Slotervaart doctors fear bankruptcy – NRC

• Doctors in Amsterdam MC Slotervaart have lost confidence in the hospital's administration, they write in a confidential letter.
• They fear that the current approach of the commission "lead to the bankruptcy of our hospital"
• The hospital suffers from a building maintenance delay, defective equipment and air traffic control problems. According to the CNR and Het Parool
• the hospital closed for emergency patients for four days last month. There is a conflict between the direct staff and the medical staff on how to deal with the problems. Management is studying scenarios where 10 to 15% of specialist physicians must leave.
• See the letter here :

  
  
  

  

In the heat, MC Slotervaart's patients search for a path through the dust clouds. A trephine reverberates on the hospital grounds, filled with cables and tubes, concrete slabs and steel containers. An outside porch of a hospital floor was lined with a red and white fence.

This has been a route of obstacles around the hospital for months. Long rows of fencing try to drive visitors like marmots to the right road.

The interview inside is what really matters to patients. It took a lot of time. The machines to sterilize the surgical instruments are regularly broken, the MRI outdated. Climate control in the operating rooms does not always work well. Call it late maintenance, call it economy.

Doctors say – anonymously – about NRC and Het Parool . The hospital did not make the problems public.

At the end of the year 2016, the Health and Youth Inspectorate discovered ten "gaps" regarding hospital operations. The hospital is assured that most of them were resolved within six months. He has therefore installed new air management systems in the operating rooms.

This did not go very well, according to the inspection. He stated that "a long-term inspection pressure was necessary to allow MC Slotervaart to take all necessary measures."

Last month, it still went badly wrong. The hospital was forced to close the seven operating rooms and the emergency room for four days. The hospital has not informed the patients, the insurer or the inspection.

Again, these air management systems. A woman shared her discomfort online. "The first scheduled date of operation, May 14, did not occur because" the instruments could not be delivered on time. "The 2nd operation dates from June 7, I was expecting 4 hours in my surgical gown and the operation could not continue because the climate system of the broken ok was gone. "

Loans fishy

Four years ago, the new rescuing owners brought : Businessmen Loek Winter, Willem de Boer and Dirk Brouwer. They already had a hospital in Lelystad. All hope was based on them. There had to be change.

The hospital has lost since opening in 1975. In 2006, it was serviced by a Beverwijk land speculator, Jan Schram. But the new management has not always managed to separate their own money and that of their patients. There were assignments to friendly parties. CEO Aysel Erbudak had no salary but lived on the credit card of the hospital. There is a criminal case against her.

After the death of the land speculator, internal conflicts provoked troubles. Erbudak has been disputed with doctors, health insurers and supervisory directors and has been fired. After leaving, the hospital remained uncontrolled and had financial problems.

Now there would be peace. Just before the trio took over in 2013, medical specialist and driver Dees Brandjes said confidently: "By selling to Loek Winter, the owner will soon no longer be a ground operator, but a reliable health care partner."

little has changed. Staff fear again bankruptcy. There are assignments to friendly parties, late maintenance, quarrels between management and staff, and imprecise loans, according to NRC research . One in ten jobs is at stake. Nobody knows what the hospital really represents. This is a problem because a hospital is not an ordinary company: MC Slotervaart annually pays 120 million euros in premiums that force the Dutch insured.

Sick Children

The daily management of the hospital is in the hands of the owner and CEO Willem de Boer. He is forty years old, thinks fast and has striking blue eyes. He is not on guard. He was Vice President at the US investment bank Merrill Lynch in London and became an investor. On this summer day, he is wearing a nonchalant shirt over the leather boat shoes with a braided lacing on the outside hem.

He has made drastic choices in recent years. He rejected less frequent and expensive treatments at the hospital. For example, you can not give birth at the hospital and no sick child will be treated. The pharmacy of the hospital was sold.

Treatments that are more profitable and that the hospital is good, it has developed – sleep problems, obesity. Traditionally, the hospital is good for reducing the stomach. The hospital has declined, sales have declined by a quarter over the past four years.

It can not be otherwise, says De Boer. Recent research by an external agency has shown, for example, that the production of surgeons is too low and their costs are too high. In the circulating scenarios, 10 to 15% of specialist physicians must be removed. Specialist doctors have lost confidence in management, a mediator has been called.

De Boer is ready to explain how the hospital stands with his fellow director Mariska Tichem. Sanitation, says De Boer in a room on the fifth floor, does not come out of nowhere. When they arrived, the new owners "approached a number of problems, but did not implement them.We now see that we must do this." There are too many doctors, he means.

