The financial crisis may also increase social inequalities in health between and within our countries. To avoid inequalities there is a need to integrate health into all policies.

These challenges are on the agenda of the OECD ministerial meeting in Paris, October 2010. The outcome of the meeting will hopefully provide valuable input for all health ministers. Then the economic crisis may provide a window of opportunity to rethink health priorities.

As health minister in Norway, I face a number of challenges. Norway and other OECD countries are highly integrated in the global economy. The challenges are therefore common for many countries. The demographic change with growing numbers of elderly people is one major issue. In some countries the percentage of people over 80 is expected to double by the year 2040. A longer life is one of the great success stories of the health systems. However, an aging population will require more health and care services. Furthermore, we are facing the challenge of a smaller percentage of population working to finance these increasing costs.

At the same time the burden of disease is changing in most OECD countries. The number of patients with chronic diseases, such as diabetes, is rapidly increasing. More people are diagnosed with mental problems. Obesity is increasing. All this has to be handled through our health systems.

A major challenge is to organise the health systems so that they maximise health and give better value for money. If the highest amount of resources is spent at an early stage, then more efforts can be channelled to prevent, for example, diabetes, and the overall costs will be reduced.

Many of today’s most common diseases are caused by poor lifestyles–smoking, harmful use of alcohol, and being overweight and unfit. Several OECD countries have had great success in reducing the number of people smoking–though more still needs to be done. From this success, there is a challenge to find ways to tackle obesity and harmful use of alcohol.

The Norwegian government is about to implement a health reform which emphasises prevention and early intervention. Primary healthcare is a key component of our health systems. A major challenge is the level of co-ordination between the specialist and primary healthcare. Too many patients end up being hospitalised because they do not get the appropriate treatment at local level. This is expensive and does not benefit the patients. We also know that the most vulnerable groups often do not receive the services they are entitled to.

We must not allow the aftermath of the financial turmoil to contribute to social inequalities in health. Instead we must use this opportunity to reform and improve our healthcare systems. Prevention, strong primary care and increased co-ordination are keys to meet changing demographics and new disease patterns.


The Norwegian health ministry at http://hod.dep.no

See also www.oecd.org/health/ministerial


©OECD Observer No 281, October 2010