Forget the “elderly wave”. Now it is the “younger wave” that worries Norwegian municipal leaders. Strong growth in younger people with major care needs produces bright red figures in many places. – We have to make tough priorities between different weak groups. The growth is much greater than we are able to handle, says municipal director Turid Stubø Johnsen in Sarpsborg to news. MUST CUT: Municipality director Turid Stubø Johnsen in Sarpsborg acknowledges that she pits weak groups against each other. Photo: Eirik Pessl-Kleiven / news The old industrial town with around 60,000 inhabitants can serve as an example: In 2020, Sarpsborg had 168 families who needed extensive follow-up and resource-intensive services. Three years later, the number had risen to 433 families. Next year, the municipality has set aside NOK 663 million for schools. At the same time, NOK 726 million goes to child welfare and what is known as the housing guidance service, which assists people with developmental disabilities, diagnoses on the autism spectrum or other functional disabilities. Put another way: Next year, the municipality will spend NOK 63 million more on the around 1,000 users within housing guidance and child protection than on the 6,690 students from first to tenth grade in primary school. – Very unfortunate High interest rates, price growth and failure in tax collection are the main explanations for the acute financial crisis that Norwegian municipalities now feel they are in. But the growth in expenses for younger people in need of care amplifies the problems significantly. – We must find coverage for the costs of statutory services for child protection and residents with special needs, says municipal director Turid Stubø Johnsen in Sarpsborg. In the municipal administration’s budget proposal for 2025, the Kruseløkka nursing home in Sarpsborg is proposed to be closed. It happens just a few months after another nursing home was closed down in the municipality. In total, around 100 nursing home places will disappear in a short time. The care has been good everywhere she has been, says Tormod Skjøren. His wife Brita had to move when Tingvoll nursing home in Sarpsborg was closed down. Now the same thing can happen again. The reason is, among other things, an explosive growth in the costs of young people with great care needs. Photo: Eirik Pessl-Kleiven / news One of those affected by the cut is Tormod Skjøren. Every day he visits his wife Brita at the nursing home, which is located right next to the Sarpsborg stadium. In five years, she has changed departments five times. She has now lived in three different nursing homes – the previous one was also closed down. – It is very unfortunate. I was on a next-of-kin course at the time, and there we learned that demented people should not be moved, Skjøren tells news. – Very unfortunate, says Tormod Skjøren about the nursing home cuts in Sarpsborg. Photo: Eirik Pessl-Kleiven / news “Yngrebølge” Sarpsborg municipality is not alone in struggling with increased expenses for younger people with complex challenges and major care needs. The municipal organization KS calls it a “younger wave” and refers to the following figures: 5 per cent of users in health and care account for 40 per cent of the costs, and they are under 50 years of age. – There can be a lot of one-to-one services. This means that you must have one person 24 hours a day to assist, says KS chairman Gunn Marit Helgesen. KS leader Gunn Marit Helgesen Photo: Eirik Pessl-Kleiven / news She believes the development is not sustainable. Partly because the costs are increasing so sharply, but also because the municipalities are short of people and therefore have to resort to expensive substitutes and more overtime. – But we are talking here about services that make life better for many people, right? – Yes, absolutely. That is the big dilemma. Because if someone has absolute rights and needs one-to-one follow-up, then it will come at the expense of other residents, she says. REACTS: Confederation leader Tove Linnea Brandvik of the Handikapforbundet believes the municipal sector is running a “serious campaign” against young disabled people. Photo: news Isabel Trandum / Isabel Trandum, news Leader Tove Linnea Brandvik of the Norwegian Association for the Disabled believes that these are absolutely fundamental rights. – To be able to get up in the morning, to be able to shower and get food and to get help to breathe for those who need respiratory assistance. This is really not about luxury services, she says to news. This costs the most expensive users. Earlier this year, the Altinget website obtained figures from the Directorate of Health, which show: 8,665 users received such extensive help in 2023 that the salary expenses of the helpers cost an average of NOK 4 million for each of them. 125 people received help that exceeded NOK 10 million. The single user who tops the statistics received help that added up to approx. NOK 22.7 million. Salary costs for administration and planning are not included in the calculation, nor are aids. What is the cause? But why do the expenses of so-called resource-intensive users increase so much? KS points to a political development with an increased degree of enforcement of rights. In short, the municipalities must provide an extended range of services to the individual – in order not to break the law. An example that is often referred to is the scheme with user-controlled personal