Collective Prevention Services introduces immune boosting vaccine for children under age two on St. Maarten

FRIDAY, 10 MAY 2013

PHILIPSBURG– The Collective Prevention Services (CPS) will be introducing a new immune boosting vaccine called the Pneumococcal vaccine (pronounced noo-muh-kok-uhl) for children under age 2 as of May 12.

This new vaccine will help protect children from bacteria called Streptococcus pneumonia (pneumococcal), which can cause Pneumococcal diseases, such as pneumococcal pneumonia, bacteraemia, meningitis and otitis media. Pneumococcus (a type of bacteria) is in the nose and throat of many people, and is spread by coughing, sneezing, or contact with respiratory secretions, which can be very dangerous for children under the age of two and elderly adults.

Vaccines have been used to prevent pneumococcal disease for more than 30 years. Currently, there are two different types of pneumococcal vaccines on the market: a 23-valent polysaccharide vaccine (PPV23) available since the early 1980s and 2 conjugate vaccines available since 2009, one 10-valent (PCV10) the other 13-valent (PCV13).

The 7-valent conjugate vaccine (PCV7) is gradually being removed from the market. The vaccine that is new to St. Maarten, which is now being introduced, is the 13-valent vaccine.

Currently available PCVs are safe, effective and the increased number of serotypes present in these vaccines, compared to the first licensed PCV7, represents significant progress in the fight against pneumococcal morbidity and mortality. The use of pneumococcal vaccine is complementary to the use of other pneumonia control measures, such as appropriate case management, promotion of exclusive breastfeeding for the first six months of life, and the reduction of known risk factors, such as indoor pollutants and tobacco smoke.

In the event that children started the series of pneumococcal vaccination with a different vaccine type (PCV 7 or PCV 10) and they are under the age of 24 months, the schedule can be completed with the PCV 13 vaccine. Registration for the vaccination will take place on the yellow vaccination cards in the field “others” in the child’s chart and in the baby book.

As of May 12, the Baby Clinic next to the Yogesh Building will begin administrating the Pneumococcal Vaccine to all children under the age of two. Parents can also contact their family doctor or paediatrician for more information.

Health Minister Cornelius de Weever announced the introduction of the vaccine during Wednesday’s Council of Ministers’ press briefing.

Nurses Association focuses on improving health care on St. Maarten

TUESDAY, 07 MAY 2013

~ International Nurses Week opens ~

CAY HILL–Improving health care and closing the healthcare gap are among the things on which the St. Maarten Nurses Association will focus this year, Association President Candida McRae said at the opening of International Nurses week at St. Maarten Medical Center (SMMC) on Monday.

The opening ceremony featured the hoisting the St. Maarten Nurses Association Flag outside the SMMC building and the cutting of a huge celebration cake presented by SMMC management.

Prime Minister Sarah Wescot-Williams and Health Minister Cornelius de Weever were among the dignitaries who attended the ceremony. Nurses also took part in the annual Torch Walk from Raoul Illidge Sports Complex to Taloula Mango’s on Boardwalk Boulevard (the Great Bay beach promenade) on Monday evening in celebration of the week, which runs May 6-13.

McRae said during the opening ceremony that nurses found themselves in the unique position of being able to influence the way people think, feel and act, and as a result nurses should feel encouraged to join a professional body targeted toward enhancing their profession and allowing their voices to heard as they continued to work with government and others to strengthen the health system and create the conditions necessary to maximise their contribution.

“For this nurse’s week and throughout this year we will be focused on closing the gap and improving healthcare by taking a closer look at the Millennium Development Goals and how they can help to improve health care on our little piece of the world.”

International Nurses Week is being observed under the theme: “Closing the Gap: the Millennium Development Goals: 8, 7, 6, 5, 4, 3, 2, 1.” McRae said this slogan was intended to be a countdown to 2015, with an emphasis on the health-related goals.

The adoption of the Millennium Declaration by the UN General Assembly in 2000 resulted in the creation of the Millennium Development Goal (MDG) framework, which has been used to galvanise development efforts, set global and national priorities, and focus attention, action and resources.

Eight MDGs with a range of targets and indicators were developed and agreed. Taken together, these provide an holistic framework for sustainable poverty reduction and development. Three goals – numbers 4, 5 and 6 – are specifically related to health and their achievement is closely linked to the other goals, including those focused on poverty, hunger, gender equality and women’s empowerment.

“When we take an in-depth look at the MDGs, we might be prone to ask ourselves what they have to do with St. Maarten. Well, though we may not face some of these problems on a large scale, we too can improve our health care as it refers to the MDGs 4, 5 and 6 and adapt the MDGs to suit our situation.

“We can improve maternal health and thus reduce child mortality and we are all aware of the fight to combat HIV/AIDS. We too here in St. Maarten have families in our community that are struggling with poverty, and to this fact we cannot turn a blind eye,” said McRae.

“The ICN is encouraging nurses to engage in advocacy and lobbying. We must be involved in the development of any programme introduced to improve health services, as it is nurses who have the practical knowledge of how health service delivery can be designed, coordinated and effectively implemented.”

She said national nurses associations (NNAs) also were being encouraged to assume an important role in informing, advising, encouraging and supporting nurses in their work. NNAs are being encouraged to continue to work with governments and others to strengthen health systems and create the conditions necessary to maximise nurses’ contributions.

“The St. Maarten Nurses Association since its inception has been working together with the government of St. Maarten to create, enhance and improve the communication channels, which will help to improve health services on our island for the good of our population,” she said, thanking all the nurses in St. Maarten for their hard work and dedication.

Prime Minister Sarah Wescot-Williams commended nurses for being committed to their calling and for the improvement of health care.

SMMC’s new General Director Yvonne van Ameijden said she was happy to note that patient care at SMMC had been in order when she arrived, giving her time to focus on other things.

Patient Care Manager Tony Pantophlet said the fact that nurses were present must mean something for patients. He said patients might not remember their doses of medication or the injections they had been given, but they would remember the warmth, smile and nurse’s touch given.

A number of other activities are planned this week for International Nurses Week, including lectures and social functions.

Omgaan met psychisch zieke gedetineerden op St. Maarten

 

ZATERDAG, 20 APRIL 2013

PHILIPSBURG — De Mental Health Foundation (MHF) en de directie van de gevangenis gaan trainingen verzorgen voor het gevangenispersoneel in het omgaan met gedetineerden met een psychische ziekte.

Dat zei minister Cornelius de Weever van Volksgezondheid tijdens de begrotingsbehandeling. Op dit moment zitten er zeventien personen in de gevangenis met een psychische aandoening. De Mental Health Foundation staat hen bij met onder andere medicatie.

Wegens veiligheidsredenen mogen medewerkers van de stichting op dit moment niet de gevangenisfaciliteiten binnenkomen. Voor die situatie wordt een oplossing gezocht. In totaal staan bij de stichting 720 cliënten ingeschreven. Hierin zijn cliënten van Saba, St. Eustatius en het Wit-Gele Kruis niet meegerekend.

Plan approved for phased implementation of National Health Insurance on St. Maarten

SATURDAY, 20 APRIL 2013

PHILIPSBURG–An adjusted plan outlining a phased implementation for the National Health Insurance (NHI) was recently submitted and approved, Health Minister Cornelius de Weever told Parliament earlier this week.

Phase one of the implementation entails the preparation of a proper health information system which will commence with the general practitioners; phase two involves the merging of various groups currently managed by the Social and Health Insurance (SZV) and phase three is for draft legislation to be presented to Parliament.

The minister said it has been calculated that a fixed-fee contribution from Government totalling NAf. 24.5 million will be required. This will contribute to the AVBZ, the current medical aid cardholders and family members of the former ZV group.

De Weever said NHI is not only a new insurance but is, in fact, general health care reform. There are various aspects within the system that will be reformed. The key elements of the reform are the introduction of a proper functioning health information system; an adjusted tariff structure and an adjusted benefit package.

Minister De Weever: local institution willing to finance St. Maarten Medical Center expansion project

TUESDAY, 16 APRIL 2013

PHILIPSBURG–Health Minister Cornelius de Weever said he has been in discussions with “one of our local institutions” that is willing to finance the entire St. Maarten Medical Center (SMMC) expansion project.

“They don’t even have to float a bond,” De Weever said during Monday’s plenary session of parliament on the draft 2013 budget.

The minister did not name the local institution in question. Alluding to a question that had been asked during the meeting of the Central Committee of Parliament last week about the cutting of SMMC’s subsidy, the minister said SMMC had “never really used it last year.”

He said too that the medical centre never made use of the services of the Central Bank, even though he had “introduced” them to bank officials to work on a bond issue. “They [SMMC - Ed] chose to go with another company. That is beyond my control, that was the board’s decision. I believe that we should continue the communications and try to resolve these issues.”

SMMC had been exploring several options for its expansion.

Minister De Weever assures St. Maarten Medical Center issue has his full attention

MONDAY, 15 APRIL 2013

PHILIPSBURG–Health Minister Cornelius de Weever said on Sunday that the serious governance issues at the St. Maarten Medical Centre (SMMC), which resulted in the end of the specialist care cooperation with two Amsterdam hospitals has his “full attention.”

De Weever’s comments were in reaction to the statements made by Minister of Home Affairs and Kingdom Relations Ronald Plasterk on the issue in a letter to the Second Chamber of the Dutch Parliament, which was published by The Daily Herald on Saturday. The letter, also sent on behalf of Minister of Public Health, Well-being and Sports Edith Schippers, was a response to the agreements that the four Parliaments in the Kingdom made during their meetings in The Hague in March this year.

De Weever said in a press release on Sunday evening that “Great efforts have been and are still continuously being made by both my Ministry and the Inspectorate of Health to address these issues. These efforts have resulted in the placement by the Health Inspectorate of SMMC under intensified supervision and the subsequent issuance of 14 orders by the Health Inspectorate to SMMC, to address amongst others several governance matters, or else pay significant fines.”

De Weever said one of these measures was the much discussed measure to either terminate the contract with former Board Chairman Dr. George Scot, or terminate the contract with his consultancy firm ANG Consulting N.V. “Although SMMC is still opposing all the imposed measures through litigation, it has meanwhile complied with some of them. There has consequently been some improvement. There is, however, still much work to do and I can only hope that with the appointment of a new interim director of SMMC recently the era of constant opposition and litigation by SMMC will be replaced with the much needed collaboration, dialogue and decisive actions, so that our combined efforts can promptly resolve the existing issues.”

The minister said the cooperation with AMC and VUmc is important for both

St. Maarten and our sister islands Saba and St. Eustatius. Conditions must be set for the prompt realization thereof.

Social Economic Council agrees with annual increase minimum wage on St. Maarten

POSTED: 04/3/13

St. Maarten – The Social Economic Council (SER) agrees with the government’s proposal to annually index the minimum wage. At the same time the council advises to increase tax compliance from the current 36 percent to a higher level. “This could lead to a lower tax rate for all citizens, thereby increasing purchasing power and boosting the economy,” the SER writes in an advice it submitted to the government on December 28 of last year, but that was only published in the National Gazette last week Thursday, March 28.

The government should have published to advice the latest on February 8 based on regulations established in the national ordinance on public administration. It was however published almost seven weeks late.

In its advice, the SER notes that “one of the major obstacles contributing to an increase in cost of living is the lack of execution of price controls” in supermarkets and at wholesalers. “These prices have a direct effect on the purchasing power of not only persons who earn a minimum wage, but on the entire population.”

The SER furthermore advises to adjust the AOV premium (for old age pensions) downwards. “This measure would immediately affect all net payouts and increase purchasing power, while also giving some much needed relief in the cost of doing business.”

The SER also advised the government to expand the list of controlled items with a variety of more basic food products.

Labor Minister Cornelius de Weever decided to increase the minimum wage by 4.7 percent per January 1 from 7.96 to 8.33 guilders per hours. The increase mimics the rise of the consumer price index between august 2011 and august 2012.

The United Federation of the Windward Antilles (Ufa) took a minority position in the SER: it wanted the minimum wage to go up by 13 percent to 9 guilders per hour and to apply the full minimum wage from the age of 18. Currently the full minimum wage applies to workers of 21 years and older.

The SER still has a couple of concerns. The first point of criticism is that the government should have engaged at an earlier stage in dialogue with the private sector. Another concern is the effect of the increase: “One immediate effect – without adjusting the wage tax scale – may be that the minimum wage earners may have to pay more taxes. Depending on the tax scale they are placed in after the increase, this may eventually decrease their purchasing power, while the indirect objective of this proposal is the opposite.”

There are two methods to calculate future increases in the minimum wage: based on the average wage increase of the entire population, or based on the consumer price index.

The SER also is of the opinion that the government has to specify “various minimum wage brackets in the law, based on someone’s education. “For example: persons who have a bachelor’s degree cannot make less than X amount based on the minimum wage bracket in which they are placed.”

St. Maarten minister looks into better patient experience abroad

TUESDAY, 26 MARCH 2013

PHILIPSBURG–Public Health Minister Cornelius de Weever is currently working with the COOMEVA Medical Group from Colombia and Social and Health Insurance SZV to make the patient experience abroad a less tedious one.

De Weever recently met with the COOMEVA group, during which a number of issues were discussed. The main topic was providing a Health Charter Flights Programme.

Currently patients referred by SZV to travel to Colombia for medical care make use of the commercial flights, which at times can become an uncomfortable experience for patients, due to flight availability, delays and cost.

Unwanted delays usually happen with patients who must travel immediately for medical treatment, and once the treatment in Colombia has ended, delays caused by unavailability of flights generate extra cost in accommodation, transportation and other expenses the patient incurs.

De Weever said he will be working diligently with SZV and COOMEVA on the logistics of this programme, with the aim of making the patient experience as pleasant as possible.

“As a Minister, I am here to serve the people of St. Maarten and to ensure that all their medical priorities are taken care of in a professional and attentive manner. I believe that this programme will be a great help to all medical referrals to Colombia,” he said.

Once all the logistics will be worked out for the inbound and outbound charter flight programme, the process for the patient will become faster and smoother. The proposed programme will have a significant impact on the medical referral procedure in terms of better quality, timeliness, logistics and cost.

The programme will provide an opportunity for patients who seek immediate medical treatment, especially for those people with complex medical conditions who must be transferred to Colombia promptly.

All flights will be executed with an exclusive charter flight with a capacity for 18 people from St. Maarten directly to Colombia. A professional nurse will be on all inbound/outbound flights. “We will also collaborate with Saba and St. Eustatius to ensure we have a full flight each time,” he said.

Largest gathering of Caribbean advocates at cancer conference on St. Maarten

FRIDAY, 22 MARCH 2013

PHILIPSBURG–Some 20 cancer organizations representing 16 Caribbean countries gathered at the Sonesta Great Bay Beach Resort on Thursday for the start of a two day Cervical Cancer Advocacy workshop.

President of the Healthy Caribbean Coalition (HCC) Professor Trevor Hassell said there has never been a coming together of such a large number of Caribbean cancer organizations, an achievement of which he is proud. Hassell, said too that due to the work of participants, the coalition now has a comprehensive and active audit of Caribbean cancer organizations as well as an audit of cervical cancer programmes in many Caribbean countries.

Health Minister Cornelius de Weever said although there is very little data available, it is known that non-communicable diseases such as cancer and cardiovascular disease are by far the leading cause of death in St. Maarten.

He said the country’s financial report shows that these diseases put a huge burden on the health care system of St. Maarten, placing an ever increasing burden on health care expenditures.

According to the minister non-communicable diseases are responsible for considerable loss of quality of life and are the main cause of premature death for both men and women. These diseases, he added, are preventable through healthy behaviour by eliminating casual risk factors such as tobacco use, unhealthy eating habits and a lack of physical exercise. The socio-economic burden can seriously be decreased by means of early detection and screening of diseases.

He said it is government’s responsibility to have in the country a health system receptive of and geared towards the needs of its user or users to ensure health and wealth for all people living in St. Maarten. This system must be maintained through a continuous cycle of quality improvement with technical expertise, information technology and input from the grass roots organizations. These are important sources of feedback for government to fine tune policies and legislation according to the needs of the people.

The minister said it is government’s goal to decrease and delay mortality and disability due to non-communicable diseases thereby increasing productivity and ultimately improving the quality of life and life expectancy.

Government’s decision to co-host and co-organise the workshop is not just a privilege, but also an opportunity to support and empower local stakeholders in their endeavours to continue to alleviate the burden of non-communicable diseases in general and cancer specifically. “As minister of health I see it as my duty to support this event of which the results will contribute to the health and wellbeing of our people in the Caribbean region,” the minister said.

Prime Minister Sarah Wescot-Williams expressed hope that the discussions will provide participants with the kind of information necessary for them to continue their work in the area of cancer awareness and cancer prevention.

The information will serve as a basis for participants to strengthen their ties and commitment to their goals and objectives as individual Foundations. “As you focus on advocacy for brining that message across the region I encourage you to give it your best shot. There is a lot of available information and best practices and ideas and experiences that I am sure will be shared during this conference. I think all of your coming together is a powerful way of moving this message forward,” she said.

Cervical cancer is the second leading cause of death in the Caribbean with mortality rates higher than the developed countries such as the USA.

Raising awareness of this cancer and advocating steps to reduce the mortality rates is a priority concern of the HCC which has a key mandate to develop and strengthen the skills and organizational capacity of the various members involved in health throughout the Caribbean.

