Dutch and St. Maarten authorities are looking to add a nephrologist, neurologist, orthopaedist and urologist, who also would provide service for residents of St. Eustatius and Saba. The Dutch Ministry of Public Health, Wellbeing and Sports VWS is involved because of its responsibility for residents of the latter two islands as they are part of the Netherlands. Schippers said she wanted to treat St. Eustatius and Saba patients as close to home as possible.
The expansion by three to four specialists at SMMC depends on the approval of the St. Maarten Government, Schippers told Parliament's Permanent Committee for Kingdom Relations. Members of Parliament (MPs) asked the Minister to secure more cooperation between hospitals within the Kingdom. This would reduce the number of referrals of patients in Bonaire, St. Eustatius and Saba to hospitals abroad in Colombia and Guadeloupe.
Treating patients closer to home is not only more cost-effective, but also better for the patients, who don't have to travel too far to receive medical care, said MP Ineke van Gent of the green left party GroenLinks.
A team of Dutch medical specialists of Academic Medical Center (AMC) and Free University Medical Center VUMC in the Netherlands visited St. Maarten last week for talks with SMMC management and specialists. SMMC Human Resource/Communications Manager Juli�tte Hassell said the meeting had gone "very well."
The team of Dutch medical specialists, who arrived in St. Maarten last week Tuesday and left over the weekend, included a neurologist, urologist, nephrologist and an orthopaedic specialist, among others.
Other MPs shared similar sentiments. "Sabans and Statians are best served with good specialist care in St. Maarten," said Jeroen Recourt of the Labour Party PvdA.
"Facilities at SMMC should be made more use of," said Kees van der Staaij of the reformed SGP party, who made a case for "practical solutions to practical problems."
Schippers agreed. She said she was in favour of referring patients to SMMC where possible, but added that it would be unwise not to make use of the high level and cheap medical care in Colombia. "The quality of health care in Colombia is excellent. It is at European level, if not higher, and at one third of the cost," she said.
The Minister said she foresaw an increase in the number of referrals to Colombia this year because of the declining level of health care at Cura�ao's St. Elisabeth Hospital Sehos. "Medical care in Cura�ao is deteriorating at a rapid pace. Cura�ao has to get things in order. They have to adjust the downwards spiral," she said. She stressed that Cura�ao was an autonomous country and that it was its responsibility to do so. She didn't mention the level of care at the Guadeloupe hospital.
Schippers provided numbers of referrals abroad during Monday's meeting. In 2011, there were some 7,000 in Bonaire, and 4,500 in St. Eustatius and Saba combined. The majority of patients in St. Eustatius and Saba were referred to St. Maarten and St. Martin.
Specialist care at Bonaire's hospital has been expanded in seven areas, in cooperation with the AMC and VUMC hospitals from Amsterdam. The cost of health care for the three islands was 50 million euros in 2011, and 40 million euros has been made available for 2012.
The Minister said the cooperation with SMMC and St. Maarten was "intensive." However, not all health care can be provided in St. Maarten and that is why it remains important to maintain an alternative, which is Colombia and Guadeloupe. She announced that she would be visiting the islands late March.
MP Ronald van Raak of the Socialist Party (SP) criticised the high monthly fee for permanent helicopter medical evacuation service from St. Maarten to St. Eustatius and Saba. "We pay US $16,000 per month, also when it doesn't fly," he said.
Schippers announced that this cost might go down in the future, as the Coast Guard had expressed interest in making use of the helicopter. She promised that this would be discussed with the Ministry of Defence before May 1. She explained that the helicopter service was in addition to medical evacuations via the regular Winair flights.
The high cost of medication in St. Eustatius also was raised during Monday's meeting. Schippers said her policy was to reduce the cost of medication on all three islands and that this had been successful so far, with the exception of St. Eustatius. She explained that the pharmacies in St. Eustatius were independent facilities.
MP Van Raak said St. Eustatius "refused" to purchase cheaper medication via SMMC. MP Erica Lucassen of the Party for Freedom PVV questioned the high cost of medication in St. Eustatius and urged the Minister to look into the possibilities of making use of SMMC's offer to deliver medication at a lower price.
In the meantime, Hassell said it was SMMC's strategic objective to establish a relationship with a large hospital to help guarantee and maintain continued quality care. Alluding to the nephrologist, who will be based here, Hassell said there were a number patients suffering from kidney diseases in Saba, Statia and in particular St. Maarten, and the services of such a specialist would be a positive development for dialysis care.
A nephrologist visited SMMC last year for two weeks on invitation of Dr. Theo Jolles. There were a lot of positive reactions from the dialysis patients to the advice given by that specialist.
"The specialists from both Dutch hospitals had a chance to see for themselves the level of service that SMMC currently offers. They also had the opportunity to speak with the local specialists and exchange ideas how best to introduce new specialties or increase the level of specialities currently provided. In addition the discussions included training," Hassell said about last week's visit.
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