Minister Ernst Kuipers (Public Health) wants to concentrate pediatric heart surgery in Utrecht and Rotterdam. This means that specialist child care will disappear from Groningen and people will therefore only be able to get this care in the Randstad in the future. The plan is met with a lot of resistance, including from dozens of pediatricians in Overijssel.
1. How many inhabitants of Overijssel will have heart surgery in Groningen?
There are no exact figures, but every year about 200 to 250 inhabitants of Overijssel undergo specialist heart surgery in Groningen, says pediatric cardiologist Rolf Berger of the UMCG.
2. Do all hospitals in Overijssel send children to Groningen?
Most do. Pediatric heart surgery is so specialized that the hospitals in Overijssel do not perform this type of surgery. Hospital Group Twente (ZGT) in Almelo and Hengelo refers all patients to the UMCG in Groningen, as does the Saxenburgh Medical Center in Hardenberg.
Isala in Zwolle also refers children to ‘the north’. “If the UMCG is full or if Utrecht is more practical for a patient, we will refer you to Utrecht,” says a spokesperson. The Deventer Hospital works together with both the hospital in Utrecht and the hospital in Groningen. “But more with Groningen, because the pediatric cardiologist from the UMCG also does consultations here,” says a spokesperson.
Medical Spectrum Twente (MST) in Enschede also often refers to Groningen, although a spokesperson says he cannot indicate this exactly.
Isala almost always refers to the UMCG in Groningen for specialist pediatric heart surgery
3. How bad is this decision for me as a resident of Overijssel?
That depends entirely on where you live. For residents of Zwolle, for example, Utrecht or Groningen makes little difference in terms of travel time. But if you live in Hardenberg, Groningen is a lot closer. Groningen is also often easier to drive on than Utrecht for people on the east side of Twente.
Nicoline Kommelt is fighting with the Hartekind Oost-Nederland Foundation to preserve pediatric heart surgery in Groningen. “There are plenty of children in, for example, Oldenzaal, Almelo or Enschede, for whom Groningen is much closer than the busy Randstad. It is not nothing that a family experiences.”
De Markelose is an expert by experience: she herself had a child with a congenital heart defect. Her son Hidde died six months after birth.
In the video she tells her story:
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4. If it sometimes makes little difference in terms of travel distance, why are the dozens of pediatricians in Overijssel so vehemently against this plan?
She point out that ‘Groningen’ trains many paediatricians who work in Overijssel. “Our region is largely dependent on the University Medical Center Groningen to provide ready-made pediatricians. The choice that has been made now therefore concerns us with regard to the future quality and safety of pediatric care in our region,” write the pediatricians to the minister.
Moreover, by ‘removing’ pediatric heart surgery, more is lost than just performing heart surgery, according to the pediatricians. “In addition to children with a congenital heart defect, this concerns children who need to be treated with the heart-lung machine for other reasons, such as drowning persons, children with serious lung infections, trauma or other conditions. This decision will have major consequences for the expertise and capacity of the pediatric intensive care unit, on which our entire region depends.”
5. Are there any arguments in favor of this decision?
And. There are currently five hospitals in the Netherlands that perform specialist pediatric heart operations: Groningen, Utrecht, Rotterdam, Amsterdam and Leiden. As early as 2009, the then minister Klink wanted to return to fewer centers, but those plans fell through at the time. Several reports, including one from last year, have shown that it is better to coordinate complex child care in two or three hospitals.
Why? The quality of care can be better guaranteed, the researchers say. In our country, about 1,400 operations are performed annually on children with a congenital heart defect. That is not enough to maintain the required expertise per hospital, the researchers concluded last year.
The vulnerability of the teams that carry out these operations also plays a role. Nurses for the pediatric IC are difficult to find, but there are only a handful of pediatricians who have enough medical knowledge and experience to perform these kinds of complicated operations.
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