A quarter of Dutch hospitals are not experienced enough to carry out some operations for cancer, leaving patients at risk of post-operative bleeding, unremoved cancer cells and even death, the AD reports.

The paper, which publishes an annual hospital top 100, analysed hospital operation figures for eight types of cancer for which a minimum number of operations is required to ensure a sufficient skill levels.

The AD found that 419 cancer patients were operated on in hospitals which fell below one or more norms and had too little experience in the type of operation involved.

Seven hospitals did not have enough expertise to carry out bladder cancer operations and five fell short on the number for prostate cancer. In 2017 174 patients had a prostate cancer operation at hospitals which fell below the minimum of 50 operations a year. 120 bladder cancer patients were operated on in hospitals which carried out fewer than 20 of the annual number required.

The paper said patients are much better off if they go to hospitals with more experienced surgeons. For prostate cancer patients, for instance, the risk of irreversible incontinence is cut by 30% if the operation is performed in a hospital which carries out over 100 prostate removals.

‘The survival rate for patients operated on in a hospital with experienced surgeons is 40% higher, an enormous bonus,’ said Wim Schellekens, fomer health inspection chief and initiator of the norms.

Reasons

The eighteen hospitals cited by the AD offered different explanations, from falling just below the norm because of the planning of operations around holidays, to patients that could not be moved to another hospital because of their condition.

Nine hospitals realised they would not be carrying out the required number of operations and either stopped doing the operation or entered into some form of cooperation with a specialised hospital.

It is not easy to sanction underperforming hospitals, health minister Bruno Bruins said in a reaction, because hospitals cannot ‘simply and quickly take on each other’s patients and the matter is very complex’.

Magreeth Fernhout of the health inspection service told the paper hospitals that don’t achieve the norm will only be sanctioned if they underperform for three years in a row, during which improvements must be made. ‘In practice sanctions are never necessary,’ she said.