Discrimination: a reason why healthcare services don't work

- The Norwegian Nurses' Association has been working for years to improve healthcare services for patients with long-term and complex diagnoses, and one of our three prioritised goals is better task sharing using technology and innovation, says Lill Sverresdatter Larsen, head of the Norwegian Nurses' Association. She is not satisfied with how, for example, frail elderly or chronically ill patients are followed up in today's health service.

Must recognize the problem

- I think we not only see discrimination based on age, but also on the basis of gender, ethnicity and place of residence. We see dramatic differences in life expectancy and quality of life. For example, there are major differences between Oslo East and Oslo West, and major differences in the availability and accessibility of health services between the south and the north, she explains.

- The narrative of "the world's best health service" is weighted towards the country's emergency services, which, to put it bluntly, are customised for men between the ages of 40 and 60. Other groups, such as the frail elderly, are so dependent on carers that we cannot call it equal health services.

Larsen is clear that Norway needs to invest far more in collaborative services.

- Neither funding nor specialisation came with the Coordination Reform. You can't achieve interdisciplinary collaboration without financial instruments. This needs to be put in place, but first and foremost we need to recognise that this is a problem: The fact that we treat some patient groups much worse than others and that relatives must bear much of the burden around these.

Need better tools

The Norwegian Nurses' Association is more than ready for a tool like the one being researched by Dignity Care, which can make it easier to interact with a patient on the patient's terms.

- The patient's needs must always be the basis for all decisions made by doctors, nurses and other healthcare professionals. This also means that we should use available tools to increase the population's health expertise. This will enable them to make better choices for their life situation, in what can appear to be a myriad of treatment solutions, the organisation's leader points out.

- Central to the interaction is a common language between healthcare professionals that is also understandable to the patient. At the same time, the public sector must have ownership of the solution to guarantee equality in service provision. If we are to succeed with better collaboration, we must maintain strong and public health services, preferably in combination with health innovation entrepreneurs and others with good solutions and initiatives.

The Norwegian Nurses' Association is also in favour of better task sharing, especially for patient groups that need long-term follow-up of many concurrent diseases. By changing ways of working, healthcare professionals can be freed up for other tasks. The correct use of resources will be central to the Norwegian health service in the years to come. Not just in terms of money, but first and foremost in terms of having enough available healthcare personnel.

Holistic approach important for all

Larsen points out that she has seen team-based care models established in several parts of the country that work very well. And that more people than the patient find that these new ways of providing care are very positive.

- Research shows that facilitating holistic care - being able to follow up the patient as part of a holistic service - helps to retain healthcare professionals in their jobs. Good collaboration is good for perceived patient quality, it is good for years of life and quality of life, and not least for the working day of healthcare professionals, says Lill Sverresdatter Larsen.