Health and care on the Faroe Islands

The white building to the right in the picture is the oldest part of Landssjúkrahúsið (the National Hospital of the Faroe Islands) from 1924. The green building in the middle is from 1968, and the grey to the left is from 2004. The most recent extension can be seen in the background of the picture. ÓLAVUR FREDERIKSEN, 2019

The state of health in the Faroe Islands is generally good. Life expectancy and the fertility rate are among the highest in the Nordic region, and while alcohol consumption has historically been – and continues to be – modest, the previously relatively high number of smokers is on the decline. However, signs are seen of a certain degree of poor mental well-being among young people, and the reasons for this are yet to be found. There are three hospitals located in the northern, central and southern parts of the country as well as general practitioners and dentists distributed throughout the country. And the current challenge of recruiting doctors is expected to improve in the near future.

Organisation and resources in the healthcare system

The Faroese Government is responsible for the dimensioning, operation and financing of the healthcare system in collaboration with the municipalities. There are three hospitals in Tórshavn, Klaksvík and Tvøroyri, respectively. The National Hospital in Tórshavn is the main hospital with wards for medical, surgical and psychiatric patients. In addition, there are outpatient clinics for eye diseases, ear-nose-throat diseases, skin diseases and neurological diseases. Apart from brain surgery and thoracic surgery, most specialties are practiced within the Faroese hospital system. Most positions are filled by Faroese specialists, while others are undertaken by visiting specialists, especially from Denmark. The hospitals in Klaksvík and Tvøroyri are smaller.

The National Hospital has undergone expansion for the past several years, and a new psychiatric ward has almost been completed. The total bed capacity has been reduced in recent decades in favour of shorter admission and increased outpatient diagnostics and treatment. In the event that more specialised assessment and/or treatment are needed, patients are referred to foreign hospitals, primarily to Rigshospitalet in Copenhagen, which also has a special patient hotel for patients from the Faroe Islands.

The first case of COVID-19 infection was detected on 3 March 2020. Abundant and easily accessible testing capacity with quick responses, quarantine for all infected people and their close contacts as well as mandatory testing at the national border resulted in a low number of infections and a largely normal functioning society. ÓLAVUR FREDERIKSEN

The general practitioners, called municipal doctors, are distributed throughout the country and work either alone or in medical centres. They are public employees, but most of their salaries are based on income from individual benefits paid by public health insurance. The Faroe Islands is rated for 34 municipal doctors, but some of the positions are filled with temporary employees. The doctors have the opportunity to refer patients for treatment in the hospital system, but also to psychologists, physiotherapists, occupational therapists and dietitians in private practice.

General dental care is private, but children’s dental care is municipal and free. There are a total of 51 dentists, some of whom work exclusively in children’s dentistry. School dental care began in the late 1950s and has gradually spread throughout the country, and the dental status of the children is generally good. Dental services are partly paid for by citizens and partly by a subsidy from public health insurance.

The total public expenditure on the healthcare system in 2020 was just under DKK 1.4 billion, corresponding to about 7 % of GDP. The total number of doctors, especially specialists, seen in relation to the size of the population is lower than in Denmark, which is due to recruitment problems. However, this is expected to become less of a problem in the future, as many young Faroese are training to become doctors.

Organisation of care and resources in the sector

Social services are mainly a national task with some areas assigned to the municipal sector. The nationwide social administration is managed by a national board of social services under the Faroese Government’s Ministry of Social Affairs. The national board of social services manages legal matters with regard to social security benefits as well as institutions and services within special care, consisting of accommodation and treatment facilities, personal support as well as sheltered homes and workshops. Social legislation in the Faroe Islands has been developed on the basis of the Danish legislation, and the areas of law and administration have gradually been taken over from Danish authorities and adapted to Faroese conditions. The pension legislation guarantees all citizens from the age of 67 a state pension, which amounts to DKK 8,240 per month for singles and DKK 6,371 per person for married couples. Furthermore, a labour market supplementary pension scheme was established in 1991, which in 1997 started paying benefits to people aged 67 and over. In 2020, the amount was DKK 5,740 per month.

In addition, the legislation ensures that all citizens who, due to illness or other circumstances, do not have an income receive a basic allowance. It is the National Board of Social Services that administers rehabilitation as well as job activation and wage subsidies for re-training schemes. Schemes involving job activation and wage subsidies are mainly used in collaboration with the general business community, but there is also an independent rehabilitation centre, through which work ability testing can be mediated. In addition, the National Board of Social Services administers disability and health-related early retirement pension, which still has three levels: lowest, middle and highest pension.

At the beginning of 2020, the group of people in job activation and wage subsidy schemes made up 3 % of the total workforce between the ages of 18 and 67. By comparison, the share of disability and health-related early pensioners was about 6 % of the adult population between 18 and 67 years of age. As for the elderly over the state pension age, the group made up 8 % of the total population.

