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A regional health authority ( no, Regionalt helseforetak or RHF) is a state enterprise responsible for specialist healthcare in one of four regions of
Norway Norway, officially the Kingdom of Norway, is a Nordic country in Northern Europe, the mainland territory of which comprises the western and northernmost portion of the Scandinavian Peninsula. The remote Arctic island of Jan Mayen and the ...
. Responsibilities of the RHFs include patient treatment, education of medical staff, research and training of patients and relatives. Areas covered by the authorities are hospitals,
psychiatry Psychiatry is the specialty (medicine), medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psych ...
,
ambulance An ambulance is a medically equipped vehicle which transports 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 medi ...
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 medicines. It is a miscellaneous science as it links healt ...
at the hospitals,
emergency telephone number Most public switched telephone networks have a single emergency telephone number (sometimes known as the universal emergency telephone number or the emergency services number) that allows a caller to contact local emergency services for assis ...
and
laboratories A laboratory (; ; colloquially lab) is a facility that provides controlled conditions in which scientific or technological research, experiments, and measurement may be performed. Laboratory services are provided in a variety of settings: physici ...
. The actual performance is done by subsidiary
health trust Health trust or HF ( no, helseforetak) is a health enterprise owned by one of the four regional health authorities in Norway, with responsibility for performing a geographic and/or specialist activities of operations on behalf of the regional heal ...
s (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 The Royal Norwegian Ministry of Health and Care Services (''Helse- og omsorgsdepartementet'') is a Norwegian government ministry in charge of health policy, public health, health care services, and health legislation in Norway. It is led by the Mini ...
.


Health reform

The authorities were created on January 1, 2002 when the Government of Norway took over the responsibilities of the hospitals from the
counties A county is a geographic region of a country used for administrative or other purposesChambers Dictionary, L. Brookes (ed.), 2005, Chambers Harrap Publishers Ltd, Edinburgh in certain modern nations. The term is derived from the Old French ...
. At the time there were created five authorities, but the Southern and Eastern Norway authorities were merged 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 and other social security services. Some governments have separate ministers for mental health. Coun ...
,
Tore Tønne Tore Tønne (5 March 1948 – 20 December 2002) was the Norwegian Minister of Health and Social Affairs (responsible for social affairs) from 2000 to 2001 in Jens Stoltenberg's first cabinet. Tønne committed suicide Suicide is the act ...
( 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 114 billion, about 14% of the state budget.


Criticism

There has been some criticism of the health reform in Norway. Mr. Tønne was a corporate manager from Statoil and the Aker Group and the reform attempted to introduce
corporate governance Corporate governance is defined, described or delineated in diverse ways, depending on the writer's purpose. Writers focused on a disciplinary interest or context (such as accounting, finance, law, or management) often adopt narrow definitions ...
and to a certain degree public tender 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 used ...
, 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 active in party politics, or a person holding or seeking an elected office in government. Politicians propose, support, reject and create laws that govern the land and by an extension of its people. Broadly speaking ...
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 between the Labour Party, the Socialist Left Party and the Centre Party, known as the Red–Green Coalition. On 9 Septembe ...
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 done in a specific period of time. Some examples of wage payments include compensatory payments such as ''minimum wage'', '' prevailing wage'', and ''yearly bonuses,'' and remune ...
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 or other agreed-upon value to another party, the creditor. Debt is a deferred payment, or series of payments, which differentiates it from an immediate purchase. The ...
.


Authorities and subsidiaries

* Central Norway Regional Health Authority ** Central Norway Pharmaceutical Trust ** Møre and Romsdal Hospital Trust ** Nord-Trøndelag Hospital Trust ** St. Olav's Hospital Trust *
Northern Norway Regional Health Authority Northern Norway Regional Health Authority ( no, Helse Nord) is one of four regional health authorities in Norway. It covers the counties of Finnmark, Nordland and Troms. The authority owns five health trusts that operate the hospitals as well a ...
** Finnmark Hospital Trust ** Helgeland Hospital Trust ** Hålogaland Hospital Trust ** Nordland Hospital Trust **
Northern Norway Pharmaceutical Trust Hospital Pharmacy of North Norway Trust ( no, Sykehusapotek Nord HF, se, Davvi Buohcceviessoapotehka) is a health trust owned by Northern Norway Regional Health Authority that operates six hospital pharmacies. The pharmacies are part of the D ...
**
University Hospital of North Norway The University Hospital of North Norway ( no, Universitetssykehuset Nord-Norge) or UNN is a hospital and health trust. UNN is a university hospital for the region which includes the counties of Nordland, Troms and Finnmark. It is part of the ...
* 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 Vestre Viken Hospital Trust ( no, Vestre Viken HF) is a health trust which covers Buskerud, Asker and Bærum. The trust is owned by Southern and Eastern Norway Regional Health Authority and is headquartered in Drammen. It covers an area with 470 ...
**
Østfold Hospital Trust Østfold Hospital Trust is a health trust in Norway with bases in Fredrikstad, Moss, Sarpsborg and Halden. It is owned by Southern and Eastern Norway Regional Health Authority Southern and Eastern Norway Regional Health Authority ( no, Helse S� ...
* Western Norway Regional Health Authority **
Bergen Health Trust Bergen Hospital Trust ( no, Helse Bergen HF) is one of the five health trusts owned by the Western Norway Regional Health Authority. Institutions It consists of 14 institutions, located all over Hordaland. * Haukeland University Hospital * Sa ...
**
Fonna Health Trust Fonna Hospital Trust ( no, Helse Fonna) is a health trust which administrates hospitals and institutions in Haugaland, Sunnhordland and parts of Hardanger. Fonna Health Trust is one of five local health trusts owned by Western Norway Regional H ...
** 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