Letter by Sint Maarten Medical Center to Inspectorate

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Associatet! 'Ilh Pels Rijckcn & DlOoglcevcr FortlliJn. Thc Haguc. Thc Netherlantls
BcatrÎxqraat ~R Ka)'a Gobcmador N. Debrot 71 L.B. Smithpkill 3 W.G. BlIncampcr Road 33
Oranjcstad Krakndijk WiJlcmswd Philipshurg
Aruba Bonaire Cur.açao Sint Maarten
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Via courier and telefax (542-2936)
The lnspectorate of Public Health
attn. Dr. E.W.A. Best, Inspector General
Kanaalsteeg 1,
Philipsburg, Sint Maarten
Sint Maarten, September 12, 2012
Re: Sint Maarten Medical Center
Dear Or. Best,
Sint Maarten Medical Center Foundation, hereinafter to be referred to as "SMMC", has
requested me to react to your letter dated September 8, 2012, whereby you gave
notice to SMMC of the decision by the Inspectorate to put SMMC under "higher
supervision" as of September 8, 2012 for a period of one year and whereby you
threatened to impose fines on SMMC, or take other coercive measures, in case of
non-compliance.
The first striking element of your letter is that it fails to refer to any ordinance,
regulation or enforcement framework on which the abovementioned decision and its
implications can be and have been based. This is all the more striking since your office
was abIe and willing to provide a list of (supposedly) applicable ordinances and other
documents to members of the local media.
This list, if correct at all, is neither specific as to the legal basis for the measure of
"higher supervision" and for the implications of this measure, nor as to the legal basis
for the imposing of fines and/or for the closing of functional units.
Our review of the ordinances which have the most relevance in this matter has neither
revealed any basis for the measure of higher or intensified supervision of a medical
institution Iike SMMC or for the implications of such measures.
The above leads to the preliminary conclusion drawn by SMMC that the decision
mentioned in your letter of September 8, 2012 is either contrary to written law or in
conflict with general legal principles, the latter for instance because the decision has
not been substantiated properly and was taken in violation of the requirement of due
care (in Dutch: zorgvuldigheidsbeginsel). This violation includes but is not limited to the
genesis of the decision, such as the unprofessional way in which the draft report

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containing many factual errors was circulated, the lack of hearing both sides in that
regard and the unreasonable refusal of the request by SMMC for a short extension of
the term for providing areaction to the draft report.
Unless and until you have provided SMMC with a proper legal justification and, if the
Jatter exists at all, with a proper substantiation of your decision, SMMC will not
recognize same as being valid and will not cooperate with same.
Please be advised in this regard that SMMC does not share your opinion that your
decision cannot be appealed under the Ordinance on administratîve justice (Lar).
SMMC is of the opinion that your decision is without any doubt subject to such appeal.
and in fact intends to file such appeal within the shortest possible term. SMMC will also
consider to request the court to suspend your decision pending the handling of the
appeal case.
Furthermore, SMMC strongly takes exception to the fact that you have divulged your
iII-considered decision to the local media behind its back, thereby creating yet another
wave of unnecessary unrest in the community regarding the functioning of the hospitaI
and also to the fact that the provision by dr. Scot of his own assessment dated August
2012 and sent on September i h including an improvement plan to the Inspectorate
has deliberately been ignored by your office in the report as weil as in the press
release of September 10, 2012, whereby the erroneous impression was created that
SMMC is not committed to pursue improvements.
You are herewith summoned to refrain from making further public statements while the
abovementioned issues have not been clarified and without first consuiting SMMC.
and from performing further acts which suggest that your office lets itself be used as a
politicaI tooI.
Since it is abundantly clear that the phenomenon of "higher supervision" does not even
exist in this context, since the connotation of the term "higher supervision" is, as you
should have known, extremely ominous and leads to widespread misconceptions and
to a lack of confidence and motivation both internally and externally, and since the use
of this term is therefore highly irresponsible, you are also summoned to, within 2 days
as of the date of this letter, publicly rectify your earlier public statement(s) indicating
that SMMC has been put under "higher supervision".
Your possible disregard of the abovementioned summons williead to appropriate legal
measures to be taken by SMMC and to holding country Sint Maarten fiable for all
damages resulting from your actions or omissions.
SMMC is in the process of preparing a comprehensive reaction to both the draft and
the final version of the audit report.