Healthcare in The Netherlands - MultiMania

Noordwijk, April 2004
Healthcare
in
The Netherlands
ESTEC Medical and Social Service

Table of Contents
Introduction 3
First Aid and Emergencies 5
Family Doctor 8
Specialists 11
Hospitals 14
Dentists 16
Pharmacy 17
District Health Care 18
Mental Care 20
Travelling Abroad 22
Insurance 23
ESTEC Medical Centre 24
ESTEC Welfare Officer 26
Pregnancy & Childbirth 28
How to stay healthy 31
Medical Vocabulary 33
2

Introduction
Welcome to the Dutch Health Care System.
Although you might have heard or experienced that the medical system here
is very differently organised from in your home country: good medical care is
available!
Since we are very well aware of cultural differences and of difficulties finding
one’s way to the right place, we have compiled some useful tips and practical
advice for you.
It should be stressed right at the beginning: this brochure is not only
addressed to newcomers, but might also be useful for those who have been
living here for quite some time and especially for spouses and family
members at home!
First of all we will give you a brief introduction on how the system works. The
details of several medical and social services will be given in the subsequent
chapters.
Getting to know the system
The Dutch Medical System is set up around the family doctor. Everybody in
The Netherlands is registered with a family doctor who is the key person to
coordinate physical and mental care. This means that, for instance before
consulting a specialist –such as a surgeon or a psychologist- you need a
referral letter from your family doctor, and for medicines you need a
prescription.
It is, therefore, useful to provide him/her with as much background information
as possible (e.g.: allergies, regular medication, family history of diseases etc.)
and to keep him updated.
Your family doctor will keep your file and is, in principle, responsible for you at
all times.
Some comments about the approach or attitude of the doctors: if a Dutch
doctor is of the opinion that it is likely that a medical problem will heal
spontaneously then he/she will refrain from prescribing medication and,
especially, antibiotics. However, if your medical problem does not clear up
spontaneously, it is expected that you yourself make a follow-up appointment.
At the moment there is a shortage of doctors in The Netherlands, mainly in the
bigger cities, but increasingly in smaller towns. This makes it difficult
sometimes to find a family doctor, but we are very willing to help you find one.
3

As a result of the situation described, arranging an appointment with a
specialist can sometimes take many weeks, depending on the speciality and
the hospital. We have, therefore, made an agreement with a hospital in
Heemstede/Haarlem to limit the waiting lists to the minimum. Another option
to avoid the waiting list is to consult a specialist in Belgium (see pages 12 and
13).
What can you do yourself?
Try to set up your medical and/or social network at an early stage and in a
relaxed way in order to prevent major problems and frustrations during
emergencies.
· Get to know your family doctor: make an appointment.
· Find out about the Doctors night/weekend service (“Doktersdienst”) in your
area
· Learn the alarm number (1-1-2) by heart.
· Keep this brochure at hand.
· Write down the most important phone numbers next to your phone or
program them into your phone.
Last but not least, if something sounds too strange or you are dissatisfied or
worried: ask! Ask the family doctor/nurse/assistant or ask the ESTEC Medical
Centre. Feeling frustrated and discouraged will only increase your difficulties.
We will be happy to advise you. Your feedback and recommendations will be
appreciated.
With our best wishes for a happy and healthy stay in The Netherlands,
Your ESTEC Medical and Social Team.
Contact:
Estec.medical.centre@esa.int
Tel.: 071-5655319
Fax: 071-5654185
4

First Aid and Emergencies
To obtain the best possible response in an emergency situation, we would like
to classify emergencies into three types:
1) LIFE -THREATENING EMERGENCIES
E.g. accidents, person unconscious, heavy bleeding, suspected heart attack,
etc. This is the general alarm number: i.e., it is also for the police and the fire
brigade.
1. Dial 112.
2. Identify yourself and indicate where the help is needed.
3. Indicate what type of help you need (ambulance, police or fire brigade)
You will be connected to the requested local service immediately.
4. Explain what has happened and where, and how many casualties are
involved.
While you are giving this information, help is already on its way.
Don't worry; the person on the phone will be able to communicate with you in
English.
2) URGENT MEDICAL HELP
E.g. children with high temperature, strong allergic reactions, acute pains,
small wounds etc.
During the day (Mon/Fri 8:00 -17:00 hrs):
Call your family doctor!
If the doctor is busy or on holiday, the assistant or answering machine will
give you a telephone number for replacement doctors and urgent help. You
can check also the arrangements in your local newspaper on the page "family
doctors night- and weekend service".
5

During the night/weekends
Call the "dokterspost"!
Nowadays almost all practices are part of a “dokterspost” for nights and
weekend shifts. Please check at the list below for the nearest “dokterspost” in
your area:
For residents of: Noordwijk, Hillegom, Katwijk, Lisse, Noorwijkerhout,
Oegstgeest, Rijnsburg, Sassenheim, Voorhout, Warmond:
Call the “dokterspost” located in Voorhout: 0900-3343678
Address: Rijnsburgerweg 4
For residents of: The Hague, Voorburg, Voorschoten, Wassenaar, Rijswijk:
Call the “doktersnachtdienst-SMASH” (doctors’ nightshift) 070-3469669
You will be informed about the exact location of the practice on duty during
your call.
For residents of: Leiden, Leiderdorp, Zoeterwoude, Stompwijk, Rijpwetering:
Call the “dokterspost”: 0900-5138039
Address is Doezastraat 2a in Leiden (entrance Raamsteeg)
For residents of: Hazerswoude-Dorp, Hazerswoude-Rijndijk, Koudekerk,
Jacobswoude, Liemeer, Nieuwkoop, Alphen aan den Rijn:
Call the “dokterspost” located in Alphen aan den Rijn, 0172-467007
The “dokterspost” is located in the Rijnland Hospital in Alphen aan den Rijn
It should be noted that calling the night/weekend service does not
automatically mean that the doctor will visit you at home. Once you speak to
the doctor or an assistant on the phone, they will determine the best possible
way to solve your problem.
3) SPORTS ACCIDENTS AND SIMILAR
If you feel you need to go to hospital (e.g. for an x-ray, plaster cast or similar),
you can go directly to the First Aid station of a hospital (called “Spoedeisende
Hulp”).
At the "Spoedeisende Hulp" department the order of treating people depends
on the seriousness of the complaint. The waiting time can be long for minor
first aid problems.
All hospitals have a First Aid station during working hours, but they do not
always remain open at night and on weekends.
6

