I spoke to my youngest’s preschool teacher this week. A young, warm, passionate woman, fond of children and children love her. Over the past few months, the sparkle disappeared from her eyes. Cause: She can’t do what she wants to do. In the playgroup, it should offer high-quality pre-school and early childhood education for the relatively large proportion of ‘target group children’ who need extra attention due to language or other disadvantages. She also crafts Father’s and Mother’s Day gifts, changes diapers, posts photos on the parent-child portal and fills out extensive reports. She must be everything to everyone.
She has to solve the big problems of society. But her colleagues left despondent, got sick or have Covid, and the replacements are sweet but new. And now she can’t be everything to everyone anymore.
In the Netherlands we are used to top quality. We don’t expect otherwise. We live in one of the richest, safest, cleanest, healthiest and best organized countries in the world. Most often heard when something unexpectedly goes wrong: ‘That this is possible. In the Netherlands’. In 2021 we should not ask ourselves how we can further increase the quality in our country, but how on earth we can get rid of that high place in the world rankings.
Because what threatens our playgroup is not that less quality is delivered. What threatens is that nothing will be delivered at all in the near future. What threatens is that our good lady will leave, for an administrative position, or something else where she does not have the daily feeling of falling short.
This happens throughout the Netherlands. Everywhere young, passionate nurses, pedagogical staff, teachers and police officers leave what once was their dream job, disappointed. Take the track. The train is not running due to a lack of traffic controllers. ProRail wants to attract higher vocational education graduates from a top-quality program where less than 1 percent pass. Which then burned out after a few years due to lack of colleagues.
Top quality, diplomas, target figures, quality registration, accreditations – they form an increasingly heavy roof that leans on fewer and fewer pillars. And when the remaining pillars cannot support the roof, those pillars are reprimanded. A nursing home doctor who was given responsibility for 400 nursing home residents after her colleagues left was sentenced by the medical disciplinary committee the accusation that she should not have continued to work in such an irresponsible situation. She should have dropped the roof on the floor.
But even in times of growing staff shortages, disciplinary committees continue to chastise and inspect inspectors. Is everyone BIG registered? Do they have their certificates in order? Have they been to refresher courses? Have they completed all electronic patient records? Are all pages of the emergency report complete? Are the medicines prepared with four eyes?
I think you can swear in the church when it’s about to collapse. I argue for more insecurity and less quality. I advocate trains crashing every now and then. More unauthorized personnel. More medical misses. It will be hard for all of us – yes, also for the preschool teacher, nurse and air traffic controller who have worked hard for their diplomas and are proud of the quality they can normally deliver. But there is no other way. Because at the moment our hyperexcellent system is coming to an end as a whole.
It is better to have a train accident once every few years than no train. Rather an unauthorized but loving substitute for the class than take the class home. Rather have hip surgery with an unregistered OR assistant than no hip surgery. Rather a non-Dutch speaking nurse who recently fled than an occupied bed in the emergency room due to lack of space in the nursing home. Anything better than locking up the emergency room, followed by the hospital, followed by the whole country. Anything better than letting even more people die by further delaying our super care.
We cannot be everything to everyone.
Rosanne Hertzberger is a microbiologist.
A version of this article also appeared in NRC Handelsblad on 20 November 2021
A version of this article also appeared in NRC in the morning of November 20, 2021
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