Barend van Lieshout: Innovation slow-pokes are endangering healthcare

The Thuisapotheek (pharmacy on wheels) has been closed, another example of how big umbrella organisations strangle any attempt to innovate the healthcare sector, says Barend van Lieshout.

The Thuisapotheek had some 30,000 satisfied customers, people who are chronically ill and whose repeat prescriptions were brought to their doorstep. Throughout its six years’ existence, the company faced the dogged opposition of pharmacists’ union KNMP. As early as 2003, TNT CEO Peter Bakker, when asked by the health minister to examine the logistics of healthcare, said the added value of brick-and-mortar pharmacies was decreasing. This is especially true for chronically ill patients who know about their medication, don’t need the pharmacist’s explanation every time they fill their repeat prescriptions and who may also find the restrictions of pharmacy opening hours restrictive. Today, nine years later, it seems that the Thuisapotheek came onto the market too early: healthcare innovations take an average of 17 years to take root.
The axe has come down on the Thuisapotheek but it could just as easily have been an ambitious family doctor, an offshore radiologist or a distance diagnostician. It’s not easy to launch new healthcare initiatives. Patients are conservative when it comes to change, referrals are few and far between and insurers prefer to watch from the sidelines to see how things develop. On top of this, the healthcare innovator will have to see if the complex rules and regulations allow for a profitable business model for his ambitious plans.
Is it bad that innovation has been so slow to materialise? Yes, it’s very bad indeed. We will only be able to cope with exploding healthcare costs if we give innovation a chance. You would expect the big umbrella organisations of Dutch professionals and institutions to support and nurture innovation. Nothing could be further from the truth. The umbrella organisations of family doctors, pharmacists, medical specialists, obstetricians (the list goes on) harbour the last of the grumbling curmudgeons who are digging their heels in, sabotaging every attempt at meaningful change. And because these organisations are governed the way they are this innovation resistant bunch determines policy. Healthcare umbrella organisations are powerful in the Netherlands and it seems that the country will have to grind to a halt for a few years before even the slowest of white-coated pill makers realises that it may just possibly be time for a new direction.
Too late
The umbrella organisations not only have power, they also bear a great responsibility. They should actively look for new initiatives, help innovators and explain to the slow-pokes in their ranks that tomorrow will be too late. Which among these organisations will be clever enough to understand that innovation is not the same as asking the government for money for the next marginal change?
Barend van Lieshout is a care advisor at Rebel

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