Dutch patients travel to Spain for orthopaedic surgery

BMJ 2001; 322 doi: (Published 30 June 2001) Cite this as: BMJ 2001;322:1565
  1. Tony Sheldon
  1. Utrecht

    Dutch patients are now travelling to Spain for orthopaedic surgery, courtesy of their insurance companies, to avoid long queues at home.

    Ten Dutch patients last week flew home to the Netherlands after receiving orthopaedic surgery for knee conditions using spare beds in a Spanish hospital. The scheme was organised by two orthopaedic surgeons from the Rode Kruis Hospital in The Hague.

    The Dutch medical team, including the surgeons and a physiotherapist, travelled with their patients, whose health insurance company, Delta Lloyd, agreed to fund the scheme within their existing health cover. A similar scheme for hip and knee operations is planned for August.

    The patients had to wait between one and three months for treatment. Normal waiting times for a total knee operation at The Hague hospital, posted on the website of the Dutch Hospitals Association (, are currently 32 weeks. This is partly due to a lack of specialist operating theatre assistants.

    Some other hospitals in the Netherlands also have long waiting times for total knee surgery, ranging from 32 weeks to up to a year. The orthopaedic patients' organisation said that the picture is variable but the combination of shortages in bed capacity and insufficient nursing and operating theatre staff often result in longer waiting times.

    Another Dutch health insurer, the Agis group, also has contracts to use spare capacity in German and Belgian hospitals.

    The Dutch consumers' organisation, the Consumentenbond, wants to see health insurers being forced to provide a service to patients within a specified time. It has tried to set a legal precedent by taking legal action against Agis to make it provide care for three patients who have already waited several months for treatment. It was forced to drop its action, however, when it was announced that the three patients were to receive care, in the Netherlands, in Germany, and in Belgium.

    A report commissioned by the Dutch government last year concluded that waiting times were “unacceptably long” and that the number of people on waiting lists for hospital treatment had increased by 2% to 148600 in the previous year (BMJ 2000;321:530).


    Mrs Onbelet returning to Holland after her knee operation in Spain


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