Health Care
Prevention
There are several ways in which the Netherlands seeks to prevent illness and disease or to detect them at an early stage. Vaccination programmes against diphtheria, whooping cough, tetanus and polio reach almost all young children between the ages of 0 and 4. For other high-risk groups, general practitioners are pivotal in staving off illnesses such as influenza. Countering the spread of infectious diseases is the job of municipalities, as part of their responsibility for protecting the public and for local public health care. Measures to safeguard food and consumer products follow EU Directives, and the Health Protection, Commodities and Veterinary Health Inspectorate monitors compliance with them. No form of screening that incurs risks for participants may be carried out in the Netherlands without a licence. Screening for breast and cervical cancer occurs nationwide, with methods and target groups selected on the basis of a scientific
Care
At the "entrance" to curative somatic care stands the general practitioner. As soon as you get settled in you will need to start looking for a family doctor (huisarts). He will be the first one you call whenever you have any medical questions or you need help. Only when the GP is unable to arrive at a diagnosis, or is unable or unwilling to provide the necessary treatment, will he or she refer the patient to a specialist or paramedic. Plans exist to give GPs a similar "gatekeeper’s" role within mental health care. But GPs have many other tasks and responsibilities: coordinating the treatment of patients who are seeing one or more specialists; delivering preventive programmes; prescribing medicine effectively. In case of an emergency, call the national emergency number 112. Here they will enquire whether you need an ambulance, the police or the fire department and will connect you with the correct department.
Prescription drugs are filled at a pharmacy (apotheek). The drugstore (drogisterij) does not carry prescription drugs but handles over-the-counter remedies. Alternative medicines such as acupuncture and homeopathy are also very popular in the Netherlands. Homeopathic medicines can be bought at either an apotheek or a drogisterij.
Drugs
The Ministry of Health, Welfare and Sport plays an important role, together with the Ministry of Justice, in making policy on drugs. This is a logical partnership, as the main objective of this policy is to prevent drug use and to limit the risks associated with it.
A distinction is made between soft drugs (cannabis products) and hard drugs (e.g. heroin, cocaine and synthetic drugs), based on the different health risks. For the Ministry of Justice, the war on international drug trafficking has the highest priority. Efforts to counter the possession of small quantities of soft drugs for private use have a lower priority. On these grounds, the "coffee shops" that sell hashish and marijuana are "tolerated". That is to say that persons selling soft drugs, although such sales constitute an offence, are not prosecuted under criminal law. This approach has been adopted to prevent users of soft drugs coming into contact with hard drugs. Coffee shops are checked and closed down if they violate the strict rules under which they operate.
The number of persons addicted to hard drugs is 1.7 out of every 1,000 inhabitants in the Netherlands. This figure is lower than in most other Western countries. Methadone supply programmes, for instance, encourage drug addicts to rehabilitate and improve their social situation. Thanks to needle exchange programmes, the number of intravenous drug users as a percentage of HIV patients is relatively low in the Netherlands (10.5%). The number of drug-related deaths in the Netherlands is the lowest in Europe, as emerged from a study performed by the European Monitoring Centre for Drugs and Drug Addiction in Lisbon. One development that has been causing considerable concern in recent years is the rise of new synthetic drugs. Firm criminal-law action is being taken to counter the production and use of these hard drugs and practical health care measures have been introduced.
The cooperation between the criminal justice authorities and care agencies is excellent, as is that with international bodies engaged in the fight against drug trafficking. The factors that make the Netherlands such an ideal place for legal trade are unfortunately equally advantageous for trade in illicit products. Security has been enhanced at the port of Rotterdam with the introduction of effective scanners, and the same technology will shortly be introduced at the port of Amsterdam and Schiphol airport.
Insurance
Aside from preventive programmes and the promotion of good health, care is also crucial to public health. In the Netherlands this care is provided by a large range of organisations and professionals operating under private law. Each pursue their own policies within parameters defined by central government, quality and accessibility being the main aims. Quality is regulated in several Acts of Parliament governing professionals, care institutions, the relationship between care provider and patient, and the forced hospitalisation of persons unable to give their informed consent. Statutes and regulations governing patient and client participation also contribute to the quality of care. Professional care providers bear responsibility for setting up and monitoring their own quality systems. The Health Care Inspectorate supervises this process.
Accessibility is not only about ensuring the proper geographical spread of provision, but also about financial accessibility. Essential care must be affordable for everyone. Several statutory insurance schemes exist to safeguard this. For long-term care and nursing, the Netherlands has a compulsory insurance scheme to which everyone makes an income-linked contribution.
There are various sorts of insurance covering hospital care, GP consultations and paramedical care. People with an income below a certain amount (some 60% of the population) are compulsorily insured with the Health Insurance Fund (Ziekenfonds). The government determines the cover provided and the income-linked contribution. Everyone else has to take out private insurance. Private insurance companies set their own premiums, generally based on the risk of illness.
