The resignation of Public Health, Social Development and Labor VSA Minister Richinel Brug (see Friday/Saturday edition) opens the door to appointment of a replacement. This is happening at a time when several crucial issues that require immediate attention remain pending.
These include Social and Health Insurances SZV losing 35 million Caribbean guilders per year. Accumulated deficits of funds it manages have reached near Cg. 500 million, as recently pointed out by the Financial Supervision Committee CFT.
One of the solutions is introduction of the Sustainable Affordable Accessible Healthcare Act (SAAHA), to ensure a broader contribution base. However, there is widespread concern about possible related premium hikes for employers and workers, with many already facing difficult circumstances like rising prices for both production means and consumer goods.
What’s more, when the SZV coverage annual wage limit was almost doubled from 67,816 to 120,000 guilders in 2022, this did not solve all the problems either. SZV reportedly also owes St. Maarten Medical Center (SMMC) Cg. 23.9 million.
Another hot topic is the St. Maarten General Hospital (SMGH) under construction, which has significantly surpassed its budget and delivery time. Once operational the new facility can help lower costs for SZV for example by further reducing medical referrals abroad.
In fact, the latter was already achieved by no less than 88% last year compared to 2024, thanks to investments in the current SMMC. The Dutch-sponsored Trust Fund administered by the World Bank is playing a key role in this regard.
On the other hand, transitioning to SMGH will likely come with additional expenses such as higher rates for upgraded equipment and treatments. That too is something for the next minister to watch closely.
But perhaps most important, whoever URSM nominates must have a good understanding based on mutual respect with its political leader and Prime Minister Luc Mercelina, a doctor by trade. Parliament unanimously adopted a recent motion calling for an urgent investigation from relevant departments within the ministry into authorisation of a medical professional to practice in St. Maarten.
This is after Mercelina admitted that as acting VSA Minister he signed off on approval for a General Practitioner (GP) despite negative advice from the Public Health Council and the Inspector of Health. He did so due to a shortage of family doctors, because he knew the person involved and the quality their work.
It will be up to Brug’s successor to guide the motion’s execution, possibly putting them in a bit of an awkward position considering the role of their prime minister and party leader. In more ways than one, these are some big shoes to fill.
