NEW HOSPITALS

Denmark is in the middle of a hospital boom. Between now and 2020 it will build 16 so-called "super hospitals"; 7 completely new ones on greenfield sites in major cities such as Aarhus and Aalborg, and 9 expansions of existing facilities, including those in Copenhagen. The programme is designed to meet the country's hospital needs for the next 40 years.

And therein lies the problem. Because nobody really knows what those needs will be in 2050, the hospitals need to be flexible. Take bariatric (i.e. seriously overweight) patients, for instance, whose wards need to be bigger than the average, since they are bigger to start with and they need cranes and pulleys to help them in and out of bed. Do you extrapolate from the statistics of the past decades, which would suggest an explosion in their numbers? Or do you assume that a combination of greater awareness of the risks of obesity, changes in lifestyle, and fat suction operations will in fact reduce their numbers over time? Flexibility to cope with both possible outcomes costs money, a lot of money.

But in these straightened times, money is in short supply. Politicians have approved 16 dollops of cash, and the projects have to be finished within those envelopes. Given that building prices are currently rising faster than prices generally, this is already resulting in cuts. Planned 3-storey patient blocks are being reduced to 2; the existing kitchen is not being renovated and so on. In mid-Jutland, the two greenfield sites in Aarhus and Herning have had to cut kr.225 million out of the project.

In an earlier post, I said that rising healthcare costs have become one of the new iron laws, like death and taxes. But if the money isn't there, then it isn't there. Denmark has one of the most advanced healthcare systems in the world, and it is still free. Whether it can remain so for the next 40 years is a big question.

Walter Blotscher