Health Minister Ernst Kuipers wants to look again at the two locations that have been designated to concentrate pediatric heart surgery. There is therefore a glimmer of hope for the University Medical Center Groningen (UMCG) and with it in the north-east of the Netherlands that this highly specialized care will be preserved.
Kuipers does stick to the earlier decision to reduce this highly specialized care from five to two hospitals. His predecessor designated Utrecht and Rotterdam for this purpose. Kuipers agrees, but he is prepared “if there are good substantive reasons for this, to reconsider the choice of locations”, he writes in a letter to the House of Representatives.
Major objections to the Northern Netherlands
The D66 minister will ask the Dutch Healthcare Authority (NZa) to investigate the exact consequences of these types of operations only taking place in Erasmus MC and UMC Utrecht. The hospitals in Groningen, Leiden and Amsterdam that are still working on this should stop doing so. There are serious objections to this among doctors and among the inhabitants of the Northern Netherlands in particular, because residents then have to travel far to receive these complex treatments.
But Kuipers is convinced that the “concentration of the interventions in children with congenital heart defects and the interventions in complex congenital heart defects in adults at two locations is essential to maintain and improve the quality and continuity of this form of care.” He points out that it is about the heart interventions and not about “all facets of care” for these patients. They can go to a hospital in the region for this.
Discussion has been going on for almost thirty years
The discussion about treatment for people with congenital heart defects has been going on for almost thirty years. In 1993, the Health Council issued a recommendation stating that concentration was necessary to continue to meet the quality requirements. All kinds of other advice also went in this direction, Kuipers writes.
The knowledge and expertise for pediatric heart surgery is fragmented and that “brings serious risks to the quality and continuity of this care”. In addition, the Inspectorate found in 2019 that national cooperation was insufficient. According to Kuipers, the implementation is also vulnerable, because there are only eleven specialized pediatric heart surgeons. And they are spread over five treatment locations. This already causes problems when filling in the rosters. Some older heart surgeons will also retire in the foreseeable future.
He expects an analysis of the matter by the NZa before the summer.