Manglende likeverdighet. Om samhandlingsproblemer mellom kommunehelsetjenesten og sykehus fra 1970 – 2009
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The theme of this master thesis is cooperation between municipal health and hospitals. I was introduced to the thematic issues while I worked in hospitals and nursing-homes in the 1980s, experiencing co- operational challenges from two different angles. My interest evoke regarding that two public committees were appointed to study the challenges in 2004 and 2005. Co operational problems can be said to be contemporary, although identified as early as 1970. Different governments and the Parliament have up to today been concerned with solving the challenges. As such, I wanted to elaborate on why the cause of the cooperation between health services in municipalities and hospitals still are not resolved. My thesis depart from three major reforms; Municipal Healthcare Reform, Nursing Home Reform and Enterprise Reform. I have analyzed the public documents in relation to the processes of the laws in the three reforms. The intention has been to examine how extensive processes of change that require legislative changes, in combination with what affects the framework of administration has, have had influenced of the cooperation processes. I have primarily been interested in results regarding how various governments and the Parliament have considered the co operational problems, and about its attempt to resolve these. I also required finding out whether the reforms led to changes in operating parameters such as good relations between municipal health and hospital, additionally if these processes became difficult to fulfill. I have also analyzed the 2009 Cooperation Reform Act to resolve which understanding the current government has on cooperation. I have found evidence to suggest that the shifting governments and the Parliament has not given priority to solve the cooperation challenges between the municipal health services and hospitals. Municipal Healthcare Reform, Nursing Home Reform and Enterprise Reform appears to have contributed to that the municipal health services and hospitals have evolved in different directions, which contributes to worse co operational challenges. My analysis of the three approved reforms combined with the new coordination reform also suggests that there is no equality in the connection between municipal health and hospitals. There is no doubt that this can cause co operational challenges between the two healthcare levels.