St. Maarten Medical Center requests court to take higher supervision off table


PHILIPSBURG--The Inspectorate for Public Health has gone on a "rampage" and has painted an "ominous" and incorrect picture of sub-standard healthcare at St. Maarten Medical Center (SMMC). Attorney-at-law Maarten Le Poole said this Tuesday during the injunction filed by SMMC against the higher supervision imposed by the Inspectorate.

The Public Health Inspectorate, represented in the injunction by Inspector General Earl Best, had placed SMMC under higher supervision based on the findings of its governance audit, thematic site inspections conducted on SMMC from the end of 2011 to the first half of 2012.

The measure went into effect as of September 8, and is also based on the measures that need to be taken at SMMC concerning quality of care and patient safety, some on short-term and others within a year.

Via its attorney SMMC rejected the higher supervision and asked for clarity on the legal basis used for the measure. It asked for the lifting of higher supervision until the outcome of the court case on the merits, which is not to be heard until December 2012 or January 2013.

Minister of Public Health, Social Development and Labour Cornelius de Weever was in the audience during the hearing of the injunction.

The inspectorate had given SMMC's Board of Directors two weeks to present a feasible action plan "to address many of the critical issues found" in the report. The inspectorate also said it would be conducting announced and unannounced inspections at least three times per month at SMMC, following up on the action plan. Failure by SMMC to comply with the higher supervision may result in temporary closure of "specific functional units." or the issuance of fines.
According to SMMC, the inspectorate had overstepped the boundaries of its authority. It further claimed that within the framework of possible cooperation with Fundashon Mariadal in Bonaire, it had submitted an action plan which addressed several "points of concern and improvements."

SMMC's delegation in court, consisting of Director George Scot, Assistant Director Bonnie Dekker, Manager Patient Care Antonio Pantophlet and Human Resources/ Communications Officer Juliëtte Hassell claimed the inspectorate's findings were incorrect.

"The medical specialists underlined that the quality of patient care is up to standard and they do not agree with the assumption that the quality of patient care is being hampered," attorney Le Poole stated on SMMC's behalf.
SMMC stated that the inspection report has been founded on a "negative attitude" towards the Board of Directors and Supervisory Board, and is not in compliance with the vision of other experts and would, therefore, be a much too unsteady basis for higher supervision.

SMMC qualified this measure, which had caused "great damage," as disproportionate, untimely, inaccurate and illegitimate.

Higher supervision does not mean that SMMC's management has become subordinate to the inspectorate, said the inspectorate's lawyer Jairo Bloem.

Bloem said the audit had included quality care, internal governance, first aid, reports of calamities, as well as inspections of equipment, medication and localities. Documents were studied and operations attended, while conversations were held with hospital staff, as well as the Board of Directors and Supervisory Board.

The inspectorate mentioned various deficiencies such as the lack of logs concerning the maintenance of medical equipment, lack of communication between management, unmotivated staff and high work pressure. It said the Board of Directors should act diligently in motivating staff, optimising care and in providing transparency on the quality of provided care in order to have the higher supervision lifted.

The inspectorate contested claims that it had overstepped the boundaries of its authority and had submitted SMMC to standards applicable to large hospitals in The Netherlands. Judge René van Veen will give his decision on Tuesday, October 16.