Minister of Health Ernst Kuipers (D66) has the decision to concentrate centers for pediatric heart surgery in Erasmus MC and UMC Utrecht examined by the Dutch Healthcare Authority (NZa). He announced that on Friday in a letter to the House of Representatives. At the request of Kuipers, the NZa will present an analysis before the summer recess, which will map out the consequences of the decision. Kuipers wants to stick to two centers instead of the current four, but writes that he is prepared to reconsider the locations if the NZa sees “well-founded substantive reasons” for this.
Kuipers’ announcement is remarkable, because the NZa had previously offered to conduct an investigation, but the Ministry of Health, Welfare and Sport did not respond. The decision by Kuipers’ predecessor Hugo de Jonge (CDA) to designate Erasmus MC in Rotterdam and UMC Utrecht as the only hospitals for pediatric heart surgery was met with much criticism, especially from the north of the country. Children who live far from Rotterdam and Utrecht should be able to receive care closer to home, was the criticism. Medical specialists who work for the centers to be closed feel ‘sidelined’ in the decision-making process.
Also read: Battle over closing heart centers: are children the victims?
Three decades of discussion
Kuipers, who endorsed De Jonge’s decision, calls the return of specialist care to two centers in the letter “essential (…) to maintain and improve the quality and continuity of this form of care” and speaks of “a broad consensus” in the field of care “that it will not go on like this”. The discussion about concentrating surgery for children with congenital heart defects has been going on for almost three decades. In 1993 the Health Council advised already that concentration of specialist care was necessary to continue to meet the quality requirements. According to Kuipers, there are currently only eleven specialized pediatric heart surgeons, spread over five treatment locations. This causes problems when filling in the rosters, according to the minister.
Member of Parliament Attje Kuiken (PvdA) also agrees that care should be concentrated, but suggested earlier that NRC that there is no substantiation for choosing Rotterdam and Utrecht as locations: “Only: the step between ‘centralization is sensible’ and ‘we choose these centers’ is inimitable.” Moreover, Kuiken argues, no impact analysis has been made, as the NZa will now do anyway: “What does this mean for patients, for parents, for hospitals, for other care?”