New Helgelandssykehuset, Helse Nord RHF | We are indirectly accused of wanting to tamper with the hospitals’ functioning

Reader’s letter This is a debate entry, written by an external contributor. The post expresses the writer’s views.

We must have solutions that all municipalities can live with

The municipal directors in Rana, Bodø, Harstad, Tromsø, Alta and Narvik sent out a chronicle before the weekend which deals with the interaction between Helse Nord and the northern Norwegian municipalities.

This has caused reactions. Here are some clarifications.

The chronicle is an input to parts of the challenges Helse Nord itself describes in its consultation draft “Measures to ensure sustainability in Helse Nord”.

“Helse Nord is asking for help from the municipalities in its consultation draft. It is a fact that a well-functioning, sustainable specialist health service depends on a correspondingly well-functioning and sustainable municipal health service. We want to be part of the solution. The cities are the engine, which must lift the region into the future,” we write, among other things, in our chronicle.

In the chronicle, we further outline some possible ways of approaching this, and we point out that we are the largest municipalities that have opportunities to take action.

“The six largest municipalities in the region represent 46 per cent of the population in the north. These six city municipalities have the necessary capacity, professional strength, experience and endurance to lead the way and be a good partner for Helse Nord and the Ministry of Health and Care in the development of a better and more sustainable collaboration model.”, we write and propose that it be established a working group in which the largest municipalities are represented.

All the mayors in Lofoten and Vesterålen, mayors and leaders of Intermunicipal political councils in Lofoten and Vesterålen strongly agreed with the chronicle in a debate post on Monday. In the debate post, we are indirectly accused of wanting to tamper with the hospitals’ distribution of functions and tasks.

It is not true. What we have done is to propose an experimental municipal scheme where the aim is to find new solutions to the challenges in our joint health service. The initiative, which is taken with the best intentions, is unfortunately interpreted as if the six largest municipalities want to take the power of definition at the expense of the smaller municipalities.

This is not our intention. We want a strong municipal presence and participation in all processes that we see must come, if we are to be able to solve our statutory tasks.

We are concerned that the challenges that lie at the intersection between primary and specialist healthcare, such as the problems with patients ready for discharge, where we in our six municipalities are responsible for a large part of the challenges, and must find a solution within a framework that the municipalities can live with . This applies both financially and in terms of staffing.

We currently face major challenges that have the potential to strangle the economy in all northern Norwegian municipalities, large and small. These are linked to:

To recruit and retain healthcare personnel To reduce hiring from temp agencies To reduce the queue of patients ready for discharge

This does not resolve itself. We must actively do something to take control.

It is regrettable if our initiative is read as a contribution to a centre-periphery discussion. We need good, forward-looking solutions that embrace the entire region. We have signaled our willingness and capacity to take on a role. But it should not happen at the expense of others.

The criticism directed at us unfortunately misses the most important point when our chronicle is assigned to touch on the distribution of functions and tasks between Helse Nord’s hospitals; i.e. which hospitals in the region should contain what.

We mean nothing about this. The chronicle does not mention this problem at all.

Our chronicle is only an input on how we can establish the best possible cooperation between Helse Nord and the municipalities.

As we write: “…we experience every single day how demanding it is to maintain the quality and breadth of health care for our residents. The number of patients ready for discharge in hospitals, where a municipal service is expected, is increasing. We are struggling to recruit enough and the right skills, the budgets are red and it is very demanding to adjust the services quickly enough to meet the changed needs. (…) The municipalities are responsible for 90% of the health services that citizens receive, from cradle to grave. The task is formidable.”

This is not at all about the location of hospitals, somatics or psychiatry – but about how the interaction between Helse Nord and the municipalities can be the best possible, completely independent of where the hospitals in the region are located or what the individual hospitals are to contain.

This is a matter that is far too important for us to disagree among ourselves. And then we are happy to admit that we could have been clearer in clarifying the premise for what we have written in the chronicle.