|
 More than one in seven doctor tenures are vacant in Oulu council’s medical centres, reports Kaleva. Of the 70 positions, 20 staff members are on leave of absence and 10 further positions stand vacant. It seems harder and harder to find substitutes.
The doctor crisis is also a nationwide problem. With the decreased substitute availability, many centres in Oulu are choosing not to give appointments to non-urgent patients at all at the moment. The director of health services, Tuula Tähtinen, finds the current situation 'insane'.
Mutual Assistance
Tähtinen states that the main problem lies in the lack of a working system for mutual assistance between medical centres. The system needs to have doctors lend a hand at centres with the most acute need, says Tähtinen. The worst hit centres in Oulu are in Kaijonharju, Rajakylä, Myllyoja and the City Centre. Criticism is also been made of the ‘own doctor’ (omalääkäri) system where everyone is allocated one doctor, a system that a working group is now investigating alternatives to.
Currently very few physicians in Oulu come from abroad but this may change in a year’s time if the City’s current recruiting campaign and negotiations go well in Hungary. Oulu University Hospital is, however, not going to benefit much from this because their doctors are required to have merits in some research work as well and the language barrier is therefore likely to hold back employment prospects for most foreigners, says Juha Korpelainen of Oulu University Hospital administration. Korpelainen sees the campaign to recruit abroad benefiting mainly local medical centres and more remote towns.
Expat Doctors
Kainuu region took action a few years ago to remedy its decreasing prospects to attract doctors. Already five years ago one in every five doctors in the region came from abroad, mostly from Russia and Estonia. In fact, according to the Finnish Medical Association statistics, the number of foreign physicians in Finland has doubled in the last five years whilst the number of Finnish doctors has not risen in the required numbers. Central Ostrobothnia and Kainuu employ proportionally most foreign physicians in Finland. For doctors from the EU or European Economic Area (EEA), there is no uniform nationwide Finnish proficiency test but it is left to each employer’s assessment. A doctor from outside the EU or EEA, however, has a language test. For example, to gain a licence to practice medicine in Finland, a doctor from outside the EU or EEA has to undergo practical training and pass a three-part examination, including questions on administration, legislation and clinical medicine, and a practical section testing ability to cope with normal clinical situations. Pay Rises
Health services have tried to solve the problem of a lack of doctors in Oulu by throwing money at it. Tähtinen, the director of health services, says that in order to ease the situation any doctor can now get a triple fee for seeing patients in centres with no available doctors. That makes almost 23 euros per patient, probably the best surcharge fee in Finland, says Tähtinen. And since the shortage of doctors is a nationwide problem, it makes Oulu City want to hold onto its current staff even more. Doctors who have not, for instance, used their leave entitlements in full (leave over a month) over the past two years, have been rewarded an extra pay rise of about 120e. Additional evening consulting has been arranged in Oulu to reduce waiting times. Only urgent patients are given appointments in some of the centres whilst other patients are referred to a long waiting list. These patients are seen to as soon as there is an available doctor. Many doctors are fully booked during the day but Tähtinen hopes for more flexibility on the part of doctors. Covering one extra evening a week would help, says Tähtinen. Own Doctor System Criticised
Arrangements for the future are still open. The current ‘own doctor’ (omalaakari) system that is in use in Oulu, Kempele, Muhos and Haukipudas, for instance, has been criticised. This system, where everyone is allocated a doctor, has been found to be inefficient and been abandoned already in neighbouring Kiiminki, Oulunsalo, Tyrnävä and Liminka. There all doctors are now available for appointments. The ‘own doctor’ system has also been abandoned recently also in Mikkeli, Loviisa and Sipoo. Liisa Kylmänen, who represents doctors in the City’s employment, doesn’t see the situation as dire as Tähtinen does. Kylmänen says that doctors have been flexible and agreed to work evening consulting hours. There is a limit, however, to how much a doctor can manage in a day. (Kaleva)
|
