August 21, 2010

Rail operator ProRail wants to rein in suicide by train

Filed under: Health by Branko Collin @ 12:33 pm

ProRail, the Dutch railway network operator, wants to diminish the number of suicides committed by people jumping in front of a moving train. The organisation aims at a reduction of 5% over the next four years. Currently, 200 people kill themselves by jumping in front of a moving train, which is 12% of the total number of suicides, the highest ratio in the region.

According to ProRail, about half of all suicides are committed by people who are undergoing psychiatric care. The network operator has already experimented by placing gates near psychiatric hospitals and by turning level crossings into viaducts.

The current policy of the Dutch Association for Psychiatry (NVvP) is to advise its members to send the suicidal out into the street. This policy is much to the dismay of the Union for Train Drivers and Conductors (VVMC) who point out that people jumping in front of moving trains are very traumatic experiences for their members.

(Photo by Jason Rogers, some rights reserved)

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August 9, 2010

Psychiatric patients get a bit of privacy back

Filed under: Health by Branko Collin @ 8:25 am

healthcareA court ordered last week that the national care monitor NZA can no longer demand of psychiatrists that they provide details about their patients’ mental health problems.

Nationale Zorg Autoriteit, which monitors the application of the health care laws and sets prices where necessary, bases its rates for psychiatric care on so-called ‘diagnosis-treatment combinations’ (DBCs) and requires psychiatrists to report the DBCs they have used for specific patients.

The court (College van Beroep voor het bedrijfsleven, i.e. ‘college of appeal for businesses’) held on August 2 that since insurance company employees who were not bound by medical confidentiality had access to the DBCs, the NZA had not given enough weight to the privacy interests of patients.

NZA now gets to go back to the drawing board and come up with new plans for a rate structure that does not (or to a lesser extent) compromise patients’ privacy.

Last year, political blog Sargasso already pointed out that once these data are out from under the protective umbrella of medical confidentiality, they can easily be abused by for instance the government, which could, for example, decide not to hire somebody as a civil servant based on their detailed medical history.

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