The GP crisis: – Urgent to sort out

During the election last autumn, Ingvild Kjerkol (Labor Party) promised that the government would save the GP scheme. New figures from Helfo show that more than 175,000 Norwegians today lack a GP.

And from Kjerkol took office as Minister of State until June, more than 50,000 Norwegians have lost their GP.

– On election night, Kjerkol said that this was the first priority. This is not to keep the promise, says Bård Hoksrud (Frp), second deputy chair of the health and care committee in the Storting.

Provoked

Hoksrud thinks it is provocative that the government is not doing anything to save the GP scheme.

“Money must be on the table now – it is not enough to wait until the state budget in 2023. If the house starts to burn, you do not wait to put it out until it has burned down,” he told Dagbladet.

The leader of the General Practitioners’ Association, Nils Kristian Klev, also thinks it is urgent to sort things out.

– Had high hopes

In the revised state budget that the government presented in May, the subsidy for the GP scheme was increased by 100 million compared to the previous government. This is still not enough, Klev believes.

– We have wanted a faster implementation of measures, and had high hopes for a new government. We had hoped that something would come to reassure GPs that they were in the process of sorting things out. It did not, he says.

He points out that there is a great responsibility in the state budget for 2023.

– Kjerkol has been clear on what to do, but it is the pace and power we have missed.

– The scheme is falling apart

In the meantime, the problem seems to be increasing. Between May and June alone, 12,000 patients lost their GPs. This equates to around 400 every day.

The situation in Gjøvik and Bjørnafjorden is particularly critical. More than 6,000 inhabitants in each municipality lack a GP.

– It is no longer a GP crisis, but a patient crisis. It is the patients that go beyond. The doctors can find new jobs, but the patients lose and are left with the consequences, says Klev.

At the same time, the pressure on the rest of the health service will only increase. Hospitals and emergency rooms are gaining momentum, and then the pressure on the remaining doctors in the municipalities increases.

– The scheme is falling apart, and it is urgent to sort it out, he says.

According to Klev, the biggest challenge for the GP scheme is that the doctors’ workload has increased to an unmanageable level. It is about having time for the patients and the responsibilities that come with it.

– It is alarming that more experienced GPs are now leaving. They have lasted a long time without sufficient powerful measures. It is tragic that we now lose these, he says, and adds:

– The state has not arranged so that you can do the job you are supposed to without the working week being too long.

At the same time, the scheme is underfunded.

Differences between municipalities

Today, the municipalities themselves must subsidize the GP scheme significantly. This results in increased expenses at the municipal level, and creates large differences between the municipalities.

Klev points out that what was supposed to be a national scheme, is no longer.

– The municipalities have a role, but without sufficient state funding, I do not think it is possible to reverse the negative spiral. There must be a boost from the national team to be able to believe that the scheme can be continued.

Crisis for patients

A lot is about making the job attractive again. When the GP scheme was created in 2001, it was with good conditions for both doctors and patients.

– There was a balance between financing and tasks, so that you could have a manageable working time and comparable salary. This is no longer the case, Klev points out.

The lack of GPs was first announced ten years ago. Then nothing was done. Since then, GPs have been given more tasks, but no increase in resources.

– Not done enough

– This is a crisis we take very seriously, says State Secretary Ole Henrik Krat Bjørkholt.

He points out that something was already done in the state budget for 2022, when the subsidy for the GP scheme was increased by 100 million compared to the previous government. In addition, the so-called ALIS scheme was made national.

This is a subsidy scheme that will get more doctors to start with and complete specialization in general medicine. The ALIS scheme will provide increased security and financial predictability for general practitioners who specialize.

– A subsidy scheme has also been made for the emergency services in the districts. We are working intensively to reverse the development, and will come up with more measures in the state budget for 2023, says Bjørkholt.

– Why are you waiting to take action until 2023, when the crisis is so extensive already?

– This is a crisis that has developed and which has been announced for ten years. Then it’s not just about turning around. It’s a huge tanker, so it’s not done in a jiffy.

Bjørkholt emphasizes that even though some measures have already been taken, it has not been enough to reverse the trend.

– Since the crisis is so profound and long-lasting, it requires measures that in turn require funds in the state budget. Our first state budget is the budget for 2023, which will be presented in October, so that’s when we really get something done.

– What measures are you considering in the state budget?

– The ALIS scheme has been a great success, and recruitment in practice has worked quite well. We will further develop this. Otherwise, we work with quite powerful and structural measures, but we can not reveal more at the moment, says Bjørkholt.

He points out that the government is in close dialogue with the Norwegian Medical Association and the KS Municipal Sector’s organization to find a solution to the GP crisis.

– In the dialogue, we also look at whether we can take organizational measures to improve the service, and whether we can work in other ways so that more patients receive treatment.

– The scheme is kneeling

The leader of the General Practitioners’ Association, Nils Kristian Klev, is aware that the GP scheme should continue.

– It is the best organization in the primary health service that we have had, but now you can say that it kneels a little under its own success, he says.

Research has shown that having a doctor who knows the patient is of great importance. This means fewer emergency room visits and fewer hospital admissions. Mortality is also declining in the long run.

– Socio-economically, strengthening the GP scheme is a small cost for what you get back, Klev concludes.

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