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Governance issues at St. Maarten Medical Center ended specialist cooperation

SATURDAY, 13 APRIL 2013

THE HAGUE–Serious governance issues at St. Maarten Medical Center (SMMC) have ended the specialist care cooperation with two Amsterdam hospitals, Minister of Home Affairs and Kingdom Relations Ronald Plasterk confirmed on Thursday.

He stated this in a letter to the Second Chamber of the Dutch Parliament. The letter, also sent on behalf of Minister of Public Health, Wellbeing and Sports Edith Schippers, was a response to the agreements that the four Parliaments in the Kingdom had made during their meetings in The Hague in March this year.

Plasterk explained that the assistance offered by the Dutch Ministry of Public Health, Wellbeing and Sports VWS to expand medical specialist care from Bonaire to St. Maarten through the cooperation with VUmc and AMC from Amsterdam had ended due to “serious governance problems at SMMC.”

For a while medical specialists from the two Amsterdam hospitals worked both in Bonaire and in St. Maarten last year. This brought much needed additional specialist care to the islands.

Minister Plasterk provided no further details on what had caused these serious governance problems. VWS has also offered policy support to Curaçao several times. The hospital is not functioning up to par there either.

The Minister stated that his colleague Schippers applauded the wish of the four Parliaments in the Kingdom to seek closer cooperation in the area of health care in an effort to improve health care within the Kingdom.

Cooperation between the countries can be stimulated through policy of the various governments. But further development in this area depends on the local situation per hospital and per country. “The influence of the policy is limited because of the space of the various health care systems and the private health institutions.”

The countries have little say on policy decisions and the concentration of medical specialist care at the local hospitals, as these are private institutions. The hospitals in charge of specialist care and a possible cooperation with each other are imbedded in the health care insurance systems of the various countries. “These systems are currently undergoing major changes in Curaçao and St. Maarten.”

Plasterk and Schippers concluded that for the cooperation in the health care sector to be successful the countries must first have their own internal health care policies in order before any mutual agreements can be made.

Making agreements where it comes to health care can be useful, but countries should not set their expectations too high for the health care summit that Aruba wants to organise later this year, stated the Ministers. VWS is prepared to help with policy making, but will not make funds available for health care institutions in the countries. “This remains a responsibility of the individual countries.”

Where it comes to medical referrals abroad, Plasterk and Schippers were of the opinion that the countries first have to get their policy, including legislation, in order if the countries want to make cooperation in this area and a possible reduction of the cost of sending patients abroad a success.

Cooperation in the area of organ transplantation and matching, an idea originally brought forward by St. Maarten’s President of Parliament Rodolphe Samuel, is only possible if the entire health care system is readied to collect and match organs. “This involves a complete system of donor organisation with accompanying medical teams and legislation. The question is whether the limited scale of the islands is suitable for this.”

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