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St. Maarten Hospital will not adhere to higher supervision


~ Gives Best two days to retract statement ~

CAY HILL–St. Maarten Medical Center (SMMC) says it will not cooperate with the higher supervision order placed on it by the Inspectorate for Public Health because there is no proper legal justification for the inspectorate’s decision.
In a letter to Inspector General Earl Best on Wednesday, HBN Law, the attorneys representing the hospital, also gave the inspectorate two days within which to publicly rectify its earlier public statement indicating that SMMC had been put under “higher supervision.”

In its letter HBN law also “summoned” the inspectorate “to refrain from making further public statements” while the issues with SMMC have not been clarified and without first consulting SMMC; and to avoid performing further acts, “which suggest that its office lets itself be used as a political tool.”

“Since it is abundantly clear that the phenomenon of higher supervision does not even exist in this context, since the connotation of the term higher supervision is, as you should have known, extremely ominous and leads to widespread misconceptions and to a lack of confidence and motivation both internally and externally, and since the use of this term is therefore highly irresponsible, you are also summoned to, within two days as of the date of this letter, publicly rectify your earlier public statement(s) indicating that SMMC has been put under higher supervision,” the law firm wrote.

HBN Law said SMMC had asked it to react to the inspectorate’s letter dated September 8, in which the Inspectorate had given notice to SMMC of its decision to put SMMC under higher supervision as of September 8, 2012, for a period of one year and “whereby you threatened to impose fines on SMMC, or take other coercive measures in case of noncompliance.”
“The first striking element of your letter is that it fails to refer to any ordinance, regulation or enforcement framework on which the abovementioned decision and its implications can be and have been based. This is all the more striking since your office was able and willing to provide a list of (supposedly) applicable ordinances and other documents to members of the local media,” the letter stated.

“This list, if correct at all, is neither specific as to the legal basis for the measure of ‘higher supervision’ and for the implications of this measure, nor as to the legal basis for the imposing of fines and/or for the closing of functional units. Our review of the ordinances, which have the most relevance in this matter, has neither revealed any basis for the measure of higher or intensified supervision of a medical institution like SMMC or for the implications of such measures.”
The letter continued: “The above leads to the preliminary conclusion drawn by SMMC that the decision mentioned in your letter of September 8, 2012 is either contrary to written law or in conflict with general legal principles, the latter, for instance, because the decision has not been substantiated properly and was taken in violation of the requirement of due care (in Dutch: zorgvuldigheidsbeginsel).This violation includes, but is not limited to the genesis of the decision, such as the unprofessional way in which the draft report HBN Law since 1938 containing many factual errors was circulated, the lack of hearing both sides in that regard and the unreasonable refusal of the request by SMMC for a short extension of the term for providing a reaction to the draft report.”

“Unless and until you have provided SMMC with a proper legal justification and, if the latter exists at all, with a proper substantiation of your decision, SMMC will not recognise same as being valid and will not cooperate with same.
“Please be advised in this regard that SMMC does not share your opinion that your decision cannot be appealed under the Ordinance on Administrative Justice LAR. SMMC is of the opinion that your decision is without any doubt subject to appeal and in fact intends to file such appeal within the shortest possible term. SMMC will also consider requesting the court to suspend your decision pending the handling of the appeal case.

“Furthermore, SMMC strongly takes exception to the fact that you have divulged your ill-considered decision to the local media behind its back, thereby creating yet another wave of unnecessary unrest in the community regarding the functioning of the hospital; and also to the fact that the provision by [SMMC General Director and Board President Dr. George, ed.] Scot of his own assessment dated August 2012 and sent on September 7, including an improvement plan to the Inspectorate, has deliberately been ignored by your office in the report as well as in the press release of September 10, 2012, whereby the erroneous impression was created that SMMC is not committed to pursuing improvements.”
HBN Law says if the Inspectorate disregards its summons this will lead to appropriate legal measures being taken by SMMC and to holding country St. Maarten liable for all damages resulting from “your actions or omissions.”

“SMMC is in the process of preparing a comprehensive reaction to both the draft and the final version of the audit report,” it was stated in the letter.


De Weever vows to guarantee quality care at medical center


PHILIPSBURG–Health Minister Cornelius de Weever says if functional units at St. Maarten Medical Center (SMMC) have to be closed by the Inspectorate of Public Health if the hospital fails to comply with the higher supervision placed on it, “then that’s what will have to be done.”

The minister was responding to questions by this newspaper as to what measures had been or would be put in place for the continuity of care if certain departments at SMMC were to be closed.

The minister said that if the Inspectorate “deems it necessary” to close functional units “for the safety and quality of patient care then that’s what they have to do. If different arrangements need to be made … then that’s what we have to do, but we have to ensure a quality level of health care that doesn’t drop. We cannot allow this to continue.”

On Wednesday, the Minister stuck to his position that as long as he holds his current function he will do what is necessary to guarantee quality care at SMMC. He also told reporters at the Council of Ministers press briefing on Wednesday that the Inspectorate of Public Health was an independently functioning body that was not obligated to inform him of every decision it made.

He was alluding to a press release he had issued on Sunday regarding the SMMC issue. The Inspectorate had placed SMMC under higher supervision on Saturday.

De Weever said the Inspectorate was free to issue “sanctions” against SMMC if it considered it necessary. “They are free to do so. They do not necessarily have to communicate with me about that, because they act on their own,” he said. “If I have to interfere in everything that the Inspectorate does, I’ll be doing their job. That’s the reason for the Inspectorate being independent.”

On the issue of corporate governance, De Weever said he had expressed his belief from the inception of his “amicable meetings” with SMMC that the Corporate Governance Council should be involved to some degree, “because we are a country as of 10/10/10 and their involvement, I believe, is essential as well.”

The minister said that whether the Corporate Governance Council or Corporate Governance Code was used, “I believe that would be doing things the right way.”
He said the Corporate Governance Council had been asked in a letter dated May 7 about its role and involvement with the medical centre and articles of incorporation. A response was received on September 11. He also spoke about letters dated July 19 and July 21.

He said, “Those who believe it [SMMC, ed.] is a private foundation and that in their opinion they can even have their lawyers make statements to me, it is okay. I have responsibility as Minister of Public Health to make sure the safety of the people of St. Maarten and if I can’t do my job …

“While I sit on this chair this will not happen. This will not happen as long as I am sitting in this chair and I need to make this extremely clear to everyone. That’s my job and that’s what I have to do and I will not apologise for doing my job. If I have to end up in court then so be it.”

Responding to statements questioning why he had not been called to Parliament, the minister said he had been called to Parliament.

He said he never had requested that the Supervisory Council members resign, but rather had requested in a letter dated August 31 that they “reconsider their positions,” which he said was different from requesting that they resign.
“You can interpret it or misinterpret it. I did what I felt was the best choice. If I ask you to reconsider you can reconsider or not. I think it warranted them to reconsider, because of the process and the way it was done,” he said.

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