GGD’s that are difficult to scale up, testing capacity that is insufficient and confusion about who’s actually in charge of managing the coronacrisis. Two former GGD directors and a crisis expert are saddened by the way in which control of the pandemic is divided among far too many agencies.
“We live in a polder country. Everyone is responsible, so no one is responsible”, says Laurent de Vries, former director of GGD Netherlands. According to him, at least the Minister of Public Health should quickly be given more authority.
Former GGD director Richard Janssen calls it “irresponsible that the minister is in fact not talking about the GGDs while they are performing such a crucial task in this crisis”. According to crisis expert Gert-Jan Ludden, we cannot leave fighting the crisis to the 25 security regions. “Then there’s a huge risk of confusion.”
Minister of Justice as crisis manager
What about now? Who is responsible for national crisis management? Not Minister Hugo de Jonge of Public Health, whom we always see at press conferences, but Minister Ferd Grapperhaus of Justice. He is not only responsible for compliance with the corona guidelines, but also directs the 25 security regions, where mayors are in charge.
Those mayors, in turn, are in charge of the 25 GGDs who have a crucial responsibility during this pandemic. They have to carry out hundreds of thousands of tests and are also responsible for the large-scale source and contact research. If we don’t have that in order, according to the cabinet, it will be difficult to prevent a second wave.
According to the Public Health Act, De Jonge does have a leading role as Minister of Public Health. But over the past few months, while he continued to demand that the GGDs be scaled up, it became clear that he has no grip on that process. This is because, according to the law, he has no administrative responsibility for it and therefore no authority.
It’s a polder monstrosity’
De Jonge also mentions it in a letter he sent to the Chamber this week. “From a legal point of view there is no question of central control from the Ministry of Health, Welfare and Sport or from GGD Netherlands at the regional GGDs. They are, in case of combating an A disease, under the direction of the chairmen of the safety regions”
That is a serious weaving error in the law, says former GGD director Laurent de Vries. “Then you get that on Tuesday the minister says: we’re going to do more source and contact research and on Thursday the Municipal Health Centres of Amsterdam and Rotterdam say: we’ll do things differently anyway
As far as he is concerned, during a pandemic, there should be one main leader who is directly in charge and directly responsible for the administration. “Now there are too many parties, too many directors, too much polders. It’s a polder monstrosity.”
Crisis expert Gert-Jan Ludden also calls the role played by the 25 security regions during the corona crisis a weaving error. “They are intended for regional disaster relief and they function perfectly well there. But they are much less suitable for such a long-lasting crisis as a pandemic.”
Meanwhile, the GGDs are struggling with having to scale up at lightning speed. It makes the effect of earlier cuts painfully clear, says De Vries. He explains that as of 2008, a national and regional decision has been taken to bring the threat of a pandemic to a ‘pilot light’ level. This prompted the municipalities to make eager cuts in the Municipal Health Centres (GGDs).
According to De Vries, a number of GGDs sounded the alarm in 2013 because they were already below the ‘pilot light level’, but nothing was done with that warning. “A GGD director nowadays is a general without an army. Then it’s damn hard to scale up to a spitting volcano.”
Sjaak de Gouw, GGD director of the Hollands Midden region, always speaks on behalf of all GGD’s, giving citizens the false impression that he is the liaison officer between the minister and all GGD’s. “De Gouw is part of the Outbreak Management Team, but in the end he’s not about it but about the municipalities,” says Richard Janssen, who himself was the head of a regional GGD for many years.
Lost control after the summer
The direction in the corona crisis has completely disappeared, the three men agree on that. According to Ludden, the last press conference before the summer holidays, on 24 June, plays an important role in this. “Since then, we’ve completely lost our grip.”
He continues: “Relaxations were announced and scaled down. The Hague thus relinquished the urgency. Also because the national coordination was moved to the security regions. After the summer, they completely lost control of that.”
According to Janssen, you can clearly see at the test street at Schiphol Airport that there’s a lack of control. “We actually think we should be able to test at Schiphol 24/7. But now the test street closes at 18.00 hours, and that’s because we have placed the responsibility with the municipalities. While this calls for a national approach”