How Edith steered the ship

Edith Schippers has been minister of public health, welfare and sport since 2010. Her term of office comes to an end this year. Hugo de Jonge will follow in her footsteps from 2018 onwards. Now our question is: did Schippers achieve her healthcare-related goals in the past eight years?
 
On the 30th of September in 2010, the VVD and CDA reached a government agreement. Their plans were set out in a document. In this document the healthcare goals were mostly about the quality and the cost of care. Also, there were imminent staff shortages at the time that had to be addressed. Two years later, in 2012, the VDD and PvdA formed a new government. They still wanted to improve the quality of care and reduce the costs. In this government agreement the third priority concerns the promotion of collaboration between healthcare providers.
 
Quality of care is the degree to which healthcare services for individuals and populations increase the likelihood of desired outcomes and are consistent with current professional knowledge. Quality of care is, among other things, related to the affordability, accessibility, effectiveness, timeliness, and patient centeredness of care. Therefore it is important to maintain high quality of care. The ‘Zorgbalans’ of 2014 showed that the quality of care in The Netherlands is above average. The quality indicators demonstrated favorable developments. An example was the decrease of mortality in dutch hospitals. However, not all developments were positive. There were big differences in medical care between different healthcare providers, which led to diversity in the quality of care. Another negative development was the consequence of the high work pressure in nursing homes. Clients in nursing homes experience that nurses have lack of time and attention for them. As said before, this was already an issue in 2010 because of the staff shortages. These two problems are still items on the agenda.
 
As mentioned earlier quality depends on the affordability. In order to maintain the quality of care, it is important that continuous innovation takes place. In 2010, Schippers concluded that innovation in the Netherlands was slower than in other countries. More money was necessary to close the gap with other countries. The government could not fund the innovations entirely. Therefore, Schippers suggested that the private sector had to be introduced to healthcare. For that reason a regulated profit distribution had to be initiated. Because of this development more capital for care was available. Innovation, quality improvements and better patient logistics were possible and this improved the quality of healthcare.
 
Another way how Schippers wanted to ensure affordability was to manage the basic healthcare insurance more strictly. This is a package with treatments that are insured for everyone. Admission of innovation to the basic insurance is less ambiguous, more coherent and more consistent. Outdated treatment methods have been removed from the basic healthcare insurance package and treatments that differ from guidelines require prior consent from the healthcare provider. This reduces the risk of unnecessary treatments and that results in a reduction of costs.
 
Although minister Schippers did well on cost reduction, she also was subjected to a lot of criticism. For example the public award she received from ‘Big Brother Awards’ for her parliamentary bill which proposed that health insurers would have the right to look into patients’ medical files. According to ‘Big Brother Awards’, the patient confidentiality would be at risk. On the other hand, a lot of people say that Schippers was very successful in her work, because she was the first to constrain the costs of healthcare.
 
All together Schippers achieved most of her goals, but there is always room for improvement.
 
 
Written by: Ilze van Herten & Britt Ketelaars
Published: 30 October 2017

SHARE is the Faculty Association of the study ‘Health Policy and Management’ at the Erasmus University Rotterdam.

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