Debate, Health services | A hidden government cut in healthcare

I am worried about the cuts that are happening in the health and welfare sector in Fredrikstad municipality. This has previously been thoroughly discussed in Fredriksstad Blad.

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There are several cuts that will affect our patients, but I find the cuts in Fredrikstadhjelpa/children, youth and family help and Rapid mental health care particularly problematic.

Experience that the services work well

These services were created quite a few years ago, and were part of the transfer of health services from the health company to the municipalities. The idea appeared to be that more patients should receive quick and correct help at municipal level, with simple and effective accessibility and treatment for patients. You can contact the services directly, without a referral from a GP.

I also find that the patients are largely satisfied with the services offered

Despite this, these services are often recommended, both by GPs and by the specialist health service. The latter both as a follow-up service, or as advice to the patient and therapist after a rights assessment of a referral from a GP.

Despite the fact that there is no requirement to report back to the GPs, I feel that the services work well.

I also find that the patients are largely satisfied with the services offered.

I find that the personnel who work in municipal health services are skilled and committed.

I also indirectly experience that the personnel who work there have gained considerable experience in their level of treatment. This impression is generally shared by the general practitioner college in Fredrikstad municipality.

Low-income municipalities lead to a negative spiral

As of now, it is the case that Fredrikstad and similar municipalities have relatively low transfers from the state, due to low tax revenues per inhabitant. This is a problem because low socio-economic status generally leads to a higher need for health services, and this particularly within mental health services and substance abuse.

The transfer of health services from state to municipal level within mental health and substance abuse will therefore, as the system is now, effectively a cut in health services, with the municipality being left as the scapegoat. The municipality is thus left looking cynical, but lives with having to make hard priorities due to a transfer of tasks without the corresponding transfer of grants.

The transfer of tasks without the necessary associated funds from the state to the municipality has almost become a joke. Unfortunately, this does not only apply to health services. This applies to several low-income municipalities, and Fredrikstad municipality is happy to join the call against this serious lopsided distribution of funds from the state.

It is difficult to count a schooling that was saved or a young person who did not continue with drug abuse

Both Rask mental health care and Fredrikstadhjelpa consist of committed and experienced therapists who solve complex tasks where patients previously tended to end up as throwing balls in the system.

Complex psychosocial problems are difficult, and it is challenging to put a price or a number on how useful a treatment is for the individual and at group level.

It is difficult to count a school that was saved, a young person who did not continue with drug abuse, or a family that just managed to stay together.

Ear tagging for healthcare?

I believe that we cannot expect the municipalities to be given more and more tasks under the current financial framework. Either something must be done with the income system per capita, or more funds must be earmarked for health services that are expected to be taken care of by the municipalities.

The way things are going today, I see cuts in municipal health services for vulnerable groups. I believe this will lead to a negative socio-economic spiral, where vulnerable groups face ever greater psychosocial challenges, and ever less help is offered.

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For GPs, a change has recently been introduced to their basic allowances, so-called “risk-adjusted” basic allowances, which will compensate for the generally higher need for health care among vulnerable groups (elderly, areas with lower socio-economic status, etc.).

Perhaps the municipalities could receive similar compensation for the health services they are supposed to offer? I do not know.

From my side, I see the creation of municipal low-threshold services as a good thing for the population of Fredrikstad, but that the financial framework for offering such municipal health services must be increased.

But the idea behind the transfer of health tasks from state health enterprises to the municipalities is only good as long as the necessary funding is included. Unfortunately, that is not the case today.