It is expected that the workshop attendees will have significantly strengthened cervical cancer advocacy capacity and take tangible steps towards the establishment of a Caribbean Cancer NGO “Network.”

HCC was formed in 2008. It arose out of a 2007 Declaration of Heads of Government of the Caribbean Community (Caricom) on Non-Communicable Diseases (NCDs).

The HCC is a regional network of Caribbean health NGOs and civil society organizations who are interested in addressing NCDs. HCC works closely with regional and international leaders in NCD prevention to leverage the power of civil society by strengthening and supporting membership in the implementation of programmes aimed at reducing the morbidity and mortality associated with NCDs.

President of the St. Maarten Cancer Foundation Graciella Zimmerman also spoke at the opening ceremony.

St. Maarten ministry of Public Health, Social Development and Labour focuses on employment, quality health services in 2013

MONDAY, 04 MARCH 2013

~ Motto: We will be smarter ~

PHILIPSBURG–Promoting employment, employability and quality health services, public health and healthcare provisions are among the priorities for the Ministry of Public Health, Social Development and Labour VSA this year.

Other priorities include ensuring social protection and social provisions, as well as adherence and rights to a healthy and safe society.

These priorities were outlined to VSA staffers at an extended staff meeting held at Caribbean Cinemas Megaplex on Thursday, February 21.

During the meeting, Health Minister Cornelius de Weever and the VSA Secretary-General Jorien Wuite went over the accomplishments and challenges that the Ministry faced in 2012, and elaborated on the top priorities that each of the nine departments under the Ministry will be focusing on this year.

The intention of this meeting was to encourage, motivate and applaud staff for their work. The ministry’s motto for this year is: We will be smarter. “Smarter in the way in which we make use of our financial and human resources, which means being more critical and making choices to secure efficiency and avoid unnecessary expenditure,” it was stated in a press release.

Following the meeting, staffers were treated to popcorn, a drink and a movie. The release said staffers left the meeting “feeling enthused about their planned contributions for 2013.”

Some 200 seniors stroll through Philipsburg in effort to be active on St. Maarten

SATURDAY, 23 FEBRUARY 2013

~Senior: ‘We are going down in history’~

PHILIPSBURG–”We are going down in history,” senior citizen Olive Hodge said as she walked ahead of a group of an estimated 200 senior citizens who took a bold step to show how active they can be on Friday, when they came out in force to stroll through Philipsburg.

The seniors, some in wheelchairs, began their stroll at Sea Palace Hotel on Front Street and made stops at Oranje School and St. Joseph School along the route. Several dignitaries including Prime Minister Sarah Wescot-Williams, Deputy Prime Minister William Marlin, Health Minister Cornelius de Weever, President of Parliament Rodolphe Samuel and independent Member of Parliament Romaine Laville walked with the seniors.

The elderly ended their stroll at the Government Administration Building, where they were served refreshments and addressed by several dignitaries.

“It was not a demonstration and we did not have any placards, but we walked and it was enjoyable,” senior citizen Mary Rogers said at the end of the stroll. She told The Daily Herald that that when Home Away From Home Taking Care of the Elderly Foundation official Patsy Flanders told her about the stroll she thought it was “the funniest thing” and she could not stop laughing.

Rogers said she pictured in her mind a number of senior citizens walking down Front Street and persons coming out of the stores and lining the street watching them and she could not stop laughing. She said, however, that after experiencing the event she was happy that it was held because it was quite exciting and enjoyable. “I had a lot of fun,” Rogers told this newspaper while sitting under a tent in front of the Government Administration Building.

Prime Minister Sarah Wescot-Williams said the stroll was a demonstration of unity and willpower. “I would like to say kudos to all of you for being part of this very important event. I want to say congratulations to all of the schools who have helped out this morning and whose students came out to greet us along the way.

“What a feeling of pride it is to walk through our Front Street where representatives of government have the opportunity to recognise the contribution you have made to the country of St. Maarten. Together we can continue to build our home, Sweet St. Maarten Land.”

Deputy Prime Minister William Marlin told the seniors that the stroll was an opportunity for them to come alive again in their country. “This is your day,” he said adding that the day was an opportunity for the seniors to look back in the past and reflect on what today means as was demonstrated in the prayers said. He said the seniors had paved the way for us to be here and it was a privilege for them to have served the community they way they did.

Health Minister Cornelius de Weever said for the last two years he had been working to improve the lives of senior citizens. He said government was busy with the elderly study and given the challenges experienced during the stroll along Front Street with wheelchairs, some things will have to be changed. De Weever said he is committed to improving the lives of seniors.

The stroll was organised by the Home Away from Home Taking Care of the Elderly Foundation and involved seniors from that foundation as well as from the St. Martin’s Home, St. Maarten Recreational Foundation and Helping Hands Foundation.

Students from the St. Maarten Vocational Training School, the Voice of Our Children Foundation and the drum band were also part of the exercise.

The event began with a prayer and the singing of the St. Maarten Song by Golden Voices of SMVTS.

At the end of the event the seniors were taken to the John Larmonie Centre where they were served lunch.

St. Maarten Medical Center Council calls ‘timing’ of minister De Weever’s request ‘remarkable’

MONDAY, 18 FEBRUARY 2013

~ Will not ‘reconsider positions’ ~

CAY HILL–The St. Maarten Medical Center (SMMC) Supervisory Council will not “reconsider their positions” as requested by Health Minister Cornelius de Weever in a letter dated January 26.

De Weever has not responded to questions from The Daily Herald on Friday about his next step in this matter. He had asked the Supervisory Council, which has taken over the responsibilities of former General Director Dr. George Scot and two members of which reside off-island, to reconsider their positions. The minister had said that this bordered on mismanagement and negligence, and was unfortunate.

In a letter responding to the minister, a copy of which was sent to this newspaper along with a press release on Sunday, the Supervisory Council said “none” of its members believed there was any reason to reconsider their position, as each member had been and continuously was performing his/her duties in accordance with the articles of association of SMMC and any and all laws that apply to it.

The council said too that SMMC and its staff continuously were making all efforts to ensure that SMMC provided the best health care to its patients.

“We as a supervisory council are doing our utmost to ensure that this is done in the best possible manner and we hope that the Minister of Public Health will appreciate this and assist in this endeavour. You can always count on our cooperation,” the members said in their letter dated February 6, which was copied to the Council of Ministers and the Inspectorate of Public Health.

The SMMC Council said the timing of De Weever’s request was “remarkable” and it disagreed with the minister’s statements about mismanagement at SMMC. It said it had taken notice with “great regret” of De Weever’s letter request that “all” members of the SMMC Supervisory Council reconsider their position.

“Firstly, we feel that the timing of your request is remarkable, to say the least. As you have been fully informed by us, there is currently no managing director active at SMMC. Consequently, in accordance with the articles of association of SMMC, the Supervisory Council currently represents and is responsible for SMMC,” the Council said
“You state that it is imperative that the quality of health care provided at SMMC is safeguarded – it is unclear how your request exactly fits into this picture.

“Secondly, we do not agree with the incorrect statements made in your letter about the functioning of the Supervisory Council. Since you fail to substantiate any of the strong accusations made in your letter, we are not in a position to respond to this other than by stating that we disagree with the statements made. Please identify the matters which, in your opinion, constitute mismanagement and how the Supervisory Council in your opinion should have acted to avoid this,” the Council said.

“Thirdly, in your letter you mention that the largest investors have questioned the validity of the composition of the Supervisory Council hampering the further development of the SMMC. Please clarify to which investors you refer and how this would have hampered the further development of the SMMC in order for us to address this matter further,” the Council said.

In its release the Council said a number of statements had been made publicly again by De Weever recently regarding SMMC. “We regret this development. The Prime Minister Mrs. Sarah Wescot-Williams fairly recently requested all parties to refrain from publicly addressing any issues and St. Maarten Medical Center has chosen to honour this request.”
The Council said it agreed with the Prime Minister that holding public discussions was not conducive to further improving the care SMMC was are giving to its patients. The Council said SMMC’s dedicated personnel, patients who are residents of St. Maarten, Saba, St. Eustatius, the surrounding islands and the tourists it served had suffered enough of the “unfounded and negative public media display in recent months from the Minister of Health Care and certain members of Parliament.”

“The Minister of Health Care has now chosen to publicly discuss his request to the Supervisory Council of the SMMC to reconsider our position and has publicly referred to our response while taking this again totally out of context.”

The Council said it believed it was correct to forward to the media its official response given to the minister and said it would refrain from further comments, honouring the Prime Minister’s request.
“St. Maarten Medical Center will continue as usual to improve the care and services to all our patients who are in need of treatment, for their wellbeing and for the benefit of their families,” the Council said. “We look forward to doing so in collaboration with the Government of St. Maarten and the Inspectorate of Health.”

St. Maarten Public Health Minister De Weever outlines health care approach 2013 in governing program

POSTED: 01/18/13

St. Maarten – For 2013 it’s all about promoting jobs and protecting people, Dr. Cornelius de Weever said at Wednesday’s launch of the governing program.

With responsibility for the Ministry of Public Health, Social Development and Labour (VSA), de Weever has a budget of 59 million guilders and a staff of 139 civil servants with which to execute his many plans. While he remains a part of the National Alliance/Democratic Party/Independent-3 coalition, the minister assured that St. Maarten will continue along the course towards becoming the “wellness centre of the Caribbean.” But with some of his plans heading into 2016, and 2014 being an election year, only time will tell whether the Working for the People governing programme will run its course.

“The challenge is for us to be smarter and use our limited resources in an efficient manner,” the minister said.
He described his ministry as “the hardest working” ministry within the government apparatus to cheers of approval from the modest audience that was in attendance at the launch.
Strengthen government’s social agenda, renew or modify policies, reduce bureaucracy, strengthen supervision and adherence to legislation, national, regional and international cooperation and partnerships.

Labour
“As we acknowledge the first positive outcomes of employability programs, we recognize the global trend of high youth unemployment and therefore embrace the labour vision to ensure that the people of St. Maarten are fairly employed and that they apply themselves on the job,” the minister said.
This year he projects a proactive approach to job placement, effective registration and more use of the labour management information system (LMIS) to justify every decision that will be made.
Decisions such as the revision of the foreign employment legislation, short term contracts, the dismissal law and employment agencies will premised on data, Minister de Weever emphasized.

Health and Social Security
In the area of health and social security, the minister spoke of accelerating the quality of life, through a 4 year program. Improvements are to be phased out and extend to 2016.
His final destination?
“A supportive social security and health system that is based on clarity and good governance,” as well as “a system that gives the customer a central place.”
That vision the minister said makes provision for medical tourism and “ultimately ensures that St. Maarten becomes the wellness centre of the Caribbean where our population can experience an improved quality of life,” the minister stated.
He wants to do so through improvements in the basic health and social security infrastructure, additional regulations, more supervision, increased health promotion activities and data collection on the needs of the population.
In the area of public health, he plans to establish a water authority and push for policy reforms in quality of care, prevention and health education.
In the meantime, in the area of social development, he spoke only of increases.
“Increase pension benefits, even adding a second layer in our pension system, adjusting financial aid and more partnerships.”

He used a cartoon to illustrate his ministry’s course towards a wholistic individual and nation.

Achievements
In his address, the minister not only spoke of his vision for the ministry but spent a great deal of time on achievements to date. It read like a resume for VSA.
“With performance in mind, I believe an 82 percent accomplishment should be acknowledged and respected for the work team VSA has achieved,” he stated.
He did not say whether the 82 percent accomplishment was based on an internal or external evaluation but indicated he was still awaiting the official rating.
He cited initiatives such as HIV/ Aids and RED Campaign, Integrated Neighbourhood Development Programme, the Community Help Desks, SEI: Employability through Training project and the facelift of the Labour Office on the Pondfill as achievements over the last two years.

The establishment of the SZV and the policy units for labour, public health and social development in 2011 were also highlighted.

For 2012, the minister said that investments into customer service training and technology had also yielded good results.

He spoke of an improved turnaround time, the appointment system and translation services at Labour Affairs, the labour market information system, the E-SZV, the health management information system and various policies and forms that are now on the government website to indicate that VSA is moving in the right direction.
He reiterated that the completion of the draft legislation for Social Security and Health Reform, the AOV increase, the National Health Insurance (NHI), dismissal procedures and financial aid draft national decrees all “deserve recognition.”
“The people’s ministry,” the minister said had out numerous positions on critical issues such as short term contracts, environmental health, temporary employment agencies and accelerating the quality of life.

Evidence Based Policy Making
The minister said that the availability of statistics is important in order to make responsible decisions.
“Many VSA agencies such as the Labour Affairs, Inspectorate and Collective Preventative Services produce many facts and figures that provide careful insight to analyze trends and needs for required changes.
In summary we have managed to introduce the performance management, prepare and conduct various research studies leading to informed decision making, establish the appeals committee for social services, establish the community help desk, improving customer service at the labour and social affairs, improve ambulance services and recruit the right people for critical positions.”

St. Maarten Medical Center
A brief paragraph in the section Improved Wellness and Health Care of the governing programme referred to the St. Maarten Medical Center.

“As part of its investments in public infrastructure, government will increase the level of expenditures in the infrastructure of public health and health care systems. In concrete terms, government will continue to ensure that the St. Maarten Medical Centre meets the needs of a growing and changing St. Maarten demography as well as expands its services to accommodate more medical specialties and support services. In addition, government intends to pursue the development of medical tourism on St. Maarten. Simultaneously, government will also strengthen its control and supervisory capacity in this area by placing emphasis on an effective Inspectorate of Public Health.”
Though, Minister de Weever made no direct reference to the SMMC during his remarks, several sections of the audience remarked that his greatest accomplishment to date may have been getting rid of the hospital’s director.

Minimumloongrens omlaag op St. Maarten in 2014

DONDERDAG, 17 JANUARI 2013

PHILIPSBURG — De sociale partners hebben een akkoord bereikt over verlaging van de minimumloon-leeftijd. Met ingang van 1 januari 2014 moet het minimumloon worden uitbetaald aan werknemers die de leeftijd van 18 hebben bereikt.

Het Departement van Arbeid heeft een persbericht uitgegeven, waarin het resultaat van het overleg tussen minister Cornelius De Weever, het bedrijfsleven en de vakbonden bekend wordt gemaakt.

St. Maarten minister De Weever launches National HIV workplace policy

MONDAY, 17 DECEMBER 2012

PHILIPSBURG–Minister of Public Health Cornelius de Weever recently launched the country’s first National HIV and AIDS Workplace Policy. Minister De Weever has described the moment as a historic one for the 600+ families affected by their loves ones who are living with HIV/AIDS.

“Another historic moment is when the Chamber of Commerce was the first to sign an HIV/AIDS workplace policy when I was a board member on their behalf. I presented a draft HIV/AIDS workplace policy for government to then Commissioner of Health Franklin Meyers.

“We have now come full circle and as Minister I have the privilege to launch the HIV/AIDS workplace policy for all civil servants. I will like to call on all government owned companies, all Non-Governmental Organizations, all unions, all [red] business and businesses in general to join us by implementing their own HIV/AIDS workplace policy,” Minister of Public Health, Social Development and Labour Cornelius de Weever said on Sunday.

The National Workplace Policy on HIV/AIDS is a framework for action by government, employers and workers to deal effectively with HIV/AIDS at the workplace.

The policy takes into consideration the effects of HIV/AIDS on the most productive segment of the workforce and as such, views the problems associated with HIV/AIDS in terms of the significant negative implications they hold for the economic and national development of the country.

The purpose of the policy is to facilitate the development of a working environment that protects the rights of workers regardless of their HIV status. This includes all workers irrespective of where they work.
Those who spoke at the launch which took place in the A.C. Wathey Legislative Hall were HIV/AIDS Programme Manager Suzette Moses-Burton, Secretary General Jorien Wuite, Head of the Labour Department Rafael Boasman and HIV/AIDS Project Officer Margje Troost.

Director Scot’s contract at St. Maarten Medical Centre will end on December 31

FRIDAY, 07 DECEMBER 2012

CAY HILL–The Supervisory Council of the St. Maarten Medical Center (SMMC) has decided to end the contract of embattled General Director of SMMC Dr. George Scot as hospital Director as of December 31.

The council said in a press release on Thursday that this decision was taken “in the best interest of the SMMC, its patients, staff and personnel as well as of Scot.”

The council said SMMC has as an important goal to strengthen the organizational structure of “our institution, so that we could better cope with the changing environment and demands placed on it”, while positioning itself to be able to meet those ever- increasing demands in a most human and equitable manner, while aiming for the highest possible standard of quality of care.

“Therefore we have contracted an independent agency earlier this year with ample experience in health care institutions to make an organizational scan of the top structure of the SMMC in order to advise us as to the most ideal make-up of the top managerial structure in the SMMC,” the council said.

“This independent agency has taken the future plans, the scale of the island, the context in which we have to perform our services as well as the scarce availability of specific capacities into account. The organizational scan is currently in its final stages and on basis of the outcome and the discussions that will ensue, the Supervisory Council will make the necessary decisions regarding the ideal constellation of the Board of Directors as well as the necessary supporting Management Team,” it was stated in the release.

