– I sat with negative thoughts and it hurt to exist. At the same time, I received a claim for a “no-show”. That it did everything but help me, there is no doubt, says Ole Johan Rosenstrøm. A few years ago he was in a life crisis. He became depressed and did not function in his daily life. This also meant that he had poor finances. The depression often meant that he was unable to attend doctor’s appointments. – It would be a burden for me to go there, but then you will be punished for it, punished for being sick. Rosenstrøm is not alone. Fees for not attending a doctor’s appointment can actually make the chronically ill even sicker. This is what the State’s Commission of Inquiry for the Health and Care Service (Ukom) writes in a new report. They believe such fees are unfair and threaten patient safety. – To a large extent, it affects chroniclers who may not have the ability or function to attend classes as planned. It also affects those who do not have the ability to manage their personal finances, and thus incur large expenses related to health care, says Ukom director Pål Iden. – Personal finances are important for people’s health. Those with the worst advice are also those with the worst health, says Ukom director Pål Iden. Photo: Arild Eskeland / news Fees make it worse If you don’t show up to the hospital within an hour, you can be charged a fee of NOK 1,125. If the appointment was outpatient in psychiatry or substance abuse treatment, the maximum amount is NOK 375. If you are unable to pay, the fee can go to debt collection and increase even more. And none of this is covered by the free card scheme, which will ensure that healthcare in Norway does not become too expensive for people. – Then it might become so expensive that people don’t show up for planned treatment, and that’s worrying, says Iden. Ukom believes that bills and claims can pile up and create even more problems for someone who is already ill. – There is a fairly large group of patients who are unable to manage their personal finances. This is perhaps also the group that has the greatest need for health care, and who tend to fall outside the system, says the director. In the worst case, life goes on The background for the report to Ukom was a message of concern sent by a mother. Her son had killed himself a few years earlier. In the suicide note, the son wrote that he wanted to live, but couldn’t take it anymore. That he had problems paying bills was known to several therapists, and they knew that it contributed to his feeling of shame and lack of zest for life. After the son died, the mother discovered large amounts of unpaid bills, reminders and debt collection notices from the health service where he had been treated for, among other things, depression. In the victory, the report was found to be extremely useful, where demands from the health service contributed to a person taking their own life. – But I think it is very recognizable for a fairly large group of patients who struggle with psychological problems and chronic illness. Paying both to come to hospital and when you don’t show up is an additional burden that actually leads to you withdrawing from essential health care, he says. Uncertain effect Ukom therefore believes that the fee system threatens patient safety and that it should be evaluated. Also because you don’t know if the fees have any effect. – We actually don’t know if this will get more people to show up for class, says Iden. Janne Helen Tengesdal Øiumshaugen is health secretary at the fetal medicine outpatient clinic at Stavanger University Hospital (SUS). She believes there is little the patients need to do to avoid being charged a fee. – You have Helsenorge where you can send a message, and you can call, she says. Photo: Arild Eskeland / news 2019 is the last year we have figures from. Then nearly 375,000 hours were registered as “not met”. Between 20 and 50 per cent of patients are repeat customers and are charged several times. Iden believes that healthcare providers should take the fact that a patient does not show up for an appointment as a signal that they need extra measures and follow-up, not just send a fee. The government will look at the scheme State Secretary Karl Kristian Bekeng (Ap) in the Ministry of Health and Care says that they will now go through the scheme. – UKOM’s report shines a spotlight on an important matter. I will ensure that the arrangement with fees for patients who do not attend at the agreed time is reviewed. Any changes to the scheme must be assessed afterwards, says the state secretary, who at the same time points out that patients who do not show up at the agreed time make the waiting time longer for others.
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Payment difficulties and “no-show” fees from hospitals are a danger for patients, Ukom believes – news Rogaland – Local news, TV and radio
