Cabinet accepts reversal of decision on pediatric heart surgery: ‘It is bad that a judge makes this decision’

The government accepts the judge’s decision to reverse the proposed concentration of pediatric heart surgery in Groningen and Rotterdam. Outgoing Minister Pia Dijksta (D66) of Medical Care announced this on Wednesday.

In a letter to the House of Representatives, Dijkstra writes that she finds an appeal in this case ‘not constructive’. Instead, she hopes that the academic hospitals involved will still reach an agreement. It remains to be seen whether that will succeed in this issue that has been going on for thirty years, writes RTV North.

Last year, the then Minister of Health Kuipers decided that care for patients with a congenital heart defect should be concentrated in the UMCG and the Erasmus MC in Rotterdam. The children’s heart centers of the Leids UMC / Amsterdam UMC and the UMC Utrecht should close in 2025.

These three hospitals did not accept this and went to court. They were rejected in summary proceedings, but in the subsequent substantive proceedings the judge ruled in their favor last month. The decision was received with mixed feelings at the UMCG.

The discussion included the volume standard: how many pediatric heart operations are needed annually in a hospital to maintain the quality of care?

Operations and other interventions in children with a congenital defect are relatively rare. Moreover, these treatments involve complicated treatments that are only properly mastered by a limited group of specialists. There are too few to keep four children’s heart centers afloat. All parties involved agree on this.

But the hospitals have never agreed on which pediatric heart centers should close. Kuipers initially wanted to keep the centers in Rotterdam and Utrecht open. After a storm of protest from the UMCG camp and under pressure from the House of Representatives, he reversed his initial decision. The center in Groningen was allowed to remain open and the center in Utrecht had to close instead.

So none of that will happen. Now that there is no appeal, everything seems to be back to square one. Dijkstra is not happy with that. In a written response, Dijkstra said ‘he thinks it is a bad thing that a judge had to intervene in this decision. We all have the same goal in mind: the best care for patients, now and in the future.

She expects the five university hospitals to jointly take concrete steps in the short term to see how the intervention in children with a congenital heart defect can be organized “in the best possible way”.

The academic hospitals of Leiden, Utrecht and Amsterdam are happy with the minister’s assistance. “As UMCs, we will now continue to discuss how we can jointly guarantee the quality and accessibility of pediatric heart surgery in the future,” they say in a joint response. The umbrella organization of academic hospitals, the NFU, is working on a proposal and reports: “The UMCs in the Netherlands have expressed the wish to solve the puzzle of the concentration of pediatric cardiac surgery together.”

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