New treatment norms mean only some Dutch hospitals will offer specialized cancer care
Seemingly insignificant agreements on new treatment norms will cause massive changes in the treatment of certain types of cancer and complicated vascular problems. From 2027, only certain hospitals will offer this care, but the care will also become much more specialized, the Volkskrant reports.
On Tuesday, medical specialists, hospitals, health insurers, and patient representatives agreed to new, increased “volume standards” for treatments of five types of cancer and two life-threatening vascular conditions. These volume standards regulate how often a hospital must perform a certain type of treatment per year to continue offering that treatment.
The changes seem minor at first glance, but they will have a major impact because dozens of hospitals don’t meet the new volume standards and will therefore stop offering certain care. Of the 48 hospitals that currently perform complex kidney cancer procedures, 33 do not meet the new standard. For lung removals, 19 of the 41 hospitals perform too few treatments to keep offering the care. The same is true for 16 of the 61 institutes that currently perform risky research into pancreatic cancer.
As things stand now, Friesland and Zeeland patients with cancer in the stomach, esophagus, or pancreas will have to go to a hospital outside their province for treatment. Patients in Zuid-Limburg will also have to travel further.
The changes also impact large hospitals. The Rijnstate hospital in Arnhem performs too few esophageal surgeries. The Maasstad hospital in Rotterdam will lose lung removal surgeries, and the Haga Hospital in The Hague risks losing kidney treatments.
That sounds drastic, but it is not a bad thing, experts involved told the Volkskrant.
These changes are desperately needed, said Rob Tollenaar, a professor of oncological surgery in Leiden and the chairman of the Round Table Concentration and Distribution of Oncology, where 11 healthcare parties met. “We need to organize healthcare differently if we want to keep it accessible to everyone.”
“We will perform complex healthcare procedures in fewer hospitals, so that the teams that provide this care become better at it,” Tollenaar said. Concentrating care also “frees up space in other hospitals for other treatments. For upper abdominal complaints that are not cancer, for example. Or benign gynecological complaints. Conditions for which there are currently long waiting lists.”
This will benefit patients, agreed Peter Go, a former surgeon and the chairman of the Round Table Vascular Surgery. “As a patient, you now go to a random hospital and are often treated there, while it may well be the case that the care in another hospital is of better quality. Or that we can use the scarce resources more efficiently,” he told the newspaper.
“People with cancer can be happy with the steps that have now been taken,” Irene Dingemans of the Dutch Federation of Cancer Patients told the newspaper. “The higher volume standards pave the way for expert care. Only when you have enough patients can a hospital team specialize completely. Only then can you offer all available treatments, be aware of the latest scientific research, and see patterns in patients’ complaints.”
The improvements will also apply to all patients, not just those who know how to navigate the healthcare system and get the best treatment for themselves, Dingemans added. And yes, some patients will have to travel further. “But time and again our research shows that people are willing to do that for better care. Patients understand that there is not a hospital on every street corner where you can go for complex procedures.”
