|Implemented in this survey?|
Aiming at overcoming workforce shortages in the health sector by new functions and educational programs, the government of Netherlands has adopted a policy to improve the functioning of the health care labour market. Issued in 2002, the policy seeks to differentiate and reallocate tasks between the medical, nursing and paramedical professions.
Some of the basic responsibilities that physician assistants assume in hospital practice are 24-hour first assistant coverage for the daily and emergent operating schedule; evaluating patients in the emergency department for traumatic and surgical problems; performing history and physical evaluations; conducting daily patient rounds; evaluating changes in a patient's condition; issuing orders for medications, treatments, and laboratory tests; and writing discharge summaries. Hospitals may hire PAs to function as house staff for surgical or medical departments, in emergency departments, or in intensive care units.
to prevent/decrease shortages by new functions and educational programs
health care employers, medical specialists and GP?s, nursing professions, peri- and paramedical professions, patients, health-insurance companies, etc.
|Medienpräsenz||sehr gering||sehr hoch|
Aim of the policy was to differentiate and reallocate the tasks between professions in healthcare in order to deminish the problems of shortages. The introduction of the PA is one of these
Locals (hospitals, med. spec, nurses) took the initiative, but the government (i.c. the Ministry of Health) supports and promotes the idea's
For the qualification and education of the PA there are European rules (Bologna Agreement).
as to the legislation and the financial consequences
|Implemented in this survey?|
The ideas were generated by international contacts; the idea of P.A. was imported from the U.S.
As mentioned above, local hospitals, and the professional associations of medical specialists and nurses took the initiative. The government (i.c. the Ministry of Health) supports and promotes these initiatives.
At this moment there is little opposition. Because of the prognosed shortages of GPs and medical specialists there is much appreciation.
There is however evidence that the medical specialists and GPs will give more attention to this issue when there come more initiatives and when a discussion is needed about the financing of this functions and the tariffs.
There is commitment with the idea by several hospitals.
At this moment the legislation and regulation of professions in healthcare is in a process of evaluation. The tendency is that new legislation is needed in order to regulate these new professions,
the idea is that regulation must be sober.
There is an initiative of the National Board of Public Health and Health Care (a statuary advisory body towards the government) for discussion and policymaking on behalf of differentiation and reallocation of task between professions in healthcare. This not only implies the nurse practioner and the P.A., but all the professions in Dutch health care.
Many parties will be involved in this adaptation process: the unions of medical specialists, GPs, the employers, the educational centres, the health insurance org. etc.
Financing is needed in order to cover the costs of experiments and to cover the structural costs of the education of the PA's.
The government stimulates this development with financial support and promotion.
There is much consistency with the national health policy and particular the national manpower program for healthcare.
The policy is expected to achieve its objectives. The effects on costs are positive: lower costs and more production. There are no contra indications for loss on quality of medical services.
The development of the function and education of the nurse practitioner is rather far. At this moment there are differences in the qualification of nurse practitioners.
Initiatives at this moment has to do with uniforming the education and qualification of nurse practitioners.
The introduction of the P.A. is yet at an early stage. Only in one big city (Utrecht) there is an education for cardiacchirurg. PA.s. A second initiative is starting elsewhere in the country (the Nijmegen/Arnhem area) to develop PA's for a broader scope of services.
There are no regulations and rules for both professions yet, however, legislation is in preparation.
In 2002 there was a growth of almost 20% in the number of students for nursing professions.
In the period of 2000-2001 there was a growth of employment in health care of 2,2% a year, the same percentage expected for 2002. In 2001 the total number of persons employed in healthcare was 859.600 (employees in nursing professions: 312.100; general practitioners: 7.932; medical specialists: 13.300).
In 2002 the universities increased the number of students admitted to start the study of medicine.
Han van Dijk