Proposed health reform could lead to new labour conflict

As part of a reshaping of nation’s health services, government wants to overhaul working conditions for general practitioners

A 600 million kroner health plan is hoped to reshape the nation's health service and improve the health of the poorest Danes, according to a Health Ministry press release.

Among the initiatives are extra funding for improving the rehabilitation of cancer patients, treating alcoholism and reducing the number of smokers.

The government also hopes to restructure the health service and better integrate the services it offers, which Health Minister Astrid Krag (Socialistisk Folkeparti) argues will not only save money but also result in better treatment.

“We need to make sure that patients are provided the best possible treatment,” Krag stated in the press release. “That’s why the health service needs to function more like a single unit in which councils, doctors and hospitals work closely together to treat individual patients.”

The government hopes that mobile technology will better integrate the health service by, for example, allowing nurses who visit patients at home to send photographs and patient information to doctors and specialists who can then reply with recommendations for treatment.

Another labour conflict looming?

The most controversial aspect of the plan is a major overhaul of how general practitioners (GPs) operate. The government argues that GPs are long overdue a reform of their working conditions as the rest of the health service has been made to significantly modernise while GPs have managed to proceed unaltered.

The Health Ministry says that the reform of doctors' working conditions will bring down costs and lead to increased co-operation between hospitals, councils and GPs.

“The government wants a new and modern system of general practitioners in which the doctors' opening times and availability are made to suit the patients' needs, where doctors are increasingly made to work together in larger clinics and where residents are able to know how good or bad the quality of care is that they are receiving,” the ministry stated in a report detailing its ambitions.

The government complained that while the rest of the health service has adopted modernisation measures, GPs have blankly refused to agree to any of the government’s proposals over the years.

“Because it is the public sector that pays GPs to operate, then the public sector ought to have more of a say about the role of GPs and how they should perform it,” the government added.

A new conflict reminiscent of the recent teacher lockout may now be on the horizon between the government and GPs who are currently negotiating a new collective bargaining agreement.

Talks between the GPs' union, PLO, and the association of local health authorities, Danske Regioner, collapsed yesterday when PLO refused to concede to Danske Regioner’s demand that GPs become more efficient and lose the right to decide where to place new clinics.

In a press release, PLO chairman Henrik Dibbern said he supported many of the government’s proposals but accused Danske Regioner of an inability to negotiate.

“We are very prepared to enter into a closer co-operation with the health service,” Dibbern wrote. “But you don’t achieve much modernisation by setting ultimate demands as [Danske Regioner] have done during the negotiations.”

Dibbern added that he supported the government’s ambitions for longer opening hours and greater transparency about the quality of care, but that they had to be met with increased resources.

“If we are to lengthen our opening hours, then we need resources to hire extra staff,” Dibbern wrote. “The problem is that if a doctor has to treat someone on Saturday morning, it could affect the treatment of the patient with a chronic illness on Tuesday. The problem is that there is a shortage of doctors. We can’t just extend our opening hours if there aren’t enough doctors on call.”