“In addition and in view of the ever-increasing responsibilities and workload of the Board of Directors, the plans for the future of SMMC and the expressed wishes of Dr. Scot to be able to spend more time with his family in The Netherlands, earlier this year Dr. Scot and the Supervisory Council have jointly agreed that the current contract with AnG Consultancy NV and the appointment of Dr. Scot as managing director would not be renewed as is. Based among others on the outcome of the organizational scan, further decisions on this matter would be taken.”

“However, the situation has changed. Due to external factors beyond our control, a negative and highly stressful atmosphere has been created that has affected the doctors and staff of SMMC and their patients on a daily basis. The personal accusations and unfounded allegations from outside SMMC towards Dr. Scot moreover led to an untenable work situation.

“Therefore, in the best interest of the SMMC, its patients, staff and personnel as well as that of the person Dr. Scot, the Supervisory Council decided to end the appointment of Dr. Scot as Director by December 31, 2012. This decision was reached in agreement with Dr. Scot. This was not an easy decision for either party. We are currently engaged in finding an interim director. An interim position will allow us to manage the transition to the structure we will decide on, based on the evaluation, advice and debate following the organizational scan, while securing the continuity within our Board of Directors.

“We are also looking to strengthen the Board of Directors with an interim medical director.

The job descriptions for both positions have been presented to the Minister of Health.

“Dr. Scot will provide full collaboration towards ensuring a smooth handoff to the new interim director,” it was stated in the release.

“The SMMC will continue as always to work towards improving the level and quality of care for the benefit of all residents of St. Maarten, Saba and St. Eustatius and looks forward to doing so, working together with Government and the Inspectorate,” it concluded.

Minister De Weever says St. Maarten Medical Center request for documentation ‘inadmissible’

WEDNESDAY, 21 NOVEMBER 2012

PHILIPSBURG–”Inadmissible” was the word used by Health Minister Cornelius de Weever to describe a request from St. Maarten Medical Center (SMMC) Foundation via its attorney HBN Law to provide a number of documents to the medical facility.

SMMC made the request in a letter dated September 30. In his response, dated November 16, De Weever said the SMMC Board of Directors represented SMMC in legal matters. He said it should be unambiguous at all times who was legally authorised to represent SMMC and that representation must be compliant with any relevant legislation.

“By letter of August, 21, 2012, the Supervisory Council of SMMC was requested to provide a number of documents to enable this office [Minister's cabinet, ed.] to ascertain the relationship between the sole member of the Board of Directors and a contract with AnG Consulting (/Consultancy) NV to provide services that should be provided by an individual who is a member of the Board of Directors,” De Weever said.

“The documents as requested have not been promptly delivered and are therefore still pending. With reference to aforementioned letter, the Minister has already expressed that a construction whereby a third party is used to provide services that an individual should be providing is not in compliance with the law,” he added.

“The same member of the Board of Directors has recently received an instruction from the Inspectorate to either nullify the aforementioned contract or resign as a member of the Board of Directors. The instruction from the Inspectorate is part of an ongoing investigation regarding SMMC, whereby it’s not unthinkable that the Inspectorate will continue to seek all and use all recourse at its disposal to ensure quality care.

“Notwithstanding the aforementioned, but more so in support of the forgone, the Minister also needs to initiate the necessary procedure (civil/legislative/criminal) to ensure that clarity and good governance is achieved in an as-short-as possible time.”

De Weever continued: “Any information should only be delivered to an individual (natuurlijke persoon) as per the Articles of Incorporation of SMMC and (indirectly) based on the ‘Landsverordening zorginstellingen’ (rechtspositieregeling).

“It is at present inevitable to conclude that due to the existence of the contract with AnG, any information requested by SMMC will automatically end up in the hands of a third party (AnG), a (legal) entity whose mere existence is questionable.
“The request as submitted is deemed inadmissible, as this third party (AnG) is de facto requesting information on behalf of SMMC and that a third party is not recognized as the legal representative of SMMC.”

The Minister said the request must be denied, based on Article 11, Section 1, subsections a, and b of the LOB,. He said the information requested endangered the unity of government by creating a rift between various entities and ministries should the request be honoured.

“The safety of the country will also be damaged, as patients will increasingly shy away from SMMC. This could possibly lead to the bankruptcy of the sole hospital in the country and have a damaging impact, as government will not be able guarantee quality health care,” he added.

He said too that “based on Article 11, Section 2, subsection a of the LOB, the requested documents will not be provided, as it has not been established that SMMC has any prevailing interest in obtaining the said documents.

“The Minister considers this request as a gleaming example of poor management, not to speak of mismanagement. It is a blatant attempt to diffuse the matter of mismanagement at SMMC by the Board of Directors and the lack of supervision by the Supervisory Council of SMMC.

“To entertain the request as submitted will inevitably lead to frivolous remarks and attempts to discredit the Ministry, the Minister or the Inspectorate of Public Health and/or to delay aforementioned parties in taking the necessary steps to prevent lives from being put in danger.

“Any delays for whatever reason are not warranted, considering that this will unavoidably lead to further economic or financial loss for SMMC, government and SZV and therefore the quality of care for the citizens of St. Maarten.Furthermore, it is being determined whether or not certain matters should be brought to the attention of the Prosecutor.

“Lastly, any or all of the requested documents, if indeed available, are or should be part of the file the Inspectorate of Public Health holds on SMMC. Considering that the Inspectorate of Public Health is carrying out its legally attributed inspection task to, amongst other things, guarantee quality health care, none of the requested documents can be provided to SMMC at this time.

“Any interest SMMC may believe it has cannot at this point outweigh or stand in the way of the Inspectorate of Public Health or the Minister doing what is necessary to save lives.”

The Minister said “remarkably” the request alluded to a peculiar reversal of roles, as if SMMC believed itself to be above the Inspectorate of Public Health and/or government, or at least equal partners to them.

In its request, SMMC requested that the Minister provide any instruction given to the Inspectorate of Public Health as it relates to instructions directly or indirectly to SMMC; the Memorandum of Understanding or agreement in whatever form between the government of St. Maarten and The American Clinic and/or Mr. S. Hess, D. Haight and T. Allen, and all landsbesluiten containing the decisions to appoint the current health inspectors, including the current Inspector General, among other requests.

HBN said that if one or more of these documents had not been issued, was missing and/or was incomplete, the Minister should indicate so in his response to its request.

HBN said SMMC had a right to and had pressing interest in receiving the documents in light of recent developments regarding the investigation by the Inspectorate and/or recent announcements regarding government’s intention to allow other health care institutions to provide medical care in St. Maarten.

St. Maarten Medical Center objecting to Inspectorate’s demands in court

TUESDAY, 06 NOVEMBER 2012

PHILIPSBURG–St. Maarten Medical Center (SMMC) objected to the demands placed on it by the Inspectorate of Public Health during a hearing in the Court of First Instance on Monday.

SMMC moved to the court to object the demands that the Inspectorate had placed on it on October 12. The judge is expected to give his ruling next Tuesday at 9:00am.

The Inspectorate had imposed thirteen “demands” on SMMC geared towards improving care at the medical facility. Some of the demands were to be met by October 26 and the others by December 8.

Inspector General Dr. Earl Best said that, up to yesterday, SMMC had only complied with one of those demands – providing a service telephone number to reach SMMC General Director and Board President Dr. George Scot, who, the Inspectorate said, is off island 50 per cent of the time.

Best told this newspaper after the court case that SMMC had sent a letter on October 25, a day before the first deadline, stating that it had already complied with some of the demands. SMMC is also arguing that some of the demands have no legal basis and that the demands were overkill.

The Inspectorate, however, contends that SMMC has not complied and still has to do so. The Inspectorate presented its position in court yesterday. Best told this newspaper that SMMC has been given an extension on one of its demands – to fill in vacancies of all medical specialists. This was initially due on December 8, but has been extended to March 8, 2013.
“All the other 12 demands are still pending. They said they had complied with some of them, but not in the opinion of the Inspectorate,” Best said. He added that most of the first set of demands had to do with the functioning of the Board of Directors (Scot) “and one of the principal reasons is that he is 50 per cent off island and there is no mandatory replacement for him. And we made that clear again in court and they still hadn’t complied with it.”

The Inspectorate responded to SMMC’s letter on November 2, indicating that the demands had not been complied with, and emphasizing that this still needed to be done. Best said the Inspectorate has the authority to come up with new demands. He said, however, that given the current court case, the Inspectorate will wait for the verdict before proceeding. Both the hospital and Inspectorate were well represented in court on Monday.

Demands

The demands instituted on SMMC that were due on October 26 were: SMMC needs to have an approved Rules of Regulation for the Board of Directors as per article 5 of the Articles of Incorporation of SMMC, and article 16 of the National Ordinance on Health Care Institutions.

It has to ensure that representation of Management of SMMC, in absence of members of the Board of Directors, is regulated by means of a formal appointment of a replacement representative with the requisite experience and expertise, in accordance with the profile demands that apply to Members of the Board of Directors within SMMC. This to-be-issued mandate is meant to be guaranteed as per article 5 of the Articles of Incorporation of SMMC, and articles 8, 9 and 16 of the National Ordinance on Health Care Institutions.

The Board of Directors is to be adequately represented in absence of one board member. At the moment General Director Dr. George Scot is the only member of the SMMC Board. He is off-island two weeks out of every month.

It has to ensure that the member of the Board of Directors who is representing SMMC is at all times accessible by means of a service telephone. The medical specialists and all service providers at SMMC must receive the telephone number of the service telephone. An overview is to be sent to the Inspectorate, detailing all the dates when Scot intends to not be physically present in St. Maarten for more than one day. This was complied with.

All medical administrative data, medical data, files and computer files required for an adequate representation and care are to be placed in one location within SMMC.

The impositions due on or before October 8 were: SMMC’s Board of Directors should be expanded with one member who will take on the portfolio “Medical Technical Matters,” guaranteeing the continuity of the management. SMMC should also fill out the vacant Personnel Formation places within SMMC on or before December 8 for the basic specialist medical care of Surgery, Internal Medicine, Obstetrics/Gynaecology, Paediatrics, Anaesthesiology and Radiology.

SMMC also has to show that the Board of Directors is actively negotiating with the medical staff pertaining to an Admittance Contract for Medical Specialists that will result in a mutually accepted Admittance Contract on or before January 1, 2013.

The hospital must also provide a suitable action plan in conformity with the conditions imposed by the Inspectorate as mentioned in the report with regards to findings pertaining to infection prevention in the surgery theatre.
It needs to provide an appropriate action plan pertaining to the emergency care department (ER); the supervision, improvement of expertise of the medical staff; file management and a proper notification system for acute issues; a methodology to determine which patient needs must be addressed more urgently; introduction of protocols for the most common diseases and, finally, make working agreements with stakeholders.

It needs to deliver an updated disaster plan and a plan to promote “disaster awareness” and establish annual drills for the staff of SMMC by December 8. It should also ensure that on or before December 8, all committees in charge of safeguarding and managing the quality of care are staffed with at least three persons and that these committees report quarterly to the Board of Directors of SMMC on various matters.

Best had told reporters at a recent press conference, after the Inspectorate had won its first court case brought on by SMMC, that failure of SMMC to comply with the measures by the deadline set could result in the imposition of fines of up to US $500 per day per infringement up to a maximum of US $50,000 per infringement. The Inspectorate can also close certain functional units at SMMC or even detain SMMC officials if this becomes necessary.

Best had said at the time that the Inspectorate sincerely hoped that SMMC this time around would devote its scarce resources and energy to ensuring that these demands were properly and timely met, instead of again resorting to litigation and continuing to resist the supervision exercised by the Inspectorate.

St. Maarten Mental Health Foundation loses bid for permit in court

SATURDAY, 20 OCTOBER 2012

PHILIPSBURG–Mental Health Foundation (MHF) has lost the injunction Friday, filed against the Ministry of Public Health, Social Development and Labour in its bid to obtain the necessary permit for the admittance of psychiatric patients to its facility.

The permit in question concerns the involuntary hospitalisation and/or ambulatory psychiatric treatment of individuals.
Previously, persons with psychiatric problems, who posed a danger to themselves or others, were held in police cells or referred to Capriles Clinic in Curaçao.

This situation changed after October 10, 2010, when it was agreed that each island would have its own mental health facility. Minister of Justice Ronald Duncan then designated MHF as the facility for involuntary hospitalisation in St. Maarten.

Founded in October 2001, MHF has been providing psychiatric aid since 2006, and has a special unit with cells available for involuntary hospitalisation.

The Minister of Justice has authorised the involuntary hospitalisation, but MHF cannot work without a permit from the Ministry of Public Health.

In the injunction, MHF requested such permit and also asked the court for permission to carry out its duties until the permit has been issued.

During the court hearing, Attorney Richard Gibson Jr. said the Health Ministry had not provided a permit, because the Inspectorate of Health would have established that MHF would not be in compliance with the requirements for a mental health institution.

The Ministry of Public Health would be in favour of transferring involuntary hospitalisation to Turning Point Foundation, which mainly provides drug rehabilitation programmes.

MHF had sent a letter on July 26 to the Ministry of Health in which it stated that it would cease involuntary hospitalisation as per August 1, in case it would not receive a permit.

In the injunction MHF, represented by attorney Wim van Sambeek, had requested the court to allow MHF to provide all psychiatric health care, including “fulltime, non-ambulatory, medical treatment of psychiatric patients, as well as the execution of mandatory hospitalisation under the order of the Ministry of Justice.”

Without a permit, MHF is only able to carry out a limited number of its duties, and may only provide ambulatory care to psychiatric patients the foundation, represented in the injunction by Director Eileen Healy and board member Eric van der Hoek, stated.

Judge René van Veen stated in his decision on the injunction that the request for a permit had not been complete, and that it could not be ascertained that MHF would be fully hampered in carrying out its statutory obligations, which do not explicitly mention mandatory treatment.

“It may be that it is litigant’s objective to provide psychiatric care and treatment, but this mere fact does not imply that defendant would have to hand out a permit,” the judge stated.

The judge also rejected claims that health care in St. Maarten would be in jeopardy and that St. Maarten would benefit from care to be provided by MHF, because these claims were too “general and not-founded” to be considered in the injunction.

The judge also said there was insufficient proof for the claim that the Health Ministry had ever promised a permit to MHF.
However, The Daily Herald received copies of letters sent by Minister of Public Health, Social Development and Labour Cornelius de Weever to Mental Health Foundation concerning subsidies over the years 2011 and 2012, in which it is specifically mentioned that under reference to MHF’s multi-annual plans, these subsidies should be spent on day care, crisis intervention, ambulatory care, workshops and counselling.

Attorney Wim van Sambeek said that MHF was open to discussions with Minister de Weever concerning the matter at hand. “Further steps are being considered in consultation with stakeholders. MHF remains confident that an amicable solution may be reached,” he said.

St. Maarten government to gather valuable data at upcoming Cancer Conference

TUESDAY, 16 OCTOBER 2012

PHILIPSBURG–Government hopes to gather valuable data during the Cancer Conference at Sonesta Great Bay Beach Hotel, scheduled for Friday and Saturday, October 26 and 27.

Local and regional speakers will focus on four types of cancer: breast, cervical, colon and prostate. Government is covering the cost of the conference to the tune of a little over NAf. 45,000.

Health Minister Cornelius de Weever said at a press conference on Monday that over the past year and a half several organizations had been trying to address the issue of cancer in their own way. The conference is a way of synchronizing everyone’s efforts. He said this would hopefully synchronise the way to move forward when it comes to cancer in general.
In response to questions about available cancer statistics, Section Head General Public Health Maria Henry said figures are available at several institutions and organisations such as at St. Maarten Medical Center (SMMC), Social and Health Insurance SZV and at family practitioners.

De Weever said the main question to be answered at the conference is how to collectively structure local cancer services and registry. He said figures are available from several sources, but these are not synchronized and government is starting the process of collecting this information. It is important for government to establish the number of cancer patients on the island to be able to build on this, he added. Government is also looking at its Health Management Information System, which will also provide these data.

Shelly Alphonso of the Positive Foundation said the foundation was “extremely excited” about the conference and the information to be gathered from intended speakers. She said the foundation would be inviting the population to get involved. “We are grateful that government has seen the need to bring us together to be able to give this matter the attention that it needs,” she said. “And we definitely applaud all the organizations that are involved.”

St. Maarten Cancer Foundation Public Relations Officer (PRO) Graciella Zimmerman said cancer is a disease that touches everyone. She said government’s initiative in organizing the conference shows the seriousness of the disease.
The conference is being held under the theme “Cancer and aging, collectively improving our local cancer care and responsibility,” and is being jointly organised by the Health Ministry’s Collective Prevention Services (CPS) and a number of Non-Governmental Organizations (NGOs).

The line-up of regional speakers include Dr. Wassenaar from Aruba; Dr. Igor Gomes and Dr. Carmen Coronel from Curaçao; Dr. Jennifer Alexander from Jamaica and Professor Hassel from Barbados. Local speakers are Dr. Virginia Asin; Nurse Jasmine Cijntje; Hose Booi; Dr. Romney; Lydia Vanterpool and Graciella Zimmerman.

The conference will focus on sharing information on specific cancers with the objective of developing a strategic plan of approach in registering, managing and monitoring cancers; increasing awareness; and new treatments/techniques.
The stakeholders involved in this activity are: Cancer Foundation, Positive Foundation, The Lions, Kelaha Projects, St. Maarten Medical Center, Windward Islands Medical Association, St. Maarten Medical Association, St. Maarten Laboratory Services, SZV Social Insurance Bank, Pharmacies, Insurance Companies, and individuals. The Department of Communications is also providing support.

