Doctors wary of Ireland following footsteps of Dutch healthcare system

THE Dutch model of healthcare touted by the Government as a viable alternative to our existing two-tier system has reduced waiting lists in the Netherlands, but health costs have doubled.

In addition, patients can wait up to a week to see a family doctor and consultations are regularly limited to 10 minutes of the doctor’s time.

The creaks appearing in the five-year-old Dutch model were outlined to delegates attending the annual general meeting of the Irish Medical Organisation (IMO) in Killarney yesterday.

Dr Wim Heres, a GP in the Netherlands, said: “I would like to spend more time with my patients but to do so would see my income fall... We have less than 10 minutes to spend with the average patient. We hardly do any social visits we spend so much time on quality-related issues.”

Although the system provided greater equity — health insurance is now mandatory under the Dutch universal healthcare model — he said it was less patient-centred and while the patient could “always get what you need, you can’t always get what you want”.

Dr HF van der Velden, a senior health policy analyst at the Federation of Dutch Labour Unions, cautioned against introducing the model to Ireland because it was developed “very much as a response to Dutch problems”.

He said the insurance market in Ireland was quite different to the Netherlands where everyone had health insurance prior to the introduction of the new model in 2006.

Also, while the Netherlands had a two-tier system comprising a mixture of social health insurance and private health insurance, there was a single system of delivery. In Ireland there are two delivery systems: public and private.

The number of insurers operating under the new Dutch model has decreased from more than 30 when it was introduced, to four or five currently, Dr van der Velden said.

If competition did not result in more cost efficiencies, then the Government may limit services, he said. “I think such a system won’t work [in Ireland],” he said. The cost of delivering healthcare had risen from €10 billion in 2000 to €23bn.

Lisa Matassa, a native of Youghal, Co Cork, living in Leiden in the Netherlands, said she was “very pro the Dutch healthcare system”.

The mother-of-two pays an annual premium of €1,454, for which she gets unlimited GP access, free hospital stays and free access to certain paramedical specialities as well as midwifery care. All childcare costs are free up to the age of 18. A midwife remained with Lisa for a week after the home birth of her second child.

However Lisa said she could see problems emerging in the Dutch system. Some patients have to wait a week to see a GP because of increased healthcare consumption and that the cost has gone up €150 per patient per year, with a worry over who is going to bridge the gap.