Surfing into hospital

The Danish public-hospital system is remarkable in that it allows patients to choose where to receive treatment.

The Danish public-hospital system is remarkable in that it allows patients to choose where to receive treatment.

Even more surprising, the health ministry runs a website where people needing treatment can search for the hospital with the shortest waiting list.

Each county, or amt, funds the local hospital and levies taxes to pay for it. Rural counties with lower tax-paying populations can struggle to keep waiting lists short.

If a patient is unhappy about the wait, he or she can request treatment in any other public hospital in Denmark, paying only their transport costs.

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To help patients select a substitute hospital, the ministry's website includes waiting information (ventetidsinformation).

The section includes a range of treatment options, such as knee-joint replacement (kunstigt knμ) and breast-cancer surgery (brystkrμft).

Clicking on any of the options gives a list of public hospitals, showing two waiting periods. The first, forunders°gelse, is the wait to see a specialist after referral from a GP. The second, behandling v indlμggelse, is the wait between seeing the specialist and having in-patient treatment.

A recent random look at knee-joint replacement times showed that the combined wait from GP referral to surgery ranged from 12 weeks, at Bornholms Centralsygehus, to 81 weeks, at Fars° Sygehus.

For breast-cancer surgery, the minimum wait from referral to surgery was two weeks, at Centralsygehuset i Nμstved, while the maximum was six-and-a-half weeks, at Aalborg Sygehus.

Central government sets health policy but generally does not contribute to hospital budgets.

Two recent exceptions were made in an effort to reduce waiting lists, and the waiting times for breast-cancer treatment are a reflection of its investment.

In 1993, the government made extra funding available to the hospitals to reduce waiting times for cardiovascular treatments such as heart-bypass surgery and angioplasty.

In June, it announced a second initiative, this time for cancer treatments. Funding worth 500 million kroner (£52.97 million) was agreed and will come on stream next year, according to John Erik Pedersen, the head of the Danish health ministry's policy division. "It is an investment to boost activity and reduce waiting lists," he says.

The government went further to ensure a fall in waiting lists by passing legislation that requires fast treatment for any life-threatening cancer, he says. "It is a sort of waiting-time guarantee."

The statute, which came into full effect on September 1st, requires that access to a specialist take no more than two weeks, with a maximum two-week wait once a decision is made after tests to send a patient for surgery.

It had already come into effect last year for lung, breast, stomach and uterine cancers, which are significant killers in Denmark.

"If a hospital cannot meet a target, it is specified what they must do in terms of referral to another public hospital, a private hospital or a hospital in another country," says Pedersen.

The Danish health ministry's website, some of which is in English, is at www.sum.dk