Health Min.'s plan to centralize pediatric heart surgery can move forward, court rules

Caretaker Health Minister Ernst Kuipers’ plan to centralize pediatric heart surgery can go ahead. The university medical centers of Utrecht and Leiden/Amsterdam had objected to the plans to close their pediatric heart surgery departments. But the preliminary relief judge ruled on Friday that the plan currently has no “irreversible consequences,” and there is, therefore, no reason to press pause.

That means that the UMCs will have to discuss how to centralize pediatric heart surgery in the coming months. The court in Utrecht only ruled on whether or not to put the plans for centralization on hold. The case will be substantively handled at the end of this year when the court will rule whether Kuipers’ decision is lawful. The parties can then still appeal against the ruling.

At present, operations on congenital heart defects in children take place at four locations: Erasmus MC in Rotterdam, UMC Groningen, UMC Utrecht, and the Amsterdam-Leiden Center for Congenital Heart Defects (CAHAL), established by the Leiden University Medical Center (LUMC) and Amsterdam UMC. The Health Ministry has intended to concentrate this pediatric heart surgery in two or three hospitals for some time. Kuipers decided that from October 2025, the surgeries will only happen at the UMCs of Rotterdam and Groningen.

According to UMC Utrecht and CAHAL, Kuipers’ decision is already leading to great unrest among patients and staff. The hospitals also said that the Minister’s decision affects other care in their hospitals.

The preliminary relief judge said that this uncertainty is simply “inherent” in the decision. And even if the plan is paused, the uncertainty won’t disappear. He added that there is an urgency to start the transition quickly and that the UMCs must already take steps, as the Minister also asked of them at the end of May.

The Minister did agree that the UMCs can wait with preparations that require major investments. The conversations should be about how they can improve the quality of care. Even if the court decides at the end of this year to cancel Kuipers’ plan, these talks would not have been in vain, the preliminary relief judge said.