Regional Health Authority (Norway)
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A regional health authority ( or RHF) is a
state-owned enterprise A state-owned enterprise (SOE) is a business entity created or owned by a national or local government, either through an executive order or legislation. SOEs aim to generate profit for the government, prevent private sector monopolies, provide goo ...
responsible for specialist healthcare in one of four regions of
Norway Norway, officially the Kingdom of Norway, is a Nordic countries, Nordic country located on the Scandinavian Peninsula in Northern Europe. The remote Arctic island of Jan Mayen and the archipelago of Svalbard also form part of the Kingdom of ...
. Responsibilities of the RHFs include patient treatment, education of medical staff, research and training of patients and relatives. Areas covered by the authorities are
hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
s,
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. ...
,
ambulance An ambulance is a medically-equipped vehicle used to transport patients to treatment facilities, such as hospitals. Typically, out-of-hospital medical care is provided to the patient during the transport. Ambulances are used to respond to ...
service, operation of
pharmacies Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medication, medicines. It is a miscellaneous science as it ...
at the hospitals,
emergency telephone number An emergency telephone number is a number that allows a caller to contact local emergency services for assistance. The emergency number differs from country to country; it is typically a three-digit number so that it can be easily remembered and ...
and
laboratories A laboratory (; ; colloquially lab) is a facility that provides controlled conditions in which science, scientific or technological research, experiments, and measurement may be performed. Laboratories are found in a variety of settings such as s ...
. The actual performance is done by subsidiary health trusts (HF) that usually consist of one or more hospitals, with associate responsibilities. The authorities are subordinate to the Norwegian Ministry of Health and Care Services.


Health reform

The authorities were created on January 1, 2002 when the
Government of Norway The Council of State () is a formal body composed of the most senior government minister (government), ministers chosen by the Prime Minister of Norway, Prime Minister, and functions as the collective decision-making organ constituting the Go ...
took over the responsibilities of the hospitals from the
counties A county () is a geographic region of a country used for administrative or other purposesL. Brookes (ed.) '' Chambers Dictionary''. Edinburgh: Chambers Harrap Publishers Ltd, 2005. in some nations. The term is derived from the Old French denoti ...
. At the time there were created five authorities, but the Southern and Eastern Norway authorities were
merged Mergers and acquisitions (M&A) are business transactions in which the ownership of a company, business organization, or one of their operating units is transferred to or consolidated with another entity. They may happen through direct absorpt ...
in 2007. The reform was credited to the
Minister of Health A health minister is the member of a country's government typically responsible for protecting and promoting public health and providing welfare spending and other social security services. Some governments have separate ministers for mental heal ...
, Tore Tønne ( Labour) who only held office for one and a half years. The ultimate goal of the reform was to increase the effectiveness of the hospitals and reduce the cost of the specialist healthcare service, that in 2007 had an annual budget of
NOK Nok is a village in Jaba, Nigeria, Jaba Local Government Area of Kaduna State, Nigeria. The village is an archeological site. Archaeology The discovery of terracotta figurines at this location caused its name to be used for the Nok culture, ...
114 billion, about 14% of the
state budget A government budget is a projection of the government's revenues and expenditure for a particular period, often referred to as a financial or fiscal year, which may or may not correspond with the calendar year. Government revenues mostly include ...
.


