New Ahus hospital caught in crisis

Akershus University Hospital, better known as Ahus in Lørenskog  just northeast of Oslo, was supposed to be Norway’s most modern and largest acute-care hospital when it opened four years ago. Politicians and administrators, however, failed to provide for adequate staffing and now a high-profile board member has resigned after another case of malpractice resulted in a young patient’s death.

Leif Frode Onarheim,  former Member of Parliament for the Conservative Party and president of employers’ organization NHO, said he was taking his share of the responsibility “because I could have been clearer and more demanding when I was deputy chairman and saw that staffing was too low.”

Onarheim’s resignation follows another spate of headlines in Oslo-area newspapers about the death of 20-year-old Camilla Nymoen at the hospital last autumn. She had been admitted to have her tonsils removed, a routine operation that went terribly wrong. Investigators have determined that “the patient should have been better examined, evaluated and followed up by an experienced anesthesiologist before the operation.”

Laws broken
Her case hit the headlines this week after Norway’s health care regulatory agency Helsetilsynet issued a crushing report ruling that Ahus had broken laws regulating health care not just in Nymoen’s case but in three others in recent months. An elderly woman suffering from dementia was forced to wait more than 48 hours for an operation for a broken hip, and staff neglected to offer her food and water. A man in his 60s with epilepsy and diabetes was sent home without any provisions for his further care. A one-year-old child died from dehydration at the hospital.

These cases follow several other major complaints over care and treatment at Ahus and come amidst near constant complaints from Ahus doctors and nurses that they can’t handle all the patients sent to them. The Parliament approved construction of the new and expensive hospital in 2003 on the grounds it would take over responsibility for patients not just from Lørenskog and the rapidly growing region north of Oslo but also for 160,000 patients from the Groruddalen area of Oslo and from Follo south of Oslo. They earlier had been taken care of at either the Aker or Ullevål hospitals in Oslo, but they were subject to a massive reorganization of nearly all hospitals in the capital that also has been a target of strong criticism.

On Friday, Norwegian Broadcasting (NRK) was carrying reports that politicians in the Health Ministry and administrators at the state agency overseeing Ahus, Helse Sør-Øst, are shoving responsibility back and forth among themselves. Efforts by hospital administrators to recruit more staff were blocked by Helse Sør-Øst boss Bente Mikkelsen, who’s earlier been the subject of criticism over her leadership. She said earlier this week that she couldn’t allow Ahus to recruit staff from other districts around Norway for fear that would leave them with too little medical personnel.

‘Bad planning’
The leader of Norway’s national nursing association, Eli Gunhild Bye, summed up the situation as she sees it in newspaper Aftenposten on Friday: “The background for the problems at Ahus is bad planning regarding the reorganization of the Oslo hospitals and merger with Ahus. When so many patients are transferred to a brand-new hospital, it demands very good planning. There wasn’t enough attention paid to the need for competence and good patient care.”

Health Minister Anne-Grethe Strøm-Erichsen of the Labour Party has consistently defended the hospital reorganization for its long-term economic and professional benefits, but faces new harsh questioning in Parliament. Mikkelsen’s future as head of Helse Sør-Øst remains in question.

Views and News from Norway/Nina Berglund

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