Judge reverses decision to centralize children's heart surgeries

Operations on congenital heart defects in children will not be centralized in Rotterdam and Groningen for the time being. The Utrecht court reversed the Ministry of Health decision on Thursday. The university hospitals of Leiden, Amsterdam, and Utrecht had challenged the decision. They were in danger of losing the operations.

Ernst Kuipers, who has now left as healthcare minister and was previously boss of the Erasmus MC, had decided last year that only Rotterdam and Groningen could still carry out the operations. His predecessor, Hugo de Jonge, wanted to centralize the interventions in Rotterdam and Utrecht, to the anger of the northern provinces, among others.

According to the ministry, it would be better to centralize operations. Each center would then perform approximately sixty operations per year on newborn babies. The explanation is that the level will also increase if the number of operations increases. The claimant hospitals say that the number of sixty is not based on anything and that the minister has not demonstrated why only two hospitals can be left instead of three, four, or five.

The court agrees with them. According to the ruling, Kuipers has not adequately investigated whether having only two hospitals carry out the operations is necessary. Therefore, It is unclear whether this decision is "necessary, balanced and therefore proportionate."

Leiden, Utrecht, and Amsterdam had also said that it would be bad for their care if pediatric heart surgery disappeared. Employees would then leave, and treatment teams would fall apart. The regulator, the Dutch Healthcare Authority, had also warned about this. The authority advised first to take mitigating measures and only then to centralize, but Kuipers turned that around. He decided to centralize operations and gave the hospitals 2.5 years to take measures to soften the blow. The judge thinks that is not enough. The minister should have thought more carefully about the consequences of his decision.

The Netherlands now has four centers for pediatric heart surgery. One of these is the Center for Congenital Heart Defects Amsterdam-Leiden (CAHAL), which was set up by the Leiden University Medical Center (LUMC) and Amsterdam UMC. The other three centers are at the university hospitals in Utrecht (UMCU), Rotterdam (Erasmus MC) and Groningen (UMCG). Leiden/Amsterdam and Utrecht want to collaborate more closely.