Both acting in bad faith
WILLEMSTAD - MP Ramón Yung of the MFK faction expressed his deep concern over the accusations made by the MAN/PIN party against Minister Javier Silvania. The party accused the minister, who is in charge of healthcare, of disastrous management.
Yung noted these accusations from MAN/PIN following an open letter issued by the CMC hospital specialists' association, which was framed as an "emergency call" to the people of Curaçao.
Yung expressed regret that both the specialists' association and the MAN/PIN party are playing with the emotions of the public, attempting to create unnecessary panic. The leader of the MAN/PIN party, in a press statement, took an even more uncompromising stance, stating that, in his opinion, "the minister should step down."
"The MAN/PIN party claims that CMC faces an annual shortfall of about 50 million guilders to operate the hospital because the care costs between 35 to 42 million guilders more per year, with an additional 7 million in costs for the care of undocumented individuals," according to the MP.
Yung further stated that the MAN/PIN party acknowledges that the government has already paid for the care of undocumented individuals up to 2023 and intends to pay for 2024. However, the conditions set are unacceptable to both CMC and the MAN/PIN party. Nonetheless, according to the MP, all the government wants is a guarantee that the amounts billed by CMC for the care of undocumented individuals are accurate and reflect reality. This is to avoid situations where the government is charged for "phantom" cases for which there is no evidence that treatment was provided to undocumented individuals.
The CMC also demanded 40 million guilders for transition expenses, which the court agreed to, though the government stipulated that CMC must provide proof that these expenses were indeed incurred and not already paid by another entity.
As a result, out of the 40 million guilders demanded by CMC, they submitted invoices totaling only 32 million guilders, of which 30 million were verified and paid by the government. Therefore, a remaining sum of 8 million guilders has yet to be accounted for, with no documentation proving that CMC covered these expenses.
Regarding the waiting lists at CMC, the MAN/PIN party highlighted that eye patients have to wait over 400 days for an appointment, with some going blind before even receiving a surgery date.
The MFK parliamentarian suggested that representatives of the MAN/PIN party may either be forgetting a lot or beginning to suffer from dementia.
The lengthy waiting lists were precisely what led Minister Silvania to grant permission to Advent Hospital to perform certain surgeries, and also to authorize clinics like the Pain Clinic and Dr. Sajouri Center to carry out specific procedures, specifically to alleviate the pressure on the waiting lists. Additionally, on July 2, 2023, Health Inspector Dr. Keli informed CMC that the "directive" they received remained in effect because the goal was to reduce the waiting lists by transferring patients who could have their surgeries at Advent. However, the waiting lists continued to grow.
During the parliamentary meeting on August 29, 2023, the director of CMC stated that the hospital had managed to attract operating room personnel from Colombia, but work and residency permits were still pending, preventing the full utilization of all operating rooms.
CMC Director Gilbert Martina, at the close of the meeting, indicated that things are moving in the right direction, though there are still some issues to be addressed at CMC.
In his final remarks, the CMC director emphasized, “We started the meeting by singing our national anthem, which says, ‘Let’s do our part for the prosperity of our island,’ and we want to end on that note. Let’s do our part so that CMC can prosper, and by doing so, Curaçao can prosper.
“Given the financial challenges CMC faces, the waiting list issues, and the challenges with specialists, we are convinced that if we all do our part, CMC will prosper, and Curaçao will prosper as well.” The director also shared a lesson his mother always taught him: “Before you go out to play, finish your homework first. And we believe there is a lot of homework that we still need to do to truly allow CMC to contribute to Curaçao’s prosperity.”
So, when Yung took note of the open letter that the association of specialists addressed to the people of Curaçao, the immediate question that arises is: “What went wrong internally at CMC?” because, in August 2023, the director explicitly stated that there was “homework” that CMC needed to complete before moving forward. He also said, “Let’s do our part so that CMC can prosper, so Curaçao can prosper.”
As discussions between CMC, the “regie group,” and the association of specialists progress, a concrete proposal should have been developed on how to reduce the waiting lists at CMC. This was one of the conditions set by the Council of Ministers before discussing a Ministerial Decree for compensation under the LNT conditions.
For Yung, it is astonishing how the association of specialists, without reaching a concrete agreement on how to reduce the waiting lists, confronts the community with this statement, in which they practically say that due to the LNT (National Health Tariff Law), they will no longer be able to provide quality care and that the waiting lists will continue to grow! They also indicate that several of the recent discussion structures they have been part of have not led to the desired outcomes.
For Yung, it is incomprehensible how the association of specialists, who are part of the very working group tasked with finding solutions to reduce the waiting lists, is now coming out with such a declaration.
In the opinion of the MFK parliamentarian, something went completely wrong from the moment the former director of CMC took on the specialists in service, changing the payment structure from BMS (Basic Medical Services) to BPS (Basic Payment Services), which resulted in a much higher salary without linking it to the quantity and quality of services that each specialist is required to provide.
It is very strange that each specialist receives a different payment based on their specialization, which is tied to their knowledge and the quality they must deliver, handling cases based on complexity. But now, the association is stating that due to the LNT, they can no longer guarantee the same level of care after its implementation.
With this statement, the association of specialists clearly demonstrates that they are only interested in securing a good salary for their members without tying it to any factors that measure productivity, effectiveness, or the quality of service they provide to the community, for which the SVB (Social Insurance Bank) pays them.
In summary, the coalition parliamentarian believes that the positions taken by both the Man/Pin party and its leader, Giselle McWilliam, as well as by the association of specialists at CMC, are simply unacceptable.