PhD Defense: Quality regulation: the right to quality healthcare in Aruba

On 20 April 2021, Jayburtt Dijkhoff will defend his dissertation on the right to quality healthcare, online, at Utrecht University.

Summary

This research aims at answering the question of whether the Aruban government is fulfilling its obligation to guarantee the quality of healthcare in its own laws and regulations, and if not, what proposals can be made to improve the status quo. This study compares the Aruban legislation to the Dutch legislation using a five-step method. Five phases of the Dutch quality regulation are thereby analyzed: the quality of medical training, medical disciplinary law, the professional standard, institutionalized quality, and regulated competition for quality. 

The outcome of this comparison is worrying. The Aruban regulations have insufficient provisions, and they are not even fully implemented. Moreover, for many years they have been outdated. In addition, various pieces of legislation are poorly integrated. A systematic revision is in order to harmonize all laws and to achieve a better functioning regulation of the quality of health care. Lack of local self-regulation, additionally, makes itself felt. 

In conclusion, some proposals have been formulated to improve this situation, for example restructuring legislation from scratch, and also devising specific legislative amendments, e.g., introducing the legal right to an independent and impartial investigation into causes of death of patients in the healthcare sector. An attending physician should not have a final say on determining the cause of death. In general, the legal system is in need of revision on the basis of a coherent vision of the quality of healthcare.