More local and home-based care is central to health reforms

Patients should be much more involved in organising their own healthcare needs and more services should be carried out at a local level, health minister Edith Schippers says in an interview with website nu.nl on Wednesday.


The minister is due to debate her department’s spending plans with MPs later in the day.
This approach will ‘mean a totally different approach to organising healthcare’, the minister said. ‘You have to be rigorous about what you can do [in terms of healthcare] at home and make sure you do it,’ the minister said.
Care people cannot organise at home should largely be provided in the immediate locality. ‘This means that simple care will be taken away from hospitals, which are too expensive,’ she said.
Hospital closures
These measures will not be without pain and some medical specialists will lose their jobs as hospitals become more selective about the treatments they offer, she said, reaffirming earlier standpoints. Some hospitals will also disappear because they are not good enough.
Such steps are unavoidable in order to temper the tremendous rise in healthcare costs, she argued.
Next year, health insurers will no longer be compensated if they over-run their budgets and hospitals will be allowed to determine the cost of 70% of treatments. Currently 65% of hospital prices are fixed by the government.
Waste
Meanwhile, research by the Dutch patients’ association shows unopened medicine costing hundreds of millions of euros is thrown away in the Netherlands every year.
In addition, patients referred to a specialist by their family doctor often receive the same examination and treatment, which is a waste of money, the organisation says. Instead, specialists should be urged to check what procedures have already been carried out.
There is also considerable waste in the use of medical aids. ‘We have heard stories about wheelchairs being given to people who don’t use them, mobility scooters which are not returned after the patient has died, and other useless aids being repeatedly prescribed,’ a spokesman told the Telegraaf.
In the Netherlands, health insurance is provided by private companies but the government determines what should be included in the basic care package. Insurers can then offer extra treatment in top-up policies.

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