Schippers: “Healthcare at Dutch level is unrealistic”

Steadily developing better healthcare for the people of Bonaire, St. Eustatius and Saba is imperative to Dutch Minister of Public Health, Wellbeing and Sports Edith Schippers. However, she was also realistic: the level of healthcare in the Caribbean Netherlands can never be the same as in the Netherlands due to their insular character and small populations. “Healthcare was in very bad shape when the islands became part of the Netherlands in 2010. It was a situation that nobody should want in the Kingdom,” said Schippers in a debate in the Second Chamber of the Dutch Parliament on Thursday. Minister of Home Affairs and Kingdom Relations Ronald Plasterk was also present at the meeting. Schippers admitted that the calculations that were set at that time to improve healthcare were “unrealistic,” and that the cost of 3,700 euros per person was high, but that the investment had been necessary. “It is indeed a high amount, but a lot had to be built.”
Despite the immense amount of work that has been done and the improved healthcare services over the past few years, one should realise that the level of healthcare on the islands can’t ever be the same as in the Netherlands, also because it is impossible to have an academic hospital equipped with all sorts of specialists on a small island, she said. “We automatically have another level on the islands due to the local situation,” she said, specifically mentioning Statia and Saba, where patients have to be flown off island in a helicopter for specialist care. The minister said that because it was hard to realise a full-fledged, second-line healthcare system (specialist care), it was important to organise the first-line care (medical practitioners) as best as was possible. Referring patients abroad will always remain necessary, which is no easy operation, she said.

The Dutch government wants to send patients of the Caribbean Netherlands to hospitals that are close to home. However, she stressed, the hospitals on the nearby islands, St. Maarten for Statia and Saba, and Curaçao for Bonaire, have to be well-equipped and be able to offer care at an acceptable level, stated Schippers. The minister said she would like to see the cooperation between the St. Maarten Medical Center (SMMC) and the Amsterdam VUmc and AMC academic hospitals resumed. She explained that the specialists from these Amsterdam hospitals had worked at SMMC in the past, but that they had gone after “frictions” within SMMC. “I hope that the existing cooperation between Bonaire, VUmc and AMC can be extended to St. Maarten, because that would benefit everyone.”

The Curaçao hospital is a different story. The Dutch government stopped the referral of patients from the Caribbean Netherlands to the Sint Elisabeth Hospital Sehos because the level of care offered at the facility was deemed substandard and not in order quality-wise. Schippers said that multiple efforts had been made to help improve the quality at Sehos, but that it didn’t work out. Curaçao was even offered assistance in the area of healthcare policy. Schippers said that as long as the basic healthcare at Sehos was not up to par, she would not “take the risk” of referring patients there. “We will refer patients to nearby hospitals when we can. I am not sending a patient to Colombia if that is unnecessary, but quality comes first,” she said, adding that she didn’t have a say in healthcare affairs on Curaçao as the responsibility in this area lies with the autonomous country.

The importance of more cooperation within the Kingdom where it came to healthcare for the people of the Caribbean Netherlands was brought up by Member of the Second Chamber Roelof van Laar of the Labour Party PvdA, at whose request the meeting about healthcare in the Caribbean Netherlands was held. Van Laar also pointed out that it was important to invest in preventive healthcare by making sure that people, and especially children, on the islands had access to affordable fruits and vegetables and that people had healthy eating habits. Exercise is also an important factor in adopting a healthy lifestyle, which leads to healthier people and lower healthcare expenses.
Schippers committed to diligently keep working on better healthcare for the people in the Caribbean Netherlands. “I plan to steadily keep building, bring up the level in the broad sense, together with the local governments, which have a good sight on what is happening, so that one day we can say that healthcare is now at an acceptable level,” she said.
On the agenda of Thursday’s meeting were two reports on healthcare in the Dutch Caribbean: the trend report by the FWG bureau, released earlier this year, and the report of the healthcare committee chaired by former Governor of the Netherlands and Curaçao Frits Goedgedrag.
The FWG report listed various shortcomings in the healthcare level on all six Dutch Caribbean islands and included several recommendations. Cooperation between the healthcare institutes on the different islands and between the islands is imperative, according to the report. Cooperation will benefit the level of healthcare in general. The report recommended concentrating the specialist areas per island, whereby one island would offer specialist care in one specific area instead of spreading this over the different islands.
Both the FWG and the Goedgedrag Committee pointed out the important role of SMMC for neighbouring islands Statia and Saba. The Goedgedrag Committee recommended referring patients to SMMC as much as possible, and also French-side hospital Louis Fleming, and not to refer to Guadeloupe and Martinique.