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NORWAY

The health system of Norway is rapidly changing, and in this report will try to keep you abreast with both what has recently been changed, and what is proposed and very probably will change in the near future.

Basic Medical Education and Academic life

The four medical schools of Norway adopt very different curricula. While the school at the University of Bergen still is traditional with a sharp division between a pre-clinical and a clinical part, those of Oslo and Trondheim have established PBL-based curricula, and the school in Tromsø has an integrated, non-PBL design. A recent survey has shown that the students in Bergen are most discontent with their study conditions, but score higher on consultation skills at the end of study than do students at the three other schools.

Recently, our parliament ordered the Norwegian government to stimulate research in general practice. We are getting near to an agreement on establishing general practice research units, as has been done in Denmark, though we will try to avoid the consequences seen in Denmark with an A-team at the Research units, and a B-team at the University Departments.

The List system and Organisational life

The list system was established in 2001, and is now running smoothly. The list norm is 300 inhabitants/day/week. In a full time general practice that equals a list size of 1500 inhabitants. Some colleagues have substantially longer lists, while the mean list length is 1200 inhabitants. Lists are at the moment sold at the prize of a medium sized flat.

There has for many years been an unfriendly kind of competition between our GP labour organisation and the Norwegian Society for General Practice, the latter being the smaller but also by far the most innovative. Last year there has been a reconcilement, and we are now working out a new organisational model with two equal societies working together, the one with doctors income and politics related to that, the other working with education, research and further development of our discipline.

The National Health system and Privatisation

Our second line health system (hospitals etc) was some years ago semi-privatised as free enterprises under the government. They are strong units, also having a lot of money for research. The main problem is that they form too natural resources for attitudes adopted by the government while the dispersed general practice, run by each of the 500 municipalities has become invisible, and have no unite voice. One possible outcome is that the health enterprises administratively will swallow General practice. We are working against this possibility with what resources we have, and that is why both the research units and the reconcilement among our representative organisations are so welcome.