Store believes the current health trust model is best
Prime Minister Jonas Gahr Store is so confident that the health trust model is best that he rejects both the Centre Party's arguments and its proposal for a review
May 14, 2025
Image by AI/S&P
The Centre Party wants to review alternatives to the health trust model
During question time in the Storting today, the Centre Party challenged the health trust model. Vedum pointed out that the health trust reform has led to substantial growth in bureaucracy, and made a point of the fact that there are now twice as many health directors as members of parliament — 338 and 169 respectively.
Kjersti Toppe (Centre Party) also addressed Store on the matter. The Centre Party's message is:
that the health trust model has led to substantial growth in bureaucracy
that democracy has been weakened as a result of important decisions on health services being moved from politicians to the bureaucracy
that the business model the health trusts are subject to must be replaced by state funding
a call for Store to support a proposal for a review of a new health trust model, which the Centre Party will put forward next week
The Centre Party points out that the health trust reform has led to a reduction in the number of beds and that new hospitals are being built too small, as well as a lack of investment. A couple of examples were also cited: that the Norwegian health service has a lower number of beds than other countries, and that the dialysis unit in Askim is being closed down, so that patients must travel two hours for treatment. The Centre Party further points out that Labour has previously voted down a proposal to review alternative health models.
Store claims the trust model is best
Store rejects Vedum's and Toppe's arguments and claims that the current health trust model is the best, that he has not seen any proposal that could handle health tasks in a better way. It may be perceived that Store deliberately misunderstands the Centre Party's argument about costly bureaucracy when he somewhat too curtly dismisses the number of health directors as irrelevant. Store defends both the bureaucracy and the number of managers as a precondition for the health trust model, and further argues that the business model is necessary to keep costs within the limits set in the national budget. He also believes that democracy is safeguarded by the fact that the Minister of Health and Care Services can intervene when necessary, and points out that politicians should not micromanage how the health trusts carry out their tasks.
The Conservatives, the Progress Party and Labour formed the majority when the trust model was adopted in 2001.
Norwegian health care in poor shape
As described in an earlier article here on S&P, titled Norwegians lost 3.7 healthy life years in 8 years, the Norwegian health service is in poor shape — this after a comparison of the level with other European countries. The Norwegian health service delivers fewer health services at a higher cost than any country in the EU. It is therefore remarkable that Store claims the current Norwegian health trust model is the best; even more remarkable is that he is unwilling to assess it.
Costly bureaucracy
The reason Norway has an expensive health service appears to be the bureaucracy tied to the health trust model. There are four health regions and 33 health trusts in total.
Even though the health trust model is run on business principles, it has cost-inflating intermediaries between trust and state. State coordination of the health regions appears necessary, as does a state-determined framework for health operations, regardless of whether they are run by the state or by a health trust. This would mean that the state sets clear guidelines for the number of patients per professional so that quality requirements are maintained regardless of where one lives; the staffing need must then be reflected in the education of health personnel. Medicines and medical equipment should be funded by the state, while buildings, infrastructure, staffing and operations can be a health trust's responsibility if a suitable business model is in place. Such a framework would substantially reduce the bureaucracy and free up funds for medical treatment.
Democratic process
Through democratic processes, the Storting must decide which health services we are to have, where we are to have them and what the quality requirements should be. But then we need a government that recognises that the health trust model is not working as it should, and here Labour is failing.
SOURCES
Parliament
Question time 14 MayThe Government
Overview of the country's health trusts
Content on Society and Politics is based on reliable sources and actual events, providing a news-oriented perspective intented for further debate. To access the article’s author and the related debate, membership on Hudd is required.