That appears from an investigation by the General Audit Chamber to the test policy in the period up to June 1.
There had been media reports before that laboratories had left some of their testing capacity unused during that period. The Court now confirms this. However, the independent regulator notes that the overcapacity was exaggerated and was ‘partly apparent’, mainly because many laboratories had made too optimistic estimates about the supplies of diagnostic materials. As a result, the Court cannot determine exactly how much capacity has remained unused.
There are several explanations for the problems with testing policy in the first period of the crisis, the report shows. Soon after the outbreak of the pandemic, supplies from international manufacturers of diagnostic materials stopped. What made the situation in the Netherlands more difficult was the decentralized organization of the healthcare system. There was hardly a central overview.
‘The laboratory landscape is fragmented,’ the Court of Audit concludes. ‘The laboratories use a multitude of test systems and associated materials, each with different and varying delivery problems.’
The GGDs also had their own approach per region. The prescriptions were interpreted differently, making the testing policy in one region more stringent than in another, which regularly led to conflicts with general practitioners and company doctors. ‘There is no uniformity at the GGDs’, according to the Court of Audit.
A switch
At the slightest setback, the testing policy in the Netherlands came under pressure. Only one link in the chain had to go wrong or the system crashed. This could be because no cotton swabs were supplied or because a GGD had a shortage of personnel. The Court of Auditors speaks of ‘a structural problem’.
Due to the threat of shortages and the lack of insight into the national capacity, the OMT quickly decided to switch to a ‘minimum testing policy’. According to the Court of Audit, this decision was taken without interference from the Ministry of Health (VWS).
Paradoxically, the choice for a restrained testing policy resulted in suppliers supplying less to the Netherlands. Countries with a broader testing policy were given priority.
Grip
The Minister of Health, Welfare and Sport took several actions to get a grip on the testing policy. For example, a National Coordination Structure for Test Capacity was set up to gain insight into the capacity. There was also more coordination between laboratories and GGDs. To this end, a new central administrative system had to be set up, including a new ICT system.
Following in the footsteps of other countries, the Netherlands also started to purchase test materials nationally at the end of March. That was the only way to be competitive.
The Court of Audit does not come up with any new recommendations, even though the government’s testing policy is now more than ever under fire due to the lack of capacity. Some of the problems from the early days are still there. For example, deliveries by foreign manufacturers are still difficult.
Test question
Estimating the test question also remains a problem. In recent weeks, the cabinet has been attacked by a huge influx. In the early days, the opposite happened: fewer people came than expected.
This was partly because insufficient account had been taken of the disappearance of regular care. The test demand from that corner therefore declined sharply. In addition, some target groups were tested less than expected, so that part of the capacity remained unused.
It is clear that many infections went unnoticed in healthcare in the period up to June. Once the testing policy was expanded in April, the number of positive tests among healthcare workers immediately rose by 70 percent. The increase was only 34 percent for people outside of healthcare. ‘This doubling is a signal that healthcare workers with an infection have been missed relatively much due to the restrictive testing policy’, the Court of Audit concludes.
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