WILLEMSTAD - The Parliamentary Inquiry Committee investigating the Hospital Nobo Otrobanda (HNO) project emphasizes that the choice of location for the hospital was a crucial factor in the escalating costs. The decision to build the hospital in Otrobanda instead of on the Amstel site led to a financial overrun of approximately 200 million guilders. 

Moreover, the committee points to frequent political instability and changes in cabinets as significant weaknesses that negatively impacted the project. The report states that decision-making was often based on sentiments rather than rational arguments, leading to inefficiency and high costs. 

The committee, established by the Parliament on November 12, 2021, examined the development, construction, and operation of the current Curaçao Medical Center (CMC). This hospital, known during construction as HNO, has faced significant financial overruns and operational challenges. 

Short-Term Focused Government 

The committee's report paints a mixed picture of the HNO project. On one hand, it praises the courage of the Country of Curaçao to undertake an ambitious project like HNO. The independence achieved in 2010 brought a sense of political pride, resulting in the ambition to build a regional hospital that would attract medical tourism and serve as a profitable replacement for the outdated Sint Elisabeth Hospital. This optimism, however, overshadowed the critical view on the financial and healthcare-related implications of the project. 

On the other hand, the committee highlights the many political changes and short-term interests that undermined the project from the beginning. Crucial decisions were often made during transitional periods of governments, leading to a lack of continuity and long-term vision. 

Starting with the Asjes cabinet in 2013, a nonchalant attitude towards financial management emerged, with the financial feasibility of revised plans being insufficiently calculated. 

Location Choice 

The decision to build the hospital in Otrobanda instead of the Amstel site was made without a rational basis and proper justification, according to the committee. 

Warnings about potential cost increases and longer construction times were ignored, leading to significant cost overruns. 

The purchase of the Colon shopping center and the construction of a parking garage in a rocky area substantially contributed to rising costs, greatly exceeding the original budget. 

Oversight and Governance 

The report emphasizes that the government lacked the expertise to adequately oversee a project of this magnitude. Ministers and civil servants were insufficiently prepared and failed to utilize available expertise effectively. 

This led to a dependence on external project managers such as SONA and Berenschot, undermining ministerial responsibility. The appointment of the Ministerial Director & Supervisor in 2017 slightly improved oversight but came too late to prevent major issues. 

Transition 

The transition from SEHOS to CMC ultimately went better than expected, partly due to delays in the completion of the new hospital. This provided extra time to manage the transition more carefully. 

However, the committee highlights that insufficient attention was given to the necessary cultural change within the organization, indicating poor governance. 

Financial Future 

The financial situation of the current Curaçao Medical Center remains worrisome. The rising costs during the construction of HNO are not surprising, as both the Financial Supervision Committee and the General Audit Chamber repeatedly expressed their concerns. 

The ongoing optimism about the financial future was not based on solid plans. The absence of an updated business case after 2014 and the erosion of parliamentary budget rights have contributed to the current financial problems of the hospital. 

The findings of the Parliamentary Inquiry Committee HNO provide important lessons for the future. The committee calls for strengthening the budget rights of Parliament, investing in the expertise of civil servants, and ensuring more thorough and transparent decision-making in future projects. The committee believes that only by heeding these lessons can Curaçao prevent similar problems from occurring in the future.