Norwegian hospitals spend billions every year on hiring doctors, midwives and nurses, for example. Next year, Oslo University Hospital (OUS) has set aside NOK 120 million to hire temporary workers. That is more than the sum they are going to cut in, among other things, the neonatal intensive care unit at the hospital. Tenancy gap In recent years, the hospital has spent much more than they have set aside each year. Last year more than twice as much. And they were not alone: Helse Sør-Öst’s hospitals spent 950 million on rent last year. Almost 600 million more than planned. That’s how much the hospitals in Southern and Eastern Norway spent on hired substitutes last year: OUS explains the “crack” with, among other things, high sickness absence. Some departments have spent a lot on hiring people: the Clinic for Mental Health and Addiction had set aside NOK 300,000, but ended up spending almost NOK 6 million. The Orthopedic Clinic had set aside 3.8 million, but spent more than three times as much. The emergency clinic spent the most, around 90 million. The rental budget was 35 million. Oslo University Hospital (OUS) has for several years aimed to hire less. Among other things, they have their own temporary worker pool, to reduce the need to hire temporary workers. Cuts hire Now the health authority is tightening up: – Our goal is to significantly reduce the use of hire in 2023, and to discontinue it completely for some areas, says the hospital’s HR director Susanne Flølo. The clinics have been asked to cut back. Some have introduced a hiring freeze. HR director Susanne Flølo (pictured) says Oslo University Hospital is working actively to reduce the use of hire. Photo: Private The goal is to save money. OUS has strict requirements for profits, among other things to afford new hospitals. Then the use of temporary workers must be reduced: – It is expensive labor for us, says Flølo. Twice as expensive Hiring is about twice as expensive as permanent man-years, according to news’s calculations: 61 man-years Oslo University Hospital (Ous) has budgeted for 61 man-years hired for its clinics. In practice, this can mean more than 61 employees, because not everyone who is hired works 100%. 120 million For these 61 man-years, they have set aside approx. NOK 120.5 million. This means that they spend approximately NOK 2 million on each man-year. More expensive than permanent employees. It is cheaper for the hospital to have people employed themselves: The average salary for the man-years employed in the hospital is around NOK 742,000. If you include pension and employer’s tax, each employee costs around NOK 1 million. This is without taking into account overtime. Or, to put it another way: for every man-year that needs to be hired, the hospital could employ one more. – It is an unreasonable use of tax money, says county leader Bård Erik Ruud of the Norwegian Nurses’ Association. The hospital has set aside 120 million for 60.5 man-years. An average price of around NOK 2 million. How did we arrive at the numbers? news has taken the hospitals’ own budgets as a starting point. For Oslo University Hospital, we have used figures from updated budget documents considered by the board on 23 February. We have also looked at board documents from other hospitals, and from the regional health company Helse Sør-Øst – which owns all public hospitals in Southern and Eastern Norway. When it comes to the calculation of how much hiring costs compared to other man-years, we have done this: We have arrived at the average for the hospital’s own employees by dividing the total salary cost – including expenses for pensions and employer’s contributions – by the number of man-years. We have arrived at the average for hired man-years by looking at how much each clinic has set aside for hire, and how many man-years they calculate. An example: A clinic at the hospital has set aside NOK 17.95 million for rent in its budget. In the budget papers, it also appears that they are budgeting for 9 man-years in hire. Then we have simply divided 17.95 million by 9 man-years to arrive at an average. Finally, we have added up the sum that all the clinics have set aside for hire, and the sum of man-years they budget for. We have then carried out the same exercise to calculate the general average price for hired man-years. Could drop ABC cuts If those hired had been employed by the hospital instead, they would on average have saved approx. NOK 60 million. It is much more money than the hospital hopes to save by collecting the thoracic surgeon at Rikshospitalet. And: for 60 million they could run the ABC clinic, which was closed in March this year, for three more years. For the clinic, which was closed from March this year, 16 man-years were used last year. Cuts at Oslo University Hospital Oslo University Hospital has planned to add 50 million more this year. But already in March they are 80 million in the red. This could mean tougher cuts on top of what is already planned: In total, the hospital must save a sum equivalent to around 460 man-years. And it must be cut in all departments. There are cuts in staffed beds in several departments, for example the neonatal intensive care unit, children’s cancer and the eye department. All thoracic surgery is gathered at Rikshospitalet from 31 May. More expensive medicine is replaced with a cheaper one for patients with bone marrow cancer. Among the smaller proposed cuts are cuts in spending on dinners for hospitalized patients and cuts in cleaning. Fills the on-call schedule But the price per man-year cannot be compared directly, says HR director Flølo. Hiring temporary workers is so expensive because those who are hired are mostly used at weekends and at night, she says. – Hire is used for the expensive hours of the day or week. That is when they struggle the most to fill the duty schedule. But even in these shifts it would have been cheaper to use your own employees, she confirms. They simply don’t have the people for that. Because the hospital is struggling with recruitment, especially of nurses and doctors with special skills. – The market is empty, unfortunately, says Flølo. Therefore, they need to hire the people they lack. Flolø nevertheless believes that it is possible to cut the hiring of temporary workers. Among other things, by offering further education so that more of their own nurses can become specialists. And by planning the operation, see if any of the tasks the specialists do can be solved by others. Understaffing leads to hiring The hospitals must also take some responsibility themselves, Ruud and the Nurses’ Association believe. County head of the Oslo Norwegian Nurses Association Bård Ruud believes that tight budgets and tough rotations are causing more people to get sick or quit, and hires are increasing. Photo: Private Who believes the high use of temporary staff is a sign of something else: – Understaffing is self-reinforcing. Where there is a shortage of people at work, people quit. Then the need for letting increases, says Ruud. Hello! Do you have any thoughts about the case you have read? Or more tips about the healthcare system, the housing market, facilitation at school or mental health? 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Oslo university patients spend over 120 million on hiring nurses and substitutes – news Oslo og Viken – Local news, TV and radio
