PHILIPSBURG:--- Minister of Health Emil Lee explained to members of the media that the only reason no one from government or USZV are not speaking or doing anything with the plans of the New Hospital is because they are respecting the decision of the court which prohibits USZV and SMMC from moving forward with the agreement they have with INSO. Minister Lee said that based on court decision if any parties violate the order of the court they have a penalty hanging over their heads starting at $1. 000.00 to $25.000.00. Lee said knowing that such a high penalty is hanging over USZV it is only normal they comply. Besides that, he made clear that USZV has appealed the court’s decision which has the support of government and SMMC.
The Minister went on to call on the media to question VAMED about their concerns and reasons for filing a court case when they lost a bid. He said this is the first case of this kind he has ever seen and the only interest VAMED has is financial. The Minister went on to say that VAMED has brought on extra stress and loss of monies on the people of St. Maarten because USZV and SMMC still have to send patients abroad for medical treatment which is costing the people of St. Maarten a whole lot of monies. He said he conducted an open and transparent procedure when he placed the New Hospital on a bid and he was quite comfortable with the outcome. However, VAMED showed the court the cost the expansion would have cost the hospital in 2009 compare to the cost INSO placed on its DBM bid.
SMN News asked the Minister why USZV or INSO did hold back the contract that was signed by SMMC, government, and INSO for the construction of the New Hospital and their bid from the court if everything was open and transparent. The Minister said that INSO has to protect their interest because they bid against VAMED elsewhere and it is only normal for them to keep their figures and pricing private.
When asked by SMN News if he as Minister of Health knows how much USZV is paying on consultant fees, since he indicated that the medical insurance company is paying a lot for medical referrals, the Minister said he did not have that figure on him but that is something he intends to discuss with USZV when he meets with them. Minister Lee said he believes that will show up in the overhead cost of USZV, he also stated that an entity such as USZV that do not have the necessary expertise in-house do need to work with consultants.
So far USZV is paying KPMG millions in consultant fees (tripartite) one being for the New Hospital, they are also paying Royal Haskoning, Javier Asin (Acsion), Jeroen Veen, Human Ressource Manager Sidney Lourens, ICT Manager Mehrdad Zinatbakhsh, all of whom working as consultants for the main social insurance bank on St. Maarten.
SMN News learned that KPMG is reaping millions out of USZV all of which are being paid through the pension funds. It should be noted that basic research done on KPMG shows that they were involved in establishing the National Health Insurance (NHI) in Suriname and Curacao and the company failed miserably in both countries. Instead of St. Maarten, USZV solving their issues by hiring competent staff to run the entity they are spending millions by paying consultants one of which already failed and was involved in various scandals in the Netherlands.
VAMED delays progress in healthcare for country
“Due to the recent court case filed by VAMED against SZV, the development of the new hospital and most importantly quality care close to home has been delayed. This does not mean that a new hospital will not be built. It will! St. Maarten NEEDS a new hospital!”, stated Minister Emil Lee at press briefing on Wednesday.
Based on the court ruling, SZV has appealed the case and is complying with the verdict. Minister Lee provided an elucidation of the ruling, identifying ‘why everyone is so careful with what they say, and why there is the so-called “radio silence” about the new hospital’.
“Within the court judgement, SZV is prohibited from directly or indirectly, signing an agreement with INSO, or an entity within INSO, with the aim to build the hospital, and prohibits SZV to comply with the already signed agreement, or to provide cooperation thereto, on a penalty of a fine of $1 million per offence, whereby the total fines that can be given is a maximum of $25 million. Therefore, everyone is very cautious and careful about what they say. However this does not mean that work is not progressing in terms of the legal case and discussions about how we will improve the quality of health care are still on-going,” stated Minister Lee.
To provide at least some sort of insight regarding the developments of the new hospital and to provide some level of comfort to the public and media, Minister Lee gave a brief explanation about the claim from VAMED that the price from INSO was too low. “I want the public to know that SZV is working diligently on the appeal so that we can see the new hospital become a reality, and all stakeholder including Government is supporting that appeal.”
“During the court case, VAMED presented two arguments to justify their claim that the price of INSO was too low. (1) They used a benchmark report from an American company that was commissioned by VAMED to justify the average construction cost per square meter, and (2) was a reference to construction cost per m2 as outlined by SMMC for the expansion plans in 2009.
VAMED argued that the construction price per m2 in 2009 is higher than the one from INSO. However, I am going to illustrate why it is very difficult to use the construction price for the expansion in 2009 in order to compare to INSO’s competitive proposal.
The new hospital and the 2009 expansion plans both proposed to construct 4 operating theatres. When constructing hospitals there are a number hot floors and cold floors. An operating room is considered a hot floor as it is a room that requires technical, intricate construction details and material. Cold floors are very basic construction with walls, tiles, etc.
In the 2009 expansion, the price per construction was based on constructing all hot floors, whereas the new hospital included hot floors plus cold floors. In essence, the high cost of building an operating theatre is the most expensive square meter for the hospital. Therefore, when you divide that costs over the square meters, of course the average square meter price is a higher price. For example, if your building a house and you want a gourmet kitchen, if you only took the price per m2 for your gourmet kitchen, the price for construction would be higher than if you would calculate the price of your living room which would be merely walls and tiles.
In addition, the 2009 expansion they had planned to construct two floors, but they were only going to build the first floor in their expansion project . Therefore, the foundation and structure had to be stronger to support a two floor structure. Therefore that beefed up excavation and foundation is divided over a smaller square footage,” stated Minister Lee.
Minister Lee expressed that he is very comfortable that the price is not too high. From the beginning of the process Royal HaskoningDHV and ICE with local experience, who has extensive experience in building hospitals, was hired as an engineering consultant throughout the whole process. A budget was formulated to illustrate how much should the new hospital cost. These number were carefully calculated to provide a benchmark figure for the evaluation of the bids received.
“When you try to do everything right in an open and transparent bidding process, it is kind of surprising to me that this is where we end up; but it is what it is. In the end all parties, SMMC, Government, and SZV all have an incentive for the hospital to be built. Namely: to reduce health care costs, to improve quality of service, to provide care locally, and to provide a professional working environment for the staff of SMMC with modern equipment. While we all want and need a new hospital, the possibility of making this reality is currently being held hostage for financial personal interests.”
Minister Lee called on the media to not only seek information from our local entities but to perhaps hear from VAMED what their intentions are in terms of moving forward. “Is it there intention to pursue the long legal battle at the expense of improved health care for the people of the country?”
Press statement Minister of VSA Emil Lee