Everyman’s Right

Scandinavia has been described as Europe’s wilderness paradise. North of the densely populated countries of Central Europe it boasts an abundance of natural beauty such as the famous Northern Lights or Aurora Borealis. Barren mountains and hundreds of miles of beautiful coastline provide a natural setting that attracts hundreds of thousands of holidaymakers from all over the world.

Geographically speaking the Scandinavian Peninsula is the northernmost part of Europe shared by Norway, Sweden and Northern Finland, but historical, linguistic and cultural links mean that the term also encompasses Denmark and Iceland. A shared past and outlook on life among Scandinavians has fostered similar types of government in the five countries and close co-operation between them.

The right to walk freely in nature, known as the Everyman’s Right,’ is an important part of life often taken for granted by Scandinavian people. This is an old custom that allows people to walk, cycle or ski through most of the land as long as nothing is harmed and nobody disturbed.

Camping is also permitted as long as it does not disturb the residents of a property making Scandinavia the perfect place to get close to nature. Sarek National Park known as Europe’s last wilderness, is the continent’s largest national park. Founded in 1909 the park boasts more than 200 mountains over 1,800 metres high, and over 100 glaciers. Animals such as bear, lynx, wolverine and the Sarek moose range across the 5,200 square kilometres of unspoilt wilderness. In 1996 Laponia was made an UNESCO world heritage site because of its conservation benefits and its position as home to the aboriginal Sami or Lapp people.

As well as glacial fjords and green valleys Scandinavia boasts clean historical cities. The countryside is serene and vast - the sense of space and relaxation that characterises the Nordic countries can provide the perfect antidote to the stresses of everyday city life. Cities such as Stockholm, Oslo and Copenhagen, offer a leisurely and relaxed place to spend a weekend. Sweden’s capital, the beautiful city of Stockholm is built on 14 small islands so that no matter where you wander, you are never far from the crystal clear waters. Norway’s pretty capital Oslo has wonderfully elegant streets, stunning 19th century buildings, palaces and art galleries, and Denmark’s Copenhagen is a lively city brimming with bars and some of the best live music in Scandinavia.

Apart from their historical links the five nations have followed a common social model known as the Nordic social state since the beginning of the 20th century. This model is perhaps most obvious in their healthcare systems. The five Nordic countries have similar publicly funded healthcare systems and the region’s 24 million people benefit from state-funded medical care that is widely recognised as being amongst the best in the world.

In all five Nordic countries more than 80 per cent of the national medical cost is borne by the state. The basic tenet is that disease should not lead to unnecessary suffering or impoverishment for the stricken individual. Privately funded medical insurance is paid by only a small proportion of Scandinavians and private medical care is used by a minority.
The success of Scandi-navian healthcare systems is evident in some of the lowest child mortality and highest life expectancy rates in the world. This success has resulted in a growing number of elderly people and an increasing role of the healthcare system is to offer these people help in organising their lives in the most meaningful way possible.

Norway’s 4.4 million inhabitants benefit from a universal social security system which has its roots in social movements which took place throughout Scandinavia at the beginning of the 20th century. Although the country’s infrastructure and administration had to be re-established after the Second World War the principle of equal access to healthcare services was never questioned.

The country’s Directorate of Health, established after WWII, has been continuously strengthened in the post-war period. It is primarily a technical organisation with the responsibility for monitoring overall public health and guiding the health services, and drawing attention to conditions that might adversely affect public health.

All Norwegian citizens have the right to adequate healthcare accessible within their own communities. This is the basis of a very strong locally based healthcare system paid for through a National Insurance Fund financed by a special levy paid by all employed people. Norwegians benefit from free dental care up until 18 years of age.

Since the 1970’s responsibility for running and financing hospitals has been at a county level and since that time many of the country’s large hospitals have been expanded and significantly modernised. There are only a few private beds in the entire country.

In recent years collaboration between health services, social services and the social insurance system has been seen as increasingly important. The sphere of healthcare has expanded significantly into areas previously viewed as outside its remit. In 1991 care of the disabled was added to its list of priorities and more recently problems such as domestic violence have come under the remit of the healthcare system.

Sweden has the world’s oldest population with 18 per cent of the population aged 65 or over. All residents in Sweden are covered by national health insurance. Like all Nordic countries a fundamental principle of the Swedish Government is that the provision and financing of healthcare for the entire population is a public sector responsibility.

Although the government is responsible for health policy and legislation the counties and municipalities are responsible for operating and delivering the services. The country’s 21 county councils, with populations ranging from 60,000 to 1.8 million people, operate services and levy taxes to finance the service under the administration of local politicians.
The primary care sector treats diseases and injuries that do not require hospitalisation. This sector employs a wide variety of health professionals including physicians, nurses, auxiliary nurses, midwives and physiotherapists. Their work is organised in local health centres and everyone has the right to choose their own family doctor.

Primary care is also provided by private doctors, physiotherapists, at district nurse surgeries, and at clinics for child and maternity health. The child clinics provide vaccinations, health checks and consultations as well as certain types of treatment free of charge to all children under school age. Maternity clinics, staffed by midwives and doctors, are free of charge during pregnancy.

Sixty-five county hospitals provide care in a number of specialist fields with nine regional hospitals providing a wider range of medical services such as neurosurgery, thoracic surgery and plastic surgery.

In Sweden there is one physician (under the age of 65 years) per 320 inhabitants. Over 230,000 people are employed in the county council health services, about seven per cent of the entire Swedish workforce.

In Denmark the vast majority of health services are free of charge for users and 85 per cent of healthcare costs are borne by the state through taxation. The responsibility for running the Danish healthcare system is decentralised. Regional authorities have primary responsibility for running the service but in doing so they work in close co-operation with the government and local authorities.

The system is divided into two sections. The primary healthcare system offers general health and preventative care to all, whereas the hospital system deals with medical problems that require more focused treatment.

Like in other Nordic countries Danish GPs act as gatekeepers with regard to hospital treatment and treatment by specialists. This is to ensure that patients receive treatment at the appropriate level of specialisation.

Each of Finland’s 450 municipalities is responsible for arranging healthcare for its inhabitants. Despite spending among the lowest amount of GDP on healthcare in the EU Finland has an extensive healthcare system offering free care to Finns regardless of income. Three quarters of healthcare expenditure is financed by the public sector with 20 per cent being paid for by users.

Everyone in Finland is covered by sickness insurance, funded through taxes and administered by the Social Insurance Institution. The sickness insurance scheme reimburses fees paid by patients in relation to sickness and treatment.

Most healthcare is now delivered through a highly successful family doctor system. Each doctor is responsible for about 2,000 patients who offer assessment of treatment needs and referral to hospital within three days. Each of Finland’s 20 hospital districts has a main area hospital with departments for most main specialties.

Government finances about 85 per cent of health costs in Iceland, the rest is covered by patients through a service fee. Under the Icelandic Health Services Act all citizens have the right to the best possible medical care at any time to preserve their mental, social and physical health.

It is the responsibility of the Minister for Health and Social Security to ensure that medical care is in accordance with the best knowledge and experience at any given time is available. Like in other Nordic countries Icelandic general practitioners act as gatekeepers to further medical services and treatment in a hospital requires referral from either a doctor in primary healthcare or from a private practitioner.

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