– We see in the Municipal Index for 2022 no connection between costs and quality of municipal services. It is almost rather the opposite. That’s what advisor Rune Holbæk says. He deals with municipal finances and service development in the consultancy firm Agenda Kaupang. For a number of years, he has worked with the organization of health and care services in the municipalities. Councilor Rune Holbæk believes the debate should be about management and competence is just as important as money in elderly care. Photo: Karina Ronning / Karina Ronning – Many poor municipalities are becoming more innovative and achieving better quality. You get far with good management and hard work, says Holbæk. Kristelig Folkeparti’s leader Olaug Bollestad is the last of the politicians who are now demanding large extra funding for care for the elderly. – Norway has the money. They must be introduced to prevent violations of the law and ensure the rights and dignity of the elderly, she said at the party’s national board meeting on Saturday. In recent weeks, news Brennpunkt has revealed serious failures in the care of the elderly, both in municipal home services and in nursing homes. Rune Holbæk in Agenda Kaupang fears that the debate about what should be done with care for the elderly will become too one-sided. – It is really unfortunate if the important debate on care for the elderly is only about more nursing home places and more money. Goes a long way with good management In recent years, the consultancy firm Agenda Kaupang has named Norway’s best managed municipality. It is based on a number of indicators for what gives the best results for the citizens. The report looks at 15 different sectors in the municipalities, and shows, among other things, that there is little or no connection between the municipalities that spend the most money and the quality of the municipal services. This also seems to be true if you look exclusively at the health and care sector, which is the largest expenditure item for the municipalities, claims Holbæk. Agenda Kaupang is used by public ministries and institutions to investigate care for the elderly around the municipalities. The consulting company also evaluated the Frp’s prestigious project with state funding of care for the elderly. Holbæk is a trained nurse herself, and recognizes that it is controversial to insist that competence, culture and management are just as important as more money. – It is clear that some of the unfortunate cases are due to the fact that they have too few people, who have not received the correct training. But good management and the right expertise can be just as important as providing more places and more staffing, he claims. Nursing home places not the solution Municipalities with good care for the elderly have clear targets which they manage to follow up, according to the consultant. For example, about how many helpers the elderly will have to visit each week. The best municipalities are often far ahead in the use of technology, and ensure that the managers are not responsible for more employees than they are able to follow up. – But can there be better care without more nursing home places? – A place in a nursing home costs over one million kroner a year. Sometimes up to 1.4 million. Nursing homes will need more qualified professionals in the coming years, but they will increasingly be for the very sickest, who will be given a place to end their lives. For everyone else, it is important that the municipalities can offer proper services in their own homes. – We have great faith in small housing communities with round-the-clock staffing, believes Rune Holbæk in Agenda Kaupang. Melhus municipality is well underway. Photo: Jørgen Pettersen / news Gets support from KS Area director Helge Eide in the municipalities’ organisation, KS, thinks Holbæk and Agenda Kaupang are going too far in reducing the importance of more money for elderly care. – You will not find any Norwegian municipalities that will say that the costs have no importance, says Eide to news. At the same time, he agrees that organization and management are important for the elderly to receive the care they are entitled to. He wholeheartedly agrees that the political debate has been far too much about nursing home places. – If the main answer to care for the elderly were nursing home places, the whole offer would collapse. Both for financial reasons and because we will lack personnel, says the KS director. – But have you been too concerned that everyone should live at home, at the same time as professionals warn that loneliness and isolation are directly harmful, for example, to Alzheimer’s patients? – No, I don’t think so. Alzheimer’s patients will at some point need nursing home places. But this disease also has different phases, and we must be able to adapt the care according to the need. Believes shared housing is the solution Holbæk believes there are still a number of elderly people who are too healthy to live in a nursing home. In order for the nursing homes to have space for those who need it most, he believes that the municipalities should rather focus on housing communities close to the city centre. Bofellesskap is a group of apartments with staff available around the clock, partly because they use digital supervision. The elderly will have more supervision than in, for example, care homes, but not necessarily by qualified health personnel. Municipal manager Albert Verhagen in Melhus is asking the elderly to rethink what constitutes a good home. Photo: Jørgen Pettersen / news The focus on shared housing is one of the reasons why Melhus municipality in Trøndelag received an award last year for the work they have done in elderly care. The municipality has started work early on to make arrangements for the elderly to live in their own home for as long as possible, said the jury’s justification for awarding Melhus the “Live a lifetime award”. The municipality’s vision is “100 years in your own home”. – But that does not mean that you should always live at home on your farm or in the detached house out in the country, said municipal manager Albert Verhagen, when he was interviewed in Dagens in NRKP1 on Friday. Instead, the municipality has gathered elderly people who need help and follow-up from the Home Service in smaller housing communities, near the municipal centre. In the coming years, all municipalities will be forced to spend more money on health and care. – But you must be sure that you are doing well before you spend more money, is the advice from Rune Holbæk in Agenda Kaupang. – There is a lot of exciting stuff happening, for example in Melhus, in Oslo and in a few more municipalities in Akershus and Rogaland. But it is too tame, and too small.
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Rich municipalities do not provide better care for the elderly – news Norway – Overview of news from different parts of the country
