Bijzondere interventies aan het hart - Gezondheidsraad

From time to time, of course, all such treatments are affected by new developments,
such as the availability of new techniques. Accordingly, it is essential
that quality, accessibility, and efficiency be constantly monitored. This prompted
the Minister of Health, Welfare and Sport to ask the Health Council of the Netherlands
to produce an advisory report concerning the best treatment options. The
first two questions to be answered, therefore, are:
1 Given the current level of knowledge, which special interventions offer the
best options for the treatment of cardiovascular diseases?
2 In the interests of safeguarding quality, accessibility, and efficiency, what
conditions should be attached to the use of these procedures?
However, this is not the only area to be affected by new developments. One of
these is the introduction of the new health care system in the Netherlands. In that
context, the Minister wanted to know whether there was a need to review the current
system for providing permits for specialized medical procedures. The government
is currently issuing Planning Decrees for procedures that fall within the
scope of the Special Medical Procedures Act (WBMV). The Minister would like
to know whether deregulation in this area is possible. Accordingly, the third
question is as follows:
3 Is it advisable to scrap the permit requirement for those cardiac interventions
which are still subject to the WBMV assessment regime?
General recommendations
The response to the three requests for advice has generated summaries of the current
state of knowledge associated with each of the treatment options, and of the
best quality assessment and management regime. It has also listed the general
trends and points of special interest in the field of special cardiac interventions. A
summary of the five major recommendations is given below. This is followed by
separate discussions of the individual disorders and therapies, addressing the best
approach and the most appropriate permit policy in each case.
1 Expand the number of specialised treatment centres
An examination of the full range of treatments for patients with cardiovascular
disease reveals a steady, occasionally rapid increase in the number of treatments
and interventions that are both available and in actual use.
This is partly the result of growing incidence, i.e. the number of new cases
seen each year is rising. This trend is associated with the aging of the population,
30 Bijzondere interventies aan het hart