Hospitals with 24-hour First Aid stations in the Leiden Area:
Leids Universitair Medisch Centrum (LUMC)
Albinusdreef 2
Tel. 071-5269111
2333 ZA Leiden
Rijnland Ziekenhuis
Location St. Elisabeth
Simon Smitweg 1
Tel. 071-5454545
2353 GA Leiderdorp
In the area of The Hague all hospitals have 24-hour First Aid stations (see
page 15).
You can always dial 112, if help is needed immediately!
7

Family Doctor
HUISARTS = FAMILY DOCTOR /GENERAL PRACTITIONER = GP
The Dutch "huisarts" is the equivalent to the General Practitioner or Family
Doctor. He/she, generally speaking, has patients (clients) from around the
neighbourhood of his/her practice (surgery) and there are legal boundaries to
his/her practising area. The reason for this is safety because the doctor
should be able to attend to an emergency in the shortest possible time.
In The Netherlands, the “huisarts” has a central role within the national
healthcare system, and is the key to almost everything associated with
healthcare. The “huisarts” treats you, but also coordinates other care -
normally by means of a referral letter to a specialist or a paramedic- and
maintains your medical file, complete with specialists' reports. It is therefore
essential that you register with a “huisarts” as soon as you have settled
in The Netherlands. In choosing a doctor it is considered good etiquette to
make a "kennismaking afspraak", that is to say, an appointment where you
meet the doctor and introduce yourself. Once you have been accepted by a
doctor and you feel comfortable and happy with the care that the doctor
delivers, it is expected that you remain his/her patient permanently, but this
does not mean that your forfeit your right to change.
Most doctors speak English; nevertheless, there can be communication
problems, and this is likely to be in the area of attitude rather than the area of
language. If a Dutch doctor is not as specific as you might like, make sure you
understand everything and/or bring a list with your questions. This especially
applies when the doctor makes out a prescription. Be sure to ask for complete
instructions about taking medication - times, dosage, and possible side
effects.
You may also find the Dutch doctor's attitude to illness different from what you
have been accustomed to. Generally speaking, Dutch doctors are of the
opinion that in many instances the body heals itself without intervention. So if
your doctor is of the opinion that it is likely that a medical problem will heal
spontaneously, then he/she will refrain from prescribing medication or
referring you to a specialist.
However, if your medical problem does not clear up spontaneously it is
expected that you yourself make a follow-up appointment!
Generally Dutch doctors are not allowed by law to issue medical certificates
for sick leave, but they can give out medical information (such as diagnosis
and/or information about treatment) with the patient’s consent.
8

SURGERY HOURS (= “spreekuur”)
Almost all family doctors have fixed times during which patients may attend
their surgery without an appointment ("Inloopspreekuur"). This is usually in the
morning and covers just one or two hours. Otherwise you will have to request
an appointment, which needs to be held at a specific time of the day.
Each doctor has his/her own set-up and once you have established who your
doctor will be, you need to make sure you know the correct surgery hours as
well as the times for telephone consultations, requesting appointments or
repeat prescriptions and the procedure for emergencies and for night calls.
Most practices have a "patient information brochure that gathers these details
in writing.
Most of the time your appointment will be planned within 2 - 5 working days of
your request. If you consider your problem more urgent, ask for a "spoed
afspraak" (=emergency appointment)
Consulting hours are always during office working hours (as are consulting
hours for specialists and dentists). The “huisarts” will make home visits,
provided there is a clear medical necessity for the visit (i.e. too ill or
physically/mentally unable to go to the Doctor's office/unable to drive). The
“huisarts” will always ask if the patient can come to the practice, not because
they are unwilling to come out, but because it is easier to examine the patient
or to do tests in the surgery.
The average consulting time is 10 minutes; if you want a longer talk with the
doctor, mention this to the assistant and she will give you a double
appointment.
REGISTRATION
In The Netherlands everybody has a regular “huisarts”. You choose a
“huisarts” within the borders of the town in which you live (in bigger cities
within a radius of a few kilometers).
You phone the assistant of the “huisarts” and register yourself (with or without
family) as a new patient. Some practices will ask you to complete an "intake”
paper, so that they have some information on hand about risk factors, regular
use of medication, family situation etc. If you need a hand with filling this in,
you can do it during your first appointment ("consult" in Dutch) with the
doctor/assistant, or you are welcome to ask for help from the ESTEC Medical
Center.
Before you choose a “huisarts”, please ask the ESTEC Medical Center,
friends, colleagues and/or neighbours about those with a good reputation.
You can also visit the doctor you choose to get to know him/her a little before
9

deciding whether or not to register permanently with that particular practice.
To find a permanent family doctor in The Hague, you can contact The Hague
Family Doctors Association at telephone number 070-3129829 between 9:00
and 10: 00 hrs. on weekdays.
AVAILABILITY OUTSIDE OFFICE HOURS
In the evening, at night and at weekends there is always a "dokterspost" or a
“huisarts” on duty, but only for urgent matters that cannot wait until the next
day/until after the weekend. To find out which doctor is on duty outside normal
consulting hours:
• Call your own “huisarts” and listen to the answering machine which will
inform you of who is on duty (name and tel. numbers- although the
whole message will be in Dutch);
• Check your weekly local paper for the section "Nacht/Weekenddienst"
where you will find the name and telephone numbers of the
"dokterspost" or “huisarts” on duty, as well as the dentist and pharmacy
with associated opening hours.
• See page 5-7 about First Aid and Emergencies
10

