Dutch State Secretary of Public Health, Welfare and Sport Maarten van Rooijen deeply regrets the recent death of two patients in St. Eustatius, and announced a general investigation into the state of healthcare in the Caribbean Netherlands. And there will be a pilot for St. Eustatius and Saba to have automatic referrals for certain medical specialists.
“I find it awful that two patients came to die in such a short period of time. This must have had an immense impact on the close-knit Statia community,” stated Van Rooijen on Thursday in response to written questions submitted by Members of the Second Chamber of the Dutch Parliament Jorien Wuite and Wieke Paulusma, both of the Democratic Party D66.
The two Members of Parliament (MPs) sought clarity following media reports about the level of healthcare in St. Eustatius, the death of two patients and the medical referral system, which in the case of the two patients in St. Eustatius, was unable to prevent their deaths.
“With regard to the first death case, I can imagine that residents wonder whether the doctors of St. Eustatius Health Care Foundation (SEHCF) and the insurance office of the Ministry of Public Health, Welfare and Sport VWS handled the situation adequately,” stated Van Rooijen.
According to the state secretary, the assumptions in the media that medical mistakes were made cannot be confirmed as yet, as the cases are still under investigation. “In conformity with procedures of the Inspection Healthcare and Youth IGJ, SEHCF has initiated a calamity investigation.”
However, the concerns expressed in the media reports are sufficient reason for the state secretary to have consultations with the involved healthcare institutions to discuss the events and to make sure that healthcare in St. Eustatius is improved, Van Rooijen stated.
As for a general qualification of the level of healthcare, including medical referrals, provided in St. Eustatius and the rest of the Caribbean Netherlands, the state secretary said he found accessibility and quality “sufficient to good.”
Aside from MPs Wuite and Paulusma, two other MPs, Roelien Kamminga and Jacqueline van den Hil, both of the liberal democratic VVD party, had sought clarity via written questions about healthcare and medical referrals in St. Eustatius.
In replying to the questions by Kamminga and Van den Hil, Van Rooijen acknowledged that there was room for improvement. “There are backlogs in a number of areas and not everywhere the level of healthcare is the same as in the Netherlands. At the same time, the discussions surrounding the medical referrals with regard to the recent deaths in St. Eustatius make clear that improvements are necessary in the execution of the referral process,” he stated.
The state secretary announced a general investigation into the state of healthcare in the Caribbean Netherlands, whereby the results that have been accomplished since 2010 will be looked into. There will be special attention for the manner in which healthcare functions, the improvements desired and requirements to approach a Dutch level of supply and quality, he said.
In his reply to a question by MPs Wuite and Paulusma, Van Rooijen explained that the health insurance office ZVK of Care and Youth Caribbean Netherlands ZJCN handles between 6,000 and 8,000 medical referrals annually. Also, during the COVID-19 period, medical referrals continued, he added. In 2020, 40 complaints were filed against ZVK/ZJCN. There are bottlenecks that need to be solved, the state secretary admitted. In the past year, several steps were taken to improve the regular medical referrals. In October 2021, the medical specialists of SEHCF in St. Eustatius and the ZJCN made an agreement about the quality of referrals. For 2022, priority is being given to the medical referral process.
The state secretary further announced that possibilities to permit medical referrals without a process “for certain specialties” would be looked into. He did not state which specialist care, but said there would be a pilot for St. Eustatius and Saba.
The state secretary explained the protocols and procedures for medical referrals in his extensive reply to the written questions. A referral request is filed at ZJCN in case a doctor in Bonaire, St. Eustatius or Saba concludes that a patient requires specialist insured care which is not available on-island. The doctor indicates the level of urgency.
The medical advisors (doctors) at ZJCN assess and decide, for regular medical referrals, whether the referral request complies with the requirements of the Caribbean Netherlands health insurance law. The doctor receives a reply with substantiation in case the referral is denied.
When the referral case is approved, the staff of ZJCN further handle the medical referral and plan the appointment and the associated logistics of the flight, accommodation, transport, polymerase chain reaction (PCR) test and daily allowance. They also maintain contact with the insured person.
With regard to medical evacuations, ZJCN has made agreements with National Helicopters (Medevac) for St. Eustatius and Saba, and the Air Ambulance in Bonaire. Both services are available 24/7. In the case of the Medevac in St. Eustatius and Saba, permission is asked beforehand, but if this proves not possible, permission can also be granted afterwards.
The Daily Herald.