The Dutch healthcare system risks a repeat of the shortage of intensive care beds that it faced during the coronavirus pandemic unless it hires more staff, ICU specialist Diederik Gommers has warned.
Gommers urged parliament not to pass a law setting a minimum number of intensive care beds as the specialist units filled up at the start of the first coronavirus wave in March 2020.
“Without sufficient personnel you’re only giving patients a semblance of a solution,” he said.
During his two-hour hearing at the parliamentary inquiry into coronavirus, Gommers criticised the government’s policy both during and after the pandemic.
As the head of the national association of intensive care patients, Gommers came under pressure to ramp up capacity as the number of coronavirus patients increased from 10 at the start of March 2020 to 1,100 by the end of the month.
The Netherlands only avoided the “Code Black” scenario of running out of ICU places by transferring patients to Germany, which has four times as many beds per head of population, in the first two coronavirus waves.
Behind the facts
He said the Netherlands had “sailed close to the wind” by being too fixated on cost savings, making it impossible to raise the number of beds from 900 to 1,150.
“You need an extra 1,000 staff for 250 extra ICU beds, with day and night shifts, and we don’t have them,” Gommers explained.
He also criticised ministers for being too slow to bring back lockdown measures when infections started to rise again in the autumn of 2020, despite the warnings of the outbreak management team. “It felt as if we were running behind the facts,” he said.
Gommers said the government should have let medics concentrate on keeping the healthcare system running and not dragged doctors into discussions about whether to close bars earlier.
He described clashing with prime minister Mark Rutte and health minister Hugo de Jonge over whether elderly patients should be given intensive care treatment as the units reached capacity.
Age limit controversy
The cabinet was against setting an age limit of 80, but Gommers said the number was only a guide. “Of course everyone is equal, but sometimes we have to make choices,” he said.
Medical guidance was based on the fact that patients needed a week’s recovery time for every day spent in intensive care, he explained. “It’s not about an absolute age, such as 80, but about vulnerability. Is the patient too vulnerable to benefit from a treatment?”
After the pandemic, hospital managers were told to catch up on all the operations and procedures, such as knee surgery and cancer screening, that had been postponed to make room for coronavirus patients, but Gommers said the sector had been unable to make up the backlog.
Some lockdown measures were too strict and should never be repeated, such as denying the families of dying patients the chance to see them for the last time in hospital.
“We should never do that again,” said a visibly emotional Gommers. “People should not die alone. It’s not what we’re put on this world for.”
