Doctors have criticised a recommendation by the Dutch care authority NZa to drop the 45-minute norm for emergency help to save money on underused hospital emergency departments.

By law, everyone should be no further away than 45 minutes from an accident and emergency department but the regulation is now obsolete, the NZa said in an evalution of the future of acute medical care in the Netherlands.

Ambulances are now far better equipped to handle emergency care compared to 2002, the NZa said, and that means patients can travel longer distances. In addition, underused emergency departments, which have to remain open and staffed but whose services are only required some ten times a day, can close.

This would remove a barrier to efficient care, the NZa said, and prevent the waste of scarce resources, both financial and in terms of staff.

However David Baden, chairman of the A&E doctors association, said the NZa is ‘only looking at a paper reality’. ‘Emergency care is a relatively cheap way of treating large numbers of patients. It is more efficient to treat people in their own hospitals where doctors know your medical file,’ he told the Volkskrant.

The recommendation, which is expected to be adopted by health minister Ernst Kuipers, will have financial consequences for the 82 hospitals with an emergency department.

Baden said the NZa is approaching the  problems facing emergency care from the wrong angle. ‘The problem is not that it’s quiet in some places but that others are overly busy. That will not change by closing down a few emergency care departments,’ he told the paper.