news has gained access to a secret document that was created in connection with Helse Nord’s work on reorganizing the hospitals in the north. The document shows which alternatives Helse Nord is considering regarding the structure and content of the hospitals. What needs to be considered is, among other things: Removing emergency surgery at the hospitals in Kirkenes, Narvik, Lofoten and at one hospital in Helgeland. Helse Nord has appointed five working groups, all of which will deliver two alternatives to the current organisation. A ROS analysis must be carried out on these alternatives. In addition, they must give a reasoned recommendation of the best alternative. It is the working group that looks at emergency functions and planned functions that has drawn up the overview: Here are the alternatives assessed by Helse Nord: The 0 alternative is the current distribution of functions. Finnmark: Kirkenes 0-alternative: Emergency hospital Option 1-new: Emergency hospital without emergency surgery, orthopedics and delivery (delivery room) Option 2-new: DMS (district medical center) Hammerfest 0-alternative: Emergency hospital Option 1-new: Emergency hospital – increased volume Option 2 -new: Large emergency hospital Alta: 0-option: Clinic/DMS w/24-hour function and delivery room Option 1-new: Clinic/DMS w/24-hour function and delivery room Option 2-new: Delivery room discontinued UNN: DMS Nord-Troms 0-option: DMS w/ 24-hour function and delivery room Option 1-new: Delivery room discontinued Option 2-new: 24-hour function and delivery room discontinued Tromsø: 0-option: Regional and university hospital Option 1-new: Regional and university hospital Option 2-new: Regional and university hospital Harstad : 0-alternative: Emergency hospital Alternative 1-new: Emergency hospital – increased volume Alternative 2-new: Large emergency hospital Narvik: 0-alternative: Emergency hospital Alternative 1-new: Emergency hospital without emergency surgery, orthopedics and obstetrics+elective gy/orth Alternative 2-new : Elective hospital DMS Midt-Troms 0-option: DMS w/ delivery room Option 1-new: DMS w/ delivery room Option 2-new: Delivery room discontinued Longyearbyen: 0-option: Emergency medical emergency hospital Option 1-new: Emergency medical emergency hospital Option 2-new : Emergency medical emergency hospital Nordlandssykehuset: Vesterålen 0-option: Emergency hospital Option 1-new: Emergency hospital – increased volume Option 2-new: Emergency hospital – increased volume Lofoten 0-option: Emergency hospital Option 1-new: Emergency hospital without emergency surgery, orthopedics and delivery (delivery room) Option 2-new: DMS Bodø 0-option: Large emergency hospital Option 1-new: Large emergency hospital Option 2-new: Large emergency hospital Helgelandssykehuset: (Here, Helse Nord does not mention the hospitals by name (ed. note)). X 0-option: Emergency hospital Option 1-new: Emergency hospital without emergency surgery, orthopedics and obstetrics Option 2-new: Large emergency hospital Y 0-option: Emergency hospital Option 1-new: DMS Option 2-new: Elective hospital Z 0-option: Emergency hospital Option 1-new: Emergency hospital – increased volume Option 2-new: DMS Brønnøysund Option 0: DMS w/ maternity ward Option 1-new: Maternity ward discontinued Alternative 2-new: Maternity ward discontinued But some places must be built up And when some hospitals weaken others are to be strengthened, the overview shows. In the overview news has had access to, options are outlined for building up the hospitals in Hammerfest, Harstad, Vesterålen and one of the hospitals in Helgeland. Consideration will also be given to turning Kirkenes, Lofoten and one of the hospitals on Helgeland into DMSs. Nevertheless, it may appear that the two hospitals are not safe. There are also likely to be severe cuts in maternity services throughout the region. Helse Nord: All groups must make proposals news has submitted the document to Helse Nord. – This is an internal working document. We do not comment on this, says Acting Communications Director Ingrid Bredesen Hangaas at Helse Nord. Tonje Hansen heads the coordination group in the investigative work at Helse Nord RHF, and answers more general questions from news. – Right from the start of this work, Helse Nord has been clear that all stones must be left unturned in this work, says Tonje Hansen. Hansen says that all five working groups will each present a report with proposals for how future hospital services in northern Norway should be organised. – They must propose three alternatives, including the 0 alternative (today’s organisation), for a new division of functions and tasks for the respective areas of investigation. Tonje Hansen leads the work to coordinate the investigation of future hospital services in Helse Nord. Photo: Mats Jensaas The investigations will end up in a comprehensive plan for the division of functions and tasks in Helse Nord. This is scheduled to be sent out on 20 December for consultation for eight weeks. In April 2024, the board of Helse Nord will adopt the final plan. – Do you realize that there will be strong reactions? – Yes, the ongoing investigative work in Helse Nord is large and comprehensive, and affects and engages many people. Questions about how we should organize the health service will always create debate, says Tonje Hansen and adds: – When it comes to this specific issue, it is important to point out that this is a broad investigation process where the different groups look at everything. Building a new hospital for 4 billion: – Against all common sense One of the alternatives that Helse Nord is looking at is to downsize the emergency surgery and maternity services at the hospital in Narvik. It is happening at the same time as a new hospital worth NOK 4 billion is under