The Difficult Health Priority

Many of the tasks that nursing has set itself in recent years can with great benefit be given back to the population. If we know that there is no one else who does, can it not prove that we can do it ourselves?

Enlightenment is sometimes a double-edged sword. This is particularly true in relation to health and morbidity. It is so that the better educated and enlightened people are, the worse they think their health is. Where one might have hoped that more general knowledge would lead to less use of the health sector, it is just the opposite. It is on this background that one must look at the intense debate about how the health system works – and not work. It also means that one can get the feeling that the health policy in the kingdom is first and foremost based on the media coverage of sufferers, whether it is the acquaintance of the acquaintances that they suddenly find themselves on a waiting list or patient associations emphasizing that their members do not receive this and the more or less documented treatment, given in Sweden or Germany.

The disease statistics and treatment statistics that should legitimately constitute the basis for the planning of treatment capacity and preventive action are often pushed aside because the media coverage is perceived as being more urgent by politicians who in almost no case see a sick patient – or a headline About the same – without promising them the best possible treatment here and now.

This position implies, for example, that up to half of the hospital budgets are used for the treatment of patients who have died shortly afterwards. To the extent that those who have prolonged life by some weeks are well, it is fine, but many have severe treatment side effects over their symptoms, and there is a wide knowledge of these courses that can prove that it is and the knowledge could be used to differentiate the treatment options, and to allow the most troublesome courses to be avoided. In particular, it is about giving proper information to the affected patients through proper information. We all know that life does not last forever, and for many, the most important thing is to get out of it in a dignified way.

Now it is an almost impossible task to appreciate what it must cost to try to prolong life. Every life is irreplaceable and cannot be settled in cold cash. It is nonetheless what health policy is forced to do, and a first step in getting started could be to say openly: We cannot at all offer the very best treatment that extends life as much as possible. We are forced to prioritize, and if we do not make it open and central, then we push the priority down in the decision-making hierarchy. If the Minister of Health or the Danish Health and Medicines Authority does not issue open guidelines for what we can offer of treatment – both technically and economically – then the on-duty doctor, who must adjust to local hospital budgets.