News | 6 March 2019

Future-proof paediatric surgery for the Meuse-Rhine Euroregion

Cooperation between Aachen, Liège and Maastricht

To maintain expertise in paediatric surgery in the region, the paediatric surgeons of the academic medical centres of Aachen, Liège and Maastricht are engaging in close cooperation. The ultimate aim is to create a single, cross-border paediatric surgery centre in the Meuse-Rhine Euroregion. Research shows that the project still faces considerable obstacles, but there is positive development and at the practical level, there is already valuable collaboration.

In the Netherlands, there is a tendency to concentrate the treatment of less common conditions in a few – often central – locations in the country. Because many conditions affecting children are rare, this trend is very noticeable in specialised paediatric surgery. A result of this can be that children who require surgery are obliged to travel frequently and far, with all the associated negative consequences. The same development is taking place in Belgium and Germany. This fact prompted the paediatric surgeons of Maastricht University Medical Center+ (Maastricht UMC+), University Hospital RWTH Aachen, and the Centre Hospitalier Chrétien of Liège to enter into a partnership, with the goal of keeping complex paediatric surgery for the region at a high level and in close proximity to parents and children. Wim van Gemert, professor of paediatric surgery at Maastricht UMC+, says: “If we do nothing, it will mean that in a few years’ time, parents will have to travel with their children to Amsterdam or Groningen, for example, to seek appropriate treatment.”

Meuse-Rhine Euroregion
According to van Gemert, it is not only essential to maintain expertise and facilities in paediatric surgery, but there are also great opportunities if we dare to look beyond national borders: “In our Meuse-Rhine Euroregion in particular, good care for children is sorely needed. In this border region, there are poorer socio-economic circumstances and there is poorer health and a shorter life expectancy than in other regions. A unique opportunity is offered by Maastricht’s special location on the borders with Belgium and Germany. Cross-border cooperation between Maastricht, Aachen and Liège has great potential to take surgical care for children to a very high level for Europe, by pooling clinical practice, knowledge and experience. For this reason, we have been cooperating with increasing intensity since 2015. We are currently working on obtaining formal recognition of this partnership as a single paediatric surgery centre.”

One single surgical team
The aim is to create one single surgical team that works at several locations. Patients will be treated as much as possible at their own location by the relevant surgeon. Precare and aftercare can also be provided at the patient’s own hospital, so that children and parents are not obliged to travel back and forth, and stay overnight. The network will expand to include all the hospitals in the Meuse-Rhine Euroregion, including the non-surgical paediatric specialists.

Cross-border recognition
The medical specialism paediatric surgery is organised very differently in the Netherlands, Germany and Belgium. This has consequences for the qualifications of paediatric surgeons in the Meuse-Rhine Euroregion, both as regards the accreditation and registration of a paediatric surgeon and the cross-border training of new physicians. This is shown in research by the Institute for Transnational and Euregional cross border cooperation and Mobility (ITEM) of Maastricht University. Lavinia Kortese, PhD student at ITEM and principal researcher on this project, notes: “In this kind of cross-border healthcare cooperation, there is a lot to consider in the area of legislation. Among other things, there are issues relating to the accreditation of paediatric surgery as a medical specialism; medical practice and registration in the Meuse-Rhine Euroregion; and possibilities for cross-border training in paediatric surgery. An obvious and crucial aspect of the future centre is that paediatric surgeons should be able to practise in all three countries. Under the current system, it is not possible to be trained according to the standards of all three countries simultaneously. A decision will have to be made in favour of the system of one of the countries and, depending on the training system, qualified doctors will have to do additional internships and exams in order to be accredited in the other countries.”

Further research
There are still a large number of other obstacles to setting up a future-proof centre, such as patient mobility and funding and optimising healthcare. In this context, a great deal of follow-up research needs to be done on the various issues faced by the Euregional Paediatric Surgery Centre.

Read the complete research report Setting up a Tri-Member State Paediatric Surgery Centre in the Netherlands, Germany and Belgium: The Cross-border Mobility of Paediatric Surgeons in the Meuse-Rhine Euregion