Health – the next alerted crisis?

“If we love Norway, we must also dare to change it.”

This statement was made by Alfred Bjørlo, parliamentary representative for The Liberal Party (Norway), at a recent meeting titled Fremtidens kreftbehandling during Arendalsuka. The topic for discussion was whether Norwegian health services are prepared for future challenges.

Bjørlo said: “We are going into a revolution in cancer care, from broad cancer treatments for big patient groups to precision treatment for individual cancer patients. It is a happy situation to be in, to have come so far in research and development of new treatments that we can save lives. But the revolution in the cancer field forces us to also re-evaluate how we rig the system.”

A higher demand

The Health Personnel Commission has concluded that with the changing demography, the future demand for health services will be larger than the resources available. They have suggested several measures to combat the crisis, including organisational changes, implementing novel technologies and increasing the number of health workers.

The newly appointed State Secretary Usman A. Mushtaq for the Norwegian Ministry of Health and Care Services commented in the debate:

“There is no doubt that the demographic development, the technology development and all other great changes happening in our society affect how we think about future health challenges and opportunities. At the same time, we must not forget that people’s expectations of us are also steadily increasing. Preserving the trust in the health services is incredibly important. We see challenges that will need tough prioritisation and health is something we will continue to prioritise.”

Cancer prevention & climate crisis

Mushtaq continued: “If we look at cancer, a disease area where we invest huge resources, there are more cancer cases and more survivors, but prevention does not get enough attention. Globally, it is estimated that a third of cancer cases are preventable. We can prevent cancer through lifestyle choices and vaccines. We cannot afford not to invest money in this area.”

Bjørlo agreed: “There are many things we must do in the field of prevention. For example, there are new dietary recommendations coming on Thursday. This also affects environmental and climate politics. A lot of this is connected. We need to make the right changes on the individual and system level.”

Gunnar Bovim, Head of the Health Personnel Commission, Chairman of the Board in the Norwegian Research Council and advisor in NTNU, emphasised seeing the health services more as one whole:

“It is important to see the whole patient pathway. A larger investment at the start can make the patient healthy enough to return to work. This has an enormous value.”

The health services as one whole

One model coming from Denmark is to have better integration between the primary and the specialist health services. Norway is characterized by many small municipalities, which makes the distances from university hospitals to small municipalities longer.

Bjørlo commented: “We have worked actively to reform the municipalities and make them larger. These are extremely challenging processes. There is too much silo thinking in Norway’s health services. A lot of amazing pilot work is happening in municipalities and health organisations, but we are too bad at putting them into the system and getting an effect. This is our responsibility as politicians, to dare to be clear about it. We need to be ready to make quite large structural changes.”

Mushtaq commented: “It is a good premise to have long-term investments in health. It is always more ‘sexy’ to invest in specialist health services, while primary health services often come in second place. Some will say that the specialist services get too much media attention, and it is up to us politicians to also prioritize the primary health services.”

The meeting was led by Thomas Axelsen from the Norwegian Cancer Society. You can watch a recording of the entire event (in Norwegian) below.

Fremtidens kreftbehandling is a meeting series organized by Oslo Cancer Cluster, The Norwegian Pharmaceutical Industry Association (LMI), The Norwegian Cancer Society, AstraZeneca Norway and MSD Norway.