[ad_1]
Today, doctors from Narvik, Tromsø, Trondheim, Bergen and Stavanger go on strike.
Doctors are demanding that the workload of doctors be drastically reduced, who work both as general practitioners and in the municipal emergency system.
KS, which organizes municipalities, does not want to introduce a limit and believes that the workload of GPs should be viewed as a whole.
Currently, only 23 doctors from the largest urban municipalities are on strike.
The reason is that doctors want to avoid situations that could endanger life and health during the coronary pandemic.
– The tasks of the GPs have become too many. GPs should have a better time for their patients, and work should be able to blend in with a normal family life, Høie says.
Photo: Caroline Bækkelund Hauge / NRK
However, the medical association announces an escalation of the strike next week.
Health Minister Bent Høie (H) has expressed concern about a medical strike. He emphasizes that he is not part of the conflict, but says that he is closely following the situation.
– It is the task of the Norwegian Board of Health to assess whether a strike may pose a risk to life and health, he tells NRK.
– It can mean the end of the ER
The core of the dispute in the conflict between doctors and municipalities is the emergency room scheme.
All municipalities in Norway have an emergency room plan for immediate 24-hour medical care. The hours doctors work here are at the top of the workweek as a regular doctor. This means that there are often long shifts, especially for doctors working in the districts.
Too long, according to the Norwegian Medical Association.
The Norwegian Medical Association refers to a study by the Norwegian Health Directorate that found that a quarter of doctors in small municipalities had more than 52.8 hours of emergency care per week.
The medical association requires that physicians work no more than seven hours of emergency care per week, which corresponds to 28 hours of emergency care.
If doctors exceed their demand, it will spell the end of the emergency room scheme in many municipalities, according to health and care manager Alt Lorentsen in Karlsøy municipality in northern Norway:
– The ER swept under the rug.
The emergency room plan is expensive for municipalities. In little Karlsøy alone, ER allowances have doubled since 2018.
– There is nothing in the municipal budgets that gives us a framework for this. The state hasn’t covered a penny to double the additional cost, says health director Alf Lorentsen.
– This happens because the challenges around the emergency room have not been prioritized, says Kjersti Toppe.
Photo: Ole Berg-rest / NTB scanpix
He is supported by Storting politician Kjersti Toppe, who is vice chairman of the health and care committee, and even a doctor.
– I understand both the doctors and KS in this conflict. The challenges in the emergency room scheme are not something that can be left to the doctors and municipalities. KS does not have the framework to fix this. This is the responsibility of the government. She believes they have not followed through with the emergency room plan.
Behind the conflict over the outpatient regime there is a long-standing crisis in the general medical service of the municipalities, the so-called GP regime.
A recent evaluation of the GP plan revealed that a large proportion of GPs experience stressful and unmanageable work situations. Many doctors want to quit smoking, and few medical students want to start as doctors.
In May, the government presented an action plan to ensure that experienced GPs remain in the municipalities and that it is perceived as attractive enough for new doctors to join the plan.
The challenges surrounding the ER scheme are hardly affected in the plan, according to Toppe.
– This is an announced crisis. We are approaching the edge of the precipice and the result is a strike. This happens because the emergency room is under the rug.
Toppe also sends a kick to the doctors themselves, who he thinks have been a bit forward-thinking.
– It is quite incredible that they can be satisfied with an action plan that does not solve the challenges around the long working hours that GPs have in small municipalities, says Toppe.
– We must prioritize medical services in municipalities. It has not been done to a sufficient degree, says Marit Hermansen of the Norwegian Medical Association.
Photo: Thomas Barstad Eckhoff / Thomas Barstad Eckhoff / Norwegian Medical Association
Toppe believes that the only solution to this mess is to incorporate an emergency room during the regular business hours of GPs.
Marit Hermansen, president of the Norwegian Medical Association, agrees with Kjersti Toppe on several points.
– In the same way that the crisis in the GP scheme was a notified crisis, so is this. The issue of emergency services has not been resolved in the government’s action plan.
Hermansen, however, denies that the doctors were passive.
– We registered several proposals for the ER schematic in advance, but have not been followed up. Of course, we are not happy with that.
High: – Various things in progress
The recruitment crisis has meant that emergency services in many municipalities are very fragilely organized and understaffed, according to the Norwegian Medical Association.
Photo: Heidi Gomnæs
Health Minister Bent Høie is aware that KS alone does not have the means to solve the challenges in the current outpatient scheme.
– Here, neither more money nor more doctors alone will solve the challenges. A broader set of instruments should and should be considered.
According to Høie, the parties agree that possible measures should be discussed.
But before concluding, more knowledge is needed about the content and scope of the outpatient work of doctors in different parts of the country. Therefore, this fall an expert group will be created.
At the same time, various measures have been introduced to improve the quality of the emergency service.
Two pilot projects are already underway in Sogn og Fjordane and the Romsdal region.
– The final evaluation will provide a greater understanding of how the ER plan can be organized in the districts, says Høie.
– Should train more doctors
To remedy the doctor shortage in the districts, many municipalities spend large sums to bring in substitute doctors.
VG has previously spoken about the Bindal municipality in Nordland, which hired a Swedish-American medical assistant for up to 11,450 crowns a day.
In 20 working days, you could go home with 229,000 crowns in the doctor’s bag.
Why not hire more doctors in the municipalities? More doctors could probably reduce the high workload that GPs experience in small municipalities.
Several have spoken in favor of training more doctors. One of them is Professor Kurt Brekke of the Bergen School of Business, who in a column is anxious about this.
More doctors will also stimulate competition among GPs to include patients on the list and with it, better healthcare for patients, says Professor Kurt Brekke.
Photo: Norwegian Competition Authority
– More doctors are needed to meet future needs for health services in Norway, tells NRK.
Last year, a government-appointed committee proposed that 440 new places of study in medicine be created in Norway. However, the proposal does not involve educating more doctors, but rather bringing home Norwegian medical students who are currently studying abroad.
– This is an expensive proposal, which does not solve the growing need for more doctors, says Brekke.
Ask for short-term solutions
Kjersti Toppe from the Storting Health and Care Committee agrees that we should train more doctors.
– It is okay to bring home medical students from abroad. We have a moral responsibility to educate our own young people in our own health care system and not to parasitize other countries, such as low-cost countries. At the same time, we should educate more overall, says Toppe.
Regardless, it takes time to train more doctors, whether in Norway or abroad. Toppe believes that it is urgent to find short-term solutions.
More doctors should be employed in the municipalities.
– The more doctors, the less workload. Several municipalities in western Norway have succeeded in recruiting doctors on a fixed salary. Not all young doctors are interested in doing business. Young doctors should also have the opportunity to begin their general medicine specialization in the GP scheme, says Toppe.