New medical tariffs to be introduced in January 2013 on St. Maarten

THURSDAY, 11 OCTOBER 2012

~WIMA: ‘No changes’ with card ban~

PHILIPSBURG–Government intends to introduce new medical tariffs in January 2013, Health Minister Cornelius de Weever announced on Wednesday.

The new tariffs will take into account inflation, the minister informed the St. Maarten Insurance Association (SMIA), the Windward Islands Medical Association (WIMA) and the St. Maarten Medical Association (SMA) in a letter dated October 9.

In an invited comment, WIMA Chairman Hidde Deketh confirmed that his association had received the letter from the minister. He said WIMA is studying the letter and “can respond at a later date.” He said for now there would be no changes as it relates to the private insurance cards not being accepted.

De Weever said the ongoing discussion between SMIA and the general practitioners was brought to his attention last Monday. “The situation of private insurance cards not being accepted by the general practitioners is a discerning situation and prompted this office to immediately contact representatives of both parties to get a better understanding of the situation.”

He said the general practitioners have indicated that they have not fully benefited from annual cost-of-living adjustments since 2003. “Subsequently a request for a retroactive cost-of-living adjustment to the current tariffs was submitted to the private insurance agencies. The private insurance agencies in turn responded by indicating that they adhere and therefore will not exceed tariffs as stipulated by government,” De Weever said in his letter.

“The Policy Department of Public Health is currently in the process of finalizing a tariff structure that will include services rendered by general practitioners, in which inflation will be taken into consideration. This tariff structure has been developed in collaboration with the various health care providers, including the general practitioners.”
The minister had consulted with representatives of SMIA and the general practitioners regarding cost-of-living adjustment to tariffs.

Cards that are not accepted as of September 27, are NAGICO, ENNIA, Fatum, Sagicor and Alico. Doctors who are not accepting medical insurance cards are Dr. A. Arrindell, Dr. P. Arrindell, Dr. Bouman, Dr. Bus, Dr. Datema, Dr. Deketh, Dr. Dennoui, Dr. Douglas, Dr. Foeken, Dr. Herles, Dr. Knol, Dr. Mercuur, Dr. van Osch, Dr. Perez, Dr. A. Raghosing, Dr. R. Sanchit, Dr. Simmons, Dr. Spencer, Dr. Swanston and Dr. Tjaden.

St. Maarten Medical Center requests court to take higher supervision off table

WEDNESDAY, 10 OCTOBER 2012

PHILIPSBURG–The Inspectorate for Public Health has gone on a “rampage” and has painted an “ominous” and incorrect picture of sub-standard healthcare at St. Maarten Medical Center (SMMC). Attorney-at-law Maarten Le Poole said this Tuesday during the injunction filed by SMMC against the higher supervision imposed by the Inspectorate.

The Public Health Inspectorate, represented in the injunction by Inspector General Earl Best, had placed SMMC under higher supervision based on the findings of its governance audit, thematic site inspections conducted on SMMC from the end of 2011 to the first half of 2012.

The measure went into effect as of September 8, and is also based on the measures that need to be taken at SMMC concerning quality of care and patient safety, some on short-term and others within a year.

Via its attorney SMMC rejected the higher supervision and asked for clarity on the legal basis used for the measure. It asked for the lifting of higher supervision until the outcome of the court case on the merits, which is not to be heard until December 2012 or January 2013.

Minister of Public Health, Social Development and Labour Cornelius de Weever was in the audience during the hearing of the injunction.

The inspectorate had given SMMC’s Board of Directors two weeks to present a feasible action plan “to address many of the critical issues found” in the report. The inspectorate also said it would be conducting announced and unannounced inspections at least three times per month at SMMC, following up on the action plan. Failure by SMMC to comply with the higher supervision may result in temporary closure of “specific functional units.” or the issuance of fines.
According to SMMC, the inspectorate had overstepped the boundaries of its authority. It further claimed that within the framework of possible cooperation with Fundashon Mariadal in Bonaire, it had submitted an action plan which addressed several “points of concern and improvements.”

SMMC’s delegation in court, consisting of Director George Scot, Assistant Director Bonnie Dekker, Manager Patient Care Antonio Pantophlet and Human Resources/ Communications Officer Juliëtte Hassell claimed the inspectorate’s findings were incorrect.

“The medical specialists underlined that the quality of patient care is up to standard and they do not agree with the assumption that the quality of patient care is being hampered,” attorney Le Poole stated on SMMC’s behalf.
SMMC stated that the inspection report has been founded on a “negative attitude” towards the Board of Directors and Supervisory Board, and is not in compliance with the vision of other experts and would, therefore, be a much too unsteady basis for higher supervision.

SMMC qualified this measure, which had caused “great damage,” as disproportionate, untimely, inaccurate and illegitimate.

Higher supervision does not mean that SMMC’s management has become subordinate to the inspectorate, said the inspectorate’s lawyer Jairo Bloem.

Bloem said the audit had included quality care, internal governance, first aid, reports of calamities, as well as inspections of equipment, medication and localities. Documents were studied and operations attended, while conversations were held with hospital staff, as well as the Board of Directors and Supervisory Board.

The inspectorate mentioned various deficiencies such as the lack of logs concerning the maintenance of medical equipment, lack of communication between management, unmotivated staff and high work pressure. It said the Board of Directors should act diligently in motivating staff, optimising care and in providing transparency on the quality of provided care in order to have the higher supervision lifted.

The inspectorate contested claims that it had overstepped the boundaries of its authority and had submitted SMMC to standards applicable to large hospitals in The Netherlands. Judge René van Veen will give his decision on Tuesday, October 16.

St. Maarten parliament meeting with minister De Weever about SMMC goes on despite his request to postpone it

TUESDAY, 09 OCTOBER 2012

~ MPs question minister about health-care issues ~

PHILIPSBURG–A meeting of the Central Committee of Parliament on the health situation at St. Maarten Medical Center (SMMC) and its impact on social and labour policies continued on Monday despite a request by Health Minister Cornelius de Weever for a postponement or for Members of Parliament (MPs) to submit their questions in writing.
De Weever made the request due to “the sensitivity” of today’s court case between SMMC and the Inspectorate of Public Health. SMMC had filed an administrative appeal against the Inspectorate as well as an administrative injunction case requesting the Court to suspend the higher supervision decision by the inspectorate pending the outcome of the administrative appeal.

The minister said it would “not be in our best interest” to “discuss the details, policies, impact or strategies” before the case was heard. “The lawyers will present their case and I am sure that this is the beginning of inevitable change that will come to SMMC and health care in general,” he said.

However, several MPs objected to the minister’s request and indicated that Monday’s meeting had been duly called and should proceed as planned. Several MPs said that while they understood that the minister would be unable to answer certain questions in light of the court case, there were other issues that could be addressed.

When the meeting was initially scheduled, the minister had written Parliament Chairman Rodolphe Samuel requesting that the meeting be postponed until after the court hearing. However, Samuel denied this request in a written response to the minister dated October 4 – a move that drew commendations from some MPs who said such a decision could not be made unilaterally.

Some MPs from the opposition benches also raised concerns about what they considered the lengthy time period some ministers were taking to respond to their questions.

Monday’s meeting proceeded with MPs quizzing the minister about a range of issues regarding the Medical Center and labour issues.

The 68 questions posed by United People’s (UP) party MP Jules James drew sharp reactions from some MPs in the governing coalition, one of whom classified 99 per cent of James’ questions as “irrelevant.”

James’ list of questions included requests for the minister to explain what was causing the delay in the hospital expansion; when the minister had become aware of this expansion; and to provide Parliament with copies of all correspondence between SMMC and the health ministry, including with attorneys.

The minister was also asked whether a request had been made for members of SMMC’s Supervisory Council to resign and if so, what had prompted this request, on what basis it had been made and whether the minister was in a position to make such a request.

James also wanted details on the current capacity of the hospital and whether the minister believed a larger hospital was needed because of the population growth in St. Maarten. He also asked the minister to indicate whether he had learnt about SMMC’s expansion before or after his “scouting trip” to South Africa with other MPs. He also asked if the expansion was a priority for the minister and if this was the case, what De Weever had done to expedite this expansion. Other questions posed by James related to how much subsidy government was giving SMMC and whether De Weever was playing “politics” with SMMC.

James also asked the minister to indicate how he rated SMMC, what were some of the specialists that he would like to see working there; how many Registered Nurses were in service and whether this was sufficient. It was also asked whether the filling of Great Salt Pond for a drag-racing facility was more important at this time than the expansion of SMMC.
James said UP would be calling more ministers to Parliament and asking them “a barrage of questions,” because, according to him, ministers were not answering questions from MPs in a timely manner.

Irrelevant

Democratic Party (DP) Member of Parliament Roy Marlin reacted strongly to James’ line of questioning. Alluding to the saying, “One crazy man can ask more questions than 10 wise men,” Marlin said most of the questions asked were irrelevant. He said the issue at SMMC warranted all 15 MPs’ coming together to help the minister bring about positive changes at the hospital – that improvements were needed at SMMC and this is what focus should be placed on. He said the minister was being questioned about issues while he had no authority at the medical facility. He said the situation at SMMC was such that SMMC General Director and Board of Directors President Dr. George Scot could tell Parliament that he didn’t have to meet with them, “forcing” the calling of a parliamentary inquiry. “We wasted about 45 minutes of the people’s time, asking questions that are irrelevant,” the MP contended. He said MPs should be putting their “brains” together to talk about how to “force” changes at SMMC.

He said there were issues at SMMC that needed to be addressed. While most hospitals have separate female and male wards, this is not the case at SMMC. The SMMC Director spends half of his time abroad and half at SMMC, Marlin said. He asked whether everyone should “sit back” and allow this situation continue.
UP MP Gracita Arrindell said MPs were being paid to perform their duties and it was their prerogative to ask as many questions as they chose. She asked De Weever to give an update on the national health-care policy, to say how long the approval process took for employment permits and to list the medical credentials for health care workers, among other matters.

On the issue of receiving answers, she recommended that a system be put in place to track questions sent to government and remind ministers of their responsibilities to respond in a timely manner.

Independent MP Romain Laville said De Weever did not have the power to tell SMMC what to do and the focus of the meeting should have been what Parliament could do to help the minister prevent a health crisis in the country. He said too that the situation at SMMC was similar to that of utilities company GEBE, in which people were afraid to speak about the issues. “We cannot address the health issue in St. Maarten in the rightful way, because some of us don’t go to the SMMC for treatment so we don’t know what other people in St. Maarten are going through.”

Laville also urged some of his fellow MPs not to be used. He said some MPs had been given papers with questions to “trap” the minister and some of them did not even understand what they were asking.

UP MP Johan “Janchi” Leonard later said that they had been given questions to ask by the people. Laville said it was “petty nonsense” to mention the race track in the context of the hospital expansion.

Bridge to nowhere

Independent MP Frans Richardson said UP leader Theo Heyliger should have used some of the US $150 million that was being hidden for the “bridge to nowhere” for the hospital expansion. He said there were millions of passengers coming to St. Maarten by cruise and air and “at least the previous coalition partner should have come and said we would put the bridge aside” and invested in health. They “could have made a nice injection to SMMC with the same funds from the creation of a bridge to nowhere. Is a bridge more important that the investment in a hospital? Does a bridge give more return than the health of the people of this island?” Frans Richardson asked. The independent MP urged De Weever to present his vision for health care. This vision, he added, should take into account residents and the many visitors to the island.

Serious issues

UP MP Dr. Ruth Douglass said SMMC had been facing some “serious issues” that must be dealt with. She said as a medical practitioner it was “alarming” for her to listen to what was being said about health care. She asked what was government’s health-care standard for St. Maarten and how SMMC rated against it. She also enquired what powers the current inspectorate had over the management of SMMC and how this power was exercised. She also asked how many complaints were received by the inspectorate; how the recent higher supervision would affect SMMC’s planned expansion; and what were the specifics of higher supervision, among other questions.

UP MP Silvia Meyers asked the minister to provide the inspectorate’s report on the hospital. She also asked how many inspections had been conducted on SMMC; what were the results and when was the first time SMMC had been inspected. She also asked some labour-related questions.

Also speaking at the meeting were National Alliance (NA) MPs George Pantophlet, Hyacinth Richardson and Dr. Lloyd Richardson, independent MP Patrick Illidge and earlier in the meeting Democratic Party (DP) MP Leroy de Weever. The meeting which began at 10:00am was adjourned around 2:00pm, when another meeting with Education Minister Silveria Jacobs was scheduled. De Weever is to appear before Parliament for the continuation of the meeting within a week.

145 people take HIV test and 21 memory tests in St. Maarten

MONDAY, 01 OCTOBER 2012

COLE BAY–The importance of knowing your HIV/AIDS status continues to draw people to community testing days organised by St. Maarten AIDS Foundation. Saturday’s testing day in Cole Bay saw 145 people learning their status through the rapid, confidential HIV testing. Some 21 people had their memory measured by St. Maarten Alzheimer’s Foundation (SMAF). This was the first time the two foundations have worked together.

The majority of people getting their blood drawn from their fingertips (similar to taking a diabetes test) were men (79) of various backgrounds and ages. A total of 66 women were tested at Charles Leopard Bell Primary School.

Women who were not sure of their partner’s faithfulness or who found it difficult to convince their partner to use a condom were advised about the use of female condoms. AIDS Foundation volunteers demonstrated the use of female condoms to the women and gave them samples. The female condom was also suggested for women who are allergic to latex, the predominant material used in male condoms.

The rapid HIV tests and counselling were conducted by students of American University of the Caribbean (AUC) Medical School. The medical school has provided a steady stream of volunteers over the years for the testing days. The counselling focused on the sexual history of the person getting tested. Everyone taking the test was only identified by a registration number; no name was taken to ensure confidentiality.

Once the results were in, persons tested were given a second round of counselling by AIDS Foundation’s Dr. Gerard van Osch, foundation Prevention Unit Head Rajesh Chintaman and Dr. Pierre-Yves Merlet, a doctor from the French side who volunteered for the testing day. The results were delivered together with advice on safe sex based on the person’s sexual history.

Dr. Van Osch said that was “an excellent community response” which shows that more and more people understand the importance of getting tested and knowing their status. “We saw a larger number of people who were tested for the first time. We need this trend to continue for people to be informed about their status and how to take precautions against the contraction and spread of HIV.”

Several hundred condoms, to promote safe sex, were distributed to people who attended the testing day. Some condoms and information about HIV/AIDS were also given out to pedestrians and drivers on Union Road, opposite the testing site, by foundation volunteers and Motiance dancers (in costume).
Adding a new dimension to the testing day was the AIDS Foundation’s partnership with SMAF. People taking the test were ages 13-57.

SMAF Secretary Raymond Jessurum, who delivered the results of the memory tests, said the predominant finding was “mild cognitive impairment” – people were found to be mildly forgetful. Those with the “mild forgetfulness” were advised to see their family doctor for further testing, as the memory test is no substitution for a clinical assessment.
No severe case of Alzheimer’s or its advanced form Dementia was found.

The memory test took a just a few minutes with people being asked to remember certain words and filling out a pre-set test form. That form was then graded, along with the person being asked several questions based on things they had been asked to remember.

SMAF Foundation President Keith Franca told The Daily Herald that two foundations are exploring “forms and means of cooperation” and SMAF’s presence on Saturday was the beginning. He commended the AIDS Foundation for inviting SMAF and thanked it for allocating one of the only air-conditioned classrooms located at the entrance to the school.
Jessurun added that it was good that the two foundations were collaborating, because there is some link between a type of Alzheimer’s and AIDS due to the HIV virus attacking brain cells.

Public Health Minister Cornelius de Weever commended the AIDS Foundation and SMAF for their efforts to improve the health of the community. He also applauded the “great response” from the community.

The extensive partnership between non-governmental organisations and the public health ministry’s HIV/AIDS Prevention and Management Team (PMT) continues to be “a great initiative and proves that we can synchronise our efforts to better serve the people,” De Weever said.

Identificatie verplicht bij ministerie Volksgezondheid St. Maarten

DINSDAG, 18 SEPTEMBER 2012

PHILIPSBURG — Stafleden van het ministerie van Volksgezondheid, Sociale Ontwikkeling en Arbeid zijn nu verplicht pasjes te dragen. Het ministerie heeft verplichte identiteitsbewijzen geïntroduceerd voor het personeel van de departementen van Arbeid, Sociale Zaken, Collective Preventive Services (CPS), Sociale Ontwikkelingen en Volksgezondheid.

Het ministerie heeft verklaard dat door de pasjes het publiek bekend wordt met de persoon die zijn zaak behandelt.

“De invoering van naampasjes bij het personeel, vooral degene die direct contact heeft met het publiek, is een zeer belangrijke zaak geweest voor het ministerie van Volksgezondheid, Sociale Ontwikkeling en Arbeid. Dit komt goed over bij het publiek,” maakte een persbericht maandag bekend.

“Ik heb van veel mensen complimenten en klachten ontvangen maar als ik hen de naam vraag van de persoon die hen heeft geholpen, krijg ik een echter een beschrijving. De pasjes staan toe dat onze cliënten nu een naam kunnen opgeven terwijl onze aandacht gericht blijft op verbeteringen van de klantenservice”, verklaart minister Cornelis de Weever in het bericht.

