Health minister to slice surgery costs

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Five local hospitals in Norway will lose their ability to carry out acute surgical procedures under a new national hospital plan unveiled by Health Minister Bent Høie. He claims the cuts are necessary to preserve other health care services, and inevitable because of ongoing surgical specialization.

Health Minister Bent Høie, with the government's new hospital plan that he's proposing in parliament. PHOTO: Helse- og omsorgsdepartementet

Health Minister Bent Høie, with the government’s new hospital plan that he’s proposing in parliament. PHOTO: Helse- og omsorgsdepartementet

He noted in a commentary published in newspaper Aftenposten that cuts in local surgery services have been looming and debated for 20 years, but keep getting postponed because of the fear they create for local health services and jobs. “But we can no longer let developments (within hospitals) run their course,” Høie wrote. “We have to steer that course.”

His new plan for Norway’s nationally funded hospitals, the first since the state took over responsibility for hospitals from local municipalities in 2002, is meant to ensure better health care and preparedness around the country. “We want less variation in quality, and preparedness that provides health care services when needed,” said Høie when unveiling the plan just before the weekend.

Høie, from the Conservative Party, noted how Norway’s population is growing and getting older, with more people continuing to move to the cities. The ranks of general surgeons able to perform various types of operations are thinning, with surgeons now specializing in specific areas and making it difficult for small hospitals to recruit such specialists. “They want to work in large hospitals with many patients,” Høie said, not least to maintain their specialized skills.

Under his ministry’s new plan, local hospitals around Norway that serve fewer than 60,000-80,000 residents will lose their acute surgical services. That will affect hospitals in Narvik, Lofoten, Volda, Stord and Flekkefjord, with patients there being sent instead to hospitals in, for example, Bodø, Ålesund, Trondheim or Kristiansand.

Maternity wards that also have been on the chopping block, however, will be maintained, Høie said, and no hospitals will be closed. That should come as a relief to many communities that feared a complete loss of hospital services. The government instead wants to centralize 24-hour preparedness for all kinds of surgery at larger hospitals, but even the smaller hospitals will maintain some acute surgical functions and an anæsthesiologist, and still perform some planned surgical procedures.

The proposed cuts thus seem less severe than feared, and the opposition Labour Party, which unsuccessfully tried to streamline hospital services during its eight years in power, was positive. The cuts were quickly blasted by the rural-oriented Center Party, however, and by the Christian Democrats, who can’t understand how a loss of acute surgery wards can provide better overall health care. Local hospital activists in Narvik, in Northern Norway, also vowed to fight Høie’s proposals.

Høie maintained that the small hospitals can be better-equipped for other health care services if they no longer need to budget and be prepared for acute operations for patients who could be sent to bigger hospitals. His plan will now be debated in Parliament, where it seems likely to be approved. Berglund