Organisation

The Curaçao Association of General Practitioners (CHV) focuses on improving healthcare in general and GP care in particular. This is done by promoting the professional development of its members through training, conferences and collaboration with other medical specialists.

The association works closely with various stakeholders, including the government, insurers, medical associations and other healthcare organizations. This collaboration and communication improves the quality of care and makes GP care more visible and recognizable. This allows the CHV to offer effective solutions for healthcare problems that arise and at the same time represent the interests of GPs.

The Curacao General Practitioners Association (CHV) aims to:

The promotion of the medical arts and public health in Curaçao.
The promotion and strengthening of primary healthcare in Curaçao in general, and GP care in particular.
The promotion and encouragement of a controlled and balanced healthcare policy and its development in the short, medium, and long term.
The representation and protection of the professional and social interests of general practitioners in Curaçao.
The pursuit of optimal collaboration with other medical disciplines and existing medical and paramedical organizations.
The resolution of disputes between general practitioners, and between general practitioners and third parties, through mediation and – upon request by the involved parties – by providing binding advice.

The Association has ordinary members, extraordinary members and honorary members. Ordinary members of the Association can be those physicians who are actually established and working as general practitioners on Curacao. Extraordinary members may be physicians who are resident in Curacao, but who do not work as general practitioners and whose membership is considered to be in the interest of the Association. Honorary membership does not impose any special requirements on profession or establishment.

The board has the general management of the Association, ensures compliance with the Articles of Association, the Rules of Procedure and other regulations and general binding decisions of the general meeting of members, and furthermore takes such measures in the interest of the Association as it is entitled to according to the Articles of Association and regulations. The board represents the Association in and out of court and acts towards third parties through the chairman and the secretary, or the treasurer if it concerns funds. The board supervises the enforcement of medical and behavioral ethics in the broadest sense and advises members and the general meeting of members on this matter.

The entire board retires every two years. Retiring board members are immediately eligible for re-election. The board is appointed by the members in a General Members Meeting and is therefore accountable to the members. The Board consists of a minimum of three and a maximum of seven members. The members of the board have the following functions: chairman, vice-chairman, secretary, treasurer and general member.

The board currently consists of the following members:

Dr. E. Jacobus, chairman
Dr. C. Rolfast, vice-chairman
Dr. H. Jeung, secretary
Dr. N. Hoeve, treasurer

The board is assisted by committees. The following committees are currently active:

The Education Committee
The Audit Committee
The Education Accreditation Committee

The Education Accreditation Committee (CAN) is an independent committee appointed by the CHV. The CAN accredits continuing education for general practitioners in Curacao. In addition, it registers the accreditation points obtained for general practitioners and publishes overviews of the points obtained. This is in connection with the continuing education obligation for general practitioners working in Curacao. The VAN has been awarded the status of Institutional Accreditation Holder (IA) by the Accreditation Bureau Cluster 1 (ABC-1), part of the KNMG.

Organisatie

Challenges of our Healthcare System

Curaçao’s healthcare system faces several major challenges in the short, medium, and long term. Especially the decisions that will need to be made in the coming years—decisions made with foresight—will determine whether or not we succeed in addressing these challenges effectively.

Aging Population

Among many challenges, aging is the most pressing in the short and medium term. The increasing average life expectancy, the expanding possibilities to treat serious illnesses, and the emigration of young local people are all contributing to a shift in the population structure of Curaçao. This means there will be more elderly people. As a result, the healthcare needs of the population are also changing. Elderly individuals generally have more complex and intensive care needs. An increase in the elderly population requires, among other things:

Greater emphasis on prevention (also among younger people),
Improved cooperation in chain care,
Expansion and enhancement of care services (both home care and institutional care),
Early identification of so-called frail elderly individuals.

Increase in Chronic Diseases

There is a growing number of people with obesity, diabetes, cardiovascular diseases, and also HIV, for example. Curaçao, in fact, has one of the highest international incidence rates of diabetes and of patients requiring dialysis—primarily as a result of diabetes and high blood pressure.