Hoofd Arbeidszaken Peggy Ann Dros verklaarde: “Het is belangrijk dat het publiek ons direct kan identificeren. Zo hebben ze de kans ons een pluimpje te geven als alles goed gaat en ons te vertellen wat verbeterd kan worden. Bovendien geven wij het publiek meer macht door het hen mogelijk te maken hun klachten naar voren te brengen via een systeem dat spoedig bekend zal worden gemaakt.”

St. Maarten Medical Center to file administrative appeal against Health Inspectorate

TUESDAY, 18 SEPTEMBER 2012

~ Says hospital already submitted plan of action ~

PHILIPSBURG–St. Maarten Medical Center (SMMC) will be filing an administrative appeal to annul the decision of the Inspectorate of Public Health to place SMMC under “higher supervision.”
SMMC’s attorney Maarten le Poole of HBN law said on Monday that there seems to be no legal basis for higher supervision to be placed on the hospital and for the imposition of measures as a result of the supervision.
Le Poole said he found it disturbing that in all its communication on the SMMC issue, the Inspectorate had been silent about the plan of action SMMC had submitted to it a day before the higher supervision had been imposed. The Inspectorate had instructed SMMC’s board of directors to present a feasible action plan within two weeks to address many of the critical issues found in its governance audit and thematic site inspections at SMMC. The Inspectorate said it would also be conducting announced and unannounced inspections at least three times a month following up on the action plan.

Le Poole: “SMMC had already submitted a plan of action concerning many points addressed in the Inspectorate report. The Inspectorate has been completely silent on this. SMMC had submitted the report on September 7 and the letter of higher supervision was issued on September 8 and the press release on the subject issued on September 10.”
“There was no mention that on September 7 SMMC had already, on its own account because the hospital felt it necessary, presented a broad overview of the status of affairs at SMMC combined with a plan on certain issues. It is striking that the Inspectorate pretends that this plan does not exist and does not even mention it.”
Le Poole said he knew the Inspectorate had received the plan, because he had seen correspondence in which the Inspectorate confirmed receiving it.

He said the hospital wanted the Inspectorate to provide clarification on the law used to institute higher supervision, as SMMC is of the view that there is no legal basis. Inspector General Earl Best has said that the Inspectorate has the authority to act if health care is in jeopardy (see related story).
Best has been asked to publicly retract his statement that SMMC is under higher supervision. Le Poole said too that while SMMC had responded to Best’s correspondence, Best has not responded to SMMC’s latest correspondence sent last week Friday.

In that letter, HBN informed the Inspectorate on behalf of its clients of its plans to file an administrative appeal. The Inspectorate was also asked if it was willing to suspend its current actions pending the outcome of the administrative appeal. Le Poole said this question “remains unanswered. We can therefore only conclude that the Inspectorate refuses to communicate with us.”
Best had responded to HBN’s first correspondence.

 

Best maintains that SMMC higher supervision stands

TUESDAY, 18 SEPTEMBER 2012

~ Says: Most hospitals would be eager to comply~

PHILIPSBURG–Inspector General Earl Best has maintained that the higher supervision placed on St. Maarten Medical Center (SMMC) stands and is hoping the hospital would adhere to the content of the supervision or measures will have to be taken.

However, SMMC’s attorney Maarten le Poole of HBN Law on Monday maintained that there is no legal basis for higher supervision to be placed on SMMC and said the hospital would be filing an administrative appeal against the Inspectorate to retract its order (see related story).

Best told The Daily Herald on Monday that most hospitals finding themselves in a situation as SMMC would be eager to work together with the Inspectorate to rectify things, but not SMMC. The Inspectorate said the hospital’s rejection of the supervision was “more or less expected, seeing the way they behaved in the whole inspection process.”

Best said the Inspectorate will have to meet with SMMC and determine a way forward. “We will have to meet with them first. Wanting to comply is the most simple and normal thing to do. Instead of fighting with the Inspectorate, you try to sit and resolve the situation. That is what all hospitals would love to do, but not here in St. Maarten,” Best said. “If they [SMMC ed.] want to fight with us, we have several measures we can take. We can fine them and if they don’t abide in the end we can say we will close [some functional units ed.]. That’s an option, or the minister can take a decision to come up with a decree.”

He said SMMC has been placed under “Verscherpt toezicht,” Dutch for “higher supervision.” Asked what was the legal basis for this action, he said the Inspectorate “does not need a legal basis” for this action, as “the Inspectorate is authorized” to take such a decision if it determines that health care is in jeopardy.

He said failure by SMMC to adhere to the conditions of its supervision would result in the imposition of measures. This could include fines and the closure of certain functional units. Two units that would face closure are the Emergency Room and the Surgical Ward. He said the Inspectorate is an independently functioning body and it is incumbent on the Health Ministry to determine what measures would be put in place to guarantee continuity of care in these areas, if this measure were to be taken.

Best said he had responded to SMMC’s letter rejecting the higher supervision last Friday. In his letter he maintained that the supervision stands and he urged SMMC to comply.
Asked for his views on the summons he was given by SMMC via its attorney that the Inspectorate should refrain from making further public statements while the issues with SMMC have not been clarified, and without first consulting SMMC, and from performing further acts which suggest that its office lets itself be used as a political tool, Best said this was SMMC’s opinion.

“We are the Inspectorate. We are independent. That’s their opinion.” He said if the Inspectorate has to call on government in this case, it would do so.

St. Maarten Hospital will not adhere to higher supervision

THURSDAY, 13 SEPTEMBER 2012

~ 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

THURSDAY, 13 SEPTEMBER 2012

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.

St. Maarten Medical Center placed under supervision

TUESDAY, 11 SEPTEMBER 2012

~ Hospital has to present feasible plan in two weeks ~

CAY HILL–The Inspectorate for Public Health has placed St. Maarten Medical Center (SMMC) under higher supervision based on the findings of the inspectorate’s governance audit thematic site inspections conducted on SMMC from the end of 2011 through the first half of 2012.

The higher supervision, which took effect on September 8, also is based on the measures that need to be taken at SMMC with regard to quality of care and patient safety, some in the short term and others within a year.

The Inspectorate has given SMMC’s Board of Directors two weeks to present a feasible action plan “to address many of the critical issues found” in the report. The Inspectorate will also be conducting announced and unannounced inspections at least three times per month at SMMC, following up on the action plan.

Failure by SMMC to comply with the higher supervision may result in temporary closure of “specific functional units,” a press release issued via the Department of Communications DComm stated on Monday.

Quality of care, internal supervision (governance), surgical operations, the Emergency Department and the handling of accidents and incidents were audited through inspection visits and conversations with staff members, the board of directors and the Supervisory Council. For the audits on governance and surgical operations, support was provided by the Dutch Inspectorate for Healthcare IGZ.

The Inspectorate said it was aware of the fact that St. Maarten is a small island with only one hospital, the SMMC. “Demanding of this hospital that it complies with all requirements as stipulated for hospitals in the Western world would be unrealistic and not feasible, but one must expect the SMMC to comply with basic quality and patient-safety standards and healthcare ordinances and regulations,” it was stated in the release.

“The audit and inspections leave much to be desired. A common and important finding is the lack of proper communication in different areas and at different levels, resulting in severe delay in the development of a basic quality and safety system and a high risk for the patient.

“This situation is worsened by the fact that the Board of Directors is frequently (50 per cent of the time) off-island and replaced by a staff member without mandated authority and an incomplete Supervisory Council that cannot exercise its supervisory role adequately.”

Also included in this report are some investigative results of incidents that occurred in 2010, 2011 and 2012, because they provide insight into the way the SMMC is organised – on the one hand about the communication amongst professionals and between professionals and the board of directors, and on the other hand about how transparent management is to external supervision.

When publishing a report, the Inspectorate said it had taken into account the norms as prescribed by legislation such as the Openness in Government Law (“Landsverordening Openbaarheid van Bestuur”).

This means that wherever possible, personal information will not be mentioned in this report – for example, patient names – and staff members of SMMC will be referred to as much as possible by their function.

Due to less than optimal cooperation from the Board of Directors, it wasn’t until July 12, 2012, that the Inspectorate could speak with the director. The provided information has been processed in this report. The findings of the audit were compiled in a draft report which was delivered to the SMMC board of directors on August 24 for comment prior to publication. SMMC’s board is headed by Dr. George Scot. He is also General Director.

The Inspectorate said the deadline to deliver any comment to the Inspectorate was September 7. However, the board indicated in a September 7 letter to the Inspectorate that it couldn’t comply with the deadline due to several internal delays, and requested an extension until September 17. The Inspectorate said it had denied this request and indicated that possible comments would be dealt with when discussing the action plan to be drafted.

“Based on the findings and measures that need to be taken with regard to quality of care and patient safety, some on short term and others within a year, the Inspectorate has put the SMMC under higher supervision as of September 8, 2012.
“This means that the board of directors must present a feasible action plan within two weeks to address many of the critical issues found and that the Inspectorate will be conducting announced and unannounced inspections at least three times a month following up on the action plan. Failure to comply may result in (temporary) closure of specific functional units,” it was stated in the release.

The Inspectorate said it had used the following ordinances and regulations for this audit and measures to be taken: Landsverordening Zorginstellingen (PB 2007 no. 19); Landsverordening Corporate Governance (PB 2009 no. 74); Landsverordening Inspectie Volksgezondheid (PB 2003 no. 8); Landsverordening Beperking Vestiging Medische Beroepsbeoefenaren (PB 2005 no. 69); Landsverordening Uitoefening Geneeskunst (PB 1958 no. 174); BW boek 7 afdeling 5 Overeenkomst Inzake Geneeskundige Behandeling; Statuten SMMC 25 April 2008; Basis Reglementen Raad van Toezicht – SMMC 26 September 2011; Gedragcode Raad van Toezicht SMMC June 2011; and Model Toelatingsovereenkomst SMMC 2010 versie 6.0.

St. Maarten minister De Weever says actions SMMC must be within country’s legal framework

MONDAY, 10 SEPTEMBER 2012

PHILIPSBURG–Health Minister Cornelius de Weever said on Sunday that any actions he or government takes in relation to St. Maarten Medical Center (SMMC) “must be within the legal framework of our country and will not and shall not exclude the introduction of new legislation or amending existing laws or the amendment of existing licences.”
De Weever said in a press statement issued on Sunday that legislative processes took time, considering the necessary consultations and checks and balances. “However, in the event no other options are left, I shall proceed and expedite matters in the general interest of St. Maarten and my duty of care.”

The minister’s statement comes on the heels of a strongly-worded letter he was sent from the attorneys representing SMMC General Director Dr. George Scot and SMMC’s Supervisory Council in which the minister was told that the Council would not resign as had been requested. In the letter the minister also was requested to stop interfering in the affairs of SMMC and to stop slandering the institution.

In his release De Weever said that as Minister charged with public health, it was his duty to see to it that all care institutions in St. Maarten not only adhered to the laws governing the health care sector, but also to ensure that the provisions of those laws were not only enforced, but could be enforced justly.

“Patients, nurses, specialists, staff, management and board members of care institutions must know their responsibilities and should have been provided with the means to effectively perform their duties or seek their rights,” it was stated in the release.

“No one care institute in the world is perfect. However, that doesn’t mean that together we cannot strive for perfection. It is not uncommon that at times members of boards develop tunnel vision that no longer allows them to see their faults even when presented with sound arguments thereto.

“Boards at times may have established practices that are either inconsistent with the rules governing their institutions or that are interpretable/questionable. Both situations are undesirable with regard to the provision of care. Rules must be clear, logical and adhered to. Non-adherence to, misinterpretation or circumvention of laws, bylaws or own code of conduct is not conducive to any board, especially if such relates to our country’s largest care institution.

“The laws of our nation charge the Minister of Public Health with the issuance of various care-related licences, the amendment or revocation of previously issued ones. Furthermore, the Minister of Public Health can initiate and, together with his colleague ministers, pass resolutions (laws) that may have far reaching consequences.
“Subsequently or independently, government may together with the Parliament of St. Maarten pass new ordinances or amend existing ones to ensure that the minister charged with public health can effectively and proactively ensure the wellbeing of the citizens of St. Maarten and visitors alike.

“The extent to which the present laws allow government to intervene is far-reaching and doesn’t exclude intervening on the highest levels of any care institution. The situation at the SMMC is a very delicate matter and must be handled with the most care and as professionally as possible.

“The Public Health Department (research/policy), the Inspectorate of Public Health (inspection/issuance of fines/set instructions) play a crucial role in the public health management field and in my capacity as Minister, I cannot simply ignore those two key departments when addressing matters as presently is the case.

“As stated earlier, no institution is perfect, it is therefore necessary to continuously consult relevant stakeholders and professionals in the health care sector to strengthen and improve the governing structures of health care providers so they may improve their provision of care.

“Rest assured that I will do all that is necessary within my capacity to ensure that St. Maarten has a medical centre that is of the highest standards and that can meet the needs of the specialists, nurses, staff and most importantly the patients of the SMMC.”

St. Maarten hospital tells minister to stop interfering, stop public slander

FRIDAY, 07 SEPTEMBER 2012

~ Says no legal basis for Supervisory Council to resign ~

CAY HILL–Public Health Minister Cornelius de Weever was told on Thursday to stop interfering in the affairs of St. Maarten Medical Center (SMMC) immediately and to stop “slandering” the institution.

In a strongly-worded letter to the minister, attorneys representing the hospital and its Supervisory Council added that there was no legal basis for the minister to request that members of the Supervisory Council resign. The attorneys asked the minister to state the legal basis for his request that the members step down.

The minister had requested in a letter dated August 30 that the members of the hospital’s Supervisory Council resign.
However, on behalf of the hospital, attorneys C. J. Koster and R. Zwanikken stated in a September 6 letter to the minister that SMMC was a private foundation.

“The Minister of Public Health, Social Development and Labour only has very limited power to interfere within the corporate structure of SMMC. Based on the articles of incorporation, the minister only needs to be consulted regarding the appointment, suspension or dismissal of members of the board,” the attorneys stated.

“With regard to the appointment of members of the Supervisory Council, the minister only has the possibility to choose out of one of the two binding nominations presented by the Supervisory Council (Article 9 (2a)). If the minister does not make a choice in two months after receiving notice, then the Supervisory Council shall choose one of the two nominees.
“The request you made cannot be based on the articles of incorporation of SMMC. For clients it is unclear on what rule of law, statute or law you have based [your, ed.] requests. Please be therefore advised that the Supervisory Council will not comply with these requests, as a legal basis for same is or at least seems to be lacking.”

The attorneys said that if the minister believed there was a legal basis for his request, he should elaborate on it in a letter to the law firm BZSE Attorneys at Law and Tax Lawyers.

“In that case you are kindly requested to explicitly refer to the applicable articles in the law or to the applicable provisions in the articles of incorporation of SMMC.

“Please be also advised that clients are not pleased at all that you have decided to go to the press with negative statements about SMMC, allegedly based on a report of the Inspectorate, a report that my clients had not received yet. Clients consider this a violation of article 2c, e and f of the [transparency in government ordinance, ed.] Landsverordening Openbaarheid Bestuur IOB.

“Your statements have created unrest and have unnecessarily decreased confidence in the largest care-giving institution of the Dutch Windward Islands for residents of St. Maarten, Saba and Statia. The fact that these statements came from the Minister of Health cannot be deemed other than very irresponsible.

“Finally and last, but not least, please be advised that SMMC is of the opinion that political interference with its organisation and its daily operation is undesirable and inappropriate, especially in case the interference lacks any legal basis. Moreover, your interference and the interference of the Health Committee of Parliament have a detrimental effect on SMMC, its donors, its employees, its patients and the public opinion of the people of St. Maarten.
“SMMC requests you – and insofar as necessary summons you – to immediately cease this interference and public slandering of SMMC,” concluded the attorneys in their letter, which was copied to Parliament’s Permanent Committee for Public Health and to the media.

De Weever had sent three letters to SMMC: one dated August 21 requesting information and documents from the Supervisory Council, one dated August 31 asking the Council members to resign and one dated September 1 requesting that the Supervisory Council not enter into any agreements that might negatively affect the relationship between SMMC and government.

St. Maarten parlementarians afford SMMC-director Scot another chance to meet with them

THURSDAY, 06 SEPTEMBER 2012

~ Or they will request parliamentary inquiry ~

PHILIPSBURG–Parliament’s Permanent Committee for Public Health has given St. Maarten Medical Center (SMMC) General Director Dr. George Scot another chance to meet with them on September 13 or they will request a parliamentary inquiry into its concerns at the medical institution.

Scot, who also holds the position of President of SMMC’s Board, did not show up for a meeting called by the Committee on Monday. Scot sent a letter to the committee, requesting, among other things, that an impartial person chair that particular meeting, said Committee chairman Leroy de Weever.

De Weever (Democratic Party) said this request was not possible as Parliament’s committees have a certain structure. “I don’t know how he can expect that. We have a system and that is how it is. He [Scot ed.] also wanted specific elaborations on things,” said de Weever.

In his letter Scot had also referred to the structure of SMMC in relation to whom the MPs had invited to the closed-door meeting, which de Weever said, was “semantics” on the part of Scot.

