The fronts were hard. The mood was implacable. The breaks were many and long. What are we talking about? A board meeting in Helse Nord about hospital structure in northern Norway. Something so boring, you might think? But according to commentator in Avisa Nordland, Børre Arntzen, it is something “you can enjoy on YouTube”. Because it became almost highly dramatic throughout the morning when chairman Renate Larsen repeatedly asked the board to follow the administration’s proposal. She was not successful and the case was withdrawn after another coffee break. Now the criticism is raining down on the chairman. “Stomach splash or an elegant “feint”? The board meeting in Helse Nord started at 08.30 on Tuesday. The 10 board members had only one case to deal with. Perhaps the most important case they have ever had on their table. Managing director Marit Lind wanted the board to send out a plan for the reorganization of the hospitals in the north for consultation. After a two-hour introduction, the chairman opened the floor for comments. This is the controversial proposal from Helse Nord. It was in autumn 2022 that the Minister of Health instructed Helse Nord to find solutions to ensure sustainable operations going forward. Five working groups worked throughout last year on possible changes in each area. Their recommendations were then compiled into a joint draft. Among the proposals is to remove emergency surgery at the hospitals in Lofoten and Narvik, but to retain internal medicine emergency services at both locations. Another proposal is to discontinue the emergency caesarean section in Lofoten, which continues as a delivery room. Board member and group representative in Helse Nord, Kari B. Sandnes, calls the meeting a strange experience. Commentator Børre Arntzen in Avisa Nordland described it as a “stomach slap” and a chairman who used “ruling techniques”. Among other things, because she reminded the board that it must not abdicate its responsibility. And the head of department at Nordlandssykehuset in Lofoten, Robert Hamme, tells news that he thinks it seems that the chairman tried to manipulate the board into following her view. But it is not only criticism that the chairman receives. Maja Sojtaric in Nordlys writes that Lind and Larsen feigned a “hostile majority”. Social scientists Turid Moldenæs and Hilde Marie Pettersen at Norway’s Arctic University also think that Larsen and Lind made an honorable effort. Asked for a vote But what actually happened? Board member Svenn Are Jenssen was quick to put forward a proposal to postpone sending parts of the plan out for consultation. Among other things, what is being cut in emergency surgery. Svenn Are Jenssen, long-standing board member from Nordland and Bodø Photo: Mathias Sommerseth Kjellmo / news It became clear early on that there was a majority on the board for his proposal. And not for CEO Marit Lind’s recommendation. Several of the board members repeatedly asked that they have to vote. But the chairman didn’t want it that way. – No. That is what I decide, said Larsen after Kari B. Sandnes once again asked for a vote. Board member Kari B. Sandnes advocated several times that it should be voted on, not discussed further. Photo: TINE SKJELSTAD / HELSEA NORD And there was never actually a vote. – The chairman must not act in a “dictatorial” manner. There is a reason why the law regulates that there must be a board where everyone has a personal responsibility. If the majority wants a vote, then a vote should be carried out, says professor of jurisprudence, Anne Kjersti Befring. After a break – closer to 3.30pm, Marit Lind took the floor and said she was withdrawing the plan. Authoritarian? Professor Befring believes that what happened at yesterday’s board meeting in Helse Nord was special. – The law states that it is the board that deals with cases, not the chairman alone. It is unusual to use such means of pressure. It seems authoritarian from the point of view that the board must deal with cases, each one according to its best conviction. Chairman Renate Larsen and CEO Marit Lind did not get the majority of the Helse Nord board with them at the board meeting this week. Photo: Astrid Pedersen / NTB What do you mean by authoritarian? – I believe that the chairman must accept that board members get involved, which they should, and that proposals receive strong criticism. Read Helse Nord’s comments on the reaction from the law professor further down in the case. Befring says that if a board is to function according to the intention, the discussion and decisions must be made in the board. Not before the board, in a meeting between the chairman and the managing director. – In the board, different points of view should be sought. The chairman must be prepared for disagreement and be able to get a good discussion going on important topics. Professor of jurisprudence, Anne Kjersti Befring. Photo: University of Oslo (UiO) She adds: – Instead, strong expressions are used about board members and the proposal is prevented from being subject to voting. This is not at all how a board should function. The impression that is left is that the chairman was not prepared for a real consideration of the proposal. Minister of Health and Care Ingvild Kjerkol visiting the hospital in Lofoten. Photo: Vilde Bratland Erikstad – It is legitimate and understandable that there are divided opinions Communications Director Skjalg Fjellheim tells news that chairman Renate Larsen does not find it natural to comment on the actions of the law professor. – We register that there are divided opinions about both how the meeting was led and its outcome. It is both legitimate and understandable. Both the board and the company will now look ahead and work out a case to be dealt with by the board and sent out for consultation to the northern Norwegian population, says Fjellheim. Deadline in April Health Nord director Marit Lind writes in a comment to news that a decision for the further schedule cannot be fixed today. Minister of Health and Care Ingvild Kjerkol (Ap) insists that she will have the case on her table in April. – Since the assignment was given, the situation has worsened with several breaches of the deadline for starting treatment and longer waiting times. Last year, Helse Nord had a deviation from the budget of NOK 4-500 million. If the hospitals in the north do not get control over the use of resources, and prioritize the patients, then the health service in the region will be worse than in the rest of the country. The government will not accept that, writes Kjerkol in an e-mail to news on Wednesday. Torchlight procession at Stokmarknes in solidarity with the proposal by Helse Nord to cut emergency and maternity services in Lofoten and Narvik. Photo: Vilde Bratland Erikstad / news The current board of Helse Nord has completed its two-year term. Kjerkol has already called a company meeting on Monday 15 January for the appointment of new boards in all four health regions. – I make the decision itself in close collaboration with my government colleagues.
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– Authoritarian management – news Nordland
