A strong public health system is the very foundation of our welfare state. That is why I look at what is happening now with unease: The waiting lists have never been longer, almost all of the country’s hospitals are heading for major budget deviations, and professionals who really want to stay in the public sector are actively seeking to leave there. Our joy at work disappears when the focus is on paperwork and target figures. That should worry everyone. The number of Norwegians with private health insurance is approaching 800,000. In 2024, the completely private Aleris will open a large hospital in Tromsø, and does not seem to worry about enough labour. They know that the public health system is no longer able to be an attractive workplace. The day after Health and Care Minister Ingvild Kjerkol expressed great concern for doctors’ working conditions on news Debatten, Health South-East adopted a long-term economic plan that must be called utopian at best. The waiting lists for the next four years will decrease. The number of employees in Helse Sør-Ost is to be cut, while activity is to increase. It was clarified that this should not be solved by the employees running faster, but by better technology and new buildings during the next four-year period (!) to make better use of the capacity. We are talking about a healthcare system where employees find other jobs because they can’t bear to run faster, where we still heal knots with fax machines and where brand new hospitals are too small when they are finished. Understand it whoever can. A week later, proposals for the state budget for 2024 were presented. The extra allocation set aside for the hospitals is eaten up by the expected increased need for health services and the general price increase, which once again seems underestimated in the budget proposal. The room for maneuver for the hospitals is thus even smaller. There is no money left for investments. Can’t we at least be honest with numbers? New week, new decision – again made by people far removed from patient meetings and poorly adapted ICT systems: The Board of Health Central Norway continues the plan with the rollout of the Health Platform record system, despite still serious errors and shortcomings, warnings about threatened patient safety and demands for full stop. This system, which employees warned about from the very beginning, and which was supposed to cost 3.7 billion, now seems to pass 5 billion tax kroner. “When the reality seen from the directors’ offices no longer matches that seen from the hospital floor and doctor’s office, the very trust that holds the healthcare system together is threatened,” wrote the editor of Norway’s largest medical journal earlier this autumn. He couldn’t have been more right. The flight of expertise from the public sector is a picture of this. We who are employees of the healthcare system, who try to press the alarm button, find that we are met with platitudes and a general lack of understanding. Both with hospital managers and with politicians. This kills both commitment and job satisfaction, and is a threat to patient safety. How did we end up here? The health enterprise model, which was introduced in 2001, has led to the hospitals being run as privately owned companies. The product is patient care. Hospitals have therefore for over 20 years been subject to a constant requirement to operate smarter, treat more people in less time, with fewer hands and at the lowest possible cost. At the same time, the number of medicines we use in treatment has increased considerably and requires greater follow-up. At the same time, no one says anything about what we should do less of. The technological development has also been formidable, but also requires more human competence, not less. The professional autonomy is gone – it is no longer the subject, but the financial requirements, which are governing. The burden the employees face today is thus significantly higher than in the past, despite a steady increase in both doctors and nurses in recent decades. Long waiting lists and employees who no longer want to work in the public healthcare system ultimately affect the patients. And as always, the most resourceful will get good treatment elsewhere – they can pay for it, after all. If this development is to be reversed, we are completely dependent on being listened to and being part of the solution. Listen to us! Every nurse, midwife or doctor who leaves costs at least twice as much to replace with substitutes. At the same time, it is difficult to believe in improvement without looking at the entire health enterprise model. For those of us who work with patients, it is demanding to constantly be measured, when the most important thing we do, care, is unmeasurable. The healthcare system is being steered alarmingly fast towards “the healthcare system of the rich”, and it is happening on the watch of the left. I don’t think anyone really wants that. So, dear politicians who will now agree on a new budget, dear hospital managers: Do as we doctors do when the alarm goes off; run and save the patient. Now the patient is our joint healthcare system. You have the calling. The code is red. Run!
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We are directed against the rich’s healthcare system – Speech
