‘A Medical Doctor in Politics’. Els Borst-Eilers and the Rise of Evidence-Based Healthcare in the Netherlands

Abstract

This article examines how Els Borst-Eilers, Dutch minister of Health between 1994 and 2002, pursued the cause of Evidence-Based Medicine (ebm) - an influential movement in the medical field that gained a particularly firm foothold in the Netherlands. It focusses on the way Borst-Eilers operated within the nexus between healthcare and politics, discussing whether or not this made her a boundary person (analogous to the notion of boundary concepts). In particular, the paper analyses how she deliberately cultivated her persona as a specialist minister ('a doctor, not a politician') and how she pragmatically utilised ebm as a tool for depoliticising the thorny political issue of cost containment in healthcare. It was not so much the notion of ebm itself, but rather its specific translation into efficient and appropriate healthcare of which Els Borst-Eilers became the foremost advocate in the Netherlands.