I worked down on the islands as well flying the police helicopter and I don’t think you realize how small and difficult the airport of Saba is to land at with a fixed wing. Even during the day under good conditions it is not a routine job. There is a reason the DCA.NA (Directorate of Civil Aviation Netherlands Antilles) require fixed wing pilots to have 1500 hrs STOL time before they are allowed to land there and there are no night flights to the airport.
A couple of years ago +-6 or 7 there was a deal with the B222 from Tortolla and the Saban government and the DCA.NA to provide medical emergency evacuations. But it seems to have been dissolved or the cost were too high.
As for the police helicopter: the Netherlands Antilles government in Curacao tried going for a bigger multi-mission helicopter but the operating cost were so high that that they cancelled the whole police helicopter project for Curacao.
I agree with everything TIMTS and buitenzorg have posted. I have had lady luck on my side on a couple of nights down there but I feel my instrument training/ rating has helped change the balance for the better. Flying over water at night is dangerous and should never be taken lightly.