It is the municipalities that are responsible for the elderly care, including nursing homes and home care. Some municipalities handle this task alone, while others, especially small municipalities, form part of communities to solve the tasks. The municipalities are also responsible for children’s institutions, i.e. nurseries, kindergartens and pre-school classes. Likewise, child welfare is outsourced to municipal administration through local child welfare services, brought together under a central child welfare institution. In cooperation between the national authorities, the administrative officer and the association of municipalities, an orphanage has been set up according to a similar scheme as in Denmark. It is the child welfare institution that manages the orphanage. Institutional services for children and young people and family centres, on the other hand, are managed by the social services.

The social services also manage financial support schemes for child support, child allowance and family allowance for families in financial need. It is also the social services that administer support for adoption payments, which are the highest in the Nordic region.

Within the social sector, direct financial support is provided to disability organisations and organisations for the elderly and the visually and hearing impaired. The same applies to organisations that work for the rights of children and young people, a shelter for people with mental illnesses and a crisis centre for abused women.

In 2020, the Faroese Government’s annual expenditure on social services was DKK 1.7 billion, and the municipalities’ expenditure on elderly care and primary health services was DKK 700 million, while the expenditure on children and young people amounted to almost DKK 600 million.

State of health

Life expectancy when a child is born is 85.3 years for girls and 80.4 years for boys, or 82.7 years for both sexes. Women thus have the longest life expectancy in the Nordic region and generally tops the population in the EU. The fertility rate is also the highest in the Nordic region with 2.4 children per woman. Perinatal mortality (stillbirths and deaths in the first week of life) is low; about five per 1,000 births, which corresponds to the rest of the Nordic region. Almost all births take place in a hospital. There is no free abortion, but abortion can be performed on medical indication. The number of induced abortions is therefore low and stands at about 20 % of the abortion rate in Denmark (about 50 per 1,000 live births).

Around a quarter of the causes of death can be attributed to cardiovascular diseases and another quarter to cancer. The rest of the causes of death are mainly infectious diseases, neurological diseases, lung diseases and accidents. In this distribution, the Faroe Islands are similar to the rest of the Nordic region. Fatal accidents, incl. road traffic accidents, have been around ten a year. Suicides are rare and have been around two per year in recent years.

The incidence of disease is broadly the same as in the rest of the Nordic region, however, the frequency of inflammatory bowel diseases is higher in the Faroe Islands compared to the other European countries, and the trend is increasing. Parkinson’s disease is also more common than in other Nordic countries. The diabetes frequency roughly corresponds to the frequency in Denmark, namely 6 % type 2 diabetes and 0.7 % type 1 diabetes. The incidence of cancer and the distribution of forms of cancer do not differ significantly from the rest of the Nordic region. The sexually transmitted diseases syphilis and gonorrhoea have become extremely rare in recent decades, as have HIV infections.

Prevention and health promotion

The Faroe Islands’ alcohol history differs significantly from that of the other Nordic countries. Serving and selling alcohol was banned in the period 1907‑92, and the ban was replaced by a system of public monopoly shops for the sale of alcohol as is known from the other Nordic countries apart from Denmark. Today, as a result of this system, the annual alcohol consumption per person over 15 is at the same level as in 1992, about six litres per year. This means that the Faroe Islands have managed to meet the objective of the legislative amendment, namely that liberalisation should not lead to an increase in consumption. However, questionnaires among 9th graders show that 13 % have been drunk in the past month and the trend is increasing.

In the public statistics, alcohol-related injuries are not prevalent. There are relatively few examples of cirrhosis or other known consequences of excessive alcohol consumption. There is, however, a significant number of citizens with problematic alcohol consumption. Two institutions for the treatment of alcohol addiction are run with public support, Blue Cross, which is based on a Christian foundation, and Heilbrigdið, which is based on the Minnesota principles.

Since World War II, smoking has been common among both men and women, incl. teenagers. For the past 25 years, however, the authorities have warned against smoking in campaigns, especially among primary school pupils. This has resulted in the number of smokers in 9th grade falling drastically over the past 30 years: Where the proportion of smokers among pupils in the 9th grade in 1989 was 30 %, it is now down to 7 %. The proportion of adults who smoke on a daily basis is 19 %, halving over the last two decades.

Drug consumption has been relatively modest, which is obviously due to the location of the islands and the relatively few access routes. This has allowed effective control at the national border.

The Faroe Islands, like major parts of the world, have an overweight problem. A good 60 % of the adult population is overweight (BMI over 25), which is higher than in Denmark, Norway and Sweden and almost on a par with Iceland. Particularly the men suffer from being overweight, but the trend is also seen among women, especially among the young.

The Faroese is at roughly the same level as the rest of the Nordic region as regards physical activity/inactivity. There are many sports activities, and a large part of the population are active sportspeople, both in team sports and individually. Nevertheless, about 30 % of adults do not meet the minimum recommendations from the WHO for physical activity.

Questionnaire surveys indicate that a part of the youth is unhappy. Whether this dissatisfaction is a new or old phenomenon is not known. The reasons are not clear either.

Further reading

Read more about Society and business on the Faroe Islands

  • Pál Magni Weihe

    (b. 1949) Specialist doctor in occupational and social medicine. Chief physician at the Faroe Islands Hospital Services and adjunct professor at the University of the Faroe Islands.