Specialists
The usual procedure to access a specialist is to ask your family doctor for a
referral letter. He will not only issue the referral with all relevant information,
but also give you a recommendation about which specialist he considers to be
best qualified for your specific needs. If necessary he will arrange on the spot
an appointment for you to speed up the process. However, generally you are
free to choose the specialist yourself and can/should discuss that choice with
your doctor.
Most Dutch specialists have their surgeries in a hospital. You will have to
register at the general reception desk of the hospital first and will then be
guided to the requested "polikliniek" (=out-patient department) after being
issued with a registration card and number (keep that card for all future visits
in this hospital!).
You might have to face a long waiting list to get to see a specialist.
Detailed information on the waiting periods to be expected in NL can be found
at www.minvws.nl -> search for "wachtlijst in de zorg"
If the waiting time is unacceptably long, there are two special arrangements
made for shortcutting: 1) Spaarne hospital and 2) Antwerp hospital
arrangement. The details you find below.
1) Agreement between ESTEC and Spaarne Hospital
Please note, however, that this agreement does not waive the obligation
for every (ex-) staff, contractor and family member to be registered with
a family doctor.
How to make a regular appointment:
1: Ask for a referral from your family doctor.
2: You may call at � 023-5141516 from Monday until Friday 8.00-16.30
hrs and ask for the specialist needed.
How to make an appointment according to the agreement:
During weekdays Monday until Thursday 8.30-17.00 hrs and Friday 8.30-
11.45 hrs:
Please email to ESTEC@SpaarneZiekenhuis.nl with the below
mentioned information. Your email will be answered within a few hours
during working hours. You can also phone Mrs M. Kromhout (or her
replacer) at � 023-5142697 with the following information:
1. Name and/or Maiden name if applicable
2. Sex
3. Date of Birth
4. Address
5. Telephone number
6. Health insurance company and number *
7. Specialist needed
11

8. Preferred period for appointments
(*) For (ex-) ESA Staff and their family (via J.Van Breda & Co) this is
your staff number.
Outside working hours:
Send an email/fax with the above-mentioned information.
Consultation fee:
If either you or your family doctor makes a regular appointment with the
hospital (via the secretary of the required specialist directly), the normal
fees apply.
If you use the herewith-offered shortcut 30% admission fee will be added to
your bill on top of the regular CTG-tariff.
Emergencies:
Phone the Emergency Room ("Spoedeisende Hulp") department of
the hospital in advance and bring this letter and your Health
Insurance card (the Van Breda card for (ex-) Staff and family) with
you.
Please note that all emergencies of the Spaarne Ziekenhuis are located at
their "Spoedeisende Hulp" department in Haarlem: � 023-
5142265,
except for Heart problems those are treated in Heemstede: � 023-
5141226.
At the "Spoedeisende Hulp" department the order of treating people
depends on the seriousness of the disease. The waiting time can increase
for minor first aid problems. In that case, please contact the family doctor
during working hours or the "dokterspost / huisartsenpost" in your area
outside working hours.
The appointment:
Please bear in mind that the Spaarne Hospital is located at 2 places! Your
appointment will be either at the hospital in:
or
Haarlem; Van Heythuijzenweg 1 2012 CE � 023-5141516
Heemstede; Händellaan 2 2102 CW � 023-5141516
Please come 20 minutes in advance at your first appointment to inscribe at
the hospital.
12

2) Practical arrangements -organized through Van Breda services- to
shortcut Dutch specialists’ waiting lists
(Reference to ESA/INFO (2002) 19, 23-May-2002)
Van Breda has visited the main Antwerp hospitals to explore alternative routes
for specialist visits. The following hospitals have unlimited access for
redirected patients and employ a multilingual staff (English, German, French).
Appointments can be arranged within 1 to 3 weeks. The time between the first
consultation with the specialist and the operation/treatment is generally about
2 to 3 weeks. Their websites provide information about available specialists.
·A.Z Middelheim
Lindendreef 1
2020 Antwerpen
tel.: +32.3.280.31.11
www.ocmw.antwerpen.be/azm/
Mainly used for orthopedic treatments
·U.Z. Antwerpen
Wilrijkstraat 10 Edegemsesteenweg 240
2650 Edegem 2610 Wilrijk
tel.: +32.3.821.30.00 tel.: +32.3.821.36.70
tel.: +32.3.821.34.40
www.uza.uia.ac.be
Mainly used by patients for cardiology
·Sint-Vincentiusziekenhuis
Sint-Vincentiusstraat 20
2018 Antwerpen
tel.: +32.3.285.20.00
www.gvagroup.be
Mainly used for orthopedics and gynecology
·Sint-Augustinus Ziekenhuis
Oosterveldlaan 24
2610 Wilrijk
tel.: +32.3.443.30.11 or +32.3.440.43.78
www.gvagroup.be
Mainly used for: knee and hip-orthopedics, groin hernia operations and
gallbladder resections (by laparoscopy)
It should be noted that ESA Social Security Scheme does NOT reimburse
transportation costs.
(Distance between Noordwijk and Antwerpen is approx. 115 km)
The time spent with the specialist can be claimed as sick leave (please ask a
time-statement from the doctor and present it to the Medical Center), but
please note that the travel time involved is NOT covered in this agreement.
13

Hospitals
Between Haarlem and Den Haag, there are several hospitals:
1. Haarlem area
* Kennemer Gasthuis
Location Deo
Velserstraat 19 Tel. 023-5525252
2023 EA Haarlem
www.kg.nl
Location E. Gasthuis (EG)
Boerhaavelaan 22
2035 RC Haarlem Tel. 023-5525252
www.kg.nl
* Spaarne Ziekenhuis
Location Heemstede
Händellaan 2
2102 CW Heemstede Tel. 023-5141516
Location Haarlem
Van Heythuyzenweg 1
2012 CE Haarlem Tel. 023-5141516
2. Leiden area
* Leids Universitair Medisch Centrum (LUMC)
Albinusdreef 2 Tel. 071-5269111
2333 ZA Leiden
www.lumc.nl
* Diaconessenhuis
Houtlaan 55 Tel. 071-5178178
2334 CK Leiden
www.diac-leiden.nl
* Rijnland Ziekenhuis
Location St. Elisabeth
Simon Smitweg 1 Tel. 071-5828282
2353 GA Leiderdorp
www.rijnland.nl
14