construction. Narvik mayor Rune Edvardsen says that the municipality will not accept that the hospital in his home town should be demolished. – There is no logic in this alternative, says Narvik mayor Rune Edvardsen. Photo: Frida Brembo / news – This is against all common sense. Helse Nord does not include the social consequences in this, which I think is a great shame. He continues: – In addition, a hospital will be completed here in Narvik in 2024 at a cost of NOK 4 billion. Narvik has spent half a billion on a health center that will be connected to the hospital. Rana mayor Geir Waage (Ap) is also critical of the content of the working document which has now been leaked. – If what emerges in the media is true, a process takes place in the back room. Then we as municipalities are exposed to a skin process. Then I think we have to ask ourselves why we should participate in this. Vadsø mayor: – A betrayal of the population Wenche Pedersen is the mayor of Vadsø and leader of the Eastern Finnmark Council. She is not gracious about the investigations that Helse Nord is undertaking. – It is a betrayal of the population of Eastern Finnmark. The people who have come up with these proposals cannot possibly have understood political signals. She mentions that, as recently as September, the government granted NOK 35 million to the hospital in Kirkenes to strengthen emergency preparedness. – We have rarely heard clearer signals from Oslo, Pedersen continues. Wenche Pedersen is mayor of Vadsø. In the neighboring municipality is the hospital in Kirkenes, which serves Eastern Finnmark. Photo: Hanne Wilhelms / news – Is it surprising that Helse Nord turns over all stones as they have said? – No, but there is a political background to this which I think is easy to understand. – Now this proposal will go out for consultation – what do you think the result will be? – You can imagine for yourself… It will be hell around the ears for a lot of people. Mayor: Believes the Minister of Health must be on the field The reactions to what is now being investigated are strong. The right-wing mayor-elect in Vestvågøy, Jonny Finstad, reacts like this: – I’m a little shocked by what comes out here. This is not in line with the order from the Minister of Health either. Jonny Finstad (H), incoming mayor of Vestvågøy. Photo: Torbjørn Brovold / news In the extreme, hospitals may be closed down, and we may only get a district medical centre, he continues. – It is very serious that they are considering this. I cannot see that this has been communicated in any context to the municipalities. – It does something to the trust in the process that is now running in Helse Nord. Finstad believes this is so serious that the Minister of Health must step in. – This about emergency hospitals and what functions the individual hospitals must have belongs in the national health and hospital plan. It is a plan that the Storting will reportedly consider this autumn. – That they are anticipating such a process that will take place nationally is almost a mockery of those who are affected by this SV summit: – Super dramatic Also group leader in the new county council for SV, Christian Torset, is upset about what is now happening internally in Health North. He says the alternatives in the study indicate that Northern Norway may lose a number of emergency hospitals. – It is super dramatic. Because it undermines the health, environment and safety of everyone who lives in a region. Business will be where it is safe to live. It also affects where the defense will be present. Christian Torset, Nordland SV Photo: Kåre Riibe Ramskjell / news – The entire development of society is affected. This is not something that should be left to health bureaucrats. Ask Kjerkol to stop the process – This is after all part of the process and Helse Nord has reasons to investigate. Do you have no understanding of it? – I understand that they have to do it when the Minister of Health has ordered it. But it is Kjerkol who must stop this process now. We cannot let a health enterprise set the conditions for development in an entire part of the country. As it is set up until now. Torset is concerned that what Helse Nord is now investigating could damage recruitment in the coming years. – Who wants to get a job in Narvik, in Gravdal, in Helgeland, if they know that their hospital might become a DMS? It is completely hopeless, you are sawing off not just the branch, but the whole tree you are sitting in. This is one of the reasons why Helse Nord is considering changes: Target area 1 Establish a new division of functions and tasks in Helse Nord based on a structure that can be staffed and which provide sustainable finances: Avoiding unnecessary transfers of patients between units Good recruitment ability and ability to retain staff On-call arrangements that do not depend on continuous hiring Finances for necessary investments, building-related development and maintenance Target area 2 Follow up on the medical development trends, including increasing specialisation, new needs in medical technology, digitization and personalized medicine Modern patient care in line with medical and technological development Further development of decentralized services close to the patient’s place of residence Target area 3 Adapt the services and cooperation with the municipality to the growing proportion of elderly patients Good coherent treatment chains for acute and planned treatment across of hospitals and municipalities Equal health services with equal opportunity for the right treatment regardless of place of residence Pre-hospital services of high professional quality and with the right availability
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Looking at the possibility of removing more emergency hospitals – news Nordland
