Zware kritiek Eilandsraad Saba op Zorg en Jeugd Caribisch Nederland

Saba – De Eilandsraad van Saba en gedeputeerden hebben opnieuw hard uitgehaald naar het functioneren van Zorg en Jeugd Caribisch Nederland, een dependance van het ministerie van VWS. Enkele weken geleden deed staatssecretaris Van Ooijen na een gesprek met een delegatie uit Saba tegenover de Tweede Kamer voorkomen dat de ergste kou uit de lucht is. Niets is minder waar, bleek tijdens een Centrale Commissievergadering.

Directe aanleiding voor het ongenoegen is een publicatie van ZJCN dat inwoners van Caribisch Nederland die naar het buitenland reizen een aanvullende verzekering tegen ziektekosten nodig hebben waarbij ook Europees Nederland door ZJCN als buitenland wordt beschouwd, evenals de zustereilanden Sint Maarten, Curaçao en Aruba. Alleen spoedeisende zorg is verzekerd en dan uitsluitend met een door ZJCN verstrekt inschrijfformulier.

Eilandsraadslid Van Xanten zegt tot zijn grote ontsteltenis het bericht van ZJCN in de media te hebben gezien: “In het bericht staat dat we alleen in Caribisch Nederland gedekt zijn, maar mensen gaan niet naar Bonaire om te winkelen, ze gaan naar Sint Maarten.” Buncamper zei dat hij “verbijsterd” was door het bericht van ZJCN. Hij vindt dat de zorg op de eilanden onder ZJCN “zeer zakelijk is geworden met onvoldoende aandacht voor de wensen en zorgen van patiënten.” Charles: “Mensen bevinden zich in een kwetsbare positie als ze ziek zijn en specialistische zorg nodig hebben. ZJCN toont niet altijd empathie voor onze patiënten.”

Gedeputeerde Volksgezondheid Wilson schaarde zich achter de kritiek van de Eilandsraad. “Het is schandalig om de bureaucratie te zien waar mensen doorheen moeten voor een medische verwijzing. De situatie is onaanvaardbaar.”

“We zijn erg gefrustreerd over deze kwestie en we hebben de excuses talloze keren gehoord. We zijn het beu om het te horen en we willen concrete resultaten”, zei Zagers die sprak van een “gebrek aan empathie en respect” van de kant van ZJCN.

Van Ooijen vliegt overigens vandaag naar Saba om daar maandag een toelichting te geven op de verklaring die premier Rutte geeft over het slavernijverleden.

Island Council Saba approves budget

Saba -The Island Council approved the 2023-2026 multi-annual budget of the Public Entity Saba on Thursday, December 15. The budget for 2023 totals US $17.5 million which represents an increase of $4.5 million in comparison to 2022.

The revenues consist of the free allowance of $16.1 million and $1 million local levies. The expenditures consist of $10.2 million in personnel cost, subsidies and income transfers $1.7 million and $5.7 million in other expenditures. The biggest impact for the multi-annual budget was the signing of the Saba Package 2.0 in June 2022.

Government’s liquidity position has improved significantly with the additional means and the positive balance at the end of 2021, stated Finance Commissioner Bruce Zagers in his presentation to the Central Committee two days before the budget was adopted.

Significant achievement

“The increase we have seen in the free allowance has been a significant achievement for this government. With the additional free allowance, government has been able to create opportunities for civil servants, improve public services and make investments in the organization itself,” said Zagers.

One of the most significant changes that the Saba government implemented was to implement the $1,600 social minimum all full-time civil servants retroactively to January 2022. Saba is the only government to have taken this step which was financially possible because of the higher free allowance. In January 2023, civil servants’ salaries will go up by 4.75% gross.

Zagers said that in discussions with the Netherlands to evaluate the free allowance, the Saba government will stress that the salaries of government workers need to reflect the high cost of living. “Although we have made significant progress, we are not there yet, and this must be included as a priority during the evaluation of the free allowance,” said Zagers.

High costs

The high costs also impact the budgetary process for government. Budgeted amounts for everyday expenses like electricity, fuel and supplies have been increased significantly for 2023 in comparison to previous years. The salary improvements, the transfer to government’s structural budget of salaries financed before through special purpose grants and the increased cost of doing business have impacted the availability of funding to further improve government services and to execute policy initiatives.

