Dutch heart patient has London operation

After waiting more than eight months a Dutch patient has received a heart bypass operation in London, paid for on the orders of a court in the Hague. The court overruled national Dutch guidelines that only patients considered as emergencies can have treatment paid for abroad.

The court ordered that the patient's operation should be paid for in London within two weeks. It did not rule that the patient's case was an emergency but that there was a medical necessity caused by the delay and that no alternative was available in the Netherlands in the time set.

Heart surgeons estimate that there are 450 patients waiting for more than three months for routine heart surgery. Waiting times for non-urgent surgery vary from six weeks to a year in the 14 national heart centres, and referring cardiologists are being urged to reconsider traditional referral routes. Last year the government announced money for an extra 650 heart operations during 1995 and 1996 in an attempt to cut nonurgent waiting times to three months.

But in the civil case brought by a 63 year old patient, and supported by his regional public health insurance company, a court in the Hague heard how in January he was told that his bypass operation had been cancelled for the fourth time because of a lack of hospital capacity. He had been on a waiting list in Amsterdam for eight months but was not considered an emergency.

He requested an operation at the London Independent Hospital but was turned down by the Dutch national heart insurance council on the grounds that his case was not an emergency. A spokesperson for the health insurance council said that it was regrettable that the patient had to be treated abroad and argued that a Dutch heart centre could have been found.—TONY SHELDON, freelance journalist, Utrecht