In early 2023, the Minister of Health decided to close the pediatric heart centre at UMC Utrecht and the Centre for Congenital Heart Defects Amsterdam Leiden. UMC Utrecht went to court to prevent closure. Despite earlier doubts about the case's success, the Midden-Nederland District Court on 11 January overturned the minister's decision. André den Exter, Associate Professor of Health Law, discusses the ruling
Closure of children's heart centres
In the Netherlands, pediatric heart surgery currently takes place at four centres: Erasmus MC, Centrum Aangeboren Hartafwijkingen Amsterdam Leiden (which is a collaboration between Leiden UMC and Amsterdam UMC), UMC Utrecht and UMC Groningen.
On 20 December 2021, then-health minister Hugo de Jonge decided that Erasmus MC and UMC Utrecht could continue to offer specialist pediatric cardiac care. The centres of UMC Groningen and Centrum Aangeboren Hartafwijkingen Amsterdam Leiden would have to close. In early 2023, successor Ernst Kuipers decided that UMC Groningen's centre could remain open and the Utrecht centre would have to close its doors.
Legal procedure
UMC Utrecht went to court. The hospital was ruled against in earlier summary proceedings, but the proceedings on the merits at the Central Netherlands District Court had a different outcome. Den Exter: "The minister must better substantiate his plea, which was simply the judge's verdict. The research figures he cited were not considered reliable enough by the judge. But if the minister stands by the decision to concentrate (from four to two pediatric heart centres, ed.), He will undoubtedly come up with a better justification. Then a judge can hardly reject it, I think."
Quality, durability and affordability
The quality of care offered will improve if cardiac surgery is concentrated. This is because doctors will have to operate more, which means more flying hours. Centralisation will undoubtedly bring disadvantages. However, according to Den Exter, these disadvantages do not outweigh the advantages of centralisation. "For example, the fact that parents do not suddenly have to go to Groningen with their child is nice. Yet, at the moment, pediatric cardiac care remains fragmented over several centres, and you don't really want that. That's something everyone agreed on in the first place. So for the sake of care, its sustainability, affordability and continuity, concentrating is really best anyway. There is no question about that."
- Associate professor
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Kinderhartcentra Utrecht en Leiden-Amsterdam mogen openblijven
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