Long, hard fight

Members of the Island Council were positive about the increase of the free allowance after years of bringing to the attention of the Dutch government that the amount was too low to cover government’s operations and execute policy. “In my seven years as Island Council member, this is the first time that I have not heard the Commissioner use the word skeleton budget. It has been a long and hard fight to get a budget that is realistic. We can now take care of what government has to do. I am hopeful that we can create more structural increases, also in measures for our people that reflect the high cost of living,” said Vito Charles.

“Achieving a significant increase in our free allowance is a good start to create opportunities for all. More funding to roll out and to implement prioritized policy areas will become reality,” said Council member Carl Buncamper, who emphasized that the many accomplishments of the past years were not a fit-it-all. “We still have ways to go. It is a multi-faceted approach and we need to stay on the course.”

“I am glad to see that the free allowance has been increased. It is something we have asked for many times. This increase will allow government to run smoother and make investments in our people and island,” said Council Member Hemmie van Xanten during the Central Committee meeting on Tuesday. The Island Council members all posed multiple, clarifying questions about the various budget items such as the social domain, public transportation, subsidies to NGOs, recreational facilities, the parking policy, education and agriculture.     

Main changes

In his presentation to the Central Committee, Commissioner Zagers mentioned a number of main changes and highlights in the 2023 draft budget. For example, the budget for maintenance on government properties has been increased by $150,000, the promotion budget of the Tourist Office has been increased by $110,000, and the subsidies for Carnival and Saba Day have gone up as well.

Also, a budget has been created for the continuation of the public transportation system. This pilot project is currently being evaluated but it is being regularly used by many persons and has thus far shown to be a success, said Zagers.

The budget for the student laptop program has been increased and is now available for students who have been accepted into a Master’s Program. Furthermore, funding has been made available to support the poverty policy and to continue the employment opportunities program managed by Social Domain. In childcare, the budget has been adjusted to reflect the new situation where caregivers are now CVQ certified.

The budget for the sanitation department, mainly for the waste management facility, has been increased by $200,000. This increase is to ensure that the exportation of separated waste streams can continue, which is necessary to reduce the frequency of burning. Options are being explored to further reduce the burning of the waste. The hygiene budget has been increased to accommodate the services of a veterinarian.

Delay

The budget was delayed due to logistical issues, explained Zagers. The Finance Department has had to put in extra work to do bank transfers, processing payments individually because batch payment were not possible from the side of the bank. A significant backlog at the Receiver’s Office led to an unplanned reorganization and a merger with the Finance Department. New staff was hired to further strengthen the financial team.

Despite the challenges, the quality of the work has not been impacted, which is visible in the quality of the budget and other financial reports. Zagers extensively thanked the Finance Department where the staff often work very long hours to keep operations going and to maintain a high standard of financial management.

Health insurance

Members of the Island Council and Executive Council made critical remarks about health insurer Care and Youth Caribbean Netherlands ZJCN during the Central Committee meeting. They expressed concerns about the fact that people need additional insurance when travelling abroad. Regular medical care is not covered when people go to, for example St. Maarten, Curaçao, Aruba or the Netherlands. Only emergency care is covered and then only with a registration form issued by ZJCN.

Van Xanten said that, much to his dismay, he saw a notice of ZJCN in the media reminding people to secure travel insurance when going abroad. “The notice says we’re only covered in the Caribbean Netherlands, but people don’t go to Bonaire to shop, they go to St. Maarten,” said Van Xanten.

Buncamper said he was “baffled” by the ZJCN notice. In general, he felt that under ZJCN, healthcare on the islands had become “very businesslike” with insufficient attention for the patients’ needs and concerns.

Charles addressed the medical referral system. “People want to see change. They have been asking for it for a long time. People are in a vulnerable position when they are ill and need specialist care. ZJCN doesn’t always express empathy towards our patients,” he said.

Commissioner of Public Health Rolando Wilson supported the views of the Island Council on the matter of healthcare. “It is a shame to see the bureaucracy that people have to go through for a medical referral. The situation is unacceptable.”

“We are very frustrated about this issue and we have heard the excuses countless times. We’re tired of hearing it and we want concrete results,” said Zagers who spoke of a “lack of empathy and respect” from the side of ZJCN.

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