A better quality of life

Honorary guests, ladies and gentlemen

On behalf of the Norwegian government I am happy to welcome all of you to this world congress in Bergen, which also happens to be my own home town.

I think it is and honor that we here in Norway are able to invite to this congress for hard of hearing people from all over the world.

Hopefully these days at the congress will bring you new knowledge, but also new friendships and acquaintances.

The overall topic for this congress is "A better quality of life".

For hard of hearing people, as for everybody else in modern society, high quality in health and care services often can be of superior significance for a good life.

The Norwegian Institute for Public Health has estimated that as many as 700 000 people, or more than 14 % of the population have hearing impairments in different degrees.

Worldwide, if the situation does not differ too much from what we find in Norway, we may assume that several hundred millions of people have hearing problems.

To have a hearing disability often means that you have chronic condition. For many people this means needs for differnt types of assistance services in life's different phases – in school, at work, in leisure time and in the life as retired.

And there are challenges as users of the health and care services.

We know that in our country, municipal services often do not possess the adequate knowledge to assist hard of hearing people in an appropriate way with problems caused by hearing impairment.

The needs of people with disablement and chronic health conditions constitute the main basis for the coordination reform in the Norwegian health system, implemented from this year.

It is based on the facts that not enough has been done to prevent sickness in the population.

Another important fact is that cooperation between service levels has been too weak.

This has particularly been a problem for people with a chronic condition, often not getting the assistance they need at the time they need it.

People with chronic conditions often need help from several service entities, both from hospitals and from the municipalities.

They need continuity in services and stable relations with personnel who know them and their condition and special needs.

Instead, people often meet fragmentary services, with too little cooperation across service levels, between professions and service entities.

Finally, but not the least important, the patients' participation in treatment and rehabilitation processes has not been sufficiently defined.

Thus, the key steps recommended in the coordination reform are as follows:

• A clearer role for the patient
• A new and strengthened municipal role, emphasizing prevention and early intervention efforts
• Changing the funding system into municipal co-funding of the hospital care services
• Developing the hospital services to enable them to apply their specialized competence to a greater extent and to support the municipalities.

Health legislation and financing systems are now adapted to support the implementation of these steps.

These days, cooperation agreements between municipalities and hospital trusts are being completed all over Norway.

It has been a positive process in many ways. The most important is that the agreements are soon completed.

But let me also mention the positive side effect that people have started talking together across the boundaries of the health system.

Health services especially organized to meet the needs in the field of hearing impairment, are delivered through the hospitals, such as audiographic services and cochlea implants.

Since 2008 screening of hearing for newborns has been implemented all over Norway. This enables us to intervene and provide for hearing aids and later cochlear implantation at a very early age.

A study carried out at Oslo University Hospital indicates that early and bilateral cochlear implantation paves the way for good hearing and language development.

Approximately 40 deaf children are born in Norway each year. About 90 to 95 percent of these children are offered a cochlear implant in one or both ears.

Hopefully this will be a significant contribution to the quality of life for all the children included.

Together with the Ministry of Education and research we are now developing common guidelines for habilitation and education for children with cochlear implant, in recognition of these children's special needs.

In all 500 children now have been given cochlea implants in Norway, provided by Oslo University Hospital.

Cochlear implants for adults with acquired deafness or severe loss of hearing is provided by three of our university hospitals.

Let me now proceed a bit further into the questions of quality.

Quality and patient safety in health and care services are basic elements in everything that we do.

The Norwegian health and care system holds in general high standards.

An international statistical overview from the OECD last fall showed that the chances of survival after treatment for heart failure and several forms of cancer were among the best in the world.

This is good – and this is the basis for what we will do further on.

Other international publications, however, tell us that the picture has to be nuanced, due to:

• Variation in clinical practice
• Unacceptable waiting time for several types of treatment
• Variation in user involvement
• Adverse events

Regarding the last point, let me mention that the demand for safety is clearly stated in Norwegian health legislation.

Systematic work on quality and patient safety is a legal responsibility for health services from 2012.

Health institutions are obliged to have an overview of risk arenas and report on events that have led to, or could have led to, serious injury to a patient.

Since last year Norway has been running a campaign called "In safe hands" to promote patient safety. This year we are also doing a national survey on patient safety culture in the health service.

Research suggests that the attitude differs between employees. We want to map the situation in order to get a good knowledge base for further improvement strategies.

Finally, let me draw your attention to our government's white paper on the topics of patient safety and quality in health and care services to be launched later this year.

An important issue is the involvement of patients/users and the next of kin in the planning, development and improvement of services.

Further, we will in the white paper discuss how pay for performance mechanisms can be considered as complementary tools for creating further incentives for achieving quality improvement and efficiency gains in our health sector.

Quality indicators and registers, as well as the topic of clinical trials will also be discussed in the white paper.

Ladies and gentlemen,

In this short presentation I have given you an overview of what kind of questions that today are on our health policy agenda, most of all the development of quality in the delivery of health services.

This, however, is not an impediment to the development of services designed and organized to meet special needs, as exemplified by some of the hospital treatments for hard of hearing people.

Our basic challenge is to offer services of the highest quality, and services that co-operate better to the benefit of patients, hard of hearing people included.

And to some extent we realize that we have to learn to live our live wide a chronyc helf of contition. This way we can get better quality of live.

In the following days at this conference, you will attend lectures on mostly all topics concerning the lives you live, from school and work to cultural life and legislation.

More than 50 speakers from all over the world will ensure the quality and relevance of the subjects discussed. I hope that for all of you this conference will give the possibility of new insights and relations.

I wish you all a good time at the conference and at your stay here in Bergen.

Thank you very much for your attention.