Members of the Executive Council Governor Jonathan Johnson (second left), Bruce Zagers (right) and Rolando Wilson (left) with chairperson of the Permanent Committee for Kingdom Relations of the Dutch Parliament’s Second Chamber Mariëlle Paul in a meeting with the parliamentary delegation on May 2.
SABA--The Executive Council has submitted a letter to the Dutch Parliament in which it expressed serious concerns about the deficient curative healthcare for Saba residents. Saba is calling for direly-needed changes to the healthcare system to ensure good curative care for the people. The two recent deaths of patients in St. Eustatius underscore this need.
“As you know, our neighbouring island Statia was shaken in recent weeks by the unforeseen death of two residents. These events have a huge impact on all those directly involved, on Statia’s general population, and also affected the people in Saba,” it was stated in the letter to the members of the First and Second Chambers who visited Saba on Monday, May 2. The Executive and Island Councils also brought up the healthcare issues in the meeting with the parliamentary delegation.
In the letter to the Parliament, the Executive Council stated that it was pleased that a number of members of parliament (MPs), including Jorien Wuite of the centre-democrat Party D66 and Roelien Kamminga of the conservative VVD party, had submitted written questions about the recent events, the accessibility of curative special care and the Caribbean Netherlands healthcare system in general.
“The Public Entity Saba regularly highlighted concerns regarding the provision, accessibility, continuity and the quality of healthcare. So far, we have experienced little response. The recent sad events have led to a sense of urgency.
“We expect that the investigations of both incidents in Statia will lead to recommendations for all stakeholders. The public entity Saba wishes to emphasise that this moment should be used to make the necessary and sustainable changes to ensure the best possible curative care for the Statia and Saba inhabitants.”
In the letter, the Executive Council also addressed a number of pressing issues with regard to the curative healthcare profile and services, (temporary) uninsured residents and medical referrals.
The public entity Saba has intensified consultations with the Ministry of Public Health, Welfare and Sport VWS to discuss the challenges.
The many challenges include the availability of care on the island, the accessibility of off-island specialist care, the follow-up of medical referrals, the conditions of medical transport, communication by the Health Insurance Office ZVK, the availability of correct information for patients and medical professionals, the possibility of a second opinion, the right to a companion during travels for medical treatment abroad, the content of the insurance package and the availability of population screening programmes.
The issue of being uninsured under the ZVK when persons move to Saba for work or other reasons requires urgent addressing. It was explained in the letter that health-insurance registration can only take place when the person is registered at the Civil Registry, which in turn can only take place when a person has received a residence permit.
The residence-permit process by the Immigration and Naturalisation Department (IND) can take up to several months, a period during which the resident is uninsured through ZVK.
Unlike in the Netherlands, Saba has no access to a special fund to which a healthcare organisation can turn when a person is uninsured and cannot pay the bill. In recent months, the public entity Saba has guaranteed and paid bills for necessary care and off-island transportation of a patient who resettled in Saba.
The local government is further questioning the use of the ZVK medical advisor as the one who ultimately approves the medical referral, as this can contribute to delays in the medical-referral process.
It is generally felt that patients need medical assistance abroad in a timely manner and the logistics surrounding medical referrals should run smoothly. Having decisions take place at the ZVK back office in Bonaire instead of at Saba’s ZVK office as before is not beneficial to patients. Saba wants the authority of medical referrals, including the handling of appointments, restored to the local ZVK office.
