Schippers:”Health care on islands is always fragile”

Edith Schippers (48), number 2 on the slate of the conservative VVD party, would love to continue as Minister of Public Health, Wellbeing and Sports in a next Dutch cabinet. She has already done a lot to improve health care on Bonaire, St. Eustatius and Saba, but there is more work to be done. “Health care on an island is always fragile. Not all care is available. Basic care is limited. But it has to be in order. Not only basic care but also when acute care is needed. Health care is a top priority for me. Together we have to organise this well,” said Schippers in an interview with The Daily Herald. She feels responsible for health care on the islands and wants to finish the process of improvement that she has started.

Health care on Bonaire, St. Eustatius and Saba did not have an easy start after they became part of The Netherlands as ‘public entities’ on October 10, 2010. Dutch Government and Schippers were bombarded with complaints about the procedure of medical evacuations, dispensing of medication and the strict regulations. People complained that under the old system when the islands were still part of the Netherlands Antilles, medical referrals and evacuations were easier, quicker. with patients having more choices where they wanted to be treated. There were daily stories of ill patients who had trouble getting off their island because of bureaucracy and logistic issues and people wrote numerous angry letters to the local newspapers.

Furthermore, people were upset that they could not get their usual medication but that they had to accept a generic brand. And, they complained about the local health care office. What good did the new direct relation bring? The people openly asked. Especially for St. Eustatius and Saba, quick access to good hospitals and specialists abroad is essential because they have very limited facilities on-island.

The Second Chamber of Dutch Parliament got involved. Having heard of the complaints of the islands, they started to raise questions and asked in debates if and what the Minister was doing to remedy the situation. Schippers and her civil servants got to work to tackle the issues, seeking practical solutions more than 9,000km away.

No easy task

Organising health care on the islands is no easy task, according to Schippers. Health care is delicate and the stakes are high. She said she was proud of what had been achieved so far. “We have worked very hard. I haven’t done this by myself but together with a committed team.” Civil servants from the Ministry went to the islands to find out all ins and outs of the issues and to see how they could be solved, she said. “We still have intensive contact with the islands. We monitor how things are going, try to keep a fast pace and solve the issues as they come up because it is in the interest of the people there,” she said.

According to Schippers, major improvements were realised. Investments were made in the local medical centres on Saba and St. Eustatius and the emergency departments upgraded. A medical evacuation helicopter was arranged and lighting was installed for the helipad on Saba. The hospital on Bonaire was renovated and the services expanded.

[…]

In principle patients are referred to the nearest hospital in the Kingdom. Where possible, patients from St. Eustatius and Saba are referred to the St. Maarten Medical Centre (SMMC). The Minister was in attendance when the agreement was signed between Fundacion Mariadahl and SMMC during her visit in April this year to extend the cooperation with AMC and VUmc to the St. Maarten Medical Centre.

SMMC issues

There are still some issues with the landing of the helicopter with ill patients from St. Eustatius and Saba at SMMC. The expansion at SMMC which includes the construction of a helipad still has to kick off. For Schippers, having good landing facilities at SMMC is a matter of major importance. “It can be a matter of life and death. I have discussed this with St. Maarten and I am confident that it will be solved,” she said. Schippers did not want to go into the other problems at SMMC. “That is not my authority. It is up to SMMC and St. Maarten to sort this out. Our intention is to cooperate, but it has to be achievable from their side. The issues have to be solved quickly because a proper functioning hospital in St. Maarten is also in the interest of the people of St. Eustatius and Saba.”

As the situation at the Curaçao hospital is not optimal, the referral of patients to that hospital is kept at a minimum.

[…]

Improvement was made atthe health care offices on the islands. “There were some communication issues. Getting used to each other took some time,” admitted the Minister. People had to get used to the new medical referral and evacuation regulations, and the way medicine was dispersed, she added. Possibilities via so-called tele-medicine whereby doctors abroad can assist local doctors in treating patients are promising, said Schippers. The islands have new ambulances. Addict care has improved drastically on St. Eustatius. The Minister expressed great appreciation for the two persons involved in that project.

Abortion

Women now have the possibility to abort an unwanted pregnancy at the Bonaire hospital. “I find it important that women in distress can do an abortion out of their own free will and within the legal parameters whether they live on one of the Frisian islands or in The Caribbean Netherlands. It is not something that we force on women. It is their choice.” Schippers has discussed the possibilities of performing abortions on St. Maarten with her colleague on St. Maarten Minister Cornelius de Weever.

“St. Maarten recognises the issues. But as long as it is not legally possible there, women will have to travel to Bonaire.”

People on Bonaire, St. Eustatius and Saba may expect The Netherlands to arrange good health care for them. And that is one of the reasons why Schippers aspires a second term as Minister of Public Health, Wellbeing and Sports. “Of course I would like to stay on. When I took on this job I said yes more than two years. But first people have to go and vote. It would be arrogant to claim my spot beforehand.” Schippers urged people on the islands to vote in the Parliamentary elections on September 12. “The opportunity to let your voice be heard is lost if you don’t participate.” She called on people to see what they consider important and make sure that they are part of the discussion.

Source: “The Daily Herald” 2012-09-10