No change in medical referrals (Updated)

The policy of the Dutch Government remains unchanged: residents of Bonaire, St. Eustatius and Saba in need of specialist medical care will keep being referred to hospitals in Guadeloupe and Colombia.

Dutch Minister of Public Health, Wellbeing and Sports Edith Schippers sees no reason to reconsider the choices that were made in the past for the medical referral of patients of the Caribbean Netherlands, she stated in a recent letter to the Second Chamber of the Dutch Parliament. The minister based her decision on an elaborate study carried out by an independent professional research bureau Sigil from Panama.

The report “Benchmarking of International Rates of a Sample of Medical Procedures,” a scan of the level of health care in countries surrounding the Caribbean Netherlands, was compiled on the request of the Dutch Ministry of Public Health, Wellbeing and Sports VWS and the health care facilitating company Coomeva. Guadeloupe CHU hospital and five hospitals in Colombia were among the fourteen medical institutions that cooperated with the study. Eight other hospitals that complied with the request to provide information on their services and performance were two hospitals from Puerto Rico, two from the Dominican Republic, two from Costa Rica, as well as the hospital in Aruba and Curaçao.

Schippers explained that a total of 36 hospitals had been contacted. Despite the recommendation letter of the VWS Ministry that was sent, none of the five hospitals in the United States were willing to cooperate, and neither were a number of medical institutions in Trinidad and Tobago, Barbados, Panama and the Dominican Republic. The St. Maarten Medical Center (SMMC) did not appear on the list of contacted hospitals.

The minister gave several reasons for the low response. The absence of incentives to be transparent on vital business information because the small size of the Caribbean Netherlands population which made it less interesting as a potential growth market. The limited interest to do business with the Dutch Government, as well as the general adversity of companies to make vital information on for example their indicators and tariffs public.

The study looked at five indicators of the hospitals and their care: presence of international care facilities, availability and capacity of a number of medical specialisations that are interesting for patients of the Caribbean Netherlands, diagnostic possibilities and accreditations. The tariffs of ten different groups of treatment were compared.

The fourteen hospitals met, on average, 86 per cent of the international services parameters. The institutions had an average of 288 beds and serve medium to high complexity cases. Of the 14 hospitals, eight have international certifications and five have international recognition.

According to Schippers, the study gave a global view of the level of availability of specialist care, the presence of a specific international department and which hospitals were exceptionally and unnecessarily expensive. Hospitals that scored well in terms of a larger infrastructure and good management for the care of international health programmes were: the Santa Fe de Bogota, Health Clinic Americas and Children’s Heart Foundation in Colombia, the HIMA San Pablo and PRESBY in Puerto Rico, General Health Plaza in the Dominican Republic and the Clinica Biblica in Costa Rica.

Member of the Second Chamber of the Dutch Parliament Ronald van Raak of the Socialist Party (SP) suggested referring patients to Cuba at a debate with Minister of Home Affairs and Kingdom Relations Ronald Plasterk on Wednesday. “Cuba has excellent health care. Why not send patients especially of St. Eustatius and Saba there instead of the more expensive Colombia,” Van Raak said. Plasterk said he was not aware of Cuba’s excellent health care, but promised to bring it to the attention of his colleague Schippers.

Source: The Daily Herald.

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Published May 20, 2015:

Bonaire.nu reports that, in the future, residents of Bonaire, St. Eustatius and Saba will still have to Colombia or Guadeloupe for specialist care. Minister Edith Schippers of Public Health wrote this based on an assessment of care in other countries. This investigation was performed at the request of the Second Chamber.

“Based on this study, I see no reason to reconsider the choices made for the countries where patients from the Caribbean Netherlands are referred to today,” said Schippers. The quality and the cost of care of fourteen hospitals was compared. Besides Sehos on Curacao and the HOH in Aruba, five hospitals in Colombia, two in Costa Rica, two in the Dominican Republic, two from Puerto Rico and one in Guadeloupe were considered. They were compared, inter alia, in areas of available specialties, possibilities for diagnostics, accreditation and the associated costs.

A total of 36 hospitals were invited to cooperate, but despite a recommendation letter from the Ministry of Health, 22 hospitals did not provide information, including all reputable hospitals in the United States. According to Schippers, there may be are several reasons for this, such as not interested in doing business with the Netherlands, reluctance to share sensitive business information and especially the fact that the number of inhabitants and therefore the number of potential patients is rather small. Despite this disappointing response, the information obtained is considered sufficient to make a decision on the practical collaboration, says Schippers.

The investigation into the hospitals was conducted by the Panamanian research organization, Sigil, which was chosen because it had no connections with any of the hospitals nor the countries where these were located.