A drive into the country from Bergen, an hour and a half on “Norway’s worst road”, the maternity ward is located at Voss. Pregnant women from Sogn, Hardanger and the Nerøyfjorden come here when they know the time has come. Every year, around 500 babies are born at the local hospital. But now “Føden” is in play. Voss hospital is forced to save NOK 27 million, and among the measures being considered is the summer closure of the maternity service. – It was a shocking message, and I would rather believe that it is not true, says Britt Heidi Tefre, who is a midwife and chief trustee at Voss hospital. At a mothers’ meeting in Eidfjord, still an hour away from Bergen, Anette Hereid Olaussen and Kari Lægreid each have a June baby on their lap. – It’s about safety. It’s enough with the birth if you don’t have to worry about the long journey either, says Anette. – If we are going to live in the district, it is a shame if they remove such an important offer, says Kari. Anette Hereid Olaussen with her daughter Thea, who was born on 5 June 2022. Kari Lægreid with her son Per, born on 27 June 2022. – It was a shocking news, and I would rather believe that it is not true, says Britt Heidi Tefre , who is a midwife and chief trustee at Voss hospital. Birth overview at Voss hospital. NOK 1.7 billion in the red The background for the savings measure is “blood-red figures” at hospitals throughout the country. A review in Dagens Medisin shows that the regional health undertakings are NOK 1,709,600,000 “behind schedule”. Or a little simpler: So far this year, they have spent NOK 1.7 billion more than they should have. Health West (under which Voss hospital is classified): minus NOK 335 million Health South-East: minus NOK 730 million Health North: minus NOK 628 million Health Central Norway: minus NOK 16 million (without an ownership hall of NOK 95 million they would have were NOK 111 million in the red) To news, Helse Bergen says that these are “demanding times” and that “nothing has been decided”, but that the sum of long travel time and what is “a very well-functioning department” means that it must be a “heavy argument » to close the maternity ward at Voss for the summer. Minister of Health Ingvild Kjerkol (Ap) visiting the epicenter of the “bunads guerrilla” – Kristiansund hospital. Photo: Marius André Jenssen Stenberg / news – We must use the word crisis The explanation for the shortfall is the covid backlog, increased sickness absence and galloping wage and rental costs. In a newspaper article, seven hospital directors write that they are caught in a situation where they have to throw money at temp agencies. – A few years ago there were a dozen applicants for a vacant nursing position, today we are lucky if it is one or two. Increasingly, there is no one, they write. On top of that, there are higher expenses linked to electricity, equipment and medicine. In the budget, the University Hospital of Northern Norway (UNN) accepted a price increase of 1.5 per cent. In reality, growth has been 6.5 per cent, the highest since the 1980s. – We must use the word crisis, says Roald Linaker, who is chairman of the University Hospital of Northern Norway (UNN). Earlier this autumn, the hospital canceled the trip of 40 employees who were going to a conference on the future of the hospital. The explanation was that there was simply no money to send them. Hanne Smedal Tenggren cycled with bunad for five days from Kristiansund to Oslo to hand over an analysis that shows that it is better to keep food and emergency care in each city versus building a community hospital in Molde. Photo: Stian Lysberg Solum / NTB Kjerkol: – Can’t comment on every single proposal. Other cost-saving measures have also attracted attention, among them the complete stoppage of “non-critical purchases”, “internal reconstructions” and the proposal for ambulance cuts in Vestland. – There are several proposals in circulation, which I understand are attracting attention. But commenting on each individual proposal does not make sense for me to do now, says Health Minister Ingvild Kjerkol (Ap). In October, she presented what she herself calls “a tight budget” for 2023. In exchange for increased basic funding and more money for activity growth, the healthcare company is required to make operations more efficient with NOK 263 million. In order to ensure that the healthcare provider “gets better control over the use of resources”, the government decided in the same month to abolish free choice of treatment. – The scheme has to a small extent achieved the purpose of making the health service more efficient, said Kjerkol, with reference to an evaluation from 2021. Health Bergen: – Demanding times, but nothing has been decided Managing director of Health Bergen, Eivind Hansen, tells news that these are “demanding times, but nothing is decided”. – 90 minute journey for the birth at Voss, requires the midwife to be with you. How can this lead to savings? – There are many questions we do not have answers to today. These are ideas that we shall look at seriously. It may be that we put them aside, but it is necessary to look at all parts of the service. Terje Breivik is chairman of Helse Bergen: – I understand well that the question is being asked. Long journey times, unsafe roads and a very well-functioning maternity ward at Voss hospital mean that a very heavy argument is needed for me on the board to