Changes in Oslo Hospitals – for the Good of the Whole Country
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COMMENT Comment Changes in Oslo hospitals – for the good of the whole country There has been a lack of clarity regarding the service offered by Oslo hospitals, and they have not been geared to patient’s wishes and needs. Nor have their services been aligned to the special challenges facing Oslo, with its large group of substance users, a multi-cultural population and wide social disparities. Consolidation was called for. This is what the South-Eastern Norway Regional Health Authority was assigned to do, and the process is under way. In 2007 the Norwegian government lion in a new, modern hospital three-four a number of important projects and pro- merged two regional health authorities to kilometres outside the Oslo city limits. grammes under way in Oslo. It is important form the South-Eastern Norway Regional Akershus University Hospital can deal with that Oslo Municipality also makes its plans Health Authority. The main reason for doing all the usual complaints on streamlined, for future health services more concrete. Only so was to achieve better coordination and user-friendly premises. There was never when we collaborate as equal partners can we use of resources in the capital city and sur- any intention that people living close to develop the best services for our patients. rounding area. No less than 28 specialist the hospital should not have access to these The health authority’s restructuring pro- areas were spread between two or three sites first class services because they live on gramme entails other hospital regions out- in Oslo. There were A&E facilities, manned the other side of an invisible city boundary. side Oslo being able to give their popula- around the clock, at five hospitals less than Responsibility for the inhabitants of tions 80–90 % of all the treatment they 15 minutes drive from one another. Hospital Grorud and Stovner was transferred to need. This means that the hospitals outside activities were being run in 70 buildings, Akershus University Hospital in 2004. Oslo will be able to relieve Oslo University many of them old and inadequate. Patients living in Alna were transferred Hospital and take back more of the treat- ment of the individual patient. «The ongoing capital city hospital process Good leadership, participation is an impressive piece of work.» by employees and users I understand that many people are feeling Strengthened from 2011, together with patients from the disquiet at the changes now taking place specialist communities six municipalities in the neighbouring Follo in the Oslo area. But I also know that very In Oslo, three hospitals were merged to district. The Minister of Health approved many people in Oslo and the rest of Norway form the Oslo University Hospital. Specia- this decision in November 2008. are expecting us to make a long awaited list communities have been consolidated What is changing is the populations change in the capital city. through the merger, and the hospital is busy sectors for which the various hospitals are It is demanding to make such a major developing some of the largest and most responsible. Money and personnel are being change within a system based on annual robust medical specialist environments in redistributed in order to meet these respon- financing frameworks laid down by the the Nordic countries. sibilities. The same number of patients will Storting. We have therefore started work on This will have a positive effect on have the same hospital services in the Oslo long-term financial plans that will provide a research, developments in specialisations area both before and after the reshuffle. solid foundation for changes over a number and opportunities to provide the best patient Oslo has around 20 % of the population in of years like the one we are now carrying treatment. A single processing course and the health region, but over 40 % of the hos- out in the capital. «one door» access will result in greater equi- pital doctors. The region around the capital An impressive amount of work is being tability in the services offered. Patients in a is also very well supplied with doctors com- put into the capital city process. There are large catchment area will all have the same pared with the rest of Norway. They will an enormous number of activities. Risk waiting times. The use of equipment and per- continue to provide services for the same assessments are being made continuously, sonnel in the combined health trust will be population. From 2011, some doctors, so that measures can be applied before there more efficient. Patients in need of radiation nurses and other healthcare personnel will are negative consequences for patients. This therapy and treatment for prostate cancer are be doing so from a different hospital a few is only possible thanks to the dedicated and already noticing the improvement in service. kilometres away from where they are now. skilled leadership we have in Oslo, and the At the same time, Oslo University Hos- We have a national responsibility to ensure active participation of staff and users. pital is establishing a clearly defined local that the overall number of doctors and nurses The intention behind the restructuring is hospital service for the people of Oslo, with in the capital area does not rise as a result of to secure national cutting-edge functions services aligned to the challenges presented the changes being made. The staff increase and world class research and innovation, by the capital city area. at Akershus University Hospital will be bal- while offering the people of Oslo good and anced by a corresponding reduction in the appropriate services within the economic Akershus University Hospital – number of staff at Oslo University Hospital. framework at our disposal. best for common complaints When the Norwegian Storting (parliament) Cooperation on services Bente Mikkelsen gave the go ahead to start building the The Coordination Reform singles out a South-Eastern Norway Regional Hospital Trust new Akershus University Hospital in the number of services that must be coordinated Conflicts of interest: None national budget for 2004, the intention was among municipalities and hospitals. The that it would cater for patients from the South-East Regional Health Authority plans The manuscript was received on 8 October 2010 north-eastern suburbs of Grorud, Stovner to achieve this through a number of pro- and approved on 18 October 2010. Medical editor and Alna. Norway has invested NOK 8 bil- grammes throughout the regions. There are Anne Kveim Lie. Tidsskr Nor Legeforen nr. 21, 2010; 130 1.