Right to Hospital Care and Prioritisation from a Law and Politics Perspective – The Experiences of Norway and Denmark
| Author | Henriette Sinding Aasen,Anne-Mette Magnussen,Mette Hartlev |
| DOI | 10.1177/138826271501700402 |
| Published date | 01 December 2015 |
| Date | 01 December 2015 |
| Subject Matter | Article |
European Jour nal of Social Sec urity, Volume 17 (2015), No. 4 409
RIGHT TO HOSPITAL CARE AND
PRIORITISATION FROM A LAW AND
POLITICS PERSPECTIVE – THE EXPERIENCES
OF NORWAY AND DENMARK
H S A*, M H**
and A-M M***
Abstract
As members of the Nordic family of welfare states, both Norway and Denmark are
characterised by universal acc ess to health care. Legislation and individual rights have
increasingly been used as tools to promote and protect patients’ equal access to health
care se rvices. A t the same tim e both countr ies are str uggling w ith increa sing health c are
expenditures, waiting lists and a demand to prioritise health care resources in light of
new and expensive treatment option s. is calls for political space to adju st prioritisation
policies and procedures. e article analyses the regulation of access to hospital care in
Norway and Denmark, from a law and politics pers pective. We explore similarities and
di erenc es between the two countries with respect to the ob jectives of the regulation and
formulation of the right to hospital care, and how th e interplay between law and politics
– and juridi cation and politicisation – is expressed and managed in the regul ation. We
conclude that even though there are di erences between the two countries in the extent
of juridi cation, the regulation in both countries still leaves room for continue d political
governance of issues relate d to the prioritisation of health care services.
Keywords: access to health care ser vices; law and politics; legal regulation; Nordic
welfare states; patient rights
* Dr. Henriette Sind ing Aasen is a Professor in the Facu lty of Law, University of Bergen. Address:
Magnus Lagab øtes plass 1, PO Box 7800, 50 20 Bergen, Norway; phone: + 47 5558 9585; e-mail:
Henriette.Aasen@uib.no.
** Dr. Mette Hart lev is a Professor in t he Faculty of Law, Universit y of Copenhagen. Ad dress:
Studiestrae de 6, 1455 Copenhagen K, Denmark ; phone: +45 3533 0750; e-mail: Mette.Ha rtlev@jur.
ku.dk.
*** Dr. Anne-Mette Magnussen, is an Associate Professor at Bergen University College. Address:
Møllendalsve ien M6–508, 5063 Ber gen, Norway; phone: +47 5558 7239; e-ma il: Anne-Met te.
Magnussen@hib.no.
Henriette Sind ing Aasen, Mette Ha rtlev and Anne-Met te Magnussen
410 Intersentia
1. INTRODUCTION
e Nordic welfare states are character ised by universal access to hea lth care and other
welfare services. In the eld of health care, a w ide range of legal construc tions are
embraced with regard to polit ical and inst itutional obligations, professiona l obligations
and i ndivid ual ri ghts. H owever, we ob serve an incr easing number o f indiv idual rights
in the eld of health care regu lation. e genera l tendency to address social chal lenges
by introducing individua l rights represents a tendency towards lega l individual ism.
Legislation is an established political i nstrument of governance, closely intertwined
with the politic al sphere, and is o en the rst choice of politicians when they want to
gain politica l control over areas where professional autonomy is considered to be too
strong. e introduction of indi vidual rights into hospital treatment can be seen a s a
way of steering politica l decisions in favour of patients, but is also a way of controlling
medical decisions. In this article we analyse the regulation of access to hospital care
in two Nordic countries, Norway a nd Denmark, from a law and politics perspective.
We explore similarities a nd di erences between the t wo countries with respect to the
objectives of the regulat ion and formulation of the right to hospital care.
e Nordic countries share several characteristics in the eld of healt h care law,
all being developed welf are states with publicly funded a nd tax-based universal healt h
care systems.1 e treatment is free of cha rge for residential patients. From the 1990s
onwards, the Nordic countries have been facing challenges due to the ambition of
combining the communita rian approach based on solidarity with the increasingly
prominent individual rights’ perspective as well as the neo-liberal market-oriented
ideas in the eld of health care services. 2
e health ca re sectors of both Norway and Denmark are characterised by
extensive legal regulation. Challenges related to prioritis ation, waiting times a nd
access to care in the hospital sector are major concerns in both countries, and have
been the main drivers for increa sed juridi cation.3 Major legal reforms have taken
place in both countrie s in order to deal with these challenges. A rec ent revision took
place in Denmark, where new provisions in the Hea lth Care Act (Sundhedsloven)4
concerning waiting times have been in force from 1 January 2013. Implementation
of the EU’s Patients’ Rights Direct ive5 has also provoked a few changes in the Health
Care Act, which ca me into force on 1 January 2014. In Norway, changes in the
Patient- and User Rights Act (Pasi ent- og bru kerret tighetsl oven)6 were adop ted i n Jun e
1 Hartlev (2012) and Mag nussen et al.(2009).
2 Rynning et a l.(2010: 281).
3 Rynning et a l.(2010: 283–384 and 289–290).
4 Consolidati ng Act No. 1202 of 14 November 2014. e original Act No. 546 of 24 June 2005.
[Sundhedsloven] came into force 1Januar y 2007.
5 Directive 2011/24/EU on pat ients’ rights in cross-b order healthcare.
6 Act 2July 1999 No. 63.
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