Jakob Riis: The importance of health has increased during Covid-19, and the points made by World Economic Forum in 2020 about health being the foundation for prosperous societies (The World Economic Forum Global Risk Report 2020) have become more relevant than ever. In this perspective, which areas do you consider important to focus on in order to improve and to sustain Denmark’s competitiveness?
Nille Klæbel: No doubt, that we are at an inflection point with Covid-19. When thinking of Denmark’s possibility to attract investment, talent and ensure technological innovation, we need to address at least four pain points: The first one being our ability to handle the changing demographics in society which is a challenge for health systems in most Western countries. Considering the increasing level of people with chronic diseases, we need to make some essential structural changes, as the current system will not be able to handle this sufficiently. The second pain point is the execution of the public procurement model. The way this is carried out does not attract and promote research, development, and new private public collaborations on a larger scale. On the contrary, tendering very detailed pre-defined solutions, is a huge barrier. The third pain point is the ability to integrate sustainability into the way we think growth. In my view, growth and sustainability cross-fertilize each other and will attract investments, people and private companies. And last – but not the least: The lack of diversity. To be quite honest, if I was not a Dane, I would hesitate to take up a leadership position in a country that ranks no. 95 when it comes to women’s share in leadership positions. I would look for other countries.
No-one takes care of the patient from A-Z
Jakob Riis: As the first pain point, you mention the changing demographics due to the increase in number of people with chronic diseases. We could also add the ageing population (as projections are that by 2050 one in six people will be aged 65 years or over worldwide) and the need to look more into preventive care, as factors that effects the future healthcare system and reasons for reforming it. How should we approach this in order to make it a competitive advantage and do we already have some advantages to build upon?
Nille Klæbel: Denmark has the advantage of being a digitalized society (e-boks.dk, borger.dk. sundhed.dk, just to mention a few), and not many countries have this advantage. The problem is that we do not leverage this when it comes to healthcare. No-one takes care of the patient from A-Z, partially due to the separated cash flows in regions and municipalities. I think telemedicine could be the answer as we already have strong digital infrastructure and a population that is largely accustomed to interacting with the healthcare system through online platforms. However, in order to fully gain from this, we will have to administrate caretaking in hospitals and at home as one seamless process (care path) – and furthermore to change the regulation regarding health-related data. The solution could be an open data-suite, a digital health suite, with anonymized data which could also be used for innovative purposes and easy integration for developers of new plug-ins.
We need more large lighthouse partnerships instead of one-off pilot projects
Jakob Riis: You touched upon the Danish Procurement model as a pain point. In Norway they have implemented an “Innovative Procurement method” for the public procurement, where the needs and necessary functions are communicated to the market. The market players then respond with the best possible way to solve this. It is considered to be a great success and has promoted a greater Public Private Partnership. This could be an interesting way to pursue for Denmark’s public procurement, that amounts to over 50 billion EURO a year (or 17 % of our GDP)?
Nille Klæbel: That is exactly it. We need to establish better public private partnerships to create a coherent healthcare system. We need more large lighthouse partnerships instead of one-off pilot projects, to attract investments and innovate solutions ready for export. I believe that one central key to solving this problem is a more dialogue-based tender processes, in line with EU tender legislation, where we use public procurement to attract research and innovation to Denmark. Procurement does not have to, and cannot always, figure out what the best solution is in advance due to the speed of innovation and digital development. But by engaging with the private sector with global know-how and experience, we can figure it out together. Even though trust is basically one of the values that we are proud of carrying in the Danish society, this is definitely not the foundation for the Danish tender process at the moment. Hence, we miss out on a lot of opportunities to create outstanding solutions for the Danish society while attracting foreign research and development.
Growth and sustainability cross-fertilize each other and will attract investments, people and private companies
Jakob Riis: And when it comes to sustainability, do you consider this as a parameter to create or sustain a competitive advantage for Denmark?
Nille Klæbel: Actually not. It is more an “entry ticket” but if we do it cleverly, we will be able to take the lead. For instance, according to “Health Care Without Harm”, the healthcare systems account for 4.4 % of the global CO2 emissions, which is more than the aviation or the shipping industry. Hospitals produce 13 kg of waste per bed every day and 15-25 % of this is hazardous waste. This is a great example of a problem, where leveraging our digital expertise, could be an area for us to lead. At the same time, it is an example of an issue, that could be tendered as an issue, where partners could be invited for a dialogue on how to solve this. If we do that, and we are able to develop some groundbreaking solutions, then it might become a competitive advantage.
To be quite honest, if I was not a Dane, I would hesitate to take up a leadership position in a country that ranks no. 95 when it comes to women’s share in leadership positions.
Jakob Riis: You also mentioned lack of diversity as a pain-point for the Danish competitiveness?
Nille Klæbel: Yes, it is – to a large extent. Denmark lags far behind the Nordic peers and according to a BCG survey, it is unfortunately an area with huge unconscious biases. As the survey states: “…. Danish men, highly represented in leadership, do not believe that gender biases exist in Denmark, and Danes—both women and men—are unaware of the problem”. We need to establish more concrete goals and KPI’s, and to become more aware of our unconscious bias. Quotas have been debated a lot as a means. Personally, I am not worried about it. The quotas might be the tipping point for the woman to get the job, but it will not ensure that she keeps the job, if she is not good enough.
Jakob Riis: So, based on your view on our strengths and barriers, were to sum up with a piece of advice to the Danish government on how to strengthen our competitive advantage, what would that be?
Nille Klæbel: We need to change four elements in order to attract investment, talent and ensure development:
- The Healthcare systems need to change to adapt to demographic changes and this cannot be done by the public system alone
- The public procurement model and execution, needs to change to fully leverage innovation and digitalization
- The approach to sustainability in public tenders and Public Private Partnerships needs to change for the same reason as for no. 2: Fully leverage on innovation and digitalization
- The approach to diversity needs to change to be able to attract talent.