There is a hospital crisis in Northern Norway. Thundering financial deficit, extreme shortage of employees, missed deadlines and long waiting lists. That is the situation in the country’s northernmost health region. Today, approximately 1,200 employees are missing in Helse Nord. But that has not stopped Helse Nord from spending billions on new hospitals. In the last ten years, close to 8 billion have been spent on brand new buildings in the region. Since 2015, it has been built both in Stokmarknes, Narvik, Kirkenes and Hammerfest. In addition, it is also planned to spend roughly 3 billion on a new hospital structure in Helgeland. And at UNN in Tromsø, plans have been adopted to build new premises for mental health and substance abuse treatment. The current price tag is NOK 2.7 billion. Must save over 1 billion The financial situation in Helse Nord is very demanding. The main problem is a lack of enough people. This in turn means that the hospitals have large costs through the hiring of personnel from staffing agencies. Last autumn, Helse Nord received marching orders from Minister of Health Ingvil Kjerkol (Ap) to get the finances in order. Facts about the hospitals in Northern Norway 8 of the 13 smallest emergency hospitals are in Helse Nord About 46 per cent of emergency admissions in Helse Nord take place at Nordlandssykehuset in Bodø or at UNN in Tromsø. 8 percent of admissions at the other acute hospitals are transferred to Bodø or Tromsø. Seven hospitals in the region have, on average, fewer than two surgical and fewer than two orthopedic emergency admissions per day. 12 of the 14 maternity units in the region had an average of fewer than one birth per day in 2022. The two smallest had far less than one birth a week. 11 of the 20 smallest district medical centers (DMS) are located in Helse Nord. Source: Helse Nord In January, new 2.5 billion came to the hospitals from the government. 309 million goes to Helse Nord. But it is far from enough to balance the budget. For Helse Nord, it is estimated that they must save NOK 1.1 billion. This corresponds to approximately 5.1 percent of the entire turnover. The management, on the other hand, believes that it is not realistic to save the entire billion during 2023. Large distances are the main reason why Northern Norway has so many hospitals. But soon the current structure may become the subject of debate when Helse Nord has to save over NOK 1 billion. Putting new projects on hold – There is a reason why we have the hospital structure we have today, says Renate Larsen. She has been chairman of Helse Nord since 2018, and has been involved in adopting several of the development projects in northern Norway in recent years. Larsen says Helse Nord has taken into account an extended geography and demographics when the hospitals in northern Norway have been located. Renate Larsen is chairman of Helse Nord and will lead the task of getting the company’s finances into balance. Photo: Jørn Inge Johansen / news – Are there too many hospitals in Helse Nord given how many employees are available? – Now we are in a process that will look at the distribution of functions and tasks between the hospitals that exist today, so it will be difficult to draw conclusions now. But the chairman is clear that there will be no new construction projects in Helse Nord until the finances have been put in order. – Yes, we have been very clear about that. Loan applications for larger projects will not be approved until you have got your finances under control. This involves, among other things, New Helgeland Hospital and Åsgård at UNN – i.e. construction projects worth around NOK 6 billion. Høyre: The right way to build the hospitals After eight years in government, Høyre was behind a number of the investments in the region. Erlend Svardal Bøe (H) in the health committee at the Storting believes that all the investments have been correct. – The Conservative Party has invested a lot in hospitals in northern Norway and we think that was right. Erlend Svardal Bøe is a member of the health committee at the Storting for the Right. He believes it was right to build all the hospitals in northern Norway. Photo: Tora Kyllingstad – Given the staffing challenges in Northern Norway, have too many hospitals been built in northern Norway? – This is one of the things that Helse Nord will look at in its work to reorganize the company. The Conservative Party supports the hospital structure which is now fixed. Svardal Bøe says the economy in Helse Nord is demanding, but does not think postponing construction projects will solve the problems – quite the opposite. – We believe the government must investigate what the consequences of deferred construction projects may be. Ap: Action should have been taken earlier – I believe that from a political point of view action should have been taken earlier. This has been a foretold crisis. This is according to the spokesperson for health policy in the Labor Party, Cecilie Myrseth. – Have too many hospitals been built in Helse Nord? – No, I will not be in favor of closing down any hospitals – if that is the question. What I believe is correct is the assignment the Minister of Health has given to Health Nord, where tasks and distribution of functions in the health region must be looked at. Cecilie Myrseth is health policy spokesperson for the Labor Party and first deputy chair of the health and care committee at the Storting. Photo: Marius Fiskum – How to solve the problems with staffing in Helse Nord? – Staffing is the biggest challenge that the board has tackled. Now it is important to give them the peace of mind needed to find good proposals for solutions. – Has a good enough job been done when you have ended up in this situation? – It is easy to have hindsight, but it will again raise questions about what should have been done differently. My focus now is to look ahead and resolve the situation. SP: Wants to scrap the enterprise model While both the Labor Party and the Conservative Party will wait for Helse Nord’s work on restructuring, health policy spokesperson in the Center Party, Hans Inge Myrvold, wants to distinguish between operation and investment. In that case, it will mean scrapping the current enterprise model, which was introduced in 2002. Then the state took over the ownership of the hospitals from the county councils, and they were organized into enterprises. – The hospital sector needs more predictable frameworks for important investment projects and new hospital buildings. We want to distinguish between investments and operations, precisely because the necessary investments will go beyond patient services, he says to news. Hans Inge Myrvold is health policy spokesperson for the Center Party in the Storting. He particularly highlights the New Helgeland Hospital, which is an important project for Helse Nord to complete. Photo: Tale Hauso / news He believes the problem is not new hospital buildings that have been erected in recent years. – The health institutions are organized in the wrong way. New funding system, fewer levels of management and more government management are steps we believe are right to take. And precisely the enterprise model will be the topic when the government-appointed hospital committee must deliver its report by the end of March. Among other things, the committee will come up with a recommendation on how the hospital of the future should be organized and run. Editor: I think some hospitals will be closed down – The most special thing is that there is quite a lot of money to be saved. And then you struggle to agree on how to attack the problem. So says the editor of Dagens Perspektiv, Magne Lerø. He believes that some of today’s hospitals will have to give way if Helse Nord is to achieve its goals of saving in excess of a billion. – Yes I believe. But that does not necessarily mean that the hospitals will be left empty. Magne Lerø is an editor at Dagens Perspektiv, and has followed the health sector closely over time. Photo: Caroline Tolfsen / news Instead, he envisages that the emergency services, with 24-hour standby staff, could fail in some places. – You can get such models. But these are also controversial, because you cannot visit your local hospital. But the biggest challenge, Lerø believes, is to agree. – Will the boards have the power to make decisions that are accepted? There are big and dramatic decisions for several local communities, he says and adds: – Sometimes it is so demanding that it is almost only a decision in the Storting that is respected and has legitimacy.
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Have spent almost 8 billion on new hospitals in the north – 1,200 employees are missing – news Nordland
