1: Two captains on one ship: will it work?
If the university and the academic hospital merge, leadership will be needed for over ten thousand employees and 23 thousand students. How do they plan to go about this? Enter the “Maastricht model”, unique in the Netherlands. The hospital and university will share a five-member Executive Board with two chairs: one in charge of healthcare, the other in charge of education and research. Two captains on one ship – will it be smooth sailing?
“Everything can look perfect on paper, but it’s ultimately about how the dynamics work in practice."
2: Will there be a reorganisation?
From the outset, the board members have insisted that the integration was intended to create a stronger, more resilient organisation that would be more attractive to both staff and students. And while the merging of support services (such as finance, purchasing, HR and IT) has also been on the table from day one, it was repeatedly stressed that this isn’t the main reason to pursue integration. The documents published last week show that, for the time being, everything will remain as it is, but the idea of a shared services centre is being explored. Does that mean a reorganisation might happen after all?
“‘No changes for now’ is far less concrete than ‘no changes for the next X years’."
3: Will MUMC+ loose its academic status without an integration?
One reason why both parties are pursuing administrative integration, apart from the opportunities it offers, is the vulnerability they both feel in today’s political climate. Is it likely that academic hospitals will face budget cuts? And if so, should Maastricht University Medical Centre (MUMC+) be worried about losing its status as an academic hospital?
"It wouldn’t make sense in the wider Dutch context."
4: Will working closer together reduce healthcare costs?
A positive reason for closer cooperation, according to the report, is that it will reduce healthcare costs. Is this true?
"They’re referring to more prevention, to keep people out of hospital."
5: What value will a joint student wellbeing centre actually add?
A proposal is on the table for a joint student wellbeing centre in Randwyck. This is part of the “added value of the integration”. What will this joint approach look like and why is there a need for a centre like this?
“It’s important that the board, in pursuing close collaboration and organisational renewal, never loses sight of the students."
6: Can two partners join forces on equal terms?
Can a large hospital and a much smaller university, in terms of staff numbers and finances, really join forces on equal terms, as they intend? Won’t the bigger organisation inevitably end up wielding more power and taking control?
"If two organisations aren’t equal now, an administrative integration won’t magically change that.”
7: Will the hospital be able to draw on FHML’s financial reserves?
The Faculty of Health, Medicine and Life Sciences (FHML) will be fully integrated with the hospital. The aim is to create a single policy framework and a single budget. But how do you achieve that when funding comes from two different ministries – Education on the one hand and Health on the other? The faculty also has healthy reserves, decentralised through its research institutes. Will MUMC+ be able to draw on those reserves and invest them in patient care, new beds and equipment?
"Most likely, the money is earmarked, which means no one can simply dip into those funds.”
8: How democratic has the process been?
Since the integration was announced in June 2023, representative bodies, university boards and several working groups have been meeting exclusively behind closed doors. Much information remained confidential, leaving staff and students with no way to scrutinise it. Only now can they review two hundred pages of documents – just a few weeks before the University Council is due to vote on them on 25 February. Isn’t that far too late for the council members to take the community’s questions and concerns into account? How democratic has this process been?
"If everything was public, it would weaken the university’s negotiating position relative to the hospital."
9: Could the plans still be rejected?
Over the past few years, a great deal of time and money has been invested in developing the integration plans. Can the university’s representative bodies still realistically give a firm “no”? Moreover, detailed documents have suddenly been released. Has everything already been decided during the confidential meetings, leaving only a few minor points to be ironed out? Is the community’s input just for show?
“No, it is by no means a done deal that the council will approve the plans.”
Deborah Blekkenhorst, Wendy Degens, Peter Doorakkers, Cleo Freriks, Riki Janssen and Dennis Vaendel