A bill for the budget for the year 2011 was presented a few days ago. It promises massive savings in the nation's health. The main input is that the operations of the medical departments of hospitals in the rural areas will be largely transferred to the hospitals in Reykjavík and Akureyri. There will be "health care hospitals" with an emphasis on health care, medicine and geriatric care. These ?health care hospitals? should receive patients in selected cases from Lsp and Fsa after operations and for follow-up treatment. Healthcare must be prioritized.

How does this relate to us who live in the northern part of the Westfjords?

To achieve the goals of the Ministry of Health

A cut of 193 million has been announced in the hospital's medical department, but youth care and health care will be strengthened.

To achieve these goals, surgical services (surgeon, operating room nurses and anesthesia services), maternity services, medical services, X-ray department, research department, physical and occupational therapy must be closed. There will be a "healthcare hospital" where primary care doctors will take care of those who will be there. It is possible that the health care will be able to run the research department and the X-ray department during daytime hours if someone can be found to work in those departments without shifts.

Daytime work is 40 hours/week, but 168 hours are in one week, so research may be available for 1/4 of the year. Specialists in surgery or medicine are not expected to work at the institute. “A health care hospital? will therefore mainly carry out similar tasks as hospital shelters in the district have done so far, i.e. look after and nurse those who have reached the last destination on life's journey and make them feel comfortable. There will also be a waiting room for those who need emergency treatment and are waiting for transport.

Emergency treatment of the sick and injured

The bill states that ambulance transport must be strengthened. Acute symptoms of serious illness or serious damage caused by accidents must be referred to Reykjavík. I say symptoms of a disease or an accident because the diagnosis will more often than not be obtained otherwise than with tests that will not always be available at home in the province at that time. . Many more people will be sent south than is really needed, because it will not be possible to rule out that it is a serious situation, and it will not be assessed whether chest pains or abdominal pains, for example, are of a serious nature or not. The same applies to fractures and dislocations of limbs that may need to be straightened and fixed. It has so far saved many people that it is possible to get a diagnosis and start treatment immediately, whether waiting for an air ambulance or not, but then it is more often than not the teamwork of doctors, anesthesia services, research departments (x-rays and blood tests) and nursing that make it possible.

 

Consequences

It will not be exactly attractive to take sole responsibility for a settlement of 6000 people with no research, diagnosis, or treatment options available while waiting for outside help, i.e. air ambulance or transporting patients 450 km overland. It is often the case that both flights and land routes are unavailable due to weather. What then?

 Predictably, some will be harmed due to Reykjavík's distance from the hinterland and unsafe transportation. Pregnant women will have to live in the south at least. the last 2 weeks of pregnancy because the natural moment of birth can never be predicted with absolute certainty. No one knows which birth will be uneventful and which won't. Then minutes matter. Nothing will be possible even if there is a fully equipped hospital on the spot with everything needed to provide maternity and emergency services. As a result, the staffing of doctors in the health care field will be uncertain. It is possible that medical services will be completely stopped in the district.

The service now

One surgeon attends to patients in the hospital, performs procedures during daytime hours and performs necessary emergency procedures. He performs ultrasound examinations and serves, among other things, as a primary care physician, i.e. handles reception in Þingeyri and Súðavík. He also has a large number of patients at the hospital's day ward twice a week. One general practitioner takes care of patients in the hospital, performs gastroscopy and colonoscopies, performs stress tests for the heart and takes care of the day ward for diabetics. He provides geriatric care and home care. The pharmacist also provides health care at Flateyri. These 2 hospital doctors deal with emergency cases during the day and are always available to the primary care doctors who are on duty whether paid or unpaid. Health care and hospital services are therefore intertwined here and each has strength from the other. The medical district of Bolungarvík has just been merged with the Vestfjörður Health Center. This resulted in significant savings, but at the same time increased the burden on the doctors on duty here.

Savings?

What will be the real savings from shutting down medicine mostly at the hospital and turning it into a "Health Care Hospital"? 

There are approximately 800 admissions to the hospital here annually. Although only half are sent south by air ambulance or by land, it will cost money. If each transfer costs ISK 300 thousand. does just that 120 million ISK in a year. How much does it cost to treat all these patients in the south? According to the same budget bill, absolutely nothing, as it is estimated that around 500 million less will be spent on the fireplace in Reykjavík than before. Who pays the subsistence and travel expenses of pregnant women (50-70 per year) who are waiting to give birth in the south? Does it cost nothing to treat patients in the south? Nowhere does it appear that, against the savings here in the west and the destruction of society, there is no cost for transporting or transferring patients to the south.

Conclusion

There is a lot of talk about responsibility today, understandably so. But who is responsible for these laws that are presented to the heads of the Westfjords without any justification of real savings. Or is the government hoping that everyone will flee to the south or even further, perhaps to the Nordic welfare system, so that settlements will cease to exist here and cost nothing. Then it will be easy to sell the remaining ones into the EC, when the equality of misery is achieved.
(Previously published in Mbl. 18.10.2010)