Health Min. determined to close two pediatric heart surgery centers

Minister Ernst Kuipers of Public Health will stick to his decision to only maintain two centers for specialist pediatric heart surgery in the future. He plans to decide which two centers it will be by April 1 and has asked the teaching hospitals to help with this.

The discussion about the centers has been going on since 1993, Kuipers wrote in a letter to the Dutch Federation of University Medical Centers (NFU). That is why Kuipers feels that a decision must be made quickly. Only four centers of academic hospitals are currently performing interventions for children with a congenital heart defect - those in Rotterdam, Utrecht, Groningen, and a collaboration between Amsterdam and Leiden.

Kuipers hopes that the teaching hospitals will break through the impasse themselves. Previous attempts to do so failed, partly because of the coronavirus pandemic. But according to the Minister, it should be possible for them to make a decision. He wants to know within a month whether the NFU is willing and able to do so. If not, Kuipers will make the decision.

If the NFU agrees to investigate which centers to keep, Kuipers wants to know by April 1 at the latest which hospitals will continue to provide pediatric cardiacal care. Considering it even longer is not desirable because of the “urgency of this subject,” the Minister said.

The Minister initially planned to keep the centers in Rotterdam’s Erasmus MC and UMC Utrecht open. But the planned closure of the center in Groningen led to a lot of resistance in the northern provinces.

Kuipers also decided to await an investigation by the Dutch Healthcare Authority (NZa) into the consequences for hospital care if two pediatric cardiac care centers close. The NZa warned that the closure could affect intensive care for children and acute care in certain regions. The NZa proposed to divide the care into a northern and southern region, but patient organizations are opposed to the idea.

Kuipers hopes the NFU investigation will also help find ways to limit the negative consequences for the hospitals that would lose their pediatric heart center. He wants clarity on that by October 1.

The Health Minister did not completely adopt the NZa’s advice. He won’t slow down this process. “I expect that such a discussion will take a lot of time, while the subject really requires a decision,” he explained. He also expects that discussion between the UMCs will be difficult as long as it is not clear in which hospitals the treatments will be concentrated.

The Minister wants to concentrate certain specialist care because the hospitals providing that care will then treat more patients and increase their expertise and quality. According to him, the idea for concentration is “widely shared.”