Rutte at medtech in Leeuwarden

It is important for politicians to take time to experience what is happening on the work floor and in the market. After being introduced to FHI in the previous edition of Signalement, I went Arno Rutte, member of parliament on behalf of the VVD, on a working visit to two FHI companies in his own region, the north of the country.

First a visit was made to the company Entermed, specialized in ENT treatment units and systems for administering medical gases. Rutte then went there together with his faction employee and FHI member Kees Groeneveld Dantuma, supplier of medical devices. Both companies based in Leeuwarden are represented on the board of the FHI sector for Medical Technology, in the persons of Jan Steven van Wingerden and Oscar the Goods. A great opportunity to immediately discuss a number of industry-wide issues.

Using two examples, Martin Pos from Entermed showed Rutte how difficult it can be to get simple innovations accepted in a hospital. Both with the release of medicinal gases and with an innovation that makes blood vessels visible when taking blood samples, the low-hanging fruit improvement is not seen. Investing in technology that rules out errors is difficult because it is contrary to professional honor within healthcare to admit that simple actions go wrong (see also the article “Thirty years of worry because it is 'low interest'”, in Advisory no. 1 of February 2016, ed.). An eye-opener for Rutte. “We must tackle such matters jointly with the provider of the technology, together with the professional associations in healthcare and health insurers.” He sees a problem. “A pilot is often easy to organize, but scaling up remains a problem. It also has to do with a care attitude that is not sufficiently broadly oriented. We can certainly do something with this in the public healthcare debate.”

Investing in the ENT treatment units, which Entermed continuously develops and sells in 46 countries, also appears to be difficult for Dutch hospitals. According to Pos, hospitals behave in a risk-averse manner, focusing mainly on patient safety and much less on efficiency and Total Cost of Ownership. Private ENT practices appear to recognize this importance more quickly than large healthcare institutions. During the visit to Dantuma, the orthopedic craftsmanship was impressive. The technology to measure the correct support stockings or insoles for each patient on an individual basis is at a high level, both in terms of craftsmanship and in terms of the new digital technology to analyze foot movements. Dantuma supplies complete packages of medical devices, including for stoma and diabetes, together with parent company Mathot, the Haarlem company of Oscar de Goederen that took over the family business in Leeuwarden in April 2016. Necessary economies of scale were the reason for the merger and that was also what the discussion was about. Efficiency versus market power is the issue. “There are now actually four major health insurers left. This means that as a supplier you hardly have the opportunity to discuss, let alone refuse, matters that they want to impose on you contractually. When it comes to allowing certain products, this can inhibit innovation. This has now led to a concentration of suppliers. For many products this is now only a limited number.”

Arno Rutte, who worked for a health insurer before he became a politician, honestly admitted that he had not considered that the situation for aid suppliers is so complex. “It is not healthy if parties in the market are so condemned to each other. I will take that with me.” De Goederen also shared his experiences in the lobby for transmural projects. Patient organizations, medical specialists, hospitals, suppliers and health insurers can jointly innovate and streamline complete care lines. “We are committed to this as an industry,” says Oscar (see also the article in Signalment number 2 2016, about the care for apnea patients by FHI member Total Care together with a pulmonologist and the Red Cross Hospital in Beverwijk, ed.) . “We work together with patient organizations, ministry working groups and health insurers on 'good contracting practices' for medical aids.  

Text: Kees Groeneveld / Images: Henk Tukker