Remember to consult experts when designing the future healthcare system
It's challenging to envision how to shape the foundation of the future healthcare system without considering its complexity. Therefore, it is crucial to have the right experts involved in the healthcare structure commission.
According to the government’s reform program, a health structure commission will be established by April 2023, and there is a desire for a broad public debate “involving employees, patients, relatives, experts, and other stakeholders in the healthcare sector.” I welcome the invitation to a public debate. However, the essential aspects of the plan for the future organization of the healthcare system will be the specific formulation of the commission’s terms of reference, as well as the composition of the commission and the allocation of experts and other representatives.
The previous government established a commission for the robustness of the healthcare system with the aim of proposing solutions to ensure staff availability and more time for core tasks. The Robustness Commission, with “broad insight into and experience with the operation of the healthcare system,” consists of 16 members, including eight members from labor market parties and eight expert members. Only three of the 16 appointed members represent the public hospital system: two hospital directors from Bornholm Hospital and Nykøbing Falster Hospital, and a chief nurse from Gødstrup Regional Hospital. The terms of reference specify 12 specific points for which the members are to provide recommendations, and there are descriptions of issues that the Robustness Commission should not address.
It can be expected that the terms of reference for the new structure commission will also contain specific points and limitations. However, this carries the risk that the commission may be constrained and biased in its recommendations. Hopefully, the terms of reference will consider the expected disease burdens of the future and the associated resource requirements of the healthcare system. This background information should be a reasonable prerequisite for the commission’s work.
The composition of the structure commission will influence the recommendations for the future organization of the healthcare system. Since the government program specifically mentions the interaction between hospitals and general practice, it would be relevant to invite experts from both hospitals and general practice with hands-on experience and knowledge of the structural challenges that the current organization poses across sectors. This approach would include the necessary expertise and understanding of the overall patient journey.
The challenges of the healthcare system need to be analyzed and assessed in their entirety so that solutions to individual problems do not lead to negative consequences in other parts of the healthcare system. We must, of course, focus on addressing the overarching issues such as the shortage of staff and the increasing number of patients, but it is difficult to envision how to shape the foundation of the future healthcare system without considering its complexity. Therefore, it is important to have the right experts on the commission. Perhaps it is also worth considering what the vision for the future healthcare system should be, in addition to social and geographical equity with the patient at the center, rather than focusing solely on how the future healthcare system should be organized.