On Thursday morning, the House of Representatives showed great unanimity: Minister Ernst Kuipers (Zorg, D66) must quickly clarify what happened in the department during the corona crisis.
Parliamentarians reacted with shock to the news that the Ministry of Health has discouraged hospitals from expanding the number of beds in intensive care units in the middle of the corona crisis. From research by NRC it turns out that some hospitals were even advised to ‘delete’ ICU beds.
It is not the first time that consternation has arisen due to revelations about corona policy. These are now mainly revealed through the media. Because while the British have already completed a parliamentary inquiry and the Swedes are fully engaged in it, the announced Dutch parliamentary inquiry is still at the drawing board stage.
The ministry was in conflict for more than a year about the number of existing IC beds, the compensation for extra beds and the conditions for that subsidy, according to the reconstruction. There were hospitals that could provide extra beds, but were told during a lockdown that they showed up too late at the counter. And there were officials who advised hospitals to reduce the number of planned ICU beds for budgetary reasons.
The CDA calls it disturbing. Shocking, GroenLinks thinks. Astonishing, according to the PVV. Unforgivable, says Groep Van Haga. VVD parliamentarian Judith Tielen puts it this way: “The corona crisis has demanded a lot from healthcare. Then it is very frustrating to read that in a crisis there is bickering about financing, paper realities, and pointing at each other instead of working together. How is it possible that instead of working together with the hospitals, the ministry has mainly been busy with making things difficult? And why?”
Minister Kuipers knows the matter like no other. In his previous job as national coordinator of patient distribution, he was continuously involved in national planning of the number of ICU beds and coordination between hospitals and the department.
His ministry has not yet responded to questions from NRC about the ministry’s position after three weeks. On Thursday afternoon, Kuipers did respond to questions from journalists in the corridors of the House of Representatives.
‘Really the max’
Kuipers emphasized that his predecessors (Hugo de Jonge, Tamara van Ark and Martin van Rijn) always “sent on as many beds as possible”. In the summer of 2020, national agreements were made with hospitals about IC capacity, he said. These agreements have been translated per region into the number of extra beds that would be added per hospital. Because hospitals called 1,700 beds “really the max” at the time, money had been set aside for that number of beds.
In his response, the minister ignored the quarrel that arose about these agreements. For more than a year, the ministry and the hospitals argued about extra beds, reimbursements and conditions. The ministry was aware that this conflict could endanger the expansion of ICU beds. He also did not respond to the advice of officials to hospitals to remove ICU beds. He did, however, guarantee that there will be no fewer IC beds due to the behavior of his officials.
Regular Operations
That is exactly what Maarten Hijink of the SP is now questioning. Has the capacity of the Dutch intensive care unit been smaller than it could have been under political pressure? “You might have been able to receive more patients than happened, making the crisis more manageable, so that less strict measures would have been necessary. And therefore perhaps fewer regular operations would have had to be postponed.” This calls for more research, the SP believes. What have been the consequences of this policy? What would have happened if it hadn’t been pinched like that?
It is precisely these kinds of questions that lend themselves well to a parliamentary inquiry. For the time being, the Chamber needs patience.
With the cooperation of Pim van den Dool
A version of this article also appeared in the newspaper of May 13, 2022