The university hospitals have another two and a half months to determine which two hospitals will from now on perform operations on patients with a congenital heart defect and which two will have to stop doing so. If they cannot come to an agreement before April 1, Minister Ernst Kuipers (Health Care, D66) will make a decision himself “in the short term”. He writes this in a letter to the Dutch Federation of University Medical Centers (NFU), which represents the eight UMCs in the Netherlands.
In doing so, Minister Kuipers ignores the advice of the Dutch Healthcare Authority (NZa), which wrote emphatically last month: “Do not take an irreversible concentration decision now.” The NZa saw major risks for patients and healthcare personnel. For example, access to acute care could be endangered in some places in the Netherlands.
Four centers at five locations
There are currently four centers (at five locations) where complex heart operations are performed in children and adults: in Utrecht, Groningen, Rotterdam, Leiden and Amsterdam. To maintain the quality of these procedures, treatment teams must perform such operations often enough. There are too few patients for four such centers.
For that reason, everyone agrees that care should be centralized. But whether that should happen in two or three centers in the future, and in which places in the Netherlands, the hospitals have not been able to decide for decades.
Outgoing minister Hugo de Jonge made the decision in 2021, just before Christmas. He decided that Erasmus MC in Rotterdam and UMC Utrecht would continue to operate; the centers in Groningen, Leiden and Amsterdam would stop doing so. The victimized hospitals then protested. It was unclear on what grounds the minister had made his choice and what consequences that choice would have. What would this mean for patients from the north of the Netherlands? And could the children’s intensive care unit in Leiden remain open?
Read also: Battle over closing heart centers: are children the victims?
Mark the place
Last year, Minister Kuipers promised to have an investigation carried out into the consequences of the plan. The conclusion of the NZa last month was only on the spot: first there must be a broader plan for the future of academic care, the NZa wrote. Only then can a decision be made about the pediatric heart centers.
The current situation is too fragile to allow it to continue for any length of time
Ernst Kuipers care minister
Kuipers now ignores this conclusion. Such a plan takes too much time, he writes. “The current situation is too fragile to allow it to continue for a long time.” Kuipers uses the fact that the relationships between the healthcare professionals and the four centers are “seriously disrupted” by the difficult concentration issue to increase the pressure: potential risks to the quality of care.”
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