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The Dutch model of health human resources planning and the new challenges of an integrative European perspective.

Batenburg, R. The Dutch model of health human resources planning and the new challenges of an integrative European perspective. European Journal of Public Health: 2013, 23(Suppl. 1), p. 82. Abstract. 6th European Public Health Conference: Health in Europe: are we there yet? Learning from the past, building the future. 13-16 November 2013, Brussel.
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Background: Compared to other countries, The Netherlands has an extended system of health workforce planning. An advanced demand-led forecasting model is developed to support periodical policy decisions on the inflow in medical and specialist training. Of equal importance is the stakeholder system that involves different actors in defining scenarios and a number of healthcare developments that are modelled. The Dutch system of health workforce planning has some weaknesses and limitations, too. Methods: The Dutch ‘technical’ and policy model of health workforce planning is described and illustrated for a number of medical occupations and their related study/training. With this description we demonstrate the principles and design decisions that have been made throughout its period of development and extension, especially since 1999. A number of limitations and weaknesses are then defined, on both the operational, tactical and strategic level of the Dutch planning system. Results: The Dutch model of health workforce planning is strong in enabling centralised decisions for different medical occupations that are politically supported by different stakeholders; achieving consensus in the Dutch ‘polder’ tradition. Several developments put the model and its design decisions under pressure, however. Medical occupations tend to become ‘stovepipes’ within the occupation system, due to professional forces of specialisations. At the same time, tasks are shifting between health occupations, between echelons and between health organisations, due to costs pressures, efficiency and technological developments. This implies the model and the policy systems embedding it needs to adapt to these changes, in particular to support (and even force) integrated health human resources planning. Key messages: Developed as an advanced model of forecasting, the Dutch health workforce planning needs to adapt to support the future need for integrated planning across occupations and healthcare sectors.