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ELECTION

16 - 29 May 2019

HEALTH REFORM • Battle severity: Waterloo • Agent provocateur: Mette Frederiksen • Key incendiary device: Threat of privatisation • Potential civil war: No obvious schisms • Potential casualties: Patients, public workers

D

EPENDING on the outcome of the election, the way healthcare in Denmark is provided could change dramatically. One of the things on the table for the upcoming election is a potentially major restructuring of the Danish healthcare system: the elimination of the five regions. In his New Year’s speech, Prime Minister Lars Løkke Rasmussen announced that he intends to replace them with 21 municipal-level organisations and increased local facilities. Health reform is a major plank in Venstre’s election campaign. Socialdemokratiet, on the other hand, is advocating the retention on the regions, neighbourhood hospitals nearer to citizens, and employing 1,000 more nurses. Personal experience COPENHAGENER Tanja Juhler Maureschat, 23, is very familiar with the healthcare system from a patient’s point of view. Since she was born she has had to frequent various specialists in spina bifida, a chronic condition that can cause weakness in the legs, and other neural challenges. At least every four months Maureschat goes to Rigshospitalet for a minor procedure. She has noticed a great difference before and after the 2007 reform. “Before, I got a time I had to be there and I was seen instantly, but now I am having to wait for three, four, five hours before I’m through,” she said. Others report witnessing hospital staff under increased stress. Centralisation vs decentralisation THE CURRENT regions are composed of publicly-elected officials and were created in 2007 as part of the Danish Municipal Reform. The 2007 legislation consolidated 80 hospitals into 62, with an ultimate goal of 53 hospitals by 2025. “If you carry out this reform, you’ll have a lot more power centralised at a government level and some at the municipalities,” explained Kristian Taageby Nielsen, a consultant at Danish Regions. “You need something in between to balance the two levels. In order to create a

more coherent healthcare sector you need the regions to have a bigger overview than the municipalities, but a more local one than the national government.” Rasmussen said the reform intends to “put the needs of the patient before the system”. Nielsen doesn’t believe the upcoming reform will move Denmark towards a more integrated, seamless, healthcare system. Improving patient experience, he says, is dependent on a stronger communication infrastructure between the hospitals, regions and municipalities – and a larger healthcare workforce. Geographic differences A REPORT by economist Terkel Christiansen at the University of Southern Denmark noted that the 2007 reform, while mostly positive in its impact, led to the closure of local hospitals primarily in rural areas. Maureschat believes the influx of people from these outlying areas to Rigshospitalet is causing longer commutes and increased waiting times for her routine treatments. The new reform, while technically decentralising, probably won’t help alleviate these issues, Nielsen contends. “Of course there will be some problems with waiting times now and again, but it is hard to see how the reform to destructure is going to change this. All we can do is try to build the right hospitals and have the right technologies at the hospitals for patients to have the right treatment.” The 2007 reform aimed to streamline and enhance patient treatment across the nation. The consolidated “super-hospitals” provide the benefit of putting highly specialised professionals in close proximity to one another, enhancing collaboration and communication. These benefits are at the core of the argument for centralisation. Modernising healthcare NIELSEN emphasises that consolidating the hospitals allows for the remaining facilities to obtain the newest and best technologies available. Not only is the system continuing to improve, but centralisation should make allowances for Denmark’s ageing demographic. “A lot of patients both in the future and right now will have a chronic disease – maybe more than one. By centralising at the bigger hospitals you can offer different treatments at the same hospital,” he added. (AG)

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CPH POST 16 - 29 May 2019  

CPH POST 16 - 29 May 2019  

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