assistants, which should give greater freedom to people who need a lot of help. In September, Trønder-Avisa wrote that expenses for the BPA scheme doubled from NOK 15 to NOK 30 million in four years in Steinkjer. A research report that came out earlier this year points to the downsizing of institutions as another, related explanation. Developments in medicine and technology related to childbirth and newborn care are also highlighted. Put simply: More people than before are growing up in need of care. Full speed in the school yard at Hafslund primary school in Sarpsborg this week. Photo: Even Bjøringsøy Johnsen / news But in Sarpsborg and several other press municipalities around the big cities, another phenomenon is making itself known with particular strength in addition: the movement of so-called secondary refugees after the refugee crisis in 2015 and the arrival of new refugees from Ukraine. – It is certainly part of the picture, says municipal director Turid Stubø Johnsen. – There are many families with large groups of children. Many have trauma, many have major physical and psychological problems on the basis of the life they have led, she continues. Municipal directors from all corners of the country gathered for a meeting last week. Many of them recognize themselves well in the problem description from Sarpsborg. Photo: Eirik Pessl-Kleiven / news The same everywhere Last week the municipal organization KS held a meeting for the country’s municipal directors in Oslo. A number of those who took the floor spoke about the challenges that resource-intensive users represent. – This is the picture in the entire municipality of Norway, says municipal director Bjørn Fauchald in Vestre Toten to news. The budget proposal he recently put forward contains cuts of NOK 50 million in a municipality with 14,000 inhabitants. The level of the drawdown was about the same as last year, he says. – It goes beyond many areas. One example is that we are reducing the full-day offer at care homes for the elderly, he says. URO: Camilla Dunsæd in Kristiansand and Bjørn Fauchald in Vestre Toten are worried about the municipal finances. Photo: Eirik Pessl-Kleiven / news Municipal director Camilla Dunsæd in Kristiansand is worried about a shift away from community solutions and towards a system with more individual rights, where a few seize a large share of the municipality’s resources. – At least there is a turning point there. And there is a reason for that. There are great needs. But we must be able to balance this – over time, she says. Tough priorities Ultimately, it will be up to mayor Magnus Arnesen (H) and the other politicians in Sarpsborg how the challenges are to be resolved. The 10 extra municipal billions that the government presented last week for this year and next year will come in handy. WANTS A DEBATE: Sarpsborg mayor Magnus Arnesen believes national politicians should hold the debate on what kind of rights the citizens of Norwegian municipalities should expect to have fulfilled. Photo: Eirik Pessl-Kleiven / news But the extra funds will not solve the problem with the young resource-demanding users in the longer term, believes the Sarpsborg mayor. He believes there should be a debate about what kind of rights the citizens can expect to get from the municipality in the future. – What tasks must the municipalities solve? How big should they be and how much money should they get? The Government and the Storting have quite a big task ahead of them, he says – So the rights that have been introduced are not commensurate with what you can offer? – That is absolutely correct. We are balancing on a knife’s edge in Sarpsborg and the rest of Kommune-Norge. So something must clearly be done, he says. Get support from the state Norwegian municipalities get support from the state to pay parts of the salary costs linked to resource-intensive users. This happens through the so-called top funding scheme, which in 2025 amounts to NOK 14.6 billion. The government has recently changed this scheme in an attempt to make it more effective. The calculation basis for the support is actually incurred direct salary expenses, minus some earmarked grants, user fees, and a contribution point of NOK 1,608,000. The subsidy makes up 80 percent of the remaining amount. What will go away? Tove Linnea Brandvik of the Handikapforbundet asks the municipal management and KS to be specific and clarify what kind of rights should possibly be removed. – It is more about how the rights are to be practiced and weighed, says municipal director Turid Stubø Johnsen in Sarpsborg. Municipal director Turid Stubø Johnsen in Sarpsborg. Photo: Eirik Pessl-Kleiven / news – In principle, it is good that the individual can choose the form of living, but such a right cannot be absolute as long as the choice can cause a municipality millions in extra expenses that must be taken from other users or services, emphasizes she. – Do you think some of the citizens today get services that they don’t really need? – Some residents could receive services at a lower level than they receive, and it would still be a reasonable offer. Sometimes we are required by the state administrator to provide more extensive services than we think is right based on a balance of economy and quality, says Stubø Johnsen. Published 07.11.2024, at 16.46
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– A younger wave – news Norway – Overview of news from different parts of the country