De Weever said the Committee had sent a letter to Scot inviting him to another meeting on September 13. The Committee will also send Scot another letter this week enquiring whether he planned to show up to the meeting on September 13. The Committee plans to meet separately with Scot and the Supervisory Council on this date. “We have given Scot a new date and if that does not happen then as Parliament we will request a parliamentary inquiry and I don’t think they want to go that way,” said De Weever adding that any “recklessness” or “shady stuff” occurring at SMMC will be revealed in such an inquiry.

Members of Parliament serving on the Permanent Committee for Public Health along with other interested MPs still met among themselves on Monday and discussed the letter sent by Scot among other things.

De Weever called for the urgent meeting in August to discuss the level of care and constant “rumours” about the quality of care being delivered by SMMC. His concerns and those of other MPs stemmed from the recent passing of Ruth Olivacce, the sister of United People’s (UP) party Fraction Leader MP Silvia Meyers-Olivacce, at SMMC as well as other concerns about the institution.

MPs met with the Association of Medical Specialists and MPs on Tuesday (see related story) regarding their concerns at SMMC.

 

THURSDAY, 06 SEPTEMBER 2012

PHILIPSBURG–Members of Parliament (MPs) serving on the Permanent Committee for Public Health will be recommending that St. Maarten Medical Center (SMMC) be managed by a three-member board, instead of one person as is currently the case.

The current President of SMMC’s Board is Dr. George Scot, who is also SMMC’s General Director. This was one of the suggestions that came out of a meeting among MPs and members of the Association of Medical Specialists on Tuesday.
“It is a must that the managing board of the hospital is expanded,” said Committee Chairman Leroy de Weever. “Right now it’s only one person.”

The initial suggestion was for the board to be expanded to two persons, but De Weever said stalemates can be encountered if decisions are to be made by only two persons. This can be eliminated with a three-person board. He said one of the board members can have a financial background, one a medical background and the other a managerial background.

De Weever said the meeting attended by medical specialists, surgeon Dr. Felix Holiday, pediatrician Pieter Offringa and Internist Theo Jolles, had been a professional and cordial one. Obstetrician/Gynecologist Randall Friday could not attend due to a medical emergency. A total of 11 MPs, including those of the Committee attended the meeting.
Another recommendation to be made to Health Minister Cornelius de Weever, is for the Medical Council to be activated. De Weever said the establishment of such a body is already on paper, but does not exist in practice. The council would function as an independent body and review the applications of medical specialists and other persons who want to work in the medical field here.

De Weever said he will also be notifying the specialists of any decisions the Committee will be taking in the future, since these will ultimately affect them. “We want to be in harmony with them. Our recommendation is that physicians should also have a little more say in the management aspect of the facility and my proposal is that a physician be appointed to the supervisory board of the hospital.”

De Weever said MPs made it clear that the meeting had been called to discuss concerns at the institution and that no one had any personal vendetta against anyone.

“We want to make it clear that there is no vendetta against anyone and no one is gunning for anyone. We wanted to assure them that we are going about this enquiry not just because of bad press, but we had pointed questions such as whether physicians had problems with the constant absence of the General Director [Dr. George Scot, ed.] and not having someone to go to if issues come up in his absence.

“There is a report from [Inspector General Earl ed.] Best and we wanted to see what SMMC is doing about it and we wanted to talk about the expansion and the reluctance of Scot to provide information to the people who are financing the expansion,” said De Weever. The Committee has also requested a copy of the report from Best.

De Weever said Social and Health Insurance SZV is one of the financiers of SMMC’s expansion, yet information is not forthcoming from Scot to SZV. “He does not want to provide creditors with information and this is hampering the execution of the expansion for the hospital. A building is a building, but what’s important is the staffing. You can have the most beautiful building in the world, but if you’re not doing enough for the staff, quality will be compromised and we wanted to know how we can help,” he said.

Minister De Weever requests St. Maarten Medical Center board to make positions available

~ But procedure unclear ~

MONDAY, 03 SEPTEMBER 2012

CAY HILL–Reports over the weekend indicated that Minister of Public Health Cornelius de Weever has asked the members of the St. Maarten Medical Center Foundation (SMMC) Supervisory Board to make their position available to government.

Such a request requires some clarification considering that the SMMC board is a private one and the articles of incorporation of the foundation affords government the opportunity to appoint only a single member.
This issue was debated before between government and the SMMC in a court of law during the Chairmanship of Glen Carty. Government at the time lost that court case with the judge ruling that government could not appoint the members to the board to run the hospital.

The Daily Herald understands the minister informed the Supervisory Board of his wishes during an emergency meeting he had called on Saturday evening. The meeting had been preceded by a separate Supervisory Board meeting earlier in the day at which Reuben Essed announced to the rest of the board that he would not take up his new position as a board member. Essed had only been appointed days before.

The minister has not made a public statement and could not be reached for comment on Sunday, but will have to explain on what grounds he took the decision to make such a request of the board.

Additionally, in a letter to the Corporate Governance Council (CGC) last week, De Weever indicated that the SMMC foundation recently appointed new members to its Supervisory Board “following the procedures as set forth in the articles of incorporation,” which is an apparent acknowledgement that all procedures were followed.
Article nine empowers the SMMC to make a binding nomination of the candidate they wish to have appointed. This “binding nomination” means that the minister would have to accept such nomination as long as the procedures, as per the articles of incorporation, were followed.

The same Article nine provides the minister with the possibility to appoint a candidate if the Supervisory Board of the SMMC failed to do so within a specified time, and this would require vetting by the CGC. The minister asked the CGC to render advice concerning the appointment of supervisory board members before he takes a final decision. The CGC has not responded to the minister’s request thus far.

As such, if the minister has requested the board members to make their positions available he has done so prior to receiving the advice from the CGC, which he requested. This would put the CGC in a position that it has lamented on previous occasions, to render advice on something that a minister has already affected by virtue of ministerial action.
SMMC announced last Wednesday that two new Supervisory Board members, Reuben Essed and Robert Jan James, have been appointed as of August 25, 2012.

According to the SMMC, the Supervisory Board members have decided to view the coming six months as a transition phase during which the positions within the Supervisory Board are divided as follows: Izzy Gerstenbluth Interim Chairman (medical) since March 2011; Reuben Essed Interim Vice Chairman (legal) since August 2012; Sixto Peters Member (financial) since October 2008; Edwin Benjamin Member (business/managerial expertise) since March 2012; Robert Jan James Member (expertise on re-organisation processes and management) since August 2012.
After the six month transition phase the members will decide on the definite constellation within the Supervisory Council.

 

Parliamentarians to meet SMMC, specialists this week

MONDAY, 03 SEPTEMBER 2012

PHILIPSBURG–Members of Parliament (MPs) serving on the Permanent Committee for Public Health will meet with the Supervisory Board of St. Maarten Medical Centre (SMMC) in a closed door session today, Monday starting at 2:00pm in Parliament House.

This meeting comes following a call for an urgent session issued by Democratic Party (DP) Member of Parliament Leroy de Weever about the level of care and constant “rumours” about type of care delivered by SMMC in August.
His concerns and that of other MPs stemmed from the recent passing of Ruth Olivacce, the sister of United Peoples’ (UP) party Fraction Leader MP Silvia Meyers-Olivacce, at SMMC.

A second meeting about the SMMC issue will be held with the Association of Medical Specialists and MPs on Tuesday starting at 4:00pm in Parliament House.

The two meetings were originally slated for last week but was postponed on request of the invited parties.
Ahead of the two sessions, the specialists association and SMMC General Director Dr. George Scot met on Friday about hospital matters and other pressing issues.

St. Maarten Medical Center lashes back, will ‘fight false accusations’

THURSDAY, 23 AUGUST 2012

~Calls De Weever’s statement ‘disturbing’ ~

CAY HILL–St. Maarten Medical Center (SMMC) on Wednesday responded to the numerous statements made about it in recent days, calling statements specifically made by Health Minister Cornelius de Weever “very disturbing” and says they “create unnecessary panic and unrest.”

In its lengthy statement, SMMC also said its staff, board of directors, Supervisory Council and management team are “standing together to fight whatever false accusations are made about SMMC.
“We underline that our focus remains to provide safe, quality hospital care for the residents and visitors of St. Maarten and the surrounding islands. We will keep on working on improving the hospital care including the realization of the much-needed expansion,” SMMC said in its statement.

Referring to the media reports on SMMC as “damaging public campaign” which “holds unfounded and incorrect statements,” the hospital said the timing of the campaign is not a coincidence.

“We first and foremost wish to state that we are highly sensitive to the private and personal nature of the treatments that our patients undergo at SMMC. The handling of patient information is confidential, private and regulated by laws. We hold this confidentiality high and have utmost respect for the patients, their loved ones and for our staff as well when dealing with this information. This inherently brings along that we cannot and will not comment to public statements regarding treatment of individual patients. However, the SMMC is in its full right to defend itself and needs to provide correct information by addressing at this moment the following issues,” it was stated in a press release.

Expansion
On the issue of its expansion, SMMC said when it started 21 years ago there were about 23,000 people living on the island. It is estimated that there are now around 56,000 persons on the Dutch side of St. Maarten. So, the population more than doubled. It should be clear that the expansion of our hospital is not a luxury, but an urgent necessity, it was stated.

SMMC said following its “financial collapse” in 2003 and its rebound in 2006 it successfully balanced its financial status. “Since then we have been improving the quality of care and patient safety and we have been providing more and better services each year. We have been renovating some parts of the present building, but it has now become too small and inadequate. In 2007 we had a plan ready to build a new wing on the hospital grounds. This new wing will host a new and improved emergency room department, modern operating theatre, a larger intensive care unit and new medium care unit.

“The goal of this expansion is to improve the quality of hospital and specialist care on St. Maarten and to be able to attract more doctors, specialists and nurses.” On June 28, 2007 the government of St. Maarten agreed that the hospital and specialist care should be improved and approved a construction subsidy of over NAf. 1 million per year during five years, from the start of the construction. It is a construction subsidy, not an operational subsidy and is only provided when the construction starts, not before. This is the first and only subsidy that the government has ever pledged to give SMMC. Up to this present moment the SMMC is not receiving any subsidy from the government, it was stated in the release.

Since September 2011 SMMC is working on attracting parties to participate in the bond issue to finance the expansion of the hospital. Six parties already committed. “These parties are well-established local and regional pension funds, banks and insurance companies, SMMC said. The deadline that we set for the bond issue was August 15, 2012 and we were waiting for the last party to commit.

“On August 14, 2012, the SMMC had a meeting with the [Health ed.] Minister [Cornelius de Weever ed.] and the concerned party about the financing of the hospital building. The next day the minister went public with statements about a draft report of the Inspectorate of Health Care. The allegations ventilated, damage the reputation of staff and surely put the SMMC in a bad spotlight with the investors. It is hard to believe that the timing of these allegations and the mentioned deadline is a coincidence.”

Inspectorate of Health draft report
SMMC said Inspector General Dr. Earl Best refuted publically and in correspondence to SMMC that there is a draft inspection report, since he is still working on it. According to the Inspectorate of Health Care, the findings of its draft report need to be made known to the SMMC first. “The SMMC did not receive any draft report till this day and the Inspector General has confirmed in the media that he did not send the draft report to the SMMC. On July 12, SMMC had a meeting with the Inspectorate and the Inspector General stated that there are no urgent matters that he needs to address immediately with the SMMC.

“The minister said that he is in possession of the draft audit report. He has provided information to the press on the content of this report, while the Inspector General says that the audit report is not completed as yet.
“The statements of the minister are very disturbing. They cause great concerns and create unnecessary panic and unrest under our patients, the community, and show disrespect to the hospital staff. We expect an ethical and humane approach from our minister who in the end is responsible for the health of our population. We regret the unfair way in which the SMMC is being handled.

“In view of the contradictions in the statements of the Minister and his General Inspector, the SMMC is seriously considering to request independent and renowned experts in the field of hospital inspection to conduct an independent investigation at the SMMC.”

Misuse of funds
SMMC said last year the President of the Health Committee of Parliament started a public campaign against the SMMC. The SMMC was accused of misusing funds and our General Director of having too many “caps.” Since 2006 the SMMC has approved financial statements that are yearly audited by an external accountancy firm. This on request of the Supervisory Council to ensure and confirm that the finances are correctly used and administered, it was stated in the release. Not once were these statements questioned. Based on the negative publicity and wrongful allegations, the General Director in December 2011 requested the present Minister of Health for an independent audit by Stichting Overheidsaccountants Bureau (SOAB) to conduct an investigation in this area.

“The minister, however, till this day did not reply to this request. We assumed that it was not an issue for the minister anymore. Last week the Minister and the President of the Health Committee again publically stated their questions regarding alleged misuse of funds. We question why at this crucial stage in completing the financing of the expansion these questions are posed again.”

SMMC said on Wednesday, August 22, at the request of the WIHCUA, the Minister of Health Care addressed the staff of SMMC. “He apologized to the staff, stating that he stands by his words, but it was not his intention to attack the care given in SMMC. Different staff members remarked that his public statements created considerable unrest among patients and the general public and asked him what he is going to do to turn this around. Unfortunately this question was not answered by the minister.

 

 

 

De Weever to public: Don’t be afraid to file complaints

THURSDAY, 23 AUGUST 2012

~ Says some are intimidated ~

PHILIPSBURG–Health Minister Cornelius de Weever on Monday, said patients should not be afraid to file complaints to the Inspectorate of Health about issues at St. Maarten Medical Center (SMMC).

The minister told reporters at Wednesday’s Council of Minister’s press briefing that some persons are “intimidated” and fearful of filing complaints.

“People must not be afraid to report it. It is their duty…,” he stressed. “People must have the right as a civilian to make their remarks and their complaints to the inspectorate. We must not be afraid because some people are intimidated and some are afraid because they say if anything happens to me I have to go back to that same SMMC so I do not want to,” de Weever said.

“And I don’t think we should live in that type of fear and if we will address this, let us address it the right way, let us go through the inspectorate and whatever corrections need to be made, it will be made because that is what the inspectorate is for.”

De Weever said people are not used to having an Inspectorate based in St. Maarten. Prior to the dismantling of the Netherlands Antilles on October 10, 2010, the health Inspectorate was based in Curaçao. The inspectorate would announce when they are coming to St. Maarten to conduct their inspections, they would come and get their inspections done; then they would leave the island.

He said the inspectorate in those days were ultimately responsible to Curaçao not St. Maarten. “But now since 10/10/10 we’ve had our own inspectorate. They are on the job and they are doing what they have to do. We are a small community and these things live their own lives, but they have to do their job the right way,” de Weever said.

The minister said conducting an inspection is a tedious and lengthy process as the person filing a complaint has to give his or her statement and persons involved in the chain of care also have to give their statement. The report will then have to go back to SMMC for their rebuttal before being finalised.

The minister said persons usually approach him with complaints, and while he takes note of them and says he will inform the inspector, he always urges these persons to pursue the matter “because they or their family members had been affected by it.

“We should encourage people to complain because if we don’t then we will stay the same place.”
De Weever also mentioned at the meeting that the SMMC expansion is not the solution to everything. “We have been expanding our government building that isn’t the solution either. We have to address the issues structurally. Deal with the root and deal with it one by one, that’s the only way we will move forward,” he said.

St. Maarten nurses outraged over Minister de Weever’s remarks about SMMC

TUESDAY, 21 AUGUST 2012

CAY HILL–St. Maarten Medical Center (SMMC) nurses have expressed outrage over statements made by Health Minister Cornelius de Weever last week.

“We expected much more from this particular Minister. But not everything you see is gold. Not every sheep is without wolf’s clothing. We are not only ashamed of our Minister, who we hold up highly, but we are also deeply disappointed that he too can stoop so low,” the nurses said in a joint statement emailed to The Daily Herald on Monday.

“You have a beef with Dr. [George ed.] Scot [SMMC General Director ed]. Then deal with Dr. Scot. Have you thought of the consequences of your wording on the radio and in the papers?

“You put fear in the minds of our people. People in the hospital are now dropping their words ‘I hope you all don’t kill me too.’ Thank you Honourable Minister de Weever,” the nurses wrote.

“Is it your intention for the people to take the hospital to Court? A professional and careful thinking Minister, would and should never stoop so low to the media. You can say at the SMMC there are serious matters that need to be dealt with and government is giving their full attention. Are you crying down the care with such a statement and are you putting fear in the people?” they asked.

In a statement issued on Friday, de Weever said he had been informed of two more patients who passed away in the SMMC while or after receiving surgical treatment. He said seven cases had been reported by patients, family members or medical professionals and investigated by the Inspectorate of Health Care. “However, the SMMC has not reported accidents and incidents with mortal consequences and/or a higher rate of complications to the Inspectorate which is mandatory. The Council of Ministers received a briefing by the Inspectorate of Health Care which indicated that a lot needs to be corrected in a short time to drastically improve the quality of care in this institution.”

The minister also said while the Inspectorate of Health Care is in the final stage of its official report on the SMMC, “based on the past events and the preliminary findings, I am strongly of the opinion that there leaves much to be desired. Supervision by the Supervisory Council of the SMMC and daily management by the Board of Directors seem to have fallen short of their full responsibilities. It’s unacceptable to allow the healthcare provided by our only hospital to decline. The current situation at SMMC has my full attention and will be dealt with accordingly,” he said.

