If the government gets their way, the scheme will be discontinued as early as 1 January 2023. – We believe this is a bad scheme and that is the reason why we are discontinuing it, says Ingvild Kjerkol, Minister of Health and Care (Ap). Several people disagree with that. – It’s the stupidest thing I’ve ever heard. It is a big mistake by the government, says Krister (45). He has been addicted to drugs for 30 years and has received public drug treatment for almost as long. It was only when he ended up at the private addiction and psychiatric institution Allosstiftelsen that Krister felt he got the help he needed. – It’s a complete no-brainer to shut down the small players, who for my part have been the savior to get me out of the rush hour, he says. news has chosen to omit Krister’s surname. Krister is very critical of the government’s bill to abolish Free Treatment Choice. Photo: Marthe Svendsen / news Public help has not worked Krister started with drugs as a 15-year-old. The road was short from hashish to heroin. Eventually he got a partner, children, a permanent job and his life in order. But when he lost his job after a round of dismissals at the workplace, everything unravelled, he says. The entire profit from the sale of townhouses was used up on drugs, and the use escalated quickly. As an adult, he was diagnosed with ADHD and bipolar disorder. Krister has made use of the public provision for drug addiction, in addition to mental health care. He believes that you can get good help from the public if you have a drug problem or a mental illness. If you have both, you end up between two seats, according to Krister. – I have tried a lot, but the public sector has not worked for me at all, he says. Free treatment choice The free treatment choice scheme was established in November 2015. It means that patients can choose where they want to receive treatment. Patients can choose between public treatment facilities, private treatment facilities that have an agreement with the public sector, and private treatment facilities that have been approved by Helfo, a public agency that works under the Directorate of Health. The financing is done by the treatment centers sending their claims to Helfo, which pays out the money. Helfo then invoices the regional healthcare institutions, which ultimately pay. The vast majority of treatments are linked to drug treatment and psychiatry, but also treatment and rehabilitation of diseases such as rheumatism, Parkinson’s, multiple sclerosis (MS) and complex epilepsy are now included in the scheme. Critical of the proposal At the start of the year, Krister reached a new low point. Thanks to his sister, he ended up at the Allosstiftelsen in Trøndelag. There he gets help for both drug addiction and mental disorders. He receives follow-up from psychologists, psychiatrists, doctors and specialist nurses. Krister has access to help around the clock, he says. He also mentions trips with a fishing boat, bowling, go-karting and shooting training as part of the offer. – I have been drug-free for three months now. I have never been able to do that before with help from the public sector, he says. Krister says the help from the institution has been life-critical for several patients. He is therefore very critical of the fact that the government wants to wind up the scheme that has led him to the Allosstiftelsen. – Free choice of treatment is for many people the key to getting out of their drug and psychiatric problems, he says. Krister is very satisfied with the treatment at the private drug and psychiatric institution. Photo: Marthe Svendsen / news Kjerkol: – For a liberal arrangement The Government believes that the Free Treatment Choice arrangement has not achieved its purpose. It has not led to shorter waiting lists or more efficient hospitals, shows a report from 2021. It is the scheme that gives private actors free establishment rights which they now want to abolish. – It is a too liberal establishment scheme, which also undermines the finances of our hospitals, says Ingvild Kjerkol, Minister of Health and Care (Ap). The minister points out that patients should still be able to choose where they want to be treated, and that they will be able to choose between public hospitals and private operators who have an agreement with the health regions. The private offers will be procured through tenders and separate agreements. – We achieve stronger control by the fact that this happens with agreements where the health regions get better at intervening with the institutions, can assess the quality of the treatment provided and can also provide greater predictability, she says. The bill will be considered in the Storting before Christmas. The government’s proposal applies from 1 January 2023, with a transitional arrangement of 12 months. The institution must close The Allosstiftelsen was established in 2022 and offers holistic drug and psychiatric treatment. The institution receives all its patients through Free Treatment Choice. – We are very affected by the liquidation, then the entire income base disappears, says Christer Brenne, who is one of the two founders. Brenne thinks that the main treatment should lie with the public healthcare system. At the same time, he says that many of the patients they treat feel that the offer they have received in the public sector has not worked. – The fact that we treat the whole package, with both drugs and psychiatry, is important to them, he says. Christer Brenne is one of two founders of the Allosstiftelsen. His institution will have to close its doors if the government gets their way. Photo: Marthe Svendsen / news The founder says the institution has long waiting lists. He agrees with the government that the regulations around private institutions should be tightened. Nevertheless, he believes it would be wrong to discontinue the Free Treatment Choice scheme before a good alternative has been secured. – After all, the government wants to strengthen the public offer and remove unscrupulous actors. Won’t this lead to a better offer for patients, then? – I am in favor of stricter rules, stricter follow-up and I am also not against public tenders from regional health undertakings. I’m just very concerned that there must be a plan with all the 24-hour places that are going to disappear, he says. A new man At the Allosstiftelsen, Krister and one of the other patients have started a round of ping pong. The plastic ball moves quickly over the net and the laughter is loose. Several of the employees note that Krister looks like a completely different man than when he arrived three months ago. Then he was tired, drawn in the face, restrained. Krister is highly motivated to stay drug-free and says he is looking forward to the future. The aim is to work with lectures or in drug treatment. – Do you have something you would like to say to those who will decide on the bill? – If I had applied after this change in the law is possibly changed from 1 January, I don’t dare think about what would have happened to me. I could be dead. Krister is looking forward to the future and hopes his hard-earned experience can be of use to others struggling with addiction. Photo: Marthe Svendsen / news
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Krister is critical of the government’s proposal to abolish free choice of treatment – news Trøndelag
