The money is getting less. The demand for care is not.

Crisp and clear it is. The message from the new coalition agreement. Healthcare will face even more cuts in the coming years. Less room to invest, while the social task remains as great as ever. For many people, this feels like extra pressure on a system that is already under strain. In this article I examine what happens if we continue to make plans in times of scarcity. Or what will change if we really dare to organize differently.

In conversations I have with healthcare professionals, I notice something twofold. On the one hand, frustration: how are we going to do this with even fewer resources? On the other hand, something else: continuing in the same way is now no longer an option anyway! So where my previous article was about where the energy in healthcare is leaking away, here I want to focus even more on what happens when the financial space gets smaller. Because then one question remains: how do we organize the work so that it remains sustainable?

When planning is no longer enough

What I often see (including in other industries) when pressure mounts is an understandable reflex. Which sounds something like this: ‘Now we really need to start making good plans. Set up programs. Adjust structures.’ That feels like that keeps you in control. But in practice, I hear (healthcare) professionals say otherwise:

“A lot happens, but it doesn’t make my day any brighter.”

No offense. The intent is good, but the execution simply isn’t. Because yes, the pressure shifts. But does not disappear. Consultations remain (or become more), alignment remains complex and decisions remain stuck. Not because people don’t want to, but because we are trying to find new answers within a way of working that already squeaks and creaks. My prediction: that will make this cut painfully visible.

What scarcity exposes in healthcare industry

Less financial space exposes something that was often already there. Something that can be put this way: the biggest gain is not in what we add, but in how we organize the existing. And I’m not talking so much about small optimizations, but more of a conscious strategic choice.

We really don’t need to explain to healthcare organizations where the problem lies. They have known that for a long time. But that knowledge is not to be found in reports, but in daily work. In teams that experience where time leaks away. In consultations that cost a lot and produce little. In tasks that have been ‘added’ without stopping other things. Those insights are there. They just rarely end up where strategic choices are made.

Space is created not by adding, but by choosing

This is precisely where the opportunity lies. Not to plan even smarter, but to explicitly treat organizing differently as a strategic theme. That means making choices. Not wanting everything at once. Not facilitating everything. But determining together what really adds value to the primary care process.

In projects where we work with this, it often starts small. For example, by examining existing consultation structures. Why are we sitting here? What really needs to be decided here? And what could be done better at another time or not at all?

From talking about work to working on the task

What happens then is often surprising. Fragmented moments of consultation are merged into focused work sessions. No more talking about work, but working together on concrete tasks, within the time and resources that are already available. The effect is felt immediately. Not because people work harder, but because unnecessary complexity disappears. That looks something like this:

less reconciliation afterwards
clearer decision-making
more peace and focus in team
less noise between staff, management and shop floor

Start organizing differently tomorrow in response to scarcity

Scarcity does not call for panic or rigorous intervention. It requires focus. To have the guts to no longer see organizing differently as an improvement project, but as a prerequisite for sustaining it. That can start tomorrow. With one consultation. One team. One choice not to do something anymore. My concluding question to you is therefore this:

Where do you hold on to how things have always been done, when circumstances call for organizing differently? I would love to hear from you.