semFYC interview Dr Anna Stavdal

Anna Stavdal of Norway, President of WONCA Europe, is interviewed by Pere Vilanova of the Spanish Society of Family Medicine, semFYC. This is an edited English version of that interview.

“Family Doctors, Family Medicine and Primary Care professionals have no choice, for all of us, universal coverage is mandatory”

How would you describe the development of Family Medicine Norway over the last 30 years?

Since WW II, Norway has had strong traditions for a collective health care and welfare system, based on equity, solidarity and social cohesion. We share this with the other Nordic countries, - and it is internationally referred to as the Nordic model. We have universal health coverage, with strong public health perspectives influencing the setup of services, healthcare for all.

There are some prerequisites for such a system to be sustainable, - trust in the state, and a basic understanding in the population of the importance of solidarity.
In this sense we are in a dire situation in the Nordic region now, the tendency to fragmentation and commercialization in society in general, is reflected in health care, the result being that distribution of health services is more e consequence of demand, than of need.

What can you tell us about the current family medicine situation in the European Region of WONCA?

Our member organisations are facing different challenges due to the different national contexts.

Each of the WONCA Regions has also very different kind of priorities and their strategies regarding Family Medicine depend on their particular situation. However, the European Region of WONCA is the one with the most advanced and developed healthcare systems in the world, and the one with strong Family Medicine. We have to be aware of that, we must work hard to maintain, share and develop what we have. That’s why it is so important that we keep on working together, hand in hand, with all the members of Europe.

Despite dissimilarities between the countries, together we are fortunate to live in the best region in the world when it comes to the strength of social rights and universal healthcare. All of our member organisations are not only very important partners and allies, but also excellent fighters who share the same values and ethics. Unity is important. As WONCA Europe President, my ambition is to support and give prestige to our member organisations.

Referring to your statements delvevred to the WHO on the “Green Doctor” and a more “Green Medicine” would you say that WONCA Europe is defending the concept of better use of resources?

(Note In semFYC we’ve published the document “Do not Do”, in which we promote that a better use of resources, as well as prevention of over diagnosis, would be a first step for a more well-functioning healthcare system.)

Certainly. Indeed, a healthcare system which provides the right amount of care and which uses the right amount of resources is more efficient financially, but more important; it gives better health outcomes.

If a patient comes to me concerned because he’s experiencing pain and I request tests which are not really needed, I am at risk of doing more harm, than good. If we don’t use our resources in a correct way, then the healthcare systems will no longer be sustainable and, what is more important, we won’t help patients either. We should all become “Green Doctors”, so our awareness of the limited resources we have will increase and patients will also use healthcare and primary care systems in a more responsible way.

> WONCA Europe statements  on refugees, planetary health and "the urgent case of family medicine" delivered to WHO in 2017

Concerning the Refugee issue, what do you think should be European policy on that matter?

The Refugees crisis is dramatic, from a general perspective, and for and from the healthcare perspective in particular. Family doctors have a key role in health care for refugees and migrants. Let’s hope healthcare systems will be developed to be strong enough to shoulder the task of giving the right care on the right level to the most vulnerable. The way we solve the refugee issue will be a key element for our dignity as a Continent in the eyes of future generations.

You were talking about Universal coverage and, we have seen that Universal coverage is at stake in Spain.

As Family Doctors and healthcare professionals we must always defend universal healthcare coverage. Healthcare is not only a matter of the politics, but a fundamental human right for every single individual on the planet. Family Doctors, Family Medicine and primary care professionals have no choice, for all of us, universal coverage is mandatory.