Dutch Hospitals Warn of Rising Shortages of Medical Devices
From hospital gloves to specialist parts for complex operations and MRI scanners, hospitals say shortages are growing. Experts point to tightened EU rules and a fragmented Dutch purchasing system.
Hospitals in the Netherlands are increasingly having to cope with shortages of medical devices, ranging from everyday items like hospital gloves to highly specialised components for complex operations and MRI scanners. Experts and healthcare professionals warn that the problem is structural and growing, according to an investigation by current affairs programme Nieuwsuur.
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A daily struggle
There are hundreds of thousands of different medical devices in circulation, and shortages can affect any of them. “Every hospital deals with a looming shortage every day,” said Mariken Zijlmans of the Dutch Association for Clinical Physics (NVKF). Products needed for procedures such as operations are sometimes simply not delivered. Most of the time, she said, hospitals manage to get the right items to the right place through improvisation. “But sometimes that doesn’t work.”
Peter van der Weide, the owner of a medical wholesaler, expects such failures to become more common. Several hospitals have already come to him because their own supplier could not deliver enough.
When a shortage becomes acute
The risks are not theoretical. Last month, a specific component used for heart catheterisations was recalled on a large scale, causing an acute shortage. Around 70 hospitals had to work out among themselves, at short notice, who had stock and who needed it most urgently. Planned heart treatments were halted as a result.
Urologist Van Bezooijen warned that shortages, not only of devices but also of medicines and staff, will only grow. Patients, he said, should bear in mind that not all care can be delivered immediately. “That means care may no longer be able to meet the expectations that exist until now.”
The role of EU rules
A large part of the cause, according to those in the sector, lies in the tightening of European legislation on medical devices, the Medical Device Regulation (MDR) and the In Vitro Diagnostic Regulation (IVDR). These rules were introduced to improve patient safety after earlier scandals, but they require manufacturers to go through expensive and lengthy re-certification processes. As a result, some producers have pulled products, particularly niche ones, from the market rather than bear the cost. The vulnerability of globalised supply chains adds further pressure.
A fragmented purchasing system
Experts also point to the way Dutch hospitals buy their supplies. Unlike in many other European countries, hospitals in the Netherlands arrange their purchasing fully autonomously, making individual agreements with suppliers. Kevin Overgoor of the Healthcare Purchasing Network Netherlands (ZINN) criticised that approach. “If you purchase autonomously, you do not look at the interest of total Dutch healthcare,” he said. ZINN is calling for a radical change in which the government takes control and arranges purchasing centrally, as already happens with medicines.
What is being done
When a shortage arises, or there are signs that one is coming, hospitals are now expected to report it to ZINN, which runs a dedicated reporting point and helps search for alternative products. The Health and Youth Care Inspectorate (IGJ) is also involved, and a large European study has been carried out to get a clearer picture of device availability. In addition, a change to the Dutch Medical Devices Act, aimed at preventing shortages under the MDR and IVDR, passed both houses of parliament earlier this year.
Whether those measures will be enough to ease the pressure remains to be seen, with the sector warning that, for now, the trend is pointing the wrong way.