Ambivalent Coordination Reform

In Norway, the coordination of primary health care and hospital services has hitherto been inadequate. In June 2011, two laws, constituting the so-called Coordination Reform, passed the Storting. A main goal of the Reform is to reduce expenses for hospital services by emphasising preventive measures, primary health care, nursing homes and other services for the elderly. A joint law for health and social services imposes increased responsibilities on the local municipalities, including municipal co-financing of hospital services.

The Reform is characterized by ambivalence. On the one hand, new duties are imposed on the municipalities and the patients’ legal rights are jointed under one law (pasientrettighetsloven). On the other hand, the Reform apparently intends to limit the increasing professionalisation among health workers by introducing the term «professional neutrality» (for personnel allowed to perform certain tasks).

The Reform is considered a half-hearted attempt to cut expenses and – at the same time – reduce the gap between the demand for health services and the offers available. Stronger economical and organizational steps must probably be taken to attain the aim.

Keywords: Coordination Reform, municipal co-financing, patients’ legal rights, professional neutrality