Tackling hospital waiting times: The impact of past and current policies in the Netherlands

tThis paper reviews the impact of health policies on hospital waiting times in the Netherlandsover the last two decades. During the 1990s hospital waiting times increased as a resultof the introduction of fixed budgets and capacity constraints for specialists, in addition tothe fixed global hospital budgets that were already in place since the 1980s. To tacklethese increased waiting times over the years 2000–2011 several policies were imple-mented, including a change from fixed budgets to activity-based funding – for both hospitalsand specialists – and increased competition among hospitals. All together these measuresresulted in a strong reduction of waiting times. In 2011 mean expected waiting times foralmost all surgical procedures varied from 2 to 6 weeks, well below the broadly acceptedspecified maximum waiting times. Hence, in the Netherlands hospital waiting times arecurrently not an important policy concern. Since the waiting time reduction was achievedat the expense of rapidly growing hospital costs, these have become now the primary pol-icy concern. This has triggered the introduction of new powerful supply-side constraints in2012, which may cause waiting times to increase for the coming years.