In their statement the nurses said the minister did not take into account that he “has put himself in the same arena with those who are on the blogs with their negative and destructive remarks. He has breached patient’s confidentiality and privacy.”

They added: “Nice Job: Sell this to our tourist industry. Mr. De Weever, for most of our nurses affectionately called Connie. You have shamed us in the worst way. Of all the good praises from you to us on several occasions, which should we believe, who should we believe? We don’t know you anymore. This hurts. Again, if you have a beef with Dr. Scot go through the right channel to deal with this. Don’t pull down the whole care of the SMMC. Based on the population growth it may seem that more deaths are occurring. Don’t forget that every operation procedure has its risk.

“We have never dropped our arms in providing care to our patients then, not now and even not after your destructive comments. As the Minister of Health you should not be judgmental. We will serve all people of St. Maarten, even those who think like you. Minister what is your beef?”

 

 

 

Union chastises minister for statement on hospital

TUESDAY, 21 AUGUST 2012

~Urgent workers’ meeting called for 1:00pm today~

CAY HILL–The Windward Islands Medical Workers Union Association is furious about the statement made last week by Health Minister Cornelius de Weever about St. Maarten Medical Center (SMMC).

And, the Union’s Public Relations Officer Greg Arrindell Monday invited all hospital workers to assemble at SMMC at 1:00pm today for an “urgent” and “important” meeting to discuss the matter and to “look at further action.”
Speaking with PJD2 on Monday, Arrindell said statements made by the minister have “traumatised” the staff, whom he said are standing in the cold “without any explanation.” He said workers should not miss this meeting as “their future and life depend on it.”

In a separate statement issued earlier in the day, the board of the union was critical of the minister’s statement. “If there is a personal vendetta going on between the Minister of Health Care and the SMMC Director, please deal with that person to person and do not generalise with the Medical Center.”

“When a minister can go and put confidential information in the news media, [it ed.] makes us wonder about the level of integrity this minister has for the people of St. Maarten and in particular the staff of his Medical Center.”

The union said SMMC staff had been working to keep St. Maarten Medical Center functioning, maintaining quality care. “We have been recruiting and attracting young people of St. Maarten, studying abroad, to come back home and work for their island’s hospital. This particular statement by our honourable Minister Cornelius De Weever will surely have an impact on the decision-making of our youth returning home to work for this institution,” the union said.
“When our honourable minister can go out and cry down the care of the only hospital on Dutch St. Maarten with this type of information, then it leaves us with no other alternative than to wonder what is the capability or secret agenda of our Honourable Minister of Health.”

“Where was our present Minister Doctor Cornelius De Weever from since 1993? SMMC has been upgrading its personnel, whereby SMMC also played an important role in upgrading the White and Yellow Cross, Ambulance, Sector Health Care, and to date SMMC will produce twenty registered nurses in June 2013, and they are hailing from SMMC, Ambulance Department, White and Yellow Cross and Statia,” the union said.

The union referred to a letter from Inspector General Earl Best to SMMC General Director Dr. George Scot which reads: “As far as I know, the draft report isn’t even ready and indeed hasn’t been sent to you yet. On specific request of the minister of Health, I have given a brief verbal preliminary overview to the COM (Council of Ministers ed.) last Tuesday on our hard findings.

“During this COM meeting I specifically mentioned that once the draft report is ready it has to be reviewed by the SMMC first before compiling the final report to be released. I am not responsible for whatever story is made up in the media and I regret this as much as you do. By next week you will receive the draft report,” it was stated in the letter from Best to Scot.

The situation at St. Maarten Medical Center ‘leaves much to be desired,’ says Health Minister

~ Confirms seven cases being investigated, two more patients passed away on Thursday ~

SATURDAY, 18 AUGUST 2012

PHILIPSBURG–Health Minister Cornelius de Weever says the situation at St. Maarten Medical Centre (SMMC) leaves much to be desired and it has his full attention.

In a statement on Friday de Weever said he was informed yesterday of two more patients who passed away at the SMMC while, or after, receiving surgical treatment.

“Seven cases have been reported by patients, family members or medical professionals and investigated by the Inspectorate of Health Care.

“However, the SMMC has not reported accidents and incidents with mortal consequences and/or a higher rate of complications to the Inspectorate which is mandatory. The Council of Ministers received a briefing by the Inspectorate of Health Care who indicated that a lot needs to be corrected in a short time to drastically improve the quality of care in this institution.

“The Inspectorate of Health Care is in the final stage of its official report on the SMMC, but based on the past events and the preliminary findings, I am strongly of the opinion that there leaves much to be desired,” de Weever said Friday.
He continued: “Supervision by the Supervisory Council of the SMMC and daily management by the Board of Directors seem to have fallen short of their full responsibilities. It’s unacceptable to allow the healthcare provided by our only hospital to decline. The current situation at SMMC has my full attention and will be dealt with accordingly.”

Meanwhile Inspector General Earl Best confirmed on Friday that his report will be finalised by mid September. The report, he said, is based on inspections conducted dating back to last year. He said the draft report has to be sent to SMMC for them to respond before the report is finalised.

SMMC Human Relations/Communications Manager Juliëtte Hassell said SMMC is still to receive the report.

 

SMMC says it regrets death of dialysis patient Ruth Olivacce

SATURDAY, 18 AUGUST 2012

~ Incident reported to Health Inspectorate ~

PHILIPSBURG–St. Maarten Medical Centre (SMMC) says it regrets the passing of dialysis patient Ruth Olivacce, who died at the hospital on Thursday after undergoing a medical procedure there.

SMMC Human Relations/Communications Manager Juliëtte Hassell said SMMC has since reported the incident to the Inspectorate and the hospital will await the outcome of the Inspectorate’s investigation.

Olivacce is the sister of United People’s (UP) party parliamentary group leader Member of Parliament (MP) Silvia Meyers-Olivacce.

“We regret that the dialysis patient died and I speak on behalf of management, staff and the specialists especially the staff and specialists who had been directly involved in treatment and we wish the family and their loved ones much strength,” she said.

“We followed the procedures that we had to and immediately informed the inspector.” She said all reports will be forwarded to the inspectorate to enable them to conduct their review. “We followed the procedures to ensure that this case is handled as correctly as possible. We want to ensure that it is dealt with as soon as possible. We regret that it happened at the hospital. The staff is affected by her loss and we really want to ensure that the correct procedures are followed.”

Hassell declined to go into the specifics of what occurred saying that the Inspectorate has to be allowed to conduct its inquiry. However, she said that the patient was a dialysis patient in need of certain treatment at SMMC. She said doctors from The Netherlands who treated Olivacce explained what occurred in their report to the inspectorate. “We will await their reaction.”

The patient underwent treatment on Wednesday and Thursday. Hassell said as with any procedure there is always a risk. “It is an important procedure like any procedure and in this case the dialysis patient did a specific procedure. There is always a risk especially if you’re talking about the arteries there is a risk as with any procedure.”

 

St. Maarten health minister wants meeting about care at hospital

SATURDAY, 18 AUGUST 2012

PHILIPSBURG–An urgent meeting of the Permanent Committee of Parliament on Health is necessary to address the level of care and constant “rumours” about the type of care being delivered by St. Maarten Medical Centre (SMMC), Democratic Party (DP) Member of Parliament Leroy de Weever said on Friday.

De Weever said he would request the meeting as soon as possible and called on all fellow MPs to attend.
Speaking at Friday’s Central Committee meeting of Parliament, De Weever said the request will also call for hospital officials including representative of the surgeons and Minister of Health Cornelius de Weever to be present to answer questions.

His concerns and that of other MPs stemmed from the recent passing of Ruth Olivacce, the sister of United Peoples’ (UP) party Fraction Leader MP Silvia Meyers-Olivacce, at SMMC.

National Alliance (NA) MP Louie Laveist, also offering condolences, said he was stunned by the passing and circumstances under which this took place. He called for an enquiry and the “need for things to run effectively.”
MP Dr. Lloyd Richardson (NA) recalled working with Ruth Olivacce in the Junior Chamber Jaycees in the 1970s and 1980s. He also expressed condolences to the family of the late cyclist Gassy Richardson, cyclist from Simpson Bay. He and fellow party member MP Hyacinth Richardson wished the family strength.

Several other MPs also offered their condolences to the two families.

St. Maarten minister says SZV has right to due diligence for SMMC investment

THURSDAY, 16 AUGUST 2012

PHILIPSBURG – Social and Health Care Insurance SZV has a right to due diligence for its investment in the St. Maarten Medical Center (SMMC) expansion says minister Cornelius de Weever.

St. Maarten delegation to Holland on eHealth factfinding mission

WEDNESDAY, 11 JULY 2012

PHILIPSBURG – Minister of Public Health Cornelius de Weever is part of a delegation that has left St. Maarten over the weekend for The Netherlands on an eHealth road trip.

Obesity prevention in St. Maarten to start in new school year

TUESDAY, 19 JUNE 2012

PHILIPSBURG–The Ministry of Public Health, Social Development and Labour, Section General Public Health, presented its Obesity Prevention Programme focussing on nutrition and physical education to stakeholders recently in preparation for the 2012-2013 school year. A main item is a school breakfast programme.

The Ministry will fund the breakfast programme to the tune of NAf. 90,000 while the Ministry of Education, Culture, Youth and Sports will fund the physical education part. The project has been presented to school managers and community project coordinators.

General Public Health nutritionist Swinda Richardson and Ministry of Education, Culture, Youth and Sports physical education coordinator David Forsythe made the presentation.

Dr. Danielle Hollar, a consultant for Obesity Prevention Programming, Research and Evaluation, spoke about “The Organise Guys” Comprehensive School Programme, which focuses on improving children’s health and academic performance.

Thirty Cycle II children of each school will participate in this breakfast programme. The schools participating in this programme are Oranje School, Sister Marie Laurence School and Hillside Christian Schools. These schools were chosen specifically because research showed that the children at these schools were not having breakfast regularly.

Research shows that children who do not have a good breakfast usually have problems concentrating in class.
Teachers also will be consulted to inquire whether the children show any progress relating to their grades and general participation in class. The breakfast menu will include fruits, dairy products, vegetables, etc. The menu will be nutritionally balanced with foods from four food groups: dairy, grains, meats, fruits/vegetables.

“It is important for us to see how the children will respond to the items on the menu. We will switch it up as much as possible by offering a variety weekly,” said Richardson.

The menu will be rotated weekly. An example of the menu will be tuna sandwiches, ham and cheese sandwiches, turkey sandwiches, all with lettuce and tomato; peanut butter sandwiches; cereal; hardboiled eggs; yoghurt;100 per cent fruit juice; milk and water.

The programme will be evaluated at the end of the school year. “We hope by the 2013-2014 school year to expand the programme to other schools and we encourage others to take it up,” said Richardson.

Minister of Public Health, Social Development and Labour Cornelius de Weever stated, “It is a great programme that, if it is executed properly, will have a positive outcome especially for the children.”

19 JUNI 2012

Report suggests that pension age be raised on St. Maarten

MONDAY, 21 MAY 2012

PHILIPSBURG–Increasing the pension age to 62 from 60 and upping the maximum income to pay premiums to NAf. 100,000 are two recommendations of a report recently delivered to outgoing Public Health, Social Development and Labour Minister Cornelius de Weever.

The “relatively conservative reform” report titled “Towards a sustainable and affordable AOV Pension System” was put together by the Steering Committee on Social Security and Pensions. Reform is seen as a continuous process that needs to be monitored, evaluated and improved gradually.

De Weever said in a press statement, “Although the steering committee recommended the age of 62 for the increase in retirement age, I would prefer a flexible retirement age between the ages of 60 and 65 depending on the individual and/or the company’s needs.”

Further research is also suggested on the consequences of making exceptions for people with little or no income and/or living in St. Maarten as a resident for 10 years, in connection with the effects on financial assistance.

Other recommendations are to increase the pension AOV to NAf. 1,000 and to strengthen the so-called second-layer pension system (private employer and employee pension plans) and research the financial consequences, conditions and constraints of implementing a mandatory second-pillar pension plan (private employer and employee pension plans).

The report will be sent to the Council of Ministers for approval as well as to the Social Economic Council SER and tripartite labour committee for feedback.

Legislative changes will have to be worked on for the AOV benefits, retirement age and change in amount of the maximum income to pay premiums.

“After listening to the needs of the seniors and pensioners association, the cries of the newly retired and those who are receiving financial assistance, I understand the need of the people to raise the AOV pension. As we look toward the future, we are looking at mandatory pension plans for all employees to ensure a better retirement package for all workers,” the minister said.

 

Public Health Ministry St. Maarten concerned about doctors availability at night

THURSDAY, 26 APRIL 2012

~ Gives recommendations to improve services ~

PHILIPSBURG–Create a General Practitioner’s (GP) post in St. Maarten Medical Centre that will be managed and operated by GPs, and cancel the arrangement between GPs and St. Maarten Medical Center (SMMC) to see patients in the emergency department at night and on weekends, was one of several recommendations presented to Public Health VSA Minister Cornelius de Weever by Health Inspector Earl Best.

The Health Inspectorate is “very surprised” by the agreement between GPs and SMMC concerning GP care during the night and weekends in the emergency room, Dr. Best said.

This means that almost none of the general practitioners are available at night or on weekends, and that the emergency room does “figurative work” and most of the time has a long waiting line. “This affects the quality of care provided negatively.”

Most GPs can be consulted by telephone during office hours; however, home visits to less ambulant patients and emergency visits are not provided by many GPs, said Best, adding this is an explanation for the fact that many GPs do not possess “a doctor’s bag anymore.”

The recommendation, which has to be addressed by the VSA Minister, physician organisations, SMMC and health insurers, stems from a quality and service survey carried out by the ministry.

The 20 doctors who operate as GPs had to fill out a questionnaire dealing with the subject of the survey. All of the clinics, except one GP who refused to cooperate, were visited by the inspectorate, explained Best in his presentation in A.C. Wathey Legislative Hall on Wednesday morning.

The inspectorate also recommended the development of a registration system for general practitioners and establishment of requirements for necessary training and GP skills; as well, a sound professional communication between GPs, pharmacists and medical specialists and improvement in the quality of the patient files.

Improved quality of care by developing evidence-based diagnostic and treatment protocols/guidelines for common medical conditions and the urgent introduction of an electronic health record (EHR) were outlined as very necessary.

GPs will have to ensure the practice (clinic) is easily accessible for the disabled and proper technical maintenance of equipment, Bess pointed out from the findings.

The most important part of the survey, according to the inspector, was to examine whether the GPs complied with the conditions for qualitatively responsible care, given the fact that no substantive guidelines on the medical content exist on St. Maarten.

GPs have two organisations, Windward Islands Medical Association (WIMA) and St. Maarten Medical Association (SMA) that provide peer-to-peer contacts and to organise common and continuous training.

“Yet it is striking that in St. Maarten professional communication about the individual patient and the organisation of care is a major problem; and not just between the GPs and the medical specialists but also between GPs and pharmacists,” Best said. “Of course both parties have responsibilities in improving this issue. Except for inter-professional contacts within WIMA and SMA, the peer-to-peer contacts within the GP group needs improvement.”

The quality of patients’ files is “often very poor.” This differs considerably from the GPs using an electronic patient record (EPR) and those who do not.

“St. Maarten has no accreditation for GPs. Vocational training is not mandatory. During the interviews it was often unclear how GPs maintained their skills,” Best said.

Minister De Weever said the report establishes a baseline for the ministry to work with and build on to improve the health services to the community.

Bonaire, St. Maarten hospitals sign cooperation letter of intent

THURSDAY, 19 APRIL 2012

PHILIPSBURG–Dutch Minister of Health Edith Schippers was present on Wednesday for the signing of a letter of intent between St. Maarten Medical Center and Fundashon Mariadal, the hospital of Bonaire, for cooperation on specialty care.

This cooperation agreement will regulate, among other things, the provision of specialists by the two university hospitals in The Netherlands, VUMC and AMC, to SMMC to service the patients of St. Maarten, Saba and Statia. The signing of this agreement was hailed as an important step in further developing continued quality care.

Fundashon Mariadal General Manager Giovanni Frans lauded the fact that the countries of the Dutch Kingdom would be working together to improve quality of care. He said a final agreement would be worked out over the next three months.

He dubbed the signing as a “historic moment” after the dismantling of the Netherlands Antilles that creates a new structure to provide hospital care on the islands. He said cooperation was important considering the small size of the islands.

Minister Schippers was present, but did not make any comment during the signing. St. Maarten’s Minister of Public Health Cornelius De Weever also was present.

Alzheimer Foundation presents WHO/ADI report to St. Maarten minister De Weever

THURSDAY, 12 APRIL 2012

PHILIPSBURG–A report, titled “Dementia: A Public Health Priority” that was prepared by the World Health Organization (WHO) and Alzheimer’s Disease International (ADI) was presented to Public Health Minister Cornelius de Weever by St. Maarten Alzheimer Foundation President Keith Franca on Wednesday .

De Weever said he and his ministry are seeking to synchronize efforts via a joint plan of action on Alzheimer’s and Dementia, which he hopes will be executed in the coming months.

The report called for promoting a dementia-friendly society globally, making dementia a national public health and social care priority worldwide, improving public and professional attitudes to, and understanding of dementia, investing in health and social systems to improve care and services for people with dementia and their caregivers, and increasing the priority given to dementia in the public health research agenda.

