The Norwegian Medical Association (NMA)
The Norwegian Medical Association (NMA) has more than 15,000 members including 2,000 student members. About 95 per cent of Norwegian doctors are members of the NMA. Since 1993 the NMA has been divided into seven subgroups, and these occupational branches share occupational interests, and most of the secretariats are common with the NMA. The Association of General Practitioners (Aplf) