– Immediately after the first episode of Brennpunkt, I met several people who work in home care in the canteen. Director of Health Bjørn Guldvog tells about a meeting with the foundation of the Norwegian health service, namely the health personnel. – The first thing they said to me was to sit here and be ashamed of ourselves. It is a terrible situation to be in – and I think it is completely wrong that it is healthcare personnel who should feel shame in the situation we are now in, says Guldvog. The director of health together with nurse Solveig Håbetsås. Photo: Trygve Heide / news After many years as a top leader in the Norwegian Directorate of Health, he is now coming up with proposals for how to solve the crisis in Norwegian health. He does this the day before the Health Personnel Commission comes out with its report on how we should train, retain and recruit enough qualified personnel for health and care services in the future. Management in health Norway must take responsibility – We must remember that it is the authorities, politicians, those who plan the health service, and those who manage it, who have a responsibility to clean it up. And there is a lot that needs to be cleaned up, says Director of Health Bjørn Guldvog. In recent times, news has had several cases about objectionable conditions in the Norwegian healthcare system. news and other media have told about what patients and relatives believe was gross neglect at Ullern health centre. On Monday, midwives at Ullevål Hospital said that they do not have time to go to the bathroom or eat during their shift. The focal documentary “care behind closed doors” has also uncovered several objectionable conditions both in home care and at nursing homes in Norway. Employees say they break the law at work and relatives fear gross negligence. How is it in Norwegian nursing homes? Salary central to the future Guldvog highlights, among other things, salary as a decisive factor in obtaining enough employees in the health and care services. The director of health has written a chronicle which will be published on their website during the evening. Here, Guldvog tells more about what he sees as possible solutions to the challenges in the healthcare system. Read more about what Guldvog proposes How do we solve the problems in the health service? By Bjørn Guldvog, director of health It makes a deep impression when the health and care services are unable to provide worthy services to vulnerable people, as we have seen in news Brennpunkt’s reports and in many different media reports recently. Every day, new shortcomings in the offer to the population are revealed, and it is obvious that forceful action is needed to reverse the trend. Why has it become like this? The main explanation is the age composition of the population, which compared to a few decades ago has changed significantly. In addition, we have become better at reducing premature death, so that more people live longer with chronic diseases. This means that the health and care services become vulnerable to a lack of capacity and competence. The development is the same across Europe, and it is more difficult to recruit health workers from our neighboring countries. Then the pandemic has left its mark; healthcare workers have had a particularly demanding working situation for a long time. Sickness absence is high, both on the basis of high infection rates and heavy workload, and patient rights are violated due to a lack of capacity. This results in a worsening work situation where conscientious employees feel frustrated and inadequacy. “We’re ashamed,” replied a carer when I asked how they felt after the first Brennpunkt programme. It is of course completely unsustainable that healthcare personnel who do their utmost to help their patients should be left with the shame of not reaching out. There must be no doubt that we as health authorities have an overall responsibility for the service to function. At the same time, we must be honest enough to say that the solutions are not easy, and that the problems cannot be solved overnight either, as what we see is the result of a major societal change that has been going on for a long time. Long-term changes require long-term solutions. The health service cannot manage this alone. We in health obviously have to do our part of the job; organisation, division of tasks, patient rights, ethics, quality improvement and management development. But we must also create an understanding that the sustainability of the health and care services is a common concern for the whole of society, and that a joint effort is therefore needed to solve the challenges that lie ahead. Concretely, I believe that the following four points must be prioritized in the times we now find ourselves in: It must become more attractive to work in the health and care sector. Why? It is about being valued as an employee, being able to develop one’s competence, becoming confident in ethical and professional assessments, being both listened to and led and working in an environment with sufficient capacity where one avoids situations that are impossible to handle. And it’s about being able to work full-time with a salary that allows you to establish yourself in the local community where your job is. It must also be attractive for people with other skills to work in the health sector. news’s Dementia Choir is a good example of how professionals from the cultural field strengthen the health of both patients, relatives and staff. Closer cooperation between business and health services is also a key word. Predictable framework There is a risk that the expectations for rapid adjustment exceed what the health service is able to deliver. It is necessary to coordinate long-term financial frameworks, opportunities to retain and recruit expertise, as well as rights and duties given to both patients and personnel. This is particularly crucial in care services because the sharp change in the ratio between old and young affects the supply and demand side so strongly. Better mechanisms for prioritizing between patients Many who work in the health service express that there is a growing gap between expectations laid down in legislation and managers’ demands on the one hand, and measures to fulfill expectations on the other. We are now seeing an increase in rights violations in the municipalities and deadline violations in the specialist healthcare service, with a backlog that may never be possible to catch up on. We must give the health worker a better framework for setting health-related priorities. Prevention and technology Almost fifteen years ago, the cooperation reform was launched. The intention was to invest more in keeping people healthy and prevent the development of serious and chronic disease. We have not been able to follow through on the intentions. In these years, the growth in doctor-years has been much greater in the hospitals than in the primary healthcare service. This means that a larger proportion of healthcare services are provided late in the course of the illness. Both technology and trust are needed for closer cooperation between the many different parts of the health service. There is a need for more effective and seamless health care, for sufficient efforts early enough, and to contribute to coping and health both before and after illness strikes. The work to put in place well-functioning solutions with distance and welfare technology and supporting ICT systems is going too slowly. – I see no reason why health workers should have a lower salary than people in a similar profession, with a similar education. I think it is important that we work with what has to do with wages in the coming years, he says. The director of health believes it is important to work with pay in the coming years. Photo: Trygve Heide / news – Healthcare personnel must be able to afford to live in their immediate area, he adds. According to Guldvog, the conditions must also be better. He believes there must be a better match between healthcare personnel and the tasks they have to do. He tells of an ever-widening gap between the expectations from the legislation and the managers, and the tools the employees have to fulfill the expectations. – Every day must be such that the expectations of what one is going to do do not exceed the possibilities you have. Finally, he says that it is the authorities and the health service that must come up with solutions. – We cannot push this responsibility down the organisation, he concludes. Not enough staff to receive emergency patients Nurse Solveig Håbetsås at the neurological bedside post at the national hospital tells of a weekday with high pressure and little time. Nurse Solveig Håbetsås tells about a busy weekday with high pressure. Photo: Trygve Heide / news – We do not have enough staff to receive emergency patients. Our patients come in with strokes, and we cannot deny them treatment. Yes, it’s chaos, she says. She believes that it is to get employees in the department with the right skills. – Sometimes we don’t have enough employees with the right skills. It’s stressful, and I’m not the one who gets stressed the most. Then you can’t do it well enough for the patients. I think that hurts. When the alarm goes off, she has to run with the bed to the emergency department to receive the patient. Photo: Trygve Heide / news – I like my job. I like to help people, but if I don’t get to do that, then I haven’t done a good enough job, she says at the very end. New report can provide answers In a comment to news, Minister of Health Ingvild Kjerkol says that the new report to the health personnel commission can provide suggestions for solutions they can work on. – People must have safe and good health services also in five, ten and twenty years’ time. Then it is absolutely necessary that we work on how to recruit, train and retain professionals in our services in the years to come, writes Kjerkol to news.
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The director of health believes that the salaries of health personnel must rise – news Norway – Overview of news from various parts of the country
