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


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.


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.

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