3. Den Haag area
* Ziekenhuis Bronovo
Bronovolaan 5 Tel. 070-3124141
2597 AX ’s Gravenhage
www.bronovo.nl
* Ziekenhuis Leyenburg
Leyweg 275 Tel. 070-3592000
2545 CH 's Gravenhage
www.leyenburgziekenhuis.nl
* Westeinde Ziekenhuis (Medisch Centrum Haaglanden)
Lijnbaan 32 Tel. 070-3302000
2512 VA 's Gravenhage
www.mchaaglanden.nl
* Rode Kruis Ziekenhuis Tel. 070-3126200
Sportlaan 600
2566 MJ 's Gravenhage
www.jkz-rkz.nl
* Juliana Kinderziekenhuis (Children Hospital) Tel. 070-3127200
Sportlaan 600
2566 MJ 's Gravenhage
www.jkz-rkz.nl
Note: If your wish to remain with your child during his duration of
hospitalisation, this is usually well supported in the Netherlands. Speak with
the doctor or head-nurse for the arrangements. Further support on “child and
hospital”- issues you can request via “Vereniging Kind en Ziekenhuis”,
Aardappelmarkt 3, Dordrecht, Tel. 078-6146361
4. Categories of hospitals
Staff members can check into any class of hospital based on the
following conditions (see Regulation 22.1 of the Staff
Regulations):
3rd Class: 100% reimbursement
from 4/6 persons in each room
depending on the hospital;
2nd Class: 95% reimbursement
usually 2 persons in each room;
1st Class: 90% reimbursement
usually private room (on a "space
available" basis).
15

Tandarts/Dentist
It is also important to find a dentist in Holland soon after your arrival in the
Netherlands. Do not wait until you have a toothache!
Unfortunately there is a shortage of dentists, so it might need some
investigation and phone calls to finally register with one. (Certainly nothing
that you would want to do with a swollen cheek!) Unlike the huisarts, dentists
are not restricted to certain areas, so you are free to look for one in a wider
geographical range.
The Tandheelkundig Informatie Punt can be called under 0900-2025012
(between 9.30 and 11.30h-0, 25 euroct /min) to help you find a dentist and
answer other questions about dental care. Look also at: http://www.nmt.nl/ or
ask the ESTEC Medical Centre for the most recent list of available dentists in
the area.
Generally speaking the dentist will then be your "family-doctor for toothaffairs"!
Meaning: follow up treatment/examination related to your teeth (i.e.
orthodontics, mouth-hygiene, surgery, implants), will be coordinated by your
dentist. Again: Once registered you are considered to remain his patient.
In emergencies, during night or in the weekend there will always be a dentist
on duty. This service is changing weekly; please check the answering
machine of your dentist or the local weekly newspaper (usually free delivery to
every house in the area) for details.
It is usual in the Netherlands to have a "control" appointment every six month.
Due to their increasing workload dentist will preferably treat patients that have
followed/will follow their regular check ups.
Special items/treatments in the frame of dental care need "permission" via
Van Breda. For example there are ceilings for implant-surgery-costs and
orthodontics need prior approval. If you want to make sure you don't bite on
something very expensive soon, please check in advance with Van Breda or
in Rules and Regulations, table 1.
16

Apotheek/Pharmacy
An American "pharmacy" is a UK English "chemist" = Dutch "apotheek".
You will need a prescription from your family doctor or specialist for your
medication.
If you are on continuous medication you can give a call to the family doctor,
who will fax the follow-up prescription to the pharmacy. This will save you time
and the only thing you need to do is to pick up the medication at the
pharmacy. Some pharmacies have free of charge home delivery services.
Pharmacies are open from Monday to Friday during office hours.
Outside office hours there is always a pharmacy on duty to supply urgent
prescriptions. Usually you can find details of the pharmacy on duty posted in
the window of your regular pharmacy or the local newspaper. At the bottom of
this page you can find some pharmacies, which are open all evenings.
For common medicines, such as painkillers, vitamins, etc. one can ask your
pharmacist but you can also go to a drugstore ("drogist", such as ETOS,
Kruidvat or even the special shelves in your local supermarket). These are
also open on Saturday and during late night shopping (Thursday or Friday;
ETOS/Kruidvat open in Noordwijk/zee on all Sunday afternoons)
At the pharmacy you usually pay cash but it is also possible to open an
account in some pharmacies.
For reimbursement purposes, keep a copy of your prescription and the proof
of payment (cashier slip) or ask the pharmacy for a receipt.
Medication without prescription is not reimbursed, for example your holiday
supplies of aspirin and suntan lotion, diarrhoea tablets or vitamins are at your
own expense.
The nearest pharmacies to ESTEC are:
Katwijk:
Rijnsoever Apotheek; Hoornesplein 121; 071-402 64 57
opening hours: 8.00 a.m. to 5.30 p.m.
Noordwijk:
Duinrand Apotheek; Nieuwe Zeeweg 1; 071-361 9314
opening hours: 8.00 a.m. to 5.30 p.m.
Night pharmacy
Leiden:
Apotheek “De Nachtwacht”; Douzastraat 2a; 071-5665019
Opening hours: 9 p.m. to 8 a.m. weekdays; 9 p.m. to 10 a.m. weekend days
The Hague:
“Bronovo Apotheek”; Bronovolaan; 070-3246085
Opening hours: 5:30 p.m. to 8 a.m. weekdays; 24 hours weekend days
17

District Health Care (Kruisvereniging)
NURSING CARE
Nursing care is centralized in Holland via a regional foundation ("stichting").
Registered nurses, nursing aides and health visitors who work in close
cooperation with the local doctors, provide the service.
These people are very qualified and specialized in various fields.
They will also be able to help you to get in touch with other support institutes
such as groups of fellow patients organizations, social workers etc.
You can apply for various services such as:
Childcare
E.g. maternity care, mother and child care, "consultatie bureau" (baby and
toddler clinic) for vaccination and examination of children
Contact: Valent RDB, tel.: 071-4093333
Homecare
E.g. help for the chronically sick, handicapped or elderly people, nursing care
during illness, disability or after an accident
Renting equipment
E.g. special appliances at home for chronically sick/handicapped people,
(crutches, beds, bath-lift, baby scales), wheelchairs for the acute case….
Contact your local WELZORG winkel, to be found in the Gouden Gids.
Closest to ESTEC: Welzorg Katwijk, van Houtenstr. 7, Tel.: 071-4091700.
Health education
E.g. information about the use of medication, dietetic advice, pregnancy
classes, and discussion circles on various topics (sickness of a family
member; handicapped child; how to deal with Alzheimer….)
Meals on Wheels
E.g. prepared food brought to home address for ill/handicapped people also
on a temporary base.
Call Apetito 0800-0232975 or Tafeltje-Dekje 071-4016347
18

