WILLEMSTAD - A heated parliamentary session on the state of Curaçao's General Practitioners Clinic (HAP) unfolded yesterday, with Alexandra Severing, the clinic’s chief physician, sharply criticizing the Curaçao General Practitioners Association (CHV). Severing accused the association of trying to take control of the clinic for financial gain, triggering surprise and concern among lawmakers.
The session, called by the opposition, opened with an introduction from Health Minister Javier Silvania, followed by presentations from interim HAP director Jean-Pierre Doran and Severing. The chief physician didn’t hold back, recounting the clinic’s troubled history and her involvement since its inception in 2007.
According to Severing, a CHV committee had been working on the clinic project for over a decade, from 2007 to 2019, but internal conflicts among the GPs constantly derailed progress. "The committee was frequently plagued by disputes, and personal interests took priority over the clinic's overall goals," Severing said. She also noted that CHV failed to intervene, despite its responsibility to mediate conflicts among its members.
Severing went on to discuss a 2020 initiative between CHV and the Curaçao Medical Center (CMC), which aimed to establish a clinic with limited hours at the hospital. Under the proposal, CMC’s emergency room would handle night shifts, while CHV provided additional support. However, the project failed due to a lack of planning and budget, with disagreements preventing any concrete progress.
In 2022, the creation of the Megadienstgroep (MDG), formed by two CHV members, marked another chapter in the ongoing saga. This group, described by Severing as a forerunner to the current GP clinic, charged doctors a monthly fee and hired young physicians for shifts at relatively low pay. But MDG quickly encountered serious issues.
"These young doctors were untrained, unsupervised, and lacked support. Triage wasn’t implemented, international standards were ignored, and the clinic was poorly equipped," Severing explained. She described how the clinic’s phone lines were often unresponsive, there were frequent supply shortages, and doctors were left to manage both in-house patients and home visits without adequate staffing.
Financial irregularities also came to light. Severing revealed that GPs were billing the Social Insurance Bank (SVB) for MDG services, despite receiving an additional fee of 1 guilder per patient for after-hours and weekend services. This fee was intended to be part of the standard subscription cost for GP services, further complicating the financial landscape.
By 2023, nearly 85% of GPs had joined MDG, but only a handful actively participated in the shifts. Most GPs, Severing claimed, opted out due to professional registration requirements. Despite MDG’s struggles, the CHV took no action. "The additional compensation was spent on hiring low-cost doctors, with no real improvements made to patient care," Severing concluded.
The session left lawmakers demanding answers from CHV, with many expressing concern over the allegations and calling for the association to present its side of the story.