The Clinic for Mental Health and Addiction at Oslo University Hospital (OUS) is to save over NOK 200 million in 2023. This is revealed in one of the proposals for cuts in the budget that are now being considered by the management at OUS. Now the shop stewards for five trade unions at the clinic are sounding the alarm. The four shop stewards that news has spoken to believe that such savings are unrealistic. – It’s completely absurd, says trustee for the Joint Organization (FO), Anna Margrethe Nygård Øslebø. The cut comes after several years of downsizing in psychiatry, at the same time as the clinic notices a large influx of patients. The government, for its part, has said that it will strengthen its efforts in mental health care, but several hospitals are still forced to tighten up. Both the special polyclinic for eating disorders and the personality polyclinic are in danger of being distributed to different DPS and other units. That way, they can reduce the number of positions by 12, says a document news has been sent. Here is the savings proposal for adult psychiatry: Close a 24-hour unit out of a total of six at Nydalen DPS and Søndre Oslo DPS. The economic effect is calculated at NOK 20 million. 10 of these million will be used to establish 24-hour places for compulsory mental health care (TPH) at one of the remaining units. Thus, they will save 10 million on this. Discontinued area function at Early Psychosis Treatment (TPB) at Gaustad Hospital and transferred 50 per cent of the business to Lovisenberg Diakonale Hospital (LD). At TPB, they have patients between the ages of 17 and 30 who are going through their first psychosis. The rest will be transferred to Nydalen DPS and Søndre Oslo DPS, or to one of them. The measure will cut 15 day beds at TPB, where five of them will be transferred to LD or Diakonhjemmet, and five day beds will be moved to Nydalen DPS or Søndre Oslo DPS. They reckon this will save NOK 26 million. Reorganization of the group units at DPS, the personality disorder outpatient clinic and the outpatient clinic for eating disorders. The specialized polyclinics located in Gaustad will be added to Nydalen DPS and Søndre Oslo DPS, possibly one of them. Can save 6 million. The total effect is calculated at NOK 42 million, where 15 overnight beds will be provided. Department for drug and addiction treatment (ARA): Reduce the 24-hour capacity in Interdisciplinary specialized treatment (TSB), which will reduce the offer to patients and may lead to them admitting sicker patients in need of highly specialized services. Can save NOK 20 million. Move the outpatient clinics that offer drug-assisted rush rehabilitation (LAR) to Lovisenberg diakonale hospital and Diakonhjemmet hospital. They expect to save NOK 1.5 million on that. Streamlining measures for drug withdrawal and detoxification (RUA), which they estimate will save NOK 5 million. In addition, there will be savings measures for the Department of Child and Adolescent Psychiatry, the Research and Innovation Department and National and Regional Functions (NOR). Losing competence In addition, early psychosis treatment at Gaustad hospital is in danger of being split up and distributed to different units. All these proposals will go beyond the professional environment that the clinic has built up with its specialized services, believes trustee for the Association of General Practitioners, Ian Thomas Small. He fears that such a split will make it difficult to get the professional community back again. – It takes a long time to build up a good competence environment. Trustee in the Association of General Practitioners, Ian Thomas Small, fears that the specialized professional environment at the clinic will be destroyed if all the savings proposals go through. Photo: André Børke / André Børke Small believes that a cut in 24-hour places will save more money, because it requires people to work around the clock. But the Storting has decided not to cut 24-hour places. – Since it is so controversial, I see that they start taking a couple of psychologists here and there who are much more destructive when it comes to destroying the professional environment. Longer waiting times With the cut, trustee for the Norwegian Nursing Association, Berit Averstad, fears that the clinic can only prioritize the sickest. – The waiting time will probably be longer for each patient, believes Averstad. Both at the children’s and youth department BUPA, the specialized substance abuse department (TSB) and in adult psychiatry, they notice a big increase, says Averstad. – Several of the departments at the clinic have more patients than they have places for. In addition, they have noticed an increase in the number of children with eating disorders and people who are admitted to compulsory mental health care (TPH), she says. Trustee Anna Margrethe Nygård Øslebø in FO (left) and trustee in NSF Berit Averstad say that the cut in next year’s budget will affect patients and their relatives. Photo: André Børke / André Børke OUS: Demanding process Clinic manager Petter Andreas Ringen at the Clinic for Mental Health and Addiction says that the clinic must provide good health services for their patient groups. – The budget work for 2023 will be challenging. – In total, we use more resources than we have in the budget. The reason for this is compounded. There is a large influx of patients with serious mental illness, and at the same time we must make operations more efficient and create space for new buildings. The clinic is asked to ensure that they have an operation where they do not use more than what they are allocated in the budget, says Ringen. – I understand that employees are worried, he says. – At the same time, this is an opportunity to organize ourselves better so that we can continue to deliver better patient services. We must take care of both employees and patients in this work. He says that the clinic has strengthened the offer within the DPS and created several offers such as a day unit for children and young people with eating disorders, outpatient follow-up of the mentally ill in prison, a mental health offer for people with sensory loss and heroin-assisted treatment for people with drug addiction. – Right now we are in the middle of a process, and which measures will be implemented have not yet been decided, says Ringen. Apart from this, the management at OUS has not been available for comment. Clinic for mental health and addiction The clinic for mental health and addiction at Oslo University Hospital is responsible for treatment, research and teaching in mental health and drug and addiction. They have several underlying units: Acute psychiatry department Drug and addiction treatment department (ARA) Child and youth psychiatry department (BUPA) Research and innovation department in PHA Nydalen DPS Mental health – national and regional functions (NOR) Mental health care – inpatient treatment Søndre Oslo DPS Kjelde : Oslo University Hospital Several years of downsizing Every year hospitals in Norway are tasked with making their operations more efficient. – If you add up these percentages and go back 20 to 30 years, you can imagine how miserable, hopeless you worked back then, says Small. But efficiency in the health sector means in practice a cut in the supply. Over the years, the clinic has cut several services, such as the family and network unit and a separate psychosis unit for young people, says business trustee for Psykologforeininga Birgit Aanderaa – What is efficiency with us is that you close down services, says Aanderaa. She believes that the cut is not possible to implement if the clinic is to be able to deliver the offer they need. – I think that this is not real. Patients in mental healthcare for children and young people, drug and addiction treatment, eating disorders and seriously ill adults will receive a much worse offer. – A declaration of bankruptcy Øslebø believes these are important priorities now, but that the cuts at the clinic do not reflect such priorities. She believes that such a cut will affect the patients and their relatives, because it will be more difficult to get competent health care. – It’s actually a declaration of bankruptcy, I think. The clinic spends most of its money on salaries for employees, and a saving will therefore mean fewer employees, the union representatives say. Trustee for FO, Anne Margrethe Nygård Øslebø, believes the cut is a declaration of bankruptcy for the help patients will receive. Here she stands in front of the building where the lease is held. Photo: André Børke / André Børke This means that those who remain will have even more work tasks, and will have to work faster than before, says Averstad. – The workload is already high. I think that some may quit and find work elsewhere, because the workload will be very large, she says. Want a more thorough assessment The money the clinic has to save is a result of money they have not been able to save during the pandemic, money for new hospital buildings and extra costs as a result of high electricity prices and recruitment problems. The trustees believe that the various departments have had too little time to find good savings solutions. Therefore, they want the management to set aside more time to assess the cost-saving measures.
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Warns of severe cuts in psychiatry in Oslo – news Norway – Overview of news from various parts of the country
