Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example

IntroductionIn many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years.Case descriptionSince 1970, the Dutch government has explored different approaches to determine the inflow in medical schools. In 2000, a simulation model for health workforce planning was developed to estimate the required and available capacity of health professionals in the Netherlands. In this paper, this model is explained, using the Dutch general practitioners as an example. After the different steps in the model are clarified, it is shown how elements can be added to arrive at different versions of the model, or ‘scenarios’. A comparison is made of the results of different scenarios for different years. In addition, the subsequent stakeholder decision-making process is considered.Discussion and evaluationDiscussion of this paper shows that workforce planning in the Netherlands is a complex modelling task, which is sensitive to different developments influencing the balance between supply and demand. It seems plausible that workforce planning has resulted in a balance between supply and demand of general practitioners. Still, it remains important that the modelling process is accepted by the different stakeholders. Besides calculating the balance between supply and demand, there needs to be an agreement between the stakeholders to implement the advised training inflow.The Dutch simulation model was evaluated using six criteria to be met by models suitable for policy objectives. This model meets these criteria, as it is a comprehensive and parsimonious model that can include all relevant factors.ConclusionOver the last decade, health workforce planning in the Netherlands has become an accepted instrument for calculating the required supply of health professionals on a regular basis. One of the strengths of the Dutch model is that it can be used for different types of medical and allied health professionals. A weakness is that the model is not yet fully capable of including substitutions between different medical professions to plan from a skill-mix perspective. Several improvements remain possible.

[1]  Martin Smits,et al.  Improving Manpower Planning in Health Care , 2010, Bled eConference.

[2]  Marco C. de Witte,et al.  Underemployment in the Netherlands: How the Dutch `Poldermodel' Failed to Close the Education-Jobs Gap , 2001 .

[3]  F. Don,et al.  Models and methods for economic policy: 60 years of evolution at CPB * , 2006 .

[4]  S. Stordeur,et al.  Physician supply forecast: better than peering in a crystal ball? , 2009, Human resources for health.

[5]  M. Intriligator,et al.  Health manpower planning: an econometric approach. , 1972, Health services research.

[6]  D. Livingstone The Education-Jobs Gap: Underemployment Or Economic Democracy? , 1998 .

[7]  W. Wiegand : The System of Professions: An Essay on the Division of Expert Labor , 1990 .

[8]  G. Dussault,et al.  Migration of health personnel in the WHO European Region. , 2009 .

[9]  M. Laurant,et al.  An overview of patients' preference for, and satisfaction with, care provided by general practitioners and nurse practitioners. , 2008, Journal of clinical nursing.

[10]  A. Tarlov,et al.  Health Manpower Planning , 1983, Springer Netherlands.

[11]  L O'Brien-Pallas,et al.  Forecasting models for human resources in health care. , 2001, Journal of advanced nursing.

[12]  Gerald Tan,et al.  The Future of Capitalism: How Today's Economic Forces Shape Tomorrow's World , 1998 .

[13]  P. Sloane,et al.  Overeducation and Ethnic Minorities in Britain , 2002, SSRN Electronic Journal.

[14]  Mike Allen,et al.  Manpower Planning in the National Health Service , 1981 .

[15]  R. Scherpbier,et al.  An approach to estimating human resource requirements to achieve the Millennium Development Goals. , 2005, Health policy and planning.

[16]  W. Palm,et al.  Health Professional Mobility and Health Systems - Evidence from 17 European Countries. , 2011 .

[17]  L. Calman,et al.  Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles. OECD Health Working Papers, No. 17. , 2005 .

[18]  H. Gravelle,et al.  National survey of job satisfaction and retirement intentions among general practitioners in England , 2003, BMJ : British Medical Journal.

[19]  Herbert L. Smith Overeducation and Underemployment: An Agnostic Review. , 1986 .

[20]  M. D. Dal Poz,et al.  Imbalance in the health workforce , 2004, Human resources for health.

[21]  M. J. Berg,et al.  Workload in general practice , 2010 .

[22]  M. Willemsen,et al.  De arts van straks , 2002 .

[23]  A. Hasan,et al.  Organisation for Economic Co-operation and Development , 2007 .

[24]  M. Pollmann-Schult,et al.  Overeducation and human capital endowments , 2004 .

[25]  Debbie Singh,et al.  From staff-mix to skill-mix and beyond: towards a systemic approach to health workforce management , 2009, Human resources for health.

[26]  H. Fineberg,et al.  Health professionals for a new century: transforming education to strengthen health systems in an interdependent world , 2010, The Lancet.