Inspectorate places hospital under “higher supervision”

POSTED: 09/11/12 12:35 PM

GREAT BAY – The Sint Maarten Medical Center SMMC has been placed under “higher supervision” by the Inspectorate of the Ministry of Public Health, Social Development and Labor per Saturday September 8, it appears from a press release the inspectorate emailed to local media yesterday morning around 11.00 a.m.
The announcement comes as a surprise, because Public health Minister De Weever issued a statement to the media on Sunday, indicating that “the extent to which the present laws allow government to intervene is far reaching and does not exclude intervention on the highest level.” But De Weever did not say anything about the fact that his inspectorate had already placed the SMMC under “higher supervision” on Saturday.

Today Newspaper understands that the term “higher supervision” is in itself incorrect and that the inspectorate only has the option to place the hospital under “stricter supervision.”
The higher supervision status entails, according to the inspectorate, ‘that the board of directors must present a feasible action plan within two weeks to address many of the critical issues found (mention in an audit report it produced – ed.) 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.”

The inspectorate started its governance audit of the medical center towards the end of last year; it continued during the first half of this year. The audit covered quality of care, internal supervision, surgical operations, the emergency ward, and the handling of accidents and incidents. The inspectorate interviewed staff members, the board of directors (in fact: hospital Director Dr. George Scot) and the supervisory council. The Dutch healthcare inspectorate assisted with the audit.
The auditors found that there is a lack of proper communication in different areas and at different levels. This results in “severe delay in the development of a basic quality and safety system and in a high risk for the patient,” the inspectorate stated in its press release.
“This situation is worsened by the fact that the board of directors (read: director Dr. George Scot) is frequently (50 percent 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,” the inspectorate stated.

The inspectorate’s report also includes “some investigative results of incidents that occurred in 2010, 2011 and 2012, because they provide insight in the way the SMMC is organized.”
The report does not mention the names of patients or staff members but refers “as much as possible to their function.” However, Dr. Scot is the only member on the board of directors, a fact of public knowledge.
The press release states, after mentioning that it will not name individuals by name, the following: “due to the board of directors not being very cooperative, it was not until July 12 before the inspectorate could speak with the director. The provided information has been processed in the report.”
The inspectorate lists ten ordinances and regulations it used as points of reference for its audit. Among them are the “Model admission agreement SMMC 2010” and the hospital’s code of conduct for the supervisory council.

The inspectorate stated in the press release that it delivered its draft report to the board of directors (read: Dr. Scot on August 24) for comment prior to publication. It set a deadline for comments at September 7 (last Friday). On that day the board of directors asked for an extension until September 17. “The inspectorate denied this request and indicated that possible comments will be dealt with when discussing the action plan to be drafted.”

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