03 February 2025 | Country Update
New abortion law comes into force in NorwayFollowing the adoption of a government proposal in December 2024, a new abortion law in Norway, which introduces significant changes to abortion regulations, will come into force on 1 June 2025. The law will extend the limit for self-determined abortion (that is, the right to abort without requiring prior authorization from an abortion board) from 12 to 18 weeks of pregnancy, including the reduction of the number of fetuses. For abortions after 18 weeks, specialized committees will replace the current abortion boards to review cases. These new committees will be chaired by a doctor and include health or social care professionals, at least one member with legal expertise, and be composed of a majority of women.
The revised law also aims to strengthen the rights of minors and people with disabilities, and to ensure non-discrimination in decision-making. Medical conditions of the fetus will not be used as a direct basis for granting late-term abortions; instead, decisions will account for the impact of the condition on the pregnancy, birth and upbringing of the child.
The law emphasizes support for women considering abortion, with access to counselling, information and follow-up consultations. It also upholds and formally embeds the right of health professionals to object to abortion on grounds of conscience.
This comprehensive reform seeks to balance the rights of pregnant women with society’s responsibility to protect unborn life, while promoting fairness and transparency in abortion decisions.
Specialized outpatient care is usually provided in hospital outpatient departments called polyclinics. There are outpatient departments for somatic care, mental health care, and alcohol and substance abuse treatment. These departments also provide laboratory and radiology services.
Outpatient specialist care is also provided by self-employed privately practising specialists (e.g. obstetricians, specialists in internal medicine, etc.), mostly working in their own practices under a contractual agreement with the RHAs (Gurmu, 2017). They account for about 25% of all specialist outpatient consultations, both somatic and mental health care. For somatic care, nearly 70% of services provided by self-employed specialists are provided by ophthalmologists, ENT specialists and dermatologists. For mental health care, one third of the specialists are psychiatrists and two thirds are psychologists (Norwegian Directorate of Health, 2019b). There is also substantial regional variation in the use of privately practising specialists. People in the South-Eastern RHA are the most frequent users, whereas people in the Northern RHA are the least frequent users of somatic services and people in the Central Norway RHA are the least frequent users of privately practising specialists in mental health.
In the rural and more remote parts of the country, care is provided within community hospitals (traditionally named sykestue). They provide care that cannot be received at the patient’s home but does not require a hospital admission, as well as post-hospital care, and decide whether hospitalization to an acute hospital is necessary. These institutions are often co-located with other municipal health services. Their organizational set-up varies greatly; for example, they may be set up as a local department of the nearest hospital with a limited range of inpatient care, or care may be provided by contracted self-employed specialists who only provide outpatient care and work in cooperation with primary care services.
Inpatient specialized care is mainly provided by hospital trusts owned by the RHAs. It is also provided by seven privately owned for-profit and not-for-profit hospitals under contracts with the RHAs. Patients must get a referral to access inpatient care but they are free to choose among public and private hospitals that are approved by the Directorate of Health (see sections 2.5.2 and 3.7.1). In 2015 freedom of choice of hospital was extended to any hospital in the EU/EEC, although transportation costs are not covered.
The new Health and Hospital Plan for 2016–2019 emphasizes decentralization of hospital care with the exception of acute care services, where centralization is set to increase. According to this Plan, which at the time of writing in December 2019 has not yet been fully implemented, all hospitals are envisaged to be organized in networks, with regional hospitals, larger acute care hospitals (providing specialized emergency care for 60 000–80 000 or more inhabitants) and acute care hospitals with elective surgery and some acute care functions (specified and planned according to local needs). Within this network there are about 50 highly specialized competence centres providing services on a national scale. They are mostly located within the university hospitals, and mainly conduct activities related to professional development, competence evaluation and counselling, but sometimes also manage the process of patient treatment in the area of their competence.
Specialist care is concentrated in urban areas, and people living in rural areas have to travel longer distances to access specialist services. The relatively low number of acute hospital beds per 100 000 inhabitants, combined with high occupancy rates and relative long waiting times, indicates potential problems with accessibility of elective hospital care in Norway (see Box5.5).
Box5.5
An explicit policy goal to replace relatively expensive inpatient care with less costly outpatient and day surgery and care and bring care closer to patients’ homes has been present in Norway since the 1980s. A range of treatments are now provided as day care, including somatic care (e.g. surgery), psychiatric care (e.g. treatment of eating disorders) and treatment of drug and alcohol addiction. This shift towards day care is reflected in the decline of average length of hospital stays, and the decline in the number of acute hospital beds (see section 4.1.2).
A recent example of the substitution policy can be found in the area of dialysis treatment. In some municipalities dialysis is now provided on an outpatient basis (e.g. in nursing homes), although this is done in close cooperation with the local hospital. In 2018, 22% of Norwegian patients with chronic renal failure received dialysis at home (Norwegian Directorate of Health, 2018a).
Box5.6 presents patient evaluations of secondary health care and municipal health and care services.
Box5.6