The new report also calls on governments, policymakers and other stakeholders to make dementia a global public health priority. It provides the most authoritative overview of the impact of dementia worldwide. In addition to valuable practices and practical case studies from around the world, it contains the most comprehensive collection of data, including hard-to-get statistics from low- and middle-income countries, thereby dramatically underscoring that this is truly a global problem and not just a “disease of the industrial world.”

In her foreword, WHO Director-General Dr. Margaret Chan called the report “a major contribution to our understanding of dementia and its impact on individuals, families and society.” She called upon all stakeholders to “make health and social care systems informed and responsive to this impending threat.”

Marc Wortmann of ADI underscored the urgency of action. “With its devastating impact on people with dementia, their families, their communities and national health systems, dementia represents not only a public health crisis but a social and fiscal nightmare as well.”

Around the world, a new case of dementia arises every four seconds. That’s a staggering growth rate, equivalent to 7.7 million new cases of dementia every year – equal in number to the populations ofSwitzerlandandIsrael.

St. Maarten Alzheimer Foundation welcomes the WHO/ADI report.

Research and data about the impact of dementia in St. Maarten are not yet available, according to the foundation’s statement. “But with this global report on the impact of dementia in the world, we can get government to address dementia as a national health priority.”

The foundation added that government can ask for international assistance and cooperation to early detection and fight dementia, among which the most common is Alzheimer’s disease.

Healthcare Council St. Maarten resigning en masse

SATURDAY, 31 MARCH 2012

PHILIPSBURG–The St. Maarten Healthcare Council has had enough. After waiting some three years, and despite appeals to several successive governments, the members of the nine-person advisory board are in the process of handing in a joint letter of resignation to Minister of Health Cornelius de Weever, The Daily Herald has learned from reliable sources.

Chief among their concerns is the fact that the current membership of the board already should have been reviewed back in 2009. The board was established in 2005 and has a four-year life span. Therefore, the current members are uncomfortable about their legal status.

Many of the members, who have fulltime jobs, also no longer have the time to give their advisory tasks the proper attention. They represent all the major groups in the healthcare sector, such as dentists, family doctors, pharmacists, etc.

Repeated requests for additional funds to help them better execute their advisory role apparently also have fallen on deaf ears. The council is expected to render independent advice on issues such as the expansion of the St. Maarten Medical Center or the approval of other new developments in the various areas of the healthcare sector.

Members of the council were unavailable for comment on Friday and because the Minister’s office had not yet received the letter up to late yesterday afternoon, government officials reserved comment.

Ministers St. Maarten outline policies related to budget to MPs

TUESDAY, 20 MARCH 2012

~ Duncan aims to introduce fees for Justice services ~

PHILIPSBURG–The seven ministers have given Parliament an overview of their policies and plans for 2012 as these related to the draft 2012 budget that is before Members of Parliament (MPs) to approve.

The plenary session on the budget had a false start on Monday morning due to the lack of a quorum. That was speedily followed by the reconvening of the meeting in the afternoon by Deputy President of Parliament Leroy de Weever.

After some five hours of presentations, the meeting was adjourned until 10:00am today, Tuesday, when MPs will pose questions to the cabinet members on their policies, plans and how these fit within the budget. It is also expected that several MPs will table motions that will directly impact the budget in various ways, as the meeting progresses.

While a number of the policies outlined were repetitious based on past presentations by ministers, these somewhat fitted in with the opposition National Alliance (NA) request to have the cabinet give more substance to the budget.

Tourism, Economic Affairs, Transportation and Telecommunication Minister Franklin Meyers even asked Parliament to excuse him from making a presentation because it would be basically the same as the policy outline he gave to MPs in October 2011. De Weever said he had to continue with the presentation, as it was his “duty” to provide the information.

Meyers spoke about preparatory work to develop an investment package open to local and foreign investors as an economic booster. His ministry also is working on streamlining the business licence process and hopes to put a cap of six weeks on the process.

If no communication is received within that period, the licence will be considered as granted for straightforward businesses. For other, speciality businesses that would require the input of other departments, the processing time could be longer.

Meyers pointed out that as part of the revamping of the tax system, his ministry together with that of Finance was looking into reducing the profit tax to possibly between 15 and 18 per cent, compared to the some 34.5 per cent now levied.

He also outlined his vision to attract more high-end tourism business through branding of existing properties and encouraging the development of boutique hotels, as well as delving more into niche markets such as the honeymoon sector.

Meyers said the beach policy would be adjusted and pending Jet Ski licences for which two local youngsters had applied would be granted. He said it was not acceptable that there were moratoriums in areas where locals were involved while there was none for businesses such as jewellery stores, operated mostly by non-locals. He said it was time the people of St. Maarten were “part of the economic growth.”

Finance Minister Hiro Shigemoto outlined the process used to develop the budget and the relevant laws that play a part in the compilation. As for policies, he also rehashed his vision of revising the tax system as a means of broadening the tax base, improving government’s finance management to the level of best practices and upgrading the tax authority, among other projects.

As the last of the ministers to address Parliament, Shigemoto said it was good to have listened to his colleagues go through what was in the budget in terms of policies and plans. He added that based on the way MPs had spoken in the Central Committee of Parliament’s handing of the budget, the public might have thought that it was “a horrible document.”

Prime Minister Sarah Wescot-Williams highlighted the need to upgrade the civil service through an education plan about the way government functions that would extend to the public later. Wescot-Williams also outlined the establishment of an expanded national archive, further development of the National Gazette, and strengthening of the National Security Service, among other projects and policies.

She was critical of MPs for questioning the policies of the ministers and by extension the cabinet as a whole when the Governing Programme had been presented to Parliament since September 2011. “No one discussed the government programme,” she said.

Deputy Prime Minister/Infrastructure Minister Theo Heyliger based his presentation on the United People’ (UP) party/Democratic Party (DP)’s governing programme titled a “Foundation of Hope” and zoomed in on the need to improve the organisation of his ministry to kindle the community’s respect. He said the ministry had to contend with limited resources, human capacity and tools.

Pay for services

Justice Minister Roland Duncan pointed out again his intention to bring legislation to introduce a fee for residence permits. The ministry receives some 5,000 requests annually for renewal and new residence permits. At present, a processing fee is charged when a request for a new or renewed employment permit is logged.

Duncan also will seek to raise more money for his ministry by implementing fees for “Justice services” such as the new requests/renewals for gun permits and requests for police records and public gathering permits for events. No fee is levied for these services other than purchasing of a revenue stamp.

He also spoke about the need to acquire “The Box” in Cay Hill for use as a youth detention centre and criminal psychiatric facility, among other uses. It will also serve as the main kitchen for all the detention facilities. A proposal on “The Box” will be sent to Parliament soon for review.

He addressed the human resources shortage his ministry faces and efforts to correct this, as well as trying to access funding needed to carry out the recommendations in the Plans of Approach. He referred to the Immigration Department as “neglected” over the years and said he hopes to boost its capacity and workplace morale.

Expansion of the National Detectives unit and putting the framework in place to ensure the head has a replacement also are being looked at.

On substations and increasing police presence in the 10 districts, Duncan said he was in talks with various property owners to acquire land and spaces. He hopes to conclude talks with Port de Plaisance to use two old buildings on its property to house police officers temporarily, as construction of the substation to be built in that area is yet to be started.

Male teachers

Education, Culture, Youth and Sports Minister Rhoda Arrindell outlined the strides she had made in her portfolios, taking time to address comments made by some opposition MPs on the tweaking of the Culture Policy, efforts to host the 2013 Kingdom Games and adequate funding for youth organisations.

Arrindell spoke of the possibility of extending school hours, attracting more male teachers to the classrooms, making sports a mandatory part of the curricula and emphasising graduating students being able to converse comfortably in English, Dutch, Spanish and French.

While working on a sports policy, a Sports and Recreation Foundation and a Youth Development Foundation are in the works. An Interim Sports Technical Committee is in place. The “Get off the Block, Get on the Bus” programme will be rewritten to meet pressing goals.

Man in the mirror

Public Health, Social Development and Labour Minister Cornelius de Weever prefaced his presentation with a video clip to the sound of Michael Jackson’s “Man in the Mirror.” The clip showed scenes not in St. Maarten of emaciated children, homelessness and poverty, among other social ills. It even had a brief clip of Adolf Hilter in his trademark military uniform complete with swastika.

De Weever said the clip was “to set the mood” and evoke the question whether a better St. Maarten was desired. He said his ministry was busy with a health information system to establish a baseline, to monitor policies and any outbreak.

He urged all residents to take control of their health and see physicians regularly. He also asked MPs to support medical policies. The development of a national disability fund and pension plan are being explored.

Giving insights into other policies, De Weever said the foreign work permit policy was under review, as well as the labour laws. Those laws are seen as key to “drastically reduce” youth unemployment.

False start

Monday’s meeting was slated to start at 10:00am. However, after a 30-minute wait, only seven MPs were signed in for the start of the session, one signature short of a quorum. President of Parliament Gracita Arrindell and fellow MP Johan “Janchi” Leonard were not present, as they were travelling back from Aruba.

Although National Alliance (NA) MPs William Marlin, George Pantophlet, Louie Laveist and Hyacinth Richardson as well as independent MP Frans Richardson were present in the General Assembly Hall and in their seats, they had not signed in for the meeting.

Following a roll call, Deputy President of Parliament Leroy de Weever said the session had to be reconvened within four times 24 hours based on the Rules of Order. He immediately set the second calling of the meeting for 2:00pm. It was pushed later to 3:00pm as NA members indicated that they wanted to attend a funeral.

When the meeting was opened for the second time, there was the required number of signatures for a quorum.

The only other procedural issue to come up as the afternoon progressed was MP Laveist asking for a roll call just when Shigemoto had started with his presentation. There were about four MPs in the hall at that time. As preparations for the roll call were made, MPs in the hall gestured to their colleagues to return to their seats. Some MPs made it back to their seats just as the general secretary called their names. Ten MPs were noted as present, so the session continued.

Doctors update St. Maarten minister De Weever on medical tourism plans

MONDAY, 05 MARCH 2012

PHILIPSBURG–Health Minister Cornelius de Weever met recently with a group of doctors who are interested in working out of The American Clinic (TAC) to develop medical tourism in St. Maarten.

The doctors met with De Weever while on a familiarisation trip to the island. Specialists in emergency care, cardiology, orthopaedic surgery, spine surgery and anaesthesiology, among other areas, the doctors “were very pleased with what they have been introduced to on the island,” it was stated in a press release on Sunday.

They also will do volunteer work in the community and are looking forward to the project getting started.

De Weever and Tourism, Economic Affairs, Transport and Telecommunications Minister Franklin Meyers signed a letter of intent (LOI) with The American Clinic BV in December 2011 for a medical tourism project in St. Maarten.

“With the establishment of the medical tourism project, there will be several advantages for the island,” it was stated in the release. “One is that medical tourism would support tourism to the island, while broadening and strengthening the economic base of the country.

“In addition, by having this project in St. Maarten, it would create revenue for the island, as well as employment. Moreover, the investors are committed to establishing medical tourism on the island and are prepared to make a substantial investment in this project, to achieve the aim and objective of the LOI.”

The timeline TAC has anticipated is on schedule, the release stated. “At the present moment, they are busy finalising the architectural drawings.”

De Weever was quoted as saying he was pleased with the progress the group was making and was looking forward to the next phase of the project.

Minister De Weever wants waiting time at SMMC ER to be shorter

THURSDAY, 16 FEBRUARY 2012

~To meet with Scot Friday~

PHILIPSBURG–Health Minister Cornelius de Weever would like the waiting time at the Emergency Room at St. Maarten Medical Center (SMMC) to be shorter.

De Weever told reporters at Wednesday’s Council of Ministers press briefing that he had visited SMMC’s ER around 1:30pm one day. He presented his card and was told to wait. The minister said when he enquired how long he would have to wait – whether it would be two or three hours – the other patients in the waiting room told him they had been waiting since 9:30am and 10:30am.

The minister said this is an issue that he thinks needs attention. “I think that this needs to be addressed. We need to separate emergency care from urgent care and those who are paid to provide that service need to do so,” de Weever said.

He will be meeting with SMMC General Director Dr. George Scot on Friday and this is one of the issues that he will raise.

St. Maarten Mental Health Foundation closing ward if government continues to deny work permits

SATURDAY, 28 JANUARY 2012

~ Finding qualified staff a major challenge ~

PHILIPSBURG–If government continues to deny employment permit requests for qualified Mental Health Foundation (MHF) staff, the foundation will be forced to close its Admissions Ward.

While this would be a last resort, MHF Director Eileen Healy said she would not continue to admit patients with mental disorders without the necessary qualified staffers on board.

Healy made the comments during a meeting of the Central Committee of Parliament on Friday. “Work permits are being turned down as we speak. We are seriously looking at closing down Admissions soon if we don’t get permits, because I won’t take in more patients if we don’t have qualified staff,” she said.

Healy’s comments sparked a strong reaction from Democratic Party (DP) Member of Parliament (MP) Leroy de Weever, who said he didn’t understand where her comments “on non-cooperation” stemmed from, given that the foundation had received what he said had been a substantial increase in its subsidy from government over the years.

De Weever also questioned whose authority it was to determine whether MHF should be closed.
However, Healy pointed out that while government had been cooperating and an increase in subsidy had been budgeted for the foundation, this never had been received in January as prescribed and in fact had been given as late as August on one occasion.

Healy said obtaining qualified staff was a “major challenge and hurdle” for the foundation. This, she said, is complicated when government denies the employment permit requests for the persons from abroad.

She told MPs the foundation had gone through the required process of advertising for qualified staffers at the Labour Department and in the newspapers for several weeks and when this had not yielded any success, the foundation had submitted a request for a non- national with the necessary qualifications to work in its operations.

She told this newspaper last night that four permit requests had been submitted, two of which had been approved, one denied and one pending. The permit denied was a first-time request for a Social Psychiatric Nurse and the one that is pending is for a Registered Nurse, both of whom are for the Admissions Ward. MHF has a total of 40 workers.

In addition, while the Labour Department is supposed to give an answer on a permit request within six weeks, Healy said it took three months and longer. “And in the meantime, we have to run a facility,” she said.

She stressed that the current complement of staffers in the Admissions Ward could not provide the 24-hour service that was required, without the workers for whom permits had been requested. She said too that while the foundation had at its disposal the services of part-time nurses who had full-time jobs elsewhere, these nurses often were not familiar with patients with mental disorders, which could create a dangerous situation.

The foundation had requested exemptions from Justice Minister Roland Duncan and Labour and Health Minister Cornelius de Weever. “We understand that Minster de Weever is trying to do something about it, but our staff gets desperate. … It is not an easy situation for us now,” Healy said, noting that she wanted to take only good news to Parliament, but she had challenges and wanted to speak honestly about them.

In response to Healy’s comments De Weever said: “… You hinted that you are thinking of closing. How can a single person like yourself make that decision arbitrarily? And I’d like to know the structure of your foundation. Who represents the foundation? What are the authorities of the board versus the Director? Is the board or the supervisory board ultimately responsible? Is the director’s power mandated or delegated? And what authorities are mandated and delegated to the director?”

Healy said her concerns were shared by the board, whose President Felix Holiday had wanted to be present at Friday’s meeting, but couldn’t attend. She said the executing of policies was approved by the board and delegated to the director. For serious measures, she said, the board meets, the director advises and decisions are made.
She said they didn’t want to close down the facility, but if their Registered Nurse couldn’t handle a 24-hour schedule without a qualified assistant, they wouldn’t have a choice. “Right now we are working with on-call nurses, which is not healthy for … our patients,” Healy said.

“All civil servants don’t understand the impact on all organisations. If we now have to go and dispute something that has been turned down, it takes away from the time we have to implement quality care. We want to be busy now to set up an education plan, but instead I have to go and run behind the Labour Office. If government gives a permit to start a facility … and now tells me that I don’t have a work permit [for my staff], it takes away from the work that I want to do for patients.”

She said too that government’s subsidy did not cover the foundation’s entire operations. “Officially the subsidy should be way lower if the tariffs were higher.” She said the problem of uninsured patients also was hampering the foundation.

She said while communication with Health and Labour Minister Cornelius de Weever had been “wonderful,” MHF “doesn’t know where the recent problems are coming from.”

MHF Registered Nurse (RN) Elena Reyes, one of the persons who accompanied Healy to the meeting, suggested that government invest more in local education programmes to produce more Licensed Practical Nurses (LPNs) and RNs. “Most people have to pay out of their own pockets and we know how the economy is – not very easy.” She said there had been some internships at MHF recently and she was hoping to encourage these interns to work for MHF.

Based on a suggestion from De Weever, a tour of the MHF facility will be arranged.

Healy attended the meeting with MHF Psychiatrist Dr. Sachin Gandotra, Administrator Lila Jones and Executive Secretary Micaela Warner.

In addition to De Weever, present at the meeting were President of Parliament Gracita Arrindell; MPs Jules James, Dr. Ruth Douglass, Johan “Janchi” Leonard and Silvia Olivacce-Meyers of United People’s (UP) party; George Pantophlet and Dr. Lloyd Richardson of the National Alliance (NA); and independent MP Frans Richardson. Several of the MPs present also made remarks during the meeting.