Contact addresses
Stichting Valent Rijn-, Duin- en Bollenstreek
Schimmelpenninckstraat 10
2221 EP Katwijk
071-4093333
Stichting Thuiszorg Groot Rijnland
Schuttersveld 1
2316 XG Leiden
071-5161415
Stichting Thuiszorg Haagland
Koningin Sofie straat 120
2595TM Den Haag
070-3785050
19

Mental Care
Of course we all hope we can manage with every problem in our life
ourselves. In reality we all sometimes encounter difficult phases - whether it
has to do with raising children, problems with your partner or seeing life from a
gloomier side - then help might be useful.
It is good to know that care is available. This can vary from some counselling
sessions for financial problems to admittance to a psychiatry department and
help with addiction.
With any of these problems it is best to consult your family doctor for advice
as to have expertise where find specific help for your individual problem. The
family doctor will refer you to one of the below mentioned services. Most
insurances and also Van Breda require a referral letter to reimburse the bills.
You can also go and see the ESTEC Welfare Officer for direct help or
addresses.
Psychological Services
Parnassia is an institution for The Hague and surroundings to provide
assistance in case of psychiatric difficulties in children, adults or geriatrics,
such as depression and serious anxiety. Parnassia can also be your contact
for problems with bringing up your child or relationship crisis.
Other location and general information about the service you can look up
under www.parnassia.nl or call the general information number 070-
3917979.
The Rijngeestgroep is a similar institution as Parnassia but focused on the
area of Leiden and surroundings. There's one exception: the care for
addictions in Leiden is provided by Parnassia.
For more information about the Rijngeestgroep and their services look at
www.rijngeestgroep.nl or call the general information number 071-8907000.
Urgent mental help
If you feel that your situation is an urgent one you must stress this to your
family doctor to obtain direct help!
In case of doubt, do not hesitate to call 112, you will be referred by trained
staff to the right contact.
Addictions
Parnassia Verslavingszorg Leiden: Lange Mare 45, 071-5143641
Parnassia Verslavingszorg The Hague: Zeestraat 62-66a, 070-3917800
20

A referral of a family doctor is not needed for this specific care (but might be
helpful for a smooth entry to the care and it is certainly advised to keep your
GP in the loop of information)
More Contacts
Most importantly, do not suffer in silence. Talk to your family doctor or call one
of the phone numbers below (service is kept anonymous, if you wish):
SOS-telephone help: 0900-0767 (evening and weekend)
Korrelatie: 0900-1450 (evening and weekend)
AIDS/SDD information line: 0900-2042040 (24 hours per day)
Alcohol Anonymous: 071-615303 or 070-3661036
SHAS (sexuality) 071-5146392
21

Travelling Abroad
As staff and contracted employees, you may be expected to travel abroad ‘on
mission’ for work. Where you travel to and how long you are away is
dependent on your job.
Some destinations outside Europe may require special advice and
vaccinations. As with all trips abroad either for work or pleasure, it is
worthwhile thinking about your health and vaccination protection well in
advance of your leaving date, (preferably 4-6 weeks before!)
The Estec Medical Centre staff will be able to provide you with up-to-date,
clear travel advice and arrange a vaccination programme for you, once you
informed us about your mission. You will be asked to fill in an ‘intake’ form
giving details about your destination, route, length of stay etc. Information
leaflets are also available.
If you are planning a holiday with your family then you should contact the
GGD (Gemeentelijke Gezondheids Dienst) for travel advice and vaccinations.
Vaccination Centres ( Reizigersadvies- en vaccinatie centrum )
GGD Leiden/Katwijk/Alphen a/d Rijn: 071-5163325 (9:00 – 10:30 am)
GGD Den Haag; Thorbeckelaan 360; 070- 3537240
Other addresses and information: www.lcr.nl
Further tips to staying healthy whilst abroad
• Plan ahead and vaccinate when appropriate.
• During long haul flights drink plenty of water and walk around regularly.
• Take care of your skin if exposed to the sun, with a good sun protection
cream.
• Be careful with small wounds as they can get infected more easily in
warm climates.
• Depending on your destination drink bottled water and only eat food
that has been well cooked. Avoid shellfish, salads and fruits you have
not peeled yourself.
• Wash your hands frequently.
• Practice safe sex to avoid sexually transmitted diseases.
• Be aware of your environment and avoid accidents at work and outand-about
• Look also at the website of the world health organization: www.who.int
Illness abroad:
Arrange valid travel insurance. Van Breda does not cover repatriation for
private travel (ordinary medical costs abroad are covered via Van Breda).
22

Insurance (this chapter is mainly NOT applicable to contractors)
All ESA Staff members (including their dependents) are insured via ESA.
Van Breda acts are administrator for ESA and settles all claims and
questions versus Staff in the first instance.
In practice that means Staff is privately insured (in Dutch: “particulier”).
Bills are sent to the patient, who has to settle the payment and claim the
money (presenting bill and proof of payment) back via Van Breda.
Payment of high amounts (for example in relation to hospitalization) can
be arranged via Van Breda directly.
You will have/will get an insurance card from Personnel stating your
insurance cover and the contacts of Van Breda.
Van Breda has now introduced an on-line help service for staff in post or
when traveling for advice on all matters relating to ESA medical cover,
such as who can claim what, getting prior approval, statement of
insurance towards hospitals etc.
A list of call-free numbers is given below. Meanwhile the Personnel
Divisions are, of course, always at your disposal for further information.
For staff traveling or in post:
Italy: 800 780 991
The Netherlands: 0800 0220 773
Germany: 0800 18 30 195
France: 0800 91 29 46
Spain: 900 973 200
USA: 1800 637 6452
Other countries: +32 3217 57 31 (ask for N. van Schependom)
(Redu, Kiruna, Moscow, Kourou) = reverse call
For all staff: Van Breda email: mcc020@vanbreda.nl
Fax: 0032 32 35 0124
Refer to ESA/INFO (99)71 & ESA/INFO(2003)31
For questions about reimbursement issues you can look at Rules and
regulations, Table 1. (available also via HR online)
Contractors are advised to verify all details with their own insurance.
23

