– It’s like banging your forehead against a wall. Municipal chief physician Kristine Brix Longfellow in Høyanger municipality in Western Norway is upset. She has worked as a doctor for almost 17 years. Longfellow is a specialist in general medicine and community medicine. – Not getting the help you are entitled to is harmful. In the worst case, it ends in suicide. Longfellow has long tried to get a patient with, among other things, complex PTSD to Modum Bad. The treatment site is considered a leader in the country in trauma treatment. The patient has been to Modum once before. Now the rejections are piling up. Complaint about complaint All the health trusts in Norway believe that the trauma treatments they offer their patients are good enough. There are professionals news has spoken to disagree with. Longfellow believes the local offer for trauma patients is deficient. According to the doctor, the patient with a long medical history does not receive the treatment he or she needs. – I have tried to refer to Modum Bad several times. I have sent complaints of rejection to Modum. I have sent complaints to the State Administrator and received a rejection, Now I have complained to the Consumer Ombudsman. Everyone refers to the “provide-for-principle”. The clinic is part of the scheme with free choice of treatment. However, not all patients are offered treatment at Modum Bad. Believes the offer is good enough Over 70 percent of those who apply to Modum Bad have trauma. news has previously reported that capacity problems are the reason why the 100 patient places at the clinic are almost exclusively reserved for patients living in the south and east. In 2011, Modum Bad entered into an operating agreement with the health trust Helse Sør-Øst, with renewal of the agreement in 2015. After that, the eye of the needle to get to trauma treatment has become narrower. At the same time, all health trusts say that the trauma services in their regions are good enough and justifiable. This is “provide-for-responsibility”: As a general rule, health trusts may not reject referrals from other regions, unless the health trust risks not being able to fulfill its provide-for-responsibility to the population in its own region, cf. the Specialist Health Services Act § 2-1 a In order to be able to use this exception, the health trust must prove that it is in danger of not being able to fulfill its obligation to assess the referral / provide health care within the deadline to patients from its own region, if it accepts the patient in question. When the treatment center rejects a referral, the referral must be returned to the referring body immediately. “Provide responsibility” According to communications director Gunn Kristin Sande in Health South-East, Modum has informed the health trust that the waiting lists for treatment of serious trauma disorders are long. The law on free choice of treatment gives patients the right to choose a place of treatment. But Helse Sør-Øst believes that the Specialist Health Services Act gives the health trust the right to prioritize its own population. If the health trust risks not being able to provide for people in its own region, the so-called “provide-for-responsibility” takes effect. The health trusts answer: Helse Vest: In Helse Vest there are four health trusts (Helse Fonna, Helse Bergen, Helse Førde and Helse Stavanger) which all work with and have expertise in trauma treatment, the health trust writes. Examples of treatments are EMDR and trauma-focused cognitive therapy. The professional managers do not point to the need to buy treatment capacity outside the health region. Director of Health West says trauma patients in the region receive a sound offer under the auspices of the health trusts. Under the auspices of RVTS / NKVTS, managers and therapists have also been through a comprehensive competence program for treatment with evidence-based therapies for PTSD. Helse Midt: In local health trusts and through the Regional Unit for Trauma Treatment (REFT), patients in Central Norway have a high-quality treatment offer. Offers are offered both outpatient and as inpatient treatment. For patients at Helse Midt, trauma treatment is offered at REFT at Nidaros DPS, St. Olavs. Helse Nord: Helse Nord RHF has trauma services in our four hospital companies and through an agreement with Viken center in Bardu. The offer at Viken center has a lot in common with the offer at Modum Bad. The agreement we have with Modum bad applies to another patient group – eating disorders for children and young people. Helse Vest writes in an e-mail to news that their four health trusts work with and have expertise in trauma treatment. Examples of treatments are EMDR and trauma-focused cognitive therapy. The director of Helse Vest says that trauma patients in the region receive a sound offer under the auspices of the health trusts. Trauma patients from northern Norway are offered at ordinary psychiatric outpatient clinics at the hospitals, specialized 24-hour units, and the health trust has a separate agreement with Viken center in Bardu in Troms. – It’s a joke The doctors news talks to are provoked. They believe that people with very bad experiences do not receive good enough treatment. Psychologist specialist Arne Blindheim at the Clinic for Crisis Psychology in Bergen, largely agrees with his colleague in Høyanger. DISCLAIMER: Arne Blindheim has 25 years of experience with trauma patients. Photo: Center for Crisis Psychology He thinks that the Health Regions have sound offers within their own area is completely wrong. – I have 25 years of experience with people who have grown up with violence, abuse and neglect. In general, I can say that they get too little help. They need help for many years. The offer is far too small and far too poor. Blindheim points to low competence, poor time and bursting capacity. – If you have a cancer diagnosis, there will be a star team ready for you. The same does not apply to trauma patients. That’s a joke. These are people who suffer around the clock. – Sorry Kai Brynjar Hagen has many years of clinical medical experience. He is now a prison doctor and consulting chief physician at NAV. – We have always considered Modum to be the very center of science and practical treatment. But for us in northern Norway, it has long been inappropriate to refer there because the patients do not come in. It is very unfortunate that there are so many patients who do not get the treatment they need. According to Helse Nord, the offer for trauma patients in the region is good enough. The garden’s experience is that this is not true. – I can find many concrete examples of people not receiving offers or that the offer has been too bad. Wants waiting list Municipal chief physician Kristine Brix Longfellow says the health trusts lack expertise in complex trauma. The doctor disagrees that the health trusts locally can offer trauma treatment that is comprehensive enough. For Longfellow’s patient, the first stay at Modum Bad was crucial. The patient felt that she was greeted by someone who understood her, was able to diagnose her and meet her in the right way. Longfellow has, after many refusals of treatment on behalf of his patient, asked to get the patient on the waiting list. Also that with subsequent rejection. – If my patient learns that she can come in on time, that will only help.
ttn-69
Doctors upset over Norwegian trauma services – news Nordland
