“It all depends on whether the reserves have been earmarked”, says Jaap Bos, professor of Banking and Finance. “I understand why there would be concern on the university side if they are not. In that case, money could be drawn from the reserves freely, which is bound to cause friction. But I don’t expect that to happen. At the School of Business and Economics, if a research project generates a positive return – in other words, if the income exceeds the costs – you keep that surplus in reserve so that it can be used later, when costs are higher. I can imagine FHML working in the same way. In that case, the money is earmarked, which means no one can simply dip into those funds.”
On the topic of a joint budget for FHML and MUMC+, Bos says: “The main issue I see is the funding cycle. Our teaching is funded with a ‘lag’: you receive the money for your students a long time after they have started.” As a result, the balance can be negative in some years and positive in others. “So you have to put money aside in good years. I don’t know if the hospital operates on the same cycle, but I think that’s unlikely. So how do you align those different cycles?”
Another key issue Bos raises – and one he has previously highlighted, at the university’s request, in a presentation to members of the University Council – is “the lack of counterfactual”. “In other words: what if? Has anyone looked into an alternative? What happens if you do something else? Suppose I run a company and want to take over a competitor. I explain to my shareholders that profits will rise by 10 per cent if we go ahead with the takeover. That’s a significant increase, so they agree to it. But what if profits would rise by 20 per cent if I didn’t take over that company and invested elsewhere? I didn’t present that option to my shareholders. That’s why I think you should always consider the alternative. If you decide not to integrate with MUMC+, a different situation emerges. What would that mean for costs and revenues? Personally, I don’t see a lot of alternatives here, and I think this step makes sense. The new government has plans to cut healthcare spending. In finance, there is one key strategy when a sector is facing change: create scale. If you want to convince the government that Maastricht has a highly capable hospital that deserves to survive, the same applies here: create scale by joining forces with the university.” And what does UM stand to gain? “I told the University Council: make sure you demand commitment from the Executive Board. If they do this, you need to know very concretely what the benefits are.”
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