Healthcare at ESTEC
Introduction
The aim of the ESTEC Medical and Social Service is to protect, monitor and
improve the health and well being of ESA staff members working for ESTEC,
to promote a healthy working environment and offer assistance in case of
personal /medical or social problems.
The team: Who are we?
E.D. Kubbinga, Occupational Health Physician; (x53020)
F. Ten Hulscher, Occupational Nurse; (x53021)
B. Ditter, Medical Assistant; (x55319)
M. Barendse, Welfare Officer; (x55320)
C. Fernando, Ophthalmologist; Appointments via (x55319)
Collect email address: estec.medical.centre@esa.int
What do we do?
• Medical Examinations as required by the ESA Rules and Regulations.
Every year you will be invited personally. The main aim is to inform and
screen on work related illnesses and give you advice on these and general
health issues.
• Assistance with the Local Medical System. Every newcomer and his/her
partner are personally invited for information and advice about the Dutch
Medical System. Our purpose is to advise and assist you to get through to
the right person/medical facility. You will still need to register with a family
doctor, since we do not give treatments.
• Working Conditions Consultations. For any question about work related
issues you can contact us; not only if you have problems but also from a
preventive point of view.
• Sick Leave Consultations. The secretary of the division/department deals
with the administration of sick leave and recovery. During the first 2 weeks
of sick leave you will be contacted by the nurse. If the sick leave lasts > 2
weeks the doctor will monitor your case.
• Emergencies. In case of an emergency on site, please dial security
x53333 immediately. Security will contact us via our beepers.
• Consultations on travel medicine for individual and group missions. This
includes preventive advice, vaccinations and medication if necessary.
• Preventive or screening campaigns are organized. For example Fluvaccination
or Chest X-rays campaigns.
• Workplace visits. You can request this to check the workplace from an
ergonomic point of view.
• Advice to the management about occupational health or sick leave.
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Privacy
The whole team is bound by medical confidentiality. This means that the
members are not allowed to discuss confidential information without the
explicit permission of a client.
In the case of sick leave we are obliged to give information about the period
and duration of this sick leave (no medical details will be given).
In some situations, there could be a work related problem. Permission will be
asked to feed back this to the management to search for solutions and
prevent new cases.
Where is ESTEC Medical & Social Service located?
We are located at room Da021 on the main corridor, ground floor.
The Medical Assistant can be called to make appointments via x55319 during
working hours (Mo-Fri: 8.30h till 17.15h, Fri: till 16.00h) or write a note to
estec.medical.centre@esa.int.
If no response (out-office activities) try later or leave a message!
In case of emergencies call security x53333 straight away!
Security will contact us via our beepers.
The Welfare Officer is located at room Da029; x53201 or email:
marc.barends@esa.int
Further information:
To gather additional and/or updated information please also look at:
• Intranet Human Space (TIDC-> Administrative documents
->Human resources ->HR online)
• Mednews Bulletin bimonthly
• Bulletin Board next to our entrance
• Several health brochures
25

ESTEC Welfare Officer
Introduction.
The welfare officer at ESTEC is an independent professional advisor and part
of the ESTEC Medical and Social Service. Every staff member, YGT, RF and
pensioner is entitled to go and see the welfare office for advice in certain
situations (as mentioned below). The welfare officer is present on site
weekdays from 9.00 till 17.00.
What can the Welfare Officer do for you?
The primary job of the Welfare Officer is to offer assistance in solving personal
difficulties and helps to find solutions to such problems.
In addition, the Welfare Officer can give:
• Advice
• Consultation
• Individual aid
• Information
• Contribute to organizational social policies
The Welfare Officer can help you to solve your problems.
Everybody encounters problems at different moments of their lives, not just at
home, but also in the work environment. Should such problems arise, don’t
carry them around too long, but make an appointment with the Welfare
Officer. A good -and confidential- conversation with the Welfare Officer can be
the beginning of a suitable solution. The Welfare Officer can give assistance
with problems of a personal nature, as well as those involving occupational
difficulties. For example:
• Conflicts with colleagues or manager
• Homesickness
• Settling down in The Netherlands
• Workload
• Reorganizations and the follow-on effects
• Addictions; alcohol, drugs, gambling…
• Relationships
• Financial problems
• Mobbing
• Aggression
• Sexual harassment
• Assistance in case of illness, accident or bereavement
26

Privacy
The Welfare Officer abides by a professional secrecy policy, in the same way
as doctors and lawyers, meaning that situations are not allowed to discussed
outside the confidentiality of the office without the explicit permission of the
client. In some situations, there could be more then one individual involved in
a common problem –for example a difficulty with a manager or a colleague- in
any such case, the Welfare Officer would always ask the permission of the
individual client before discussing any situation outside the office.
Where is the Welfare Officer located?
The Welfare Officer’s Office is located at room Da029 on the main corridor,
ground floor, next to the Medical Centre; The Welfare Officer can also be
reached on telephone extension 53201 or email: marc.barendse@esa.int.
27