Criticism

There has been some criticism of the health reform in Norway. Mr. Tønne was a corporate manager from
Statoil Equinor ASA (formerly Statoil and StatoilHydro) is a Norwegian multinational energy company headquartered in Stavanger, Norway. It is primarily a petroleum company operating in 36 countries with additional investments in renewable energy. In th ...
and the Aker Group and the reform attempted to introduce
corporate governance Corporate governance refers to the mechanisms, processes, practices, and relations by which corporations are controlled and operated by their boards of directors, managers, shareholders, and stakeholders. Definitions "Corporate governance" may ...
and to a certain degree
public tender Government procurement or public procurement is the purchase of goods, works (construction) or services by the state, such as by a government agency or a state-owned enterprise. In 2019, public procurement accounted for approximately 12% of GDP ...
into the health care system of Norway. This has been criticised as being
market fundamentalism Market fundamentalism, also known as free-market fundamentalism, is a term applied to a strong belief in the ability of unregulated '' laissez-faire'' or free-market capitalist policies to solve most economic and social problems. It is often us ...
, as the system was intended to take all decisions entirely on economic grounds. This was partially escalated by the initial decision to not have any
politician A politician is a person who participates in Public policy, policy-making processes, usually holding an elective position in government. Politicians represent the people, make decisions, and influence the formulation of public policy. The roles ...
s on the boards of the authorities and trusts, thus entirely removing control of the healthcare services from political bodies. Because all decisions were taken by the boards, and not by elected political bodies, entire hospitals could be closed without political resolution. The
Second cabinet Stoltenberg Stoltenberg's Second Cabinet was the Government of Norway from 17 October 2005 to 16 October 2013. It was a coalition government, coalition between the Labour Party (Norway), Labour Party, the Socialist Left Party (Norway), Socialist Left Party a ...
has partially changed this policy by electing politicians onto the boards of the authorities. Other criticism has been directed at the organisational form of the authorities. In essence the reform created more layers of administration (government - regional health authority - health trust - hospital), where there formerly only two (county and hospital). Also, the administrations of the authorities were places in towns outside the major regional centres, places that sometimes didn't even have a hospital, making recruitment of management difficult. This has partially been criticised as directors'
wage A wage is payment made by an employer to an employee for work (human activity), work done in a specific period of time. Some examples of wage payments include wiktionary:compensatory, compensatory payments such as ''minimum wage'', ''prevailin ...
s have escalated to the level of corporate directors. The authorities have also, through cutbacks in government funding, accumulated large amounts of
debt Debt is an obligation that requires one party, the debtor, to pay money Loan, borrowed or otherwise withheld from another party, the creditor. Debt may be owed by a sovereign state or country, local government, company, or an individual. Co ...
.


Authorities and subsidiaries

*
Central Norway Regional Health Authority Central Norway Regional Health Authority () is a state-owned regional health authority responsible for operating the hospitals in the counties of Trøndelag and Møre og Romsdal in Norway. Based in Stjørdal, the authority operates five health ...
**
Central Norway Pharmaceutical Trust Central Norway Pharmaceutical Trust () is a health trust owned by Central Norway Regional Health Authority that operates four hospital pharmacies at St. Olavs Hospital in Trondheim, Kristiansund Hospital, Molde Hospital and Ã…lesund Hospita ...
**
Møre and Romsdal Hospital Trust Møre is the name of two traditional districts in different parts of Scandinavia. *Møre og Romsdal, Norway *Möre Möre is one of the original small lands of Småland, a historical province (''landskap'') in southern Sweden. It corresponds to ...
**
Nord-Trøndelag Hospital Trust Nord-Trøndelag Health Trust () is a health trust that is subordinate to the Central Norway Regional Health Authority that operates the public health care, public specialist health care in Nord-Trøndelag county, Norway. It includes the two hospi ...
** St. Olav's Hospital Trust * Northern Norway Regional Health Authority ** Finnmark Hospital Trust ** Helgeland Hospital Trust ** Hålogaland Hospital Trust ** Nordland Hospital Trust ** Northern Norway Pharmaceutical Trust ** University Hospital of North Norway * Southern and Eastern Norway Regional Health Authority ** Aker University Hospital Trust ** Blefjell Hospital Trust ** Akershus University Hospital Trust ** The New Akershus University Hospital Trust ** Innlandet Hospital Trust ** Psychiatry of Vestfold Trust ** Rikshospitalet-Radiumhospitalet Trust ** Southern and Eastern Norway Pharmaceutical Trust ** Hospital of Southern Norway Trust ** Sunnaas Hospital Trust ** Sykehuspartner ** Telemark Hospital Trust ** Ullevål University Hospital Trust ** Vestfold Hospital Trust ** Vestre Viken Hospital Trust ** Østfold Hospital Trust *
Western Norway Regional Health Authority Western Norway Regional Health Authority () is a public ownership, state-owned regional health authority (Norway), regional health authority responsible for operating the hospitals in the counties of Rogaland and Vestland in Norway. Based in Stava ...
** Bergen Health Trust ** Fonna Health Trust ** Førde Health Trust ** Stavanger Health Trust ** Western Norway Pharmaceutical Trust


References

{{Norwegian type of company Types of companies of Norway 2002 establishments in Norway Regional