SINT MAARTEN/THE NETHERLANDS – Nearly half of hospitals are in poor financial health, putting reforms to care for the ageing population and replace outdated buildings into doubt.

The latest annual review by accountancy firm BDO gave 35 of the 60 general hospitals a “satisfactory” rating for their financial performance, down from 55 a year ago.

The firm also warned that half of hospitals made a return of less than 1% in 2023, leaving them without the resources to invest in personnel, equipment and infrastructure.

The warning comes a week after the government outlined plans to cut €252 million from the health ministry’s annual budget, though much of the savings will come from cutting subsidies for sports clubs and access to healthcare for non-residents.

Health minister Fleur Agema has also been under fire for her handling of the situation at the Zuyderland hospital in Heerlen, Limburg, which wants to abolish its emergency department because of a shortage of personnel.

BDO warned that the tight margins hospitals are operating on left them with no scope to carry out the plans set out in the integral healthcare agreement drawn up two years ago by the previous government.

Keeping healthcare affordable

The agreement aims to keep healthcare affordable by reforming care for elderly people, with an emphasis on prevention and arranging more care through family doctors and relatives, leaving hospitals to deal with acute situations.

BDO said the funding model currently discourages hospitals from promoting preventive measures because they are paid for every operation and medical procedure they carry out, whereas the reforms are aimed at reducing demand.

“As hospitals become better at delivering personalised care, it eats deeper into their financial results,” the agency said in its report.

The hospitals’ association NVZ also said the way insurers finance the healthcare system needed to be reviewed. It argued that hospitals’ funding should be based on what facilities they provide, such as the number of beds, rather than how many operations they carry out.

Chairman Ad Melkert said: “It is important that hospitals have a financial perspective again and know what the future holds.

“What we need are fixed budgets for acute healthcare, contracts for multiple years and more collective purchasing by insurers.”

(DutchNews)

SINT MAARTEN/THE NETHERLANDS – Three clinics specialising in the treatment of Long Covid will open their doors on November 1 at teaching hospitals in Rotterdam, Amsterdam and Maastricht.

Family doctors can refer patients, many of whom have struggled with Covid-related symptoms for the last four years, from that date.

Some 1.3 million people still suffered from the consequences of an infection with the virus after three months. Over half have recovered but some 450,000 people are still limited in their daily activities while 100,000 are almost entirely incapacitated, experts say.

The initial intake focuses on people who have had symptoms for longer than a year, have lost at least 25% of their normal ability to function and who don’t have other illnesses that might explain their symptoms.

The hospitals hope to be able to treat 500 to 1,000 patients in the first months, coordinator and chairman of the Post Covid expertise team Léon van den Toorn told the AD.

“That is a fraction of the total but we hope that others profit from what we learn in the clinics,” he said.

The clinics will register symptoms using questionnaires and patients will be given the same medical examinations, after which the most appropriate treatment can be chosen, Van den Toorn said.

Patients with extreme tiredness, for example, can be given naltrexone, which has been shown to help but whose effects have not been properly monitored. “We will do that here so we can give considered advice on its use,” lung specialist Merel Hellemons told the paper.

All the treatments on offer are experimental, Hellemons said, but have been shown to mitigate symptoms. By making all post covid patients take the same medical route, doctors hope to find treatments which will help large groups of them and, eventually, find a cure.

“We are far from finding a cure but we are now putting the pieces of the puzzle together. If we find that even four or five of the treatments may work we will be very happy,” Van den Toorn said.

Other hospitals are expected to open their own post Covid clinics in the following months.

(DutchNews)

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SINT MAARTEN/THE NETHERLANDS – A 78-year-old man has appeared in court accused of killing his wife by putting tape over her mouth and holding her nose after she allegedly asked to die.

Harry van S. was arrested in June when his 72-year-old wife was found dead at their home in Delft.

A judge in The Hague rejected a request from his lawyers to release Van S., who has spent the last four months on remand, from prison pending his trial.

“It appears that you actively took steps that contributed to the death of your wife,” the judge said. “That is a serious offence whatever form it takes.”

Van S. said he was fulfilling the “express wish” of his wife, but the prosecution said there were “no solid indications that she wanted to die on the day in question.”

Even if it were proved that she had a sincere wish to die, Van S. was still guilty of an offence because he was not authorised to assist her. “As a citizen you are not allowed to decide when it is someone’s time to die,” the prosecution said.

Euthanasia is permitted in the Netherlands, but it must be carried out by a doctor under strict conditions and every case is examined afterwards by the prosecution service.

(DutchNews)