General Audit Chamber identifies critical shortcomings in the Medical Assistance Program

October 24, 2023 12:00 pm

Sint Maarten, October 23, 2023 — The General Audit Chamber has released its report on the management, communication, and compliance of the Medical Assistance program.

The law regulates medical coverage for those who cannot afford it. Those who qualify are issued a so-called PP card for medical assistance. The PP card entitles the applicant to the same right to medical assistance as government employees and, in some cases, provides more extensive coverage. The term "PP" stands for pro pauper - for the poor, an unfortunate term the Audit Chamber directly recommends changing.

The Audit Chamber found structural annual budget shortfalls of approximately ANG 10 million per year, which taxpayers must bear. During the audit they examined the possible causes for these structural and material budget overruns.

The provision of medical assistance involves three types of requests: standard, urgent, and abbreviated. The Audit Chamber found that urgent care poses a higher risk of irregularities and miscommunication. The Audit Chamber concludes that communication between SZV and VSA is inadequate, leading to a lack of understanding of the costs and the actual number of PP cardholders. As a result, financial and oversight problems need to be addressed.

Given the materiality, the Audit Chamber recommends urgent action to address the identified issues and improve transparency and oversight of the medical assistance program.

The report is published in both English and Dutch and is available on the website of the General Audit Chamber (