Curbing this trend requires a new attitude toward prevention and making resources available for the effective treatment of chronic illnesses. Moreover, CHV believes that healthcare providers must collaborate more closely with each other—and with patients. This would improve both the efficiency of care delivery and the care process itself. Efficient care is higher in quality and more cost-effective in the long term.

Examples include:

Structured consultation in complex medical care,
Teleconsultation,
Integrated care,
Specialization among physicians and paramedics,
Support from practice nurses and specialized community nurses.

Digitalization

Our actions should be guided by reason and informed decision-making. For something as important and costly as medical treatment and care, access to timely and accurate information is essential. The digitalization of medical data is key to achieving this. CHV firmly believes that investing in robust digital systems across the healthcare sector must be a top priority for all involved parties.

Digitalization can help make information sharing faster and more efficient. Think of connected digital networks linking doctors, labs, pharmacies, paramedics, insurance companies, and more. This has clear benefits for patients, such as:

Better coordination between healthcare providers,
Avoidance of duplicate tests,
Alert systems for allergies or drug interactions during prescribing.

Additionally, digitalization is needed to collect data for scientific research and policy development. Currently, limited digitalization and the inadequacy of many systems to produce usable data make it difficult to conduct scientific analyses. Digitally recording data in a structured and uniform way is the key to overcoming this.

Knowledge Gap

It is essential to continuously assess the outcomes of our actions. At present, there is a lack of sufficient scientific data on the health of the population in Curaçao. There is a need for more information, such as epidemiological data on the prevalence of specific health problems or treatment outcomes. Such knowledge is crucial for assessing the quality of care and adjusting healthcare policies and visions based on factual evidence.

Since over 80% of all healthcare questions are handled directly by general practitioners, it is especially important to invest in scientific research within general practice in Curaçao.

Global Infectious Diseases and Regional Disaster Response

Public education, adherence to protocols, and especially a conservative antibiotic policy—based on local resistance patterns—can help protect not only our population but also people in other countries from potentially untreatable infections.

Modern travel has a direct impact on the spread of infectious diseases. Examples include MRSA, Ebola, SARS, Chikungunya, and the Mexican flu. Curaçao also faces the risk of serious infectious diseases re-emerging. Preparedness, ongoing training, and both local and regional collaboration are essential for an effective response when needed.

Disasters can happen anywhere—including Curaçao. A well-known regional example is the 2010 Haiti earthquake. To this day, regional aid efforts for Haiti have been inadequate, prompting reflection on the relationships and responsibilities between Curaçao and its neighboring countries. Natural disasters and petrochemical incidents could also affect Curaçao.

Healthcare Expenditures

Worldwide, healthcare spending is rising by approximately 5–6% annually. This is a global trend with understandable and logical causes, including:

Increasing complexity of healthcare needs,
Aging population (see above),
Expanding possibilities for medical treatments.

Structural cutbacks in healthcare would impair our ability to adequately address all of the challenges mentioned above. Ultimately, this would lead to a decline in the quality of care and/or to patients being unable to receive needed care.

Cost Control

Therefore, it is important to understand how healthcare funds are being spent, where the major costs lie, and which expenses can be influenced—without losing sight of the effects that cost-cutting measures may have on public health or on the interconnectedness of various healthcare expenditures.

The above makes it clear that structural cutbacks in healthcare would negatively impact quality.

What can and must be done is to manage the rate of increase in healthcare spending. This is what cost control means: a strategy dependent on a clear vision of health and healthcare quality.

To control expenditures, we must:

Make costs transparent,
Monitor them carefully,
Take well-informed actions where needed,
Reassess the effects of these actions on health and finances.

