PHILIPSBURG--”It is disheartening when persons, especially those who have access to the facts, peddle half-truths to the public,” Minister of Public Health, Social Development and Labor VSA Omar Ottley stated in a press release that was sent out on Wednesday evening.
While he understands Member of Parliament (MP) Angelique Romou’s queries on mental health care, in particular the revocation of the licences of two BIG-registered psychiatrists, “her comments are misleading and lack facts,” Ottley stated.
He pointed out that MPs “are part of the legislative branch, who have the authority to amend laws that they may consider negatively affecting the country’s progress.”
He advises MP Romou to change the National Ordinance on Healthcare Institutions (Landsverordening zorginstellingen) if she wants to help the two Mental Health Foundation (MHF) psychiatrists who have taken government to court.
The lawsuit to which Ottley refers is a substantive procedure. In this ongoing process, psychiatrists Ilse Kelbrick-Furtsenburg and Hendrik Nijdam have submitted to the court an application for a provisional injunction to be allowed to treat patients as psychiatrists until the decision on the merits has been made.
On behalf of Minister Ottley, attorney Dana Kweekel, also senior legal advisor at the VSA Ministry, contested the psychiatrists’ request to treat patients. On November 9, Kweekel explained to the court that Dr. Kelbrick in August 2019 was granted an exemption to work as a psychiatrist in St Maarten on the condition that she offer her services exclusively on behalf of MHF in Cay Hill. Dr. Nijdam was granted exemption under the same condition in March 2020.
Ottley stated in his press release that the National Ordinance on Health Care Institutions “does not permit establishing a psychiatric practice without a collaboration agreement with the Mental Healthcare Foundation.”
However, this is not literally stated in the Ordinance. The Ordinance, Article 4. Paragraph 1 states: “The Minister will only grant the permit if its granting is in accordance with the guidelines for assessing the need for healthcare institutions and medical equipment as laid down in the policy document “Zorgvoorzieningen St. Maarten”.
The policy document in question dates from the year 2005. As VSA Minister, Ottley is authorised to change policy or to amend existing legislation through a ministerial decree and to expand it with measures that meet the existing need for care facilities in the year 2021. However, Ottley prefers to continue to follow the policy from 2005.
Kweekel states on behalf of Ottley that Dr. Kelbrick’s application to work as a psychiatrist is inadmissible “because she has no real interest in her application.” Her licence had expired on April 30, 2021. One day earlier, on April 29, 2021, Ottley withdrew Dr Kelbrick’s licence.
The judge is of the opinion that Dr. Kelbrick’s request to be able to work as owner/director of the new healthcare practice Psycare BV is admissible because it extends over a long period of time, not only until April 30, 2021.
According to Kweekel, Dr. Nijdam’s request is inadmissible because he wants to work for the new care institution Psycare instead of MHF and Minister Ottley has not granted this company a healthcare institution licence (Psycare does have an economic licence). Dr. Nijdam believes that Psycare should get a healthcare institution licence and it is reason enough for the judge to consider Dr. Nijdam’s request.
On behalf of Minister Ottley, Kweekel states that the applicants have no urgent interest and “that it would be disproportionately difficult to await the decision in the main proceedings.” According to Kweekel, even if the decision were positive, Dr. Kelbrick would no longer be allowed to conduct a psychiatric practice after April 30, 2021. She also pointed out that Dr. Nijdam had resigned from MHF.
The legal advisor for Minister Ottley said she does not know that Dr. Nijdam has had no income for a year, something that the doctor himself explicitly pointed out at the hearing, of which there are notes in the documents.
In his press release, Ottley stated: “Despite the challenges with the law, I have been trying to find ways and means of helping the psychiatrists.”
The impression that the VSA Minister is preventing these specialists’ establishment is false, Ottley stated. “These two psychiatrists wish to open their mental health practice, but the Ministry of VSA has received negative advice from both the Department of Public Health and the Council of Public Health. Despite this, I have thrown out an olive branch to find ways to keep them working because it is the right thing to do.”
According to Ottley, strengthening mental health has always been one of his main goals and remains a top priority of the VSA Ministry. “I have brought both the psychiatrists and the Mental Health Foundation together to try to find common ground even though they lost the summary proceedings in court. The goal is to find a way forward so the people of St. Maarten can continue to benefit from their services,” he said.
In its decision, the court stated that the psychiatrists’ request is justified. But granting this request does not offer a solution, according to the judge: the minister maintains the condition that they have to work at MHF.
“Psycare does not meet the requirement of having a cooperation agreement with a psychiatric hospital,” said the judge, who indicated that even if Psycare had received a license from the Minister, the institution should have an official cooperation with MHF.
Psycare does have an official cooperation with Turning Point, but that is not taken into account by the court. The judge also did not consider that there are other doctors on the island with their own practice without having to meet the condition of cooperation with the hospital or a clinic.
According to the decree the minister has granted to MHF, MHF has the mandate for the entire mental health care in St. Maarten. In crisis situations, MHF may not refuse patients. The question of why there should nevertheless be a cooperation agreement remains for the minister to answer.
In practice, many patients are indeed refused by MHF, as witnessed by family members. By order of MHF some patients have been locked up in a police cell in Philipsburg. As is well known, this led to the death of a patient on July 22. A year earlier, on August 25, 2020, a patient died in MHF’s isolation cell. These patients were not being treated by the two psychiatrists in question, they are not involved in the ongoing investigation by the National Detectives (Landsrecherche).