April 17, 2023 – 09:11
Utrecht, 13 April 2023 – The UMC Utrecht and the Princess Máxima Center for Pediatric Oncology are forced to take legal action against the decision of the Minister of Health, Welfare and Sport to remove interventions for congenital heart defects from Utrecht. The minister has previously indicated that he would only revert to the earlier intention to concentrate this care in Erasmus MC and UMC Utrecht if there were ‘well-founded substantive reasons’. The amended decision does not contain these reasons.
Recently, the Ministry of Health, Welfare and Sport was of the opinion that UMC Utrecht and Erasmus MC had the best starting position to fulfill the function of intervention centre. Because of the ‘optimal accessibility and accessibility’ of care for patients with congenital heart defects, this is now deviated from in the decision. However, the new decision does not lead to optimal accessibility, accessibility or future-proofness for patients.
Successful concentration is nullified
With his decision, the minister undermines the successful concentration of care and research for all children with cancer in the Netherlands in the Princess Máxima Center. Children with cancer at the Princess Máxima Center often require care from the pediatric cardiac team at UMC Utrecht/Wilhelmina Children’s Hospital. In total, this involves approximately 60 treatments per year, the majority of which cannot be planned. Emergency indications requiring the specialized children’s heart team of the WKZ occur several times a month at the Princess Máxima Center. It is not possible to provide this care while maintaining quality and safety if there is no longer a pediatric heart team in the WKZ in Utrecht. It is not for nothing that a location was chosen next to a children’s hospital where such a team is present at the start of the Máxima.
If the pediatric heart team disappears from Utrecht, seriously ill children will have to travel to another location in the country where there is no oncological expertise for highly specialized and radical parts of their treatment. This entails great risks. It is incomprehensible that this successful national concentration of care for children with cancer is largely undone.
Uncertainty about criteria
Although we are in favor of concentration of highly complex care, we do not agree with the minister. This decision is not in the patient’s interest because it does not lead to optimal access to care for patients with a congenital heart defect. Moreover, the government should have been clear in advance about the criteria to be applied and the distribution. The aim of concentration is to improve the quality of care for patients, which is not an issue at the moment. In addition to the patients from the Máxima, a considerably larger proportion of patients with a congenital heart defect will soon have to travel. There will also be two centers that are not equivalent, since the vast majority of patients will want to go to the already largest center because of the travel time. With this expected growth in the number of patients, the relevant volume standards will not be achieved in both centers.
A puzzle that has been laid is taken apart
It is therefore not the case, to use the minister’s words, that with the concentration of interventions in congenital heart defects ‘the first piece of the puzzle has to be put in place’. A puzzle that has already been put together is taken apart again. The minister’s decision does not lead to optimum accessibility of care. Not for the patients of the Princess Máxima Center, but also not for patients from the south and east of the country. For this reason, the UMC Utrecht and the Princess Máxima Center will request the court to reverse the minister’s decision.
Source: UMC Utrecht