Professor em., Department of Social Research
Have Støre and Vedum agreed on a health policy horse trade?
This is a chronicle. Opinions in the text are at the writer’s expense.
“The local shop stewards in the Oslo Labor Party agree more with us, while the national leadership agrees with the Conservatives. So if people want to turn that issue around, they have to vote for the Center Party. ” That was Trygve Slagsvold Vedum’s message before the parliamentary elections last autumn. The Center Party was the key to reversing the closure of Ullevål Hospital: «If you are concerned that Ullevål Hospital will survive, then you must vote for the Center Party. It is entirely possible to turn around. ” (Dagsavisen, 28 June 2021)
According to Vedum, the Center Party would fight hard in any government negotiations to preserve Ullevål hospital. That’s not how it went.
In the Hurdal platform, the government declaration negotiated by Minister of Finance Trygve Slagsvold Vedum and Prime Minister Jonas Gahr Støre, the defense of Ullevål is gone without a trace. On the contrary, the government will ensure that «implement changes in the hospital structure in Oslo in accordance with adopted plans».
It is quite startling when the Oslo Labor Party had also moved out in the election campaign with a promise to preserve Ullevål, and that Jonas Gahr Støre was first on the Labor Party’s Oslo list.
What happened in the conversations between the two party leaders Støre and Vedum? In the Hurdal platform, two specific hospital plans are mentioned: the capital process – ie the plans for the capital’s hospital merger at Gaustad – and the plans for Innlandet hospital. Do these two projects have anything to do with each other? Maybe.
A years-long tug of war
The question of where a new Innlandet hospital will be located has been a tug-of-war for years. It was answered in the company meeting for Health Southeast (HSØ) 15 June 2021. (The enterprise meeting is the overall decision-making body for the Minister of Health and the regional health authorities.)
According to the minutes from this meeting, signed by the then Minister Bent Høie (H) and HSØ’s chairman Svein Gjedrem, the corporate meeting agreed with the recommendation from HSØ’s board meeting a few weeks earlier to continue the plans for Innlandet Hospital with a large Mjøssykehus, estimated at NOK 8.65 billion : «Collection of specialized functions within somatics, mental health care and interdisciplinary specialized drug treatment, located in Moelv».
This is how most people assumed it would be. Not least since the SP queen Anne Enger as chairman of the board of Innlandet Hospital had been the main hospital’s banner bearer. Støre in the election campaign had also hailed it as “the world’s most modern hospital” (Gudbrandsdølen Dagningen, 18 August).
On 12 October last year, the day before the Hurdal platform was announced, however, HSØ director Terje Rootwelt was able to inform that the assessment plans adopted at the company meeting on 15 June had to be adjusted.
Another alternative for Innlandet Hospital should also be considered. Someone had obviously talked together.
In the Hurdal platform, the planned Mjøssykehuset was not mentioned in one word. On the other hand, it was stated, with a form that was perhaps not entirely permeable to the uninitiated, that the government would “ensure that the ‘zero-plus’ alternative for the Inland Hospital is fully studied”.
In the Hurdal platform, the planned Mjøssykehuset was not mentioned in one word
Director Rootwelt is now leading the study of a new alternative – a new hospital in the Hamar area, possibly in Stange. If this alternative wins, the planned Mjøssykehuset in Moelv will be scrapped.
Why should an alternative to the long-planned Mjøssykehuset suddenly be “fully investigated”? No new analyzes were available, nor was there any new documentation that required further investigation. The only new thing since June 2021 was that the election in September had given a new, red-green majority.
It was of course disturbing for the ruling elite that the Center Party had announced a rematch for Ullevål hospital and thereby for the merger of Oslo University Hospital (OUS) at Gaustad, a prestigious case for the health bureaucratic power elite.
«The new health section»
I have previously described what I have called «The new health section» (Journal of the Norwegian Medical Association 14-15 / 2017). This is constantly being added by new members.
The Gaustad project was the king idea of OUS director Bjørn Erikstein, who in June 2019 became forced to resign as a director due to mistrust of the employees.
The new director was Bjørn Atle Bjørnbeth. He had been one of the initiators of the sharp appeal from the OUS doctors “The professional communities lack confidence in the OUS project” (Aftenposten, 16 April 2019), which contributed to Erikstein’s departure.
Bjørnbeth changed his mind when he became director. Terje Rootwelt, who had been Deputy CEO of OUS, was wanted by HSØ’s management as Erikstein’s successor, but lost to Bjørnbeth.
In September 2021, Rootwelt in return became director of the entire HSØ and thus Bjørnbeth’s superior.
Rootwelt succeeded Cathrine Lofthus as HSØ director, as he had done when he became deputy CEO of OUS in 2015, after Lofthus had become HSØ director. In June 2021, Lofthus became Ministerial Councilor in the Ministry of Health and Care Services (HOD).
Dizzy? Hold out a few more names that complement the picture of this health bureaucratic power environment: Gunnar Bovim, former director of St. Olav’s hospital and director of Health Central Norway, is currently chairman of the board of OUS. He was recently appointed head of the Health Personnel Commission.
Deputy chair of the OUS board is Anne Kari Lande Hasle, longtime ministerial councilor in the Ministry of Health and a key person in the capital merger from day one.
Just Ebbesen, who had led the construction of the new Østfold Hospital in Kalnes, had to go on to become director in 2018. Ebbesen was hired by Erikstein as project director for OUS a few months before Erikstein himself had to leave.
This network also includes the former SP politician Torbjørn Almlid, deputy chairman of the board of Innlandet Hospital and chairman of the board of Østfold Hospital. Almlid is a resident of Hamar and an opponent of Mjøssykehuset in Moelv.
The capital no longer so important?
One should not ignore the fact that at least some of these may have been among those who have talked together after this autumn’s election, also with Støre and Vedum. And maybe these two gentlemen in the back room have agreed on a hospital trade. For possibly the capital was no longer so important to Vedum?
Based on a realpolitik calculation, he saw perhaps greater political gains in giving his local voters a new, modern hospital in his immediate area rather than fighting against the hospital merger in the capital, where Sp was weak anyway.
Possibly the capital was no longer so important to Vedum?
That Støre seems less concerned with the loyalty of his local voters, who are massively opposed to the Gaustad project, than the loyalty of the bureaucrats in Health Southeast, is not Vedum’s problem.
When all Oslo parties with the exception of the Conservatives (so far?) Are against the Gaustad project, and if the Planning and Building Agency’s conclusion is also negative, Minister of Health Ingvild Kjerkol (Labor Party) has made it clear that she will open for state regulation to force through an unpopular merger project without local democratic roots.
The Hurdal platform has strong formulations of “a living local democracy” as “the cornerstone of democracy and a prerequisite for trust and legitimacy of the national democracy”. Strictly speaking, it should worry Vedum a bit.
Will Vedum, on behalf of ordinary people, accept such a gross undermining of this local democratic cornerstone as Kjerkol has announced?