Finnmark Hospital – Why don’t we just ask for more money?

A lot is written about the development in Finnmark Hospital. Is the offer to the population, or are we heading for a better service? Why are bureaucrats from the south of the country governing with this? Shouldn’t the Alta be hospital? Here are some reflections after following the development from day to day for six years. From the inside of the boardroom.

Why don’t we just ask for more money?

We live – fortunately – in a democracy where we choose our politicians. They have the difficult task of balancing the use of our common money between a number of good causes. Roads are weighed against defense, schools against elderly care, hospitals for municipal health services. We are glad they are taking that job.

For the hospitals, we have a model for funding used for the entire country. It is based on how many residents the hospital takes care of. Then it is adjusted for age, social conditions and the state of health in the population. Then the money is distributed. And then it is added to 20 per cent for Finnmark. This is because everyone understands that it is more difficult to provide health services to a population that lives scattered and has so much weather.

So we start the year with as much budget as the others. Plus 20 percent. So is a facet at year -end – year after year – that we have spent 40 percent more than we have. Then finances and room for action will be worse year by year.

But maybe it is really 40 percent more expensive to provide health services in Finnmark? We don’t think so.

The Helgeland Hospital, which has quite the same challenges as us, runs 20 percent more expensive than average. Not 40 percent, as we do. Thus, we take money from other social purposes. Is it democratic?

At the same time, we have invested widely in new buildings, new equipment and new services where needed. In the emergency hospitals, but also outside in ambulance service and in offers in the municipalities. 5.1 billion is a major investment. Now we have to use the infrastructure we have wisely. But also pay for it.

Do we have too few or too many beds, and what is really the right staffing? How can we have too few professionals and at the same time cut positions?

We use the same method to assess bed needs throughout Norway. When the large departments such as medicine and surgery, on average, 15 per cent of the beds have the hospital is properly dimensioned. In Hammerfest it is so. The figure takes into account that patients can remain longer due to distance and weather.

What is the right number of employees? Here it is reasonable to think that if you lie in a bed with a hip fracture, then the same number of carers and doctors are needed around the bed wherever in the country it stands. Finnmark Hospital uses just over 20 per cent more man -years per patient than the rest of the country.

In short, the hospital is planned for more patients than we actually have. This leads to a larger planned staffing, which we are unable to hire and then rent as temporary workers.

In the reorganization in Hammerfest, staffing has been reduced by 13 man -years. There were no permanent employees in any of the positions.

But intensive in Hammerfest – this can’t be justifiable?

An intensive care unit cannot be planned in the same way as above. Here the beds should be empty more often, in readiness when someone needs them. This means that especially in small hospitals must be accepted and planned with overcapacity. We do. In Finnmark there are twice as many intensive beds per 1000 inhabitants as in the rest of the country. We reduce by two beds – and still have twice as many beds per capita.

Then we understand that it gives concern for those in the middle of the department on a daily basis. And that they do not recognize their reality in the numbers.

Why don’t we suggest that the Alta clinic should become an emergency hospital?

In connection with the National Health and Hospital Plan, the professionals assessed how large a population a hospital needs. The recommended minimum size are 100,000 inhabitants. It is simply because the professionals in hospitals need to meet enough patients to make them good.

In Finnmark today we have two emergency hospitals of 75,000 people. Should we be divided into three hospitals, there will be 25,000 per hospital. It cannot be defended professionally, nor can it be staffed.

When the quality of services in the Finnmark Hospital is actually as good as the rest of the country despite few inhabitants, it is due to good professionals who also spend time training.

Case or person – why do hospital leaders (and board leaders) so often come from other places?

Over the past four years, we have changed director of Finnmark Hospital three times. Between each director there has been a temporary director. We have thus spent a lot of time recruiting. We’ve been looking for two things; Knowledge of subjects and/or top management experience as well as local connection. We have found both. But no relevant candidates who want to take the job.

One said well, « I can’t both stay here and be director at the hospital. »

We think it’s worth thinking through. We are reasonably sure that it is because you do not distinguish the case and person. We are surprised that the name of the director is part of so many newspaper headlines where something negative should- or has happened, with an honorable exception for his desire for the roads to Hammerfest and Alta to be improved.

It is true that it is the board that points to how the hospital is to be developed. It is we who adopt budgets, and thus prioritize in practice. Then it falls on the director and the management to implement.

In a major reorganization that we are now in the middle of, it is natural, important and right to disagree. It should just be missing. But how do you really come up with the idea that someone has evil intentions? A desire to destroy? Why on earth should anyone want it?

In the reorganization of the hospital, we place great emphasis on strengthening and developing the leaders of the hospital. We want tomorrow’s leaders to be recruited locally. If they want, dry and orcs are up to all of us.

Director says he has the world’s best job – we have that

It is a privilege to participate and develop the health service in Finnmark. We are ahead when it comes to meeting some of the challenges associated with an aging population, but also outsiders and mental illness in the younger ones. The importance of the health service for social preparedness has become uncomfortably clear in the north. At the same time, the opportunities are many, and the room for action. Especially if we work with the municipalities where we experience the dialogue is getting better.

The changes we are now in the middle of will provide a professional and financially sustainable hospital in Finnmark. Tomorrow, in five years and in ten years. And we are well on our way.

Lena Nymo Helli (Chairman) and

Andreas Moan (Deputy Chairman)

Finnmark Hospital