology department, where general practitioners were allowed to request diagnostic tests for carpal tunnel syndrome without referring patients to a neurologist. The initiative reduced the need for 450 specialist appointments. “That was a real saving,” Chabot said. “But we’re only allowed to bill for these tests if the patient has had an appointment with a neurologist. So, we’re forced to see all these patients anyway.”

The Patient Federation has also expressed frustration with the slow pace of healthcare reform. “It’s clear that the pressure on the system is immense,” Hendriksen said. “But there seems to be a lack of urgency to address it effectively.”