The Basic Structure of the Norwegian health service

How is the Norwegian health service organised? This article provides an overview of the various parts of the municipal health service and the specialist health service.

The general practitioner (GP) is the patient’s most important and often first contact with the health services. Everyone who wishes has the right to a named GP.

Responsibilities of the GP 

During daytime, the GP is responsible for providing necessary general medical services to individuals on his/her list. This also includes emergency care.

The GP plays an important role in coordinating the patient’s need for medical services and collaborates with other services in the municipal health and care services, NAV (the Norwegian Labour and Welfare Administration), and the specialist health services.

In addition, GPs often have other general medical tasks in the municipalities, such as health centre services, school health services, nursing homes, municipal acute inpatient units, prison health services, and participation in emergency medical services.

When illness occurs 

In case of acute illness or injury, or the need for emergency care that arises in the evening or at night and cannot wait until the next day, you can contact the emergency medical services. For medical emergencies, call 113, while the national out-of-hours medical service number is 116 117.

Depending on the patient’s treatment or assistance needs, the GP can refer them for necessary health care. A patient who needs to be examined and/or treated in the specialist health service for a disease can be referred to a senior consultant.

The senior consultants can be private contract specialists, specialists who work at a district medical centre, at a decentralised outpatient clinic, or specialists at outpatient clinics at hospitals.

District medical centres 

At a district medical centre, specialist health services and primary health services are co-located.

Here, there may be GPs, physiotherapists, joint emergency rooms, maternity wards, senior consultants, dialysis services, and more.

District Psychiatric Centres 

A patient with mental health challenges can be referred for outpatient treatment or admission to mental health care, such as a district psychiatric centre. Specialised services within mental health care are offered here.

Patients who need more specialised treatment can be referred to hospitals.

Patients with substance abuse challenges can be referred for outpatient treatment or admission to a substance abuse institution.

Hospitals 

For conditions (both mental and somatic) that require admission, the patient is usually referred to hospitals, both public and private.

The patient can choose which hospital they want through the Hospital Choice scheme (helsenorge.no).

Patients can also choose to be treated at private hospitals with agreements with the regional health authorities. Due to medical specialisation, hospitals often become more specialised, and tasks are usually divided between hospitals.

Therefore, there are several specialised hospitals to which one can be referred and choose from for specific medical conditions.

Ambulance Services 

The ambulance services are a part of the specialist health service, and in many cases, treatment starts here, on the way to the hospital.

In serious cases, where it is important both to start treatment and to get to the hospital quickly, doctor-manned helicopters are used.

For medical emergencies, call 113.

Rehabilitation and training 

After a hospital stay, many may need a period of rehabilitation and training after the cute disease or injury. This can take place at a rehabilitation institution or in the municipality.

Some patients, especially the elderly, may need a convalescence stay after hospital treatment, which can be offered at specially equipped units at nursing homes and health centres in the municipalities.

An elderly patient with a known medical condition, for example, who experiences a worsening of a known condition that does not require hospital admission, may benefit from a stay at a sick ward or in municipal acute inpatient units, which are specially equipped to receive these patients. At hospices, pain relief and palliative care is provided.

Primary and specialist health services 

The municipalities are responsible for the primary health services. Some services are organised jointly by the municipality and the specialist health service, such as district medical centres, some nursing home services, and hospice services.

There are four regional health authorities:

The regional health authorities are responsible for providing specialist health services to the population in their health region. They also own the public hospitals in the region. The public hospitals are organised into health trusts, which are managed by the regional health authorities.