consider such a measure. During the reorganization in 2002, five regional health enterprises were established in Norway. From 2007, two of the companies, Helse Sør and Helse Aust, were merged. Today, there are thus four such companies. Photo: Lise Åserud / NTB There have been 3,800 fewer hospital beds Behind sing what is called a health economic paradox. Norway is among the countries in the world that spends the largest part of the gross domestic product on healthcare, and since 2005 specialist healthcare services have been strengthened with NOK 80 billion (40 billion adjusted for price increases). During the same period, there have been 3,800 fewer hospital beds. How can that be? Among those who will count on it are the National Health and Cooperation Plan, the Hospital Committee, the Health Personnel Commission, the Health Preparedness Report, the Public Health Report and the Expert Committee for the GP Scheme. Answers and recommendations will come during the next year. – If there are structural changes, then they must be sorted out well and thoroughly, says Per Karlsen, who is finance director at Helse Vest. He adds: – There will be a new settlement before the New Year, and then a little more money may come. I’m crossing my fingers for that. And that there will be more in the state budget. November 2022: This is the situation for the hospital Bergen Health Bergen Health has to save up to 500 million, and several construction projects have been postponed. New proposals must be considered until the final consideration of the budget in December. According to BT, this is among the proposals: Close a bed station in the Central block. Joint management of two clinics, tightening of staffing. New on-call arrangements where new technology provides room for collaboration between hospitals. Helse Sør-Aust Oslo University Hospital HF “The board notes that Oslo University Hospital HF is facing major financial challenges for 2023 and that there are therefore particularly high demands on the planning of the business”. Akershus University Hospital “The budget process is more demanding this year than in recent years, due to poorer financial results in 2022. In addition to the lack of compensation for wage and price growth in 2022 in the proposed state budget, next year’s budget is extra demanding.” Sjukehuset i Vestfold “Proposal for the state budget for 2023 appears to provide worse economic framework conditions than what was laid as a basis for the board’s decision on the long-term financial plan for 2023-2026 in May this year. This means that the surplus of NOK 20 million in 2023, which is in the long-term financial plan, appears to be a deficit. It is too early to quantify this deficit. The budget for 2023 not ready.” Hospital Innlandet “Hospital Innlandet has an annual forecast of minus NOK 110 million in 2022. It was budgeted for a positive result of NOK 40 million in 2022, so the forecast is a deviation from the budget of NOK 150 million. The health authority is now in the budget process for 2023 and is waiting for income frameworks from Helse søraust. In the long-term financial plan 2023–2026, Innlandet Hospital has planned for a positive result of NOK 80 million in 2023, but will adjust this result target down. Telemark Hospital “We are in the middle of the work and have not finally concluded when it comes to financial performance targets – the work is demanding. In the board meeting last week (26/10) we informed the board that our preliminary proposal for the profit target for 2023 is +25 million NOK. We emphasized that this is preliminary and that there is a great risk when it comes to this number. Among other things, it depends on the size of the final income framework that we expect to receive from HSØ in the first part of November.” Vestre Viken “Result per September shows a deficit of NOK 28.9 million, which is NOK 238.9 million behind the budgeted profit target. The profit forecast shows a result of 0 against a budgeted result of NOK 280 million.” Hospital partners HF “We expect to keep the 2022 budget. The budget for 2023 is in process, but the level has not been clarified. We hope to have a final budget in place in November.” Sørlandet hospital “Going about 50 million in the red this year. The 2023 budget is not ready.” Helse Midt-Noreg “The budget process for next year will not be finished until December.” Link: Helse Midt-Norge RHF, HOD (helse-midt.no) Helse Nord University Hospital Northern Norway “Has a deficit of 323 million per September this year. The budget for next year is not ready, but will be in the order of 8-9 billion. Plan cuts to reach your goal.” A review in Dagens Medisin shows that the regional health undertakings are NOK 1,709,600,000 “behind schedule” this year. Photo: Carina Johansen / Carina Johansen Budget negotiations between the government and SV began on Monday this week, three days after SV leader Audun Lysbakken presented their alternative state budget. There, SV proposes to strengthen hospitals with one billion kroner. In return, they propose two major cuts: Cuts in the investment loan for the new university hospital in Oslo, and instead prioritize the gradual development of Aker over Rikshospitalet (NOK 655 million). Cut in the use of staffing companies in the healthcare sector (NOK 150 million).
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– A shocking message, says the midwife – news Vestland
