The association of local house doctors, the GPs, lost in court just recently, a case they had lodged against AZV. The good doctors decided to work one hour less per day because AZV had cut their pay, once, then again after review. The judge decided the GPs have to work their normal hours even though they get less money!

Incidentally, they returned to work full time on May 1st.

In legal terms, national arguments won, over individual interests/needs.

As you remember AZV was obliged to cut 60M annually from its total budget, and it also targeted the GPs.

Not cool, we really would like to be able pay our health-practitioners well.

In response to the cuts a special committee was set up in order to present the Minister of Health with options, making health care more efficient instead of just eliminating services. The report made several suggestions.

I don’t know where the report got stuck, but I know for a fact that it was handed in, to MinTvs, who then questioned the qualification of Dutch report overseer.

Your typical local accredited physician goes to school for 12 years, and sets up a practice, an independent business, with personnel, a receptionist and a coffee machine in the waiting room. As it stands, the amount paid by AZV for such a production only goes so far.

Their colleague in Bonaire and in the Netherlands are much better compensated.

Consequently, I hear, a number of Aruba’s family physicians will be packing their statoscopes and leaving. They have been exposed to chronic under-funding for years and cannot take it anymore. That 14.28% cut on revenues is the straw that broke the camel’s back, because it came on top the 5.5% reduction. The doctors report they earn one third less than their counterparts in Europe and have no room for pensions, disability savings, or sickness insurance, just more work and more responsibilities for about 1,300 patients each.

The majority of Aruba’s GPs are Dutch educated, Dutch accredited, and BIG registered which means they may use the legally protected title(s) of their profession. All allied medical care professionals who are BIG registered, doctors, dentists, clinical technologist, midwives, nurses, physician assistants and dental hygienists may carry out procedures, and practice their profession independently, even when they have a foreign diploma; They can also begin specialist training in their professional field; and are subject to Dutch disciplinary law.

The BIG registry insures quality and up-to-date proficiency, it is a very demanding and well-regulated registry.

Recently the ARUBIG was introduced here, it was an election-promise by MinTvs. The AruBig will make it possible for regionally educated new doctors to practice medicine in Aruba skipping the Dutch accreditation.

At the moment just 4 regional schools have been approved, but in the future probably more will be recognized.

When questioned about the fact that many locals fail in their academic pursuits in the Netherlands, MinFec replied that enrolling locals in regional schools increases their chances to graduate. Go regional, she advised, as the key to success.


Because regional school are not as demanding as Dutch ones.

So as the Dutch educated GPs leave, our public health will be entrusted to graduates of two Costa Rican med schools and two Colombian med schools, all with a good reputation, but they ain’t Dutch.

This argument is controversial.

Locals who can, apply at Dutch higher education institutes.

And those who have an issue with the language or with the admission requirements go to regional schools.

The local Dutch educated elite repeatedly says the level of care will be negatively affected, as ARUBIG takes over from the BIG Registry.

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May 28, 2021
Rona Coster