Åpnet konferanse

Thank you for the invitation to come here and open this 17 Nordic Congress of General Practice. GP Services are a cornerstone of the Norwegian health system. Although we have been aware of the significance of this part of the health system since the 1970s and the Alma Ata Declaration, the recognition of this is growing internationally. This is partly due to changes in population structure and disease pattern, with an increase in the number of old people, people with chronic diseases and multimorbidity and the growth in spending on healthcare. GPs have a unique position in relation to securing a medical service that is equitable and accessible to all, and which is continuous and coordinated. GPs may also address the full range of services, from prevention to treatment and rehabilitation. A good GP service is essential to meet the current challenges in health care. It goes without saying that you, the general practitioners, therefore have a key role in achieving the goals of collaboration reform.

Three key documents for the implementation of the reform was debated and passed by Parliament yesterday, i.e. the new law on health and care services in the municipalities, the new Public Health Act and the whitepaper “The national health and care plan”. One of the main objectives of the reform coincides with the vision for this Congress, that is: "Caring for people where they are." People should get health care services as close as possible to where they live their lives. In addition, a theme for the congress is the relationship between a person's bibliography and his or her biology. This connection, i.e. the connection between peoples’ living conditions and health, which is now being scientifically documented, is yet another reason for the coordination reform and to give local authorities and primary care a greater role. It is in the municipality people live and that's where their livelihoods are shaped. The municipalities shall, in accordance with this, have a greater responsibility for citizens' health, a new and more central role. They get both a reinforced responsibility for public health, through the new Public Health Act, and a greater responsibility for health care services, through the law of municipal health and care services.

A new role for the municipalities will require a more active leadership with medical expertise in the municipalities. There is also a need for more expertise in the service. And for the municipalities to succeed the GPs are essential. You are important as service providers. But you are also important as public health promoters.  I believe it is important that you, general practitioners, engage in how local government address their new tasks and shape their new role.

In the reform we want to build on the GP scheme, which has largely been a success. But there is still room for improvement. It is important that the GPs become a more integral part of the health and care services in the municipalities. At present, GPs are too much soloists in a landscape that is otherwise characterized by orchestras. It is also the case that GPs work best for those who know how to ask for their services. They are not always the people who need services the most.
Measures to strengthen the GP scheme are to clarify what the GPs responsibility for the citizens on his or her list, and to establish national quality and functional requirements for GP activity and associated reporting requirements in a revised GP secondary law. To strengthen primary care, however, there is a need for multiple measures over time. Such measures will be related both to capacity, research, education and recruitment, etc.. We will get back to the follow-up.

As we aim to prevent more and intervene earlier, it is important not to increase the level of illness in the population. To support the populations’ health it is important to teach people what gives good health, and to help people to cope and to influence their own life situation. The GPs are important to achieve this. But we politicians alto have a responsibility. One important initiative we have taken is that the new law will ensure that users participate in the design of services to a much greater extent than today. It will benefit us all. They have experience, knowledge and opinions that are invaluable for developing good services at home and in institutions.
 
We will succeed with the coordination reform, which will be implemented from the 1st of January 2012. We have presented a package of measures: financial, legal, organizational and professional. Now we put the reform into reality. We have taken many small steps. Now we take the big leap into a health and care services for the future. I hope we take this leap with you. With this, I wish you all an engaging and informative conference.