Pregnancy & Childbirth
The Dutch have always looked upon pregnancy and childbirth, as a natural
part of life therefore home birthing is common. In recent years, however,
more women, especially those living in cities, are having their babies in
hospitals. Some 35% of first babies and 65% of second babies are born at
home.
If a woman suspects that she is pregnant she should first go to see her family
doctor. She may have already performed a home pregnancy test or may take
an early morning urine sample to the doctor who will perform the test for her.
Once the doctor has the results and there are no contraindications, he/she will
then refer the woman to a midwife who will then take care of all aspects of the
pregnancy and birthing. If there is an indication or should the woman
particularly request it, she may be referred to an obstetrician.
The Midwife (Verloskundige):
The midwife in The Netherlands is a specialist and has three years training
before being licensed to deliver babies. The midwife will have her own
practice (office), which may be within a hospital or private rooms outside the
hospital. Some midwives have "group practices" just as some doctors do.
Once a woman is referred to a midwife she should make an appointment in
the same manner as for a doctor. The midwife may deliver the baby at home,
at the polyclinic (up to 24 hour stay) within a hospital or in the obstetric
department when a longer stay is necessary or desired. The choice of where
one delivers may be personal or be determined by maternal/fetal health.
The Obstetrician (Gynaecoloog / Vrouwenarts):
The obstetrician usually becomes involved only if there is some complication
with the pregnancy, e.g. twin pregnancy, and the delivery will take place within
the hospital. It is of course the right of the woman to choose and should a
woman particularly want to see the obstetrician this may be arranged through
the family doctor. Bear in mind though that in The Netherlands it is considered
that a pregnancy is a well state for a woman and not an illness, and the
obstetrician may well refer the woman back to the midwife should there be no
complications.
They are also involved if becoming pregnant is more difficult. The centers that
offer IVF (in vitro fertilization) etc. are located at all the university hospitals in
the Netherlands. This means in this region LUMC, but also Diaconessenhuis
Voorburg and “Stichting Medisch Centrum voor Geboorteregeling” Leiden. All
insurances require prior approval.
The Maternity Nurse (“Kraamverzorgster”):
Another service offered in The Netherlands is the "kraamverzorgster" or
maternity nurse. This person is trained in care of mothers and babies and
may or may not, depending on the midwife, assist the midwife with the home
delivery. Apart from that, the service extends to post-natal care at your
house. You have the choice of having a nurse come to your home for three to
eight hours a day. The basic care is for the mother and baby's well-being and
education (for new parents). Many young parents find this help essential. The
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nurse will come for a maximum of eight days after delivery. If you want this
service you should register with a “Kraamzorg” Service as soon as possible
and remember to request an English-speaking nurse. Ask your doctor or
midwife which “Kraamzorg” Service is preferable. The cost is set at an hourly
rate and one must pay a deposit of when registering with the “Kraamzorg”.
Bear in mind that in The Netherlands once you have had a baby you are a
"kraamvrouw" for six weeks and expected to take it easy.
Exercise Classes (“Gymles“):
There are many different exercise classes available, from pre-natal classes
within a hospital to yoga classes held privately. The midwife will have
suggestions and ACCESS also can advise on this subject and will know of
classes held in the English language.
(ACCESS=Administrative Committee to coordinate English speaking services
via www. euronet.nl)
A Hospital Birth (“Ziekenhuis“):
It is possible to stay in a hospital twenty-four hours (or less) after the baby is
born. This is what is termed as a "Polyclinic" stay. Otherwise it may be up to
an 8-day stay.
Not only will the woman need her own personal items for her stay, but she will
be expected to bring along several items that her baby will need. Check with
the midwife or hospital in advance, usually there are printed guides as to what
is needed.
In The Netherlands it is practice to keep medical intervention to the minimum.
Please be sure that you understand the delivery procedures and what, if any,
medication you will receive. If you wish to have pain relief during your labour
it is advisable to discuss this with your obstetrician or midwife in advance
Furthermore, it is customary for husbands to be present when a baby is being
born and all hospitals accommodate this practice.
Home Care (“Thuiszorg”)
"Thuiszorg" is the combined social services for people with medical or social
problems. Among the services they provide are visiting nurses, dieticians and
the lending out of medical equipment such as crutches, wheel chairs, beds,
baby scales etc.
For a couple that choose to have a polyclinic or home delivery, there will
be several items that they will need to borrow from “Thuiszorg” (for the
normal period of use this service is free of charge).
Birth Registration (“Geboorte aangifte”)
Once your baby is born you will need to register the birth at your local Town
Hall (“Stadhuis”). This must be done within three days of the birth. This does
not mean that your baby will receive Dutch nationality, but it will receive a
Dutch birth certificate. It is a good idea to request for an international birth
certificate. You will need also to inquire about registering the birth with your
own Embassy or consulate.
29

Community Nurse (“Wijkverpleegster”):
Three to four weeks after the baby is born, the community nurse will come to
visit you at home. She will check on you and the baby and make an
appointment with you for the baby to attend the Baby Health Clinic
(consultatiebureau).
Baby Health Clinic (Consultatiebureau):
The "Consultatiebureau" is a part of the public health care system offered free
of charge. It offers such services as:
Immunisations
Monitoring growth and development
Speech and hearing testing
Nutrition advice
Advice giving
Either when you register your baby or on your first visit to the baby clinic, you
will receive a Dutch "Groeiboek" (Growth Book). This book is also published
in English and enables you to note down details about vaccinations, feeding,
height and weight etc., and has other useful tips relating to you and your baby.
Parent and Baby Groups (“Moeder en Kind-Groepen”):
There are many international groups of which offer contact, friendly advice
and support to mother's-to-be and parents of young children. Groups in many
areas have been started out of necessity by a nucleus of parents in their local
church or community hall. Call ACCESS for further details. Phone: 070
3462525
Baby /Child Care (“Baby/Kind Oppas”):
There are many possibilities for baby /childcare here in The Netherlands from
private carers to government subsidised crèches. They all run under strict
guidelines set out by Dutch law. The Estec Welfare Officer can advise you on
the options available locally. Your Embassy may have a list of baby /child
minders (that possibly speak your language), the local place of worship,
ACCESS (www. euronet.nl), and the various international schools will also
be able to help. You can also advertise in the local newspaper and interview
for a baby sitter/child minder. Your choice will depend on your needs.
For questions about sexuality or contraceptives:
contact SHAS 071-5146392
30

