WILLEMSTAD - Curaçao’s largest general hospital, the Curaçao Medical Center (CMC), is facing a financial crisis of unprecedented proportions. The hospital can no longer pay its bills, leading to a deterioration in healthcare services and mass resignations among medical staff. Experts are warning that without immediate financial support from the Netherlands, the island’s healthcare system is on the brink of collapse.
The CMC has been grappling with financial difficulties since its opening in 2019, but the situation has now become critical. A recent confidential report by KPMG, obtained by FD, highlights the hospital’s inability to meet its short-term payment obligations. The quality of care has fallen below acceptable standards, according to Gilbert Martina, chairman of the hospital’s board. “We are not just treading water—we are at risk of sinking. Basic care in several departments, such as gastroenterology, ophthalmology, and neurology, is often unavailable,” he said.
A Plea for Dutch Intervention
The hospital’s management has made an urgent appeal to both the Curaçao and Dutch governments, seeking immediate assistance. Last week, a letter was sent to the island’s government, which was also forwarded to the Dutch ministries of Interior Affairs and Health, as well as members of the Dutch Parliament.
Lidewijde Ongering, chair of the Financial Supervision Board (Cft), which oversees the finances of the Caribbean parts of the Dutch kingdom, confirmed the gravity of the situation. “The hospital’s negative equity and operational deficits are increasing, placing a significant burden on both the hospital and the country. While it is primarily Curaçao’s responsibility to resolve this, the future of healthcare on the island is deeply concerning,” she said.
Technically Bankrupt for Years
Experts predict that the Netherlands will eventually have to bear the cost of this crisis. “Our government must act to prevent a complete collapse and a healthcare emergency,” Martina warned. He expressed concerns that structural support from the Netherlands for healthcare within the kingdom might be unavoidable.
The financial issues at CMC stem from the hospital's construction, which exceeded its budget, leaving the facility technically bankrupt from its inception. The hospital relies on the government for 85% of its income, primarily through the island’s basic health insurance system. However, the rising costs have far outpaced revenue. There is no money available for maintenance or investment in new equipment, and vacancies are becoming increasingly difficult to fill as more doctors leave the island. “One in five medical specialists has already left or is planning to leave,” said CMC’s medical director, Ingemar Merkies.
Mounting Debt and Limited Resources
The construction of the CMC was largely funded by loans from the Netherlands, amounting to around €200 million. However, cost overruns forced local banks to step in with additional loans. By the end of 2023, the hospital’s total debt had climbed to 543.4 million Antillean guilders (approximately €270 million), according to the KPMG report. The liquidity shortfall is expected to rise to 30.5 million Antillean guilders (€15.2 million) by the end of this year.
The hospital’s financial problems are compounded by Curaçao’s broader economic challenges, including the 2018 closure of its oil refinery and the COVID-19 pandemic, which has severely impacted the island’s economy. The Netherlands has already provided nearly €500 million in COVID-19 relief to Curaçao, and the island is also trying to save its failing pension insurer, Ennia, at a similar cost.
Former Dutch MP André Bosman, who closely followed the issue during his time in Parliament, predicts that the final bill for this healthcare crisis will ultimately land with the Netherlands. He believes the exodus of doctors marks a dangerous escalation. “If doctors stop working, healthcare stops, and then things get serious. Something must be done,” he said.
Doctors’ Salaries Capped, Leading to Resignations
The mass resignation of doctors is partly driven by the Curaçao government’s plan to cap doctors' salaries. Starting later this year, newly hired doctors will fall under the Dutch law that regulates top incomes. Hospital management fears that this policy is deterring candidates from accepting positions at the CMC.
Former health inspector Jan Huurman also believes that Dutch intervention is inevitable. “The outcome is clear. All these consultant reports are a waste of time because the problem has been obvious from the start: the hospital is far too expensive and too luxurious. The local government will never be able to fill this gap on its own.”
Urgent Action Needed to Avoid Collapse
As the financial situation at CMC deteriorates further, the future of healthcare in Curaçao hangs in the balance. While hospital management is determined to keep the facility open, the lack of funding and the ongoing exodus of medical professionals have brought the island’s healthcare system to the brink. Without substantial financial support from the Netherlands, experts warn, the collapse of healthcare in Curaçao seems inevitable.