A modern health service needs many hands - not just "cold" and "warm"

​DEBATE: New management of the health service will build on more liberal frameworks, and acknowledgement that creating a modern and human health service requires many different “hands”. This is particularly important to remember now, when regional budgets are again to be negotiated.

It already seems like a long time ago that all of Denmark held their breath while intense negotiations on the new collective agreements threatened to strangle-hold the entire Danish public sector.

However, even though we are now out of shadow of a crippling general strike, there is an important lesson to remember: Dividing society into “warm” and “cold” hands is a hopelessly outdated way of looking at the world.

The conflict showed very clearly that our modern society is composed of many types of people and skills – all of which need each other.

This applies not least in the health service, where the one hand deeply depends on what do the other hand is doing.

For example, a strike in the Capital Region of Denmark would have crippled our IT operations, and handicapped all support for hospital IT systems. Our Centre for Real Estate was also under threat, so that clean bed linen and other important items could not reach the hospitals. Our central administration was also a target, and it was possible that general practitioners, for example, would not get paid.

Diversity of employees gives peace of mind

When we fall ill or are injured we cannot simply “make do" with skilled and hard-working doctors and nurses.

There is also a need for X-ray images, sterile operating theatres, beds and instruments, electronic patient records and much more. Competent and dedicated people are required, and their skills are anything but “cold” (even though the Ministry of Finance and others are in the habit of processing them as "administration" in their spreadsheets).

And what about bioanalysts? Without their help, physicians, nurses and midwives would never get crucial test results to ensure the correct diagnosis, treatment and patient safety.

Similarly, technicians and IT staff make sure that scanners, radiotherapy devices and computer programs are all working. HR, financial staff and analysts make sure that continuing training courses are available, salaries are paid, and that forecasts are prepared for where and when we will experience shortages of labour, resources or hospital wards.

We only have good and safe treatment because it is supported by a multitude of employees with different skills and competences. In contrast to this diverse and modern health service is the outdated and misleading conception of a health service in which some people do something of value for patients, while the others are bureaucrats, only there to control and keep statistics.

The human health service

An over-simplified misconception overshadows what many of us are concerned with: How can we cut back unnecessary bureaucracy, control and red tape?

Let me make it clear that I will not tolerate bureaucracy that obstructs our employees in their important work.

On the contrary, as a politician I have a clear vision that our health service must be more human.

That if you fall ill, you will meet a system that treats you as a human being with needs and desires, and not just as another statistic. A health service that takes into account what matters to you - for example that, if possible, you are both examined and treated on the same day. That you understand and are confident with the information you receive from your doctor or from the region. That you know who to ask, and who will look after you. That you feel you are being heard, understood and prepared for the treatment you receive.  

The point is that a secure treatment pathway not only comes from one single specialist group, but from many safe hands working together and enhancing each other. From people who are free to do their work without constant interruption from too many instructions, too much control and too tight budgets.

Much needed change

Therefore, we need new management in the health service. And fortunately the wind of change is blowing. The much despised annual two-percent requirement is now history.

Ellen Crane Nørby, the Minister for Health, recently aired the idea of a new management tool to encourage the regions to move more patients out to the local health services. It is rather hard to understand what the Minister's proposal will actually means.

If it means that treatment will be more adapted to the life and family life of the individual patient, I'm very positive.

However, if, in reality, it means more cut-backs for the regions and a new way of rewarding hospitals for sending most patients home after the shortest time, then I’m convinced that it is not the way forward for our health services.

The negotiations on the regions’ finances are already in progress, and over the next few months the Ministry of Finance will be looking into new ways to manage our regional finances.

In both cases, we must remember what we learnt from the conflict: We need many types of hands and a more liberal framework for planning people’s lives, needs and wishes. We don’t need a new management model that just means ever-more control and ever-more efficiency.

Responsible editor