How to stay healthy
In this chapter you can find some tips how to stay in shape and healthy and
how to avoid the above-mentioned doctors and hospitals as much as possible.
Fitness
Physical Exercise
Getting fit doesn't mean being confined to a sweaty gym or paying homage to
stretch latex in an aerobics studio. Choose an activity that you actually enjoy
and you're more likely to stick with it.
So if you like dancing in your kitchen, cycling to work or walking your dog -
this all counts as regular exercise! Start with two times 20 minutes a week and
build it up to 3/4 times 40 minutes a week.
Good night sleep
The best way to get a good night sleep is to have a daily routine with relaxing
activities 2 hours before you go to bed. Read, take a hot bath, have a walk
around the block or find other ways to relax to reduce the adrenaline flowing
through your body. Try to keep the same rhythm for getting up and going to
bed.
If you have worries, write them down and promise yourself to take care of
them the next day.
Reload the battery
Take breaks. Do not fill up your agenda completely even if there are only
positive activities. Leave a few evenings a week open for yourself to relax or
to think over the activities you have done.
Some small long weekend breaks are often very helpful to regain the energy
to continue busy life.
Healthy lifestyle
Alcohol should be taken in moderation since it can be addictive. The
maximum intake for women is 1-2 units daily and for men 2-3 units. Pregnant
women should not take any.
Try hard to quit smoking. Some people benefit from programs and courses.
Inform with your family doctor or us about the available sources. Also look at:
http://www.givingupsmoking.co.uk/
Diet
Healthy diet
Food is a very important source of energy and eating with friends and/or
friends can be a very pleasant social event.
Eat plenty of vegetables and fruits to get enough fibers and vitamins. Food
products containing animal fats are unhealthy in large quantities. Be very
moderate with meat and cheeses.
Sugar is also an energy source that should be taken in moderate quantities to
keep your weight under control.
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Concerning the weight, it is very important to prevent being overweight or
obese to keep away several types of diseases, especially diabetes and cardio
vascular diseases. Do you have a healthy weight? If you want to know look at:
http://www.bbc.co.uk/health/yourweight/bmi_metric.shtml
Hygiene
The very basics:
Hygiene of food. Look regularly at the expiring dates. Do not use the same
carving board for raw meat or fish for other food products.
Washing your hands regularly can prevent transmission of viruses and
bacteria. Did you know that washing your hands 5x a day reduces the chance
of the flu with 50% during the winter season?
If you have wounds prevent them to get infected by cleaning them with
chloorhexidine or iodine and cover it with a bandage.
First Aid Kit at home
If you would like to stock a medical box at home you can buy a ready First Aid
Kit at the Pharmacy or Drugstore.
You could add the following over the counter available medication. Make sure
kids cannot reach or open the box. Realize that not all medication can be
used for children and children need adapted dosages.
Please read always the instruction leaflet first.
Chloorhexidine or Iodine for disinfecting wounds;
Paracetamol tablets for general pain and fever;
Naproxen tablets for heavier pain;
Azaron cream for insect bites;
Midalgan cream for muscle pains;
Hibitane/Trachitol sucking tablets for throat ache;
Xylomethazoline nose spray for congested nose;
Menthol powder for itching;
Maalox chewing tablets for stomach problems;
Dulcolax capsules for constipation;
ORS to dilute in water for diarrhea
First Aid Courses
Are you interested in a course to help your friends and/or family in case of an
emergency? There are several courses available: http://www.firstaid.nl/
For staff members look at the trainings schedule of the ESTEC/ESA intranet.
32

Medical vocabulary
Doctors
Nurses
Health workers
English Dutch
doctor arts
GP / family doctor huisarts
anaesthetist + anesthesist
cardiologist cardioloog
dermatologist dermataloog
ears/nose/throat specialist (ENT) keel/neus/oor-arts KNO
gynaecologist gynaecoloog
lung/ thoracic specialist longarts
medical consultant internist
neurologist neuroloog
obstetrician vrouwenarts
orthopaedic surgeon orthopaedic chirurg
pediatrician kinderarts
psychiatrist psychiater
psychologist psycholoog
rheumatologist reumatoloog
surgeon chirurg
nurse verpleegkundige
district nurse wijkverpleegkundige
midwife verloskundige
maternity nurse kraamverzorgster
nurse assistant verpleeghulp
physiotherapist fysiotherapeut
chiropodist pedicure
dietician diëtiste
speech therapist logopedist
pharmacist apotheker
social worker maatschappelijk werker
33

Places
Terms
doctors practice huisarts praktijk
hospital ziekenhuis
department / ward afdeling
out-patients department polikliniek
emergency / casualty / first aid eerste hulp
X-ray department röntgen afdeling
laboratory laboratorium
nursing home verpleeghuis
child and baby clinic consultatie bureau
pharmacy / chemist apotheek
consultation time spreekuur
visiting time bezoekuur
house call / visit huisbezoek
prescription recept
referral verwijzing
blood test bloed onderzoek
blood pressure bloeddruk
admission opname
discharge ontslag
healthy gezond
childbirth / delivery bevalling
home help thuiszorg
34

IMPORTANT PHONENUMBERS
Family doctor…………………………………………………………………………...
Dentist…………………………………………………………………………………..
Pharmacy………………………………………………………………………………..
Doctors night/weekend service..………………………………………………………
(look up the relevant number for your area on page 6 of the DMS brochure)
Ambulance/Fire brigade/Police…………………………………………………...112
(this number can be used throughout Europe for emergencies)
Local police station………………………………………………………..0900-8844
Hospital (with 24h duty):
LUMC (Leids Universitair Medisch Centrum), Albinusdreef 2, Leiden…071-5269111
Rijnland Ziekenhuis, Simon Smitweg 1, Leiderdorp……………………..071-5828282
Bronovo Ziekenhuis, Bronovolaan 5, Den Haag…………………………070-3124141
Rode Kruis/Juliana Kinderziekenhuis, Sportlaan 600, Den Haag…..……070-3127200
Leyenburg Ziekenhuis, Leyweg 275……………………………………...070-3592000
ESTEC Medical Center (during office hours)……………………………071-5655319
ESTEC Security (emergencies on Site, at all times)………………………………3333
Insurance J. Van Breda (from NL)……………………………………..0800 0220773
From other countries ………………………………………………….0032 32 175717
35