news has previously written about full emergency departments at several Norwegian hospitals. The hospitals have no good explanation for why the number of admissions has increased drastically. Elderly waves, patients ready for discharge and people from Ukraine are referred to as possible factors, but no clear answers are given. Both researcher Steinar Hunskår and general practitioners’ associations believe the reason is something completely different. – A big explanation is precisely the effect of the GP crisis. That’s what Christine Agdestein, board member of the General Practitioners’ Association and GP in Steinkjer, says. Less frequently admitted We lack GPs. A new report estimates that 175,000 Norwegians lack a GP. The workload on those who work in the profession is very high, and medical students will not choose the GP profession. In addition, many GPs have left. – This has led to broken patient relationships and more substitutes in the GP offices and in the emergency room, says Agdestein. Agdestein believes that there is a clear connection between the GP crisis and the increase in hospital admissions. Research shows that those with a stable relationship with their GP over time are less likely to be admitted. Christine Agdestein is a board member of the General Practitioners’ Association and a regular doctor in Steinkjer. She believes that the hospitals have overlooked an important explanation related to burst capacity, namely that the GP scheme is collapsing. Photo: Sigrun Hofstad / news Inexperienced people send more to hospital his doctor for a year. Steinar Hunskår is a professor of general medicine at the University of Bergen and is one of the researchers behind the study. He points to other studies to explain why the relationship with GPs is related to emergency admissions. – If you are someone’s doctor over time, you know your patient much better. This means that you have heard it before, seen it before, and can judge something based on how it went last time, says Hunskår. He adds that a young and inexperienced doctor will be more insecure and have an easier time sending the patient to hospital. – The GP crisis leads to temporary staff relays and young and inexperienced doctors who do not know the patients. Therefore, it generates more admissions, he says. Can mean an increase of several hundred thousand patients Small changes in the GP offices can create a crisis in the hospital, Hunskår believes. The researcher presents a calculation to support this. An experienced GP admits 1 percent of patients to hospital. An inexperienced GP adds 2 percent. This corresponds to a difference of several hundred thousand patients a year. – There is a tiny difference, but it doubles hospital admissions. What is barely noticeable at the doctor has a colossal effect on the hospital, says Hunskår. Hunskår believes that the hospitals have not understood the importance of stability among GPs to a sufficient degree. He also does not think the politicians have clearly seen the connection between the GP crisis and increased pressure on hospitals. – There has been a rather skewed prioritization of the sectors. The supplements the hospitals receive in one year could save the entire GP scheme, says Hunskår. Steinar Hunskår is a professor of general medicine at the University of Bergen and has researched the relationship between GP and patient. Photo: Ingrid Tangstad Hatlevoll / news – Will get worse and worse Christine Agdestein, board member of the General Practitioners’ Association, agrees with Hunskår that hospitals must also become more concerned with the GP scheme. She believes that the crisis solution the hospitals now have to resort to, by having more people at work, is not long-term. Stabilization of the GP scheme is the key to preventing the hospitals’ capacity from exploding and will also benefit the state budget, according to Agdestein. – It is much more expensive to treat people in hospitals than in the doctor’s office. The General Practitioners’ Association is disappointed that the allocations to the GP scheme were not increased in the revised national budget. – This is just a taste of how it will be. If the crisis is not resolved soon, this will only get worse and worse, says Agdestein. Opens inspection in four municipalities The state administrator in Trøndelag recently submitted a status report on his own initiative on the GP scheme in the county to the Ministry of Health and Care Services. The report states that they receive many messages that give cause for great concern for patient safety in the county. Large workloads, test results that remain and lack of health care for patients without a GP are among the reports. They have therefore started supervision of the GP scheme in four municipalities in Trøndelag, including Trondheim. The state administrator concludes the report by calling for national measures to stabilize and recruit for the GP scheme. These are some of the findings in the State Administrator’s report. 13,900 inhabitants in Trøndelag do not have a GP. Patients on doctor’s lists without a doctor become a toss-up between the GP’s office and the emergency room The municipalities are struggling to find medical assistants and GPs for available homes, despite extra basic allowances and welfare benefits. Verdal municipality has reported that they are unable to deliver the comprehensive health service in relation to GPs Steinkjer is unable to provide health station checks. Due to the lack of a health center doctor, AMK is burdened with capacity challenges in the emergency center and receives several non-acute inquiries that should have been taken care of by the emergency centers. St. Olav has had to increase its staff on evenings and weekends due to this. Has increased the allocations State Secretary Ole Henrik Bjørkholt (Labor Party) in the Ministry of Health and Care Services believes that the government has understood the connection between the GP crisis and blown up capacity in the hospitals. – It is obvious that it is putting more pressure on the hospitals and the specialist health service, says Bjørkholt. He adds that this is not the only explanation for the situation the hospitals are now in. The State Secretary says that it is the regional health authorities that are responsible for the hospitals. He adds that the government has increased the fixed allocations by just over 750 million, in addition to 1500 million in corona allocations in 2022. He thinks it would be wrong to set the allocation of the hospitals up against the GP scheme. Bjørkholt describes the GP scheme as the individual case with the highest priority with the government. He says the crisis is so long-lasting and profound that it is no longer enough to come up with small drops of increased funding. – Here you have to make some powerful moves, and also consider structural changes. We are in dialogue with KS and the medical association about this. Bjørkholt says there are two measures the government will consider; a new funding scheme for GPs, and facilitate more professions into the GP scheme. He does not want to elaborate on this further, but says the government will be able to share more details this autumn. State Secretary Ole Henrik Bjørkholt (Labor Party) in the Ministry of Health and Care Services says the government prioritises the GP scheme. Photo: Borgo’s photo Warns of strong measures in 2023 Bjørkholt refers to a number of measures the government has already introduced to improve the GP situation. The design of a scheme to get young doctors in specialization, a subsidy scheme for outpatient care in districts and increased basic funding of 200 million from the GP scheme are among the measures he points to. – If we assume that improving the GP scheme could also save the hospitals, why does the government not allocate more to stabilizing the GP scheme? – We have not been able to present our first state budget yet, so it is limited how much can be done in nine months on the previous government’s budget, says Bjørkholt, and points out that there will be powerful measures and investments in the 2023 budget. – How seriously does the government view the situation that the hospitals are now in? – There is no danger to life and health. We are fully aware that the financial situation in some of the health trusts is very demanding. We know that intensive work is being done to gain control of this, says the State Secretary.
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The GP scheme is to blame for bursting emergency departments at hospitals, according to the General Practitioners’ Association – news Trøndelag