She emphasizes again the recent research: "It is a fact that we can employ too many medical specialists, according to the analysis of the consulting firm Logex."

But how independent is this agency? The owner is a current business partner of De Boer. The boss of Logex was until recently co-owner and director of MC Slotervaart.

Hospital owners continue to assign orders to acquaintances. Last year, the hospital rented a surgery space in a company owned by the shareholder and then by the driver Loek Winter. It is an assignment of a small 20,000 euros.

Much more money goes to the unknown company Cashcure which offers help for sending and collecting hospital bills. From NRC-owned internal documents, Amsterdam and Lelystad hospitals pay Cashcure about 800,000 euros annually.

Han van de Haar is one of the founders of Cashcure. The company has held some time at his private address. According to the Chamber of Commerce, she has no employees and has never published an annual report. A cashcure manager says the business figure rises to 1.2 million.

Van de Haar is also "Director of Finance and Control" of MC Slotervaart and Lelystad Hospital. The documents show that he provides the missions to Cashcure on behalf of the hospitals. In fact, in 2014, he signed a long-term contract with himself. One of Cashcure's shareholders is, once again, De Boer's partner and partners. Another shareholder worked on a temporary basis at the hospital for four years, while sending his company bills to his colleague Van de Haar

How are all these transactions going? Money does not flow from the hospital to friendly parties? Despite the founding act and other documents, Van de Haar denies having ever been involved with Cashcure. But his involvement is also confirmed by one of the other founders of the company

De Boer also has trouble remembering some remarkable deals. Internal documents show that the hospital, for example, is still paying money to the descendants of the previous owner of the hospital, the heirs of land speculator Schram. At the end of last year, the hospital transferred a commission of 125,000 euros to an investment vehicle Schram, another fine of 233,000 euros a few months ago. Are the descendants of Schram still involved in the hospital?

De Boer blows a breath of air between his lips. Pfft. "No"

Does the hospital not lend to Schram's heirs?

"No, as far as I do not know."

After insisting, he promises to find out. "I'll have to check this with Han [van de Haar]."

The spokesman said a few days later that a commission had been paid and a penalty for a loan that was never withdrawn. It was a renovation last year for 5 million euros for which no financier had yet been found. There is a complicated explanation.

Schram was ready to engage. It was for this provision. The penalty interest was for "a part of the interest that they failed because we did not withdraw their funding". In short, the hospital paid 3.5 tons for a non-existent loan of 5 million – converted more than 7 percent, a very high rate. It indicates lethargy, or major financial problems.

Spitfire

The way the hospital develops four years after the takeover is perhaps the biggest mystery. He has filed his results for years with great delays. Alternative accountants warn repeatedly about the risk of bankruptcy.

The last known figures are those of 2016 and the listener did not approve them. In 2015, the accountant was still "a material error", which had resulted in a turnover too high of a few million. The "Advisory Committee" of former directors, Dees Brandjes and Jos Beijnen, also raised issues with the accountant. In addition to their remuneration as a director and / or medical specialist, they received more than 860,000 euros for advice in court proceedings. The auditor was unable to find a proper basis for this in 2015.

But De Boer denies that the hospital figures are weak: he has relatively little debt and a strong collection capacity. "In itself, MC Slotervaart has an excellent starting position." But the money is needed for late maintenance. The pressure is on this point

De Boer assures him, Winter and Brouwer are the only owners of the hospital, but the outside world can not verify it. The shareholder Brouwer is a former colleague of De Boer at Merrill Lynch. He has a holding on Curaçao and especially on his companies, at the address of a trust office. He does not lay any public figure

Until the end of 2015, Willem de Boer held his shares at Slotervaart Hospital in a company owned by an anonymous Cypriot company. The company has been dissolved.

Spitfire Global BV, the Dutch company of De Boer whose shares are held by MC Slotervaart, has more than 22 million debts – much more than the assets of this company. His financial ties with businesses in the tax havens of the British Virgin Islands and Guernsey are unclear. De Boer also has private mortgage loans of over 1.2 million euros at an 8% interest rate with a company in the British Virgin Islands, and Spitfire has recently taken over these loans.

Spitfire's debt would disappear now. De Boer: "In itself, it's not so exciting because I've lived in London for years, this structure has been set aside like that." In the Netherlands, this leads to a lot of things. "All this information has not been published yet.

The hospital regularly changes the listener's books. KPMG in 2014. EY in 2015 and 2016. Now there is a new one. As far as we know, MC Slotervaart is the first hospital in the Netherlands that can not be inspected by any of the big four accounting firms. A local office with 8 employees from Dordrecht will evaluate the figures for 2017. The accountant is so small that he does not publish an annual report