CHV’s Vision: Bringing the Challenges Together

According to CHV, all the aforementioned challenges converge under five key priorities:

A vision of health as a guiding principle for cost planning,
Digitalization as a tool for monitoring health and expenses,
Collaboration to improve efficiency and patient-centered care,
Prevention as an investment in future health and cost reduction,
Science to structure and substantiate care,
External collaboration for safety at home and abroad through shared experience and resources.

Uitdagingen

Vision

General Vision for General Practice Care

Healthcare in Curaçao—just like everywhere else—is a key pillar of society. Simply put, healthcare carries the responsibility of safeguarding the health of every individual in the community, thereby ensuring that society continues to function as optimally as possible.

Every healthcare system consists of different levels or layers of care (zero, primary, secondary, and tertiary care), each with its own quality and role, and interconnected with one another. Primary care includes all care that is accessible without barriers for everyone, such as general practitioners, community nurses, psychologists, and physiotherapists.

The general practitioner (GP) is a care provider who, thanks to their broad medical knowledge, their practice within the living, working, and social environments of their patients, and their knowledge of the patients' life course, is uniquely positioned to provide patient-centered care. GPs have been able to handle approximately 80% of patients’ healthcare needs independently and in an accessible way. Historically, GPs have developed into what are known as the “gatekeepers” of healthcare. This means that they address most health questions themselves and, when necessary, act within the broader healthcare system as both advocates and protectors of the patient’s health.

A system with a strong primary care foundation has been shown to increase the overall quality of healthcare and help keep total healthcare costs manageable. International organizations such as the WHO (World Health Organization on Public Health) strongly recommend investing in primary care. The government of Curaçao shares this view and clearly expressed it in its approved Healthcare Policy Note II.

CHV’s Vision

CHV (Curaçaose Huisartsen Vereniging – Curaçao Association of General Practitioners) aims to fully embrace its pivotal role within the healthcare system.

CHV not only strives to improve the overall quality of care and general practice in particular, but also believes that high-quality care and all supporting conditions for such care must be as clearly defined and safeguarded as possible in a vision document, in legislation, and in regulations. According to CHV, establishing clear quality standards is crucial for:

The continuity of healthcare,
Stimulating continuous improvement,
Ensuring transparency toward all stakeholders.

To this end, in 2014 CHV developed a broadly supported vision for the period 2015–2025, laid out in the Vision Document Curaçao General Practice Care 2015–2025. This document includes clearly defined objectives and aims to create a dynamic healthcare system where:

The patient is central,
Quality, performance, and costs are continuously measured,
And Curaçao is equipped to face future healthcare challenges.

CHV envisions achieving this future healthcare structure as follows: improving the quality of care begins with identifying the current quality and defining the desired future quality. The vision must outline how to move from the current situation to the desired one. Finally, the healthcare budget must support and enable this transition.

NIVEL Research

Prior to 2010, there was virtually no vision for reforming primary care based on policy changes grounded in quality measurement. For this reason, in 2010, CHV initiated a project to strengthen primary care.

In 2012, the globally recognized and independent healthcare research institute NIVEL conducted an evaluation of Curaçao’s primary care system and measured its quality. In December 2012, NIVEL presented the results in the report Evaluation Study of Primary Healthcare (ELGZ) in Curaçao.

This study showed that, compared to other countries, Curaçao’s primary care—and especially its general practice—performed reasonably well. However, it also identified several key areas for improvement.

The NIVEL study became a major source of information for developing the Vision Document, which was initiated in 2014.

The Vision Document

Based on the NIVEL report, CHV—together with a research bureau experienced in Curaçao’s healthcare system—conducted a comprehensive analysis of the current state of primary care, especially general practice. This analysis was then aligned with:

The specific challenges facing Curaçao’s healthcare system,
The current global perspective (including WHO guidance) on the most efficient healthcare structures.

From this, the necessary improvements and changes were formulated—both at the organizational level and in the direct care delivery within primary care.

All of this is documented in the Vision Document Curaçao General Practice Care 2015–2025.

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