^iEALTHY PARTNERSHIP LBS B What's NkwS Issue 2 February 1996 working relations 3 The Delta Psychiatrie Hospital in Rotterdam confronts something of a dilemma. The political, regulatory, and financial environment in Dutch health care is in a state of almost unprecedented flux. Yet Delta's mission - to provide high-quality care - remains unchanged. high-tech business that can act the instant it arrivés at a decision. Our activities are closely regulated by the government. It can take years for decisions to be approved. So it is very important that we have a partner that is well- versed in the regulatory aspects of this work - and that can help us financially navigate these regulatory seas.' HIATWSCHME^^ buta psychiatrisch 0 OVERLAST HTJNC «gwwf vt« Vnder construction - Delta director Eddy Schuyer's new, Rabobank-financed facility This dilemma is hardly unique to Holland, in fact. Throughout the developed world, populations are aging and the pressures of modern life are on the rise. l.ittle surprise that demand for psychiatrie services is high. But at the same time, economie realities are narrowing the scope for government to maneouvre; policymakers are seeking ways to 'rationalize' public commitments. UNIQUE PROFILE Institutions like Delta are caught in between. When it became clear that it was to be privatized last year, one of Delta's first concerns was to lay strong foundations for its financial security. It chose a bank that understood the challenges it faced and was committed to meeting its long-term needs. 'This was more than a question of money and interest rates,' explains Delta's director Eddy Schuyer. 'I came away with a very definite impression that Rabobank was devoted to understanding the unique profile of the health care business NAVIGATING REGULATIONS Schuyer has good reason to understand ^he significance of this 'unique profile.' In Brddition to his directorship of Delta, he has the distinction of serving as leader of the reformist D66 political party in the upper house of the Dutch parliament in The Hague. 'Delta is not IBM or some S SPECIAL NEEDS There is a great deal at stake. With nearly 800 beds, Delta ranks among the top three psychiatrie hospitals in Holland. It serves a uniquely diverse region of 650,000 people which includes not only residents from the urban centre of Rotterdam and the so-called Randstad but also a significant Calvinist farming community that is clustered among the Zuid Holland islands of the Rhine. 'These are really quite different populations and each has its own special needs,' observes Schuyer. Inner city Rotterdam, for example generates a great many drug-related maladies. The demographic trend overall has increased demands for care targeted at the problems of aging. Almost half the patients are at Delta for a long-term stay. At the same time, the hospital serves some 1,500 outpatients annually as well. DELTA PSYCHIATRISCH ZIEKENHUIS - GEZOND PARTNERSHIP De Nederlandse gezondheidszorg is bijna volledig geprivatiseerd Dankzij de jarenlange ervaring van de Rabobank in de gezondheidszorgsector, de kennis van de overheidsregels op dit gebied en de goede contacten die zijn opgebouwd, koos het Delta Ziekenhuis voor de Rabobank. De Rabobank financiert onder andere het nieuwe complex voor de opvang van tbs- patiënten dat naast het ziekenhuis wordt gebouwd. Elk kwartaal wordt met het accountmanagement de financiële strategie besproken en ook op lokaal niveau bestaan goede contacten. SECURE EXPANSION A quite separate but related departure for Delta is the expected opening this summer of an altogether new facility now under construction. Holland's criminal justice system is overburdened with offenders who have been declared criminally insane and need long-term help. Several hundred are waiting for placement. A large high- security hospital - the largest in Holland - is being built with help from a NLG 200 million Rabobank credit line on grounds directly adjacent to the Delta facility. Eddy Schuyer has been appointed as director of this hospital, and hopes to synergize the resources of both, including not only the medicai staff but such ancillary facilities as the laundry and kitchens as well. LOCAL SOLUTIONS Schuyer meets with Rabobank account managers quarterly to discuss issues of financial business strategy. His staff and controller have direct contacts at local Rabobank level for problems that can arise day by day. To address some of those problems, for example, a NLG 10 million credit facility has been designed to meet cash flow needs when, as often happens, medicai insurance companies are late with their monthly reimbursements. PROACTIVE SERVICE Schuyer says he has come to appreciate the unusual degree of personal attention - 'almost a family relationship' - with Rabobank. For example, the bank will alert him to the most favourable moments in the interest rate cycle at which to borrow funds. When it was first bidding for Delta's business, Rabobank designed a special package for hospital employees that included savings, insurance and mortgages on favourable terms. The bank even sponsored the purchase of a pair of special busses designed for patients with physical disabilities. UNIQUE RELATIONSHIP The special relationship with Delta reflects Rabobank's strategie commitment to the health care and pharmaceutical markets. 'Of course, every business has its own risks,' says Leendert Mastenbroek, one of the Delta account managers. 'But this is an area where we see a good prospect for long-term growth.' In the end, of course, a banking relationship boils down to trust. 'It's interesting,' remarks Schuyer: 'if you meet other executives who use Rabobank, you find they spend less time talking about interest rates and more about the special relationship they've developed with the bank and about how much attention is devoted to their individual needs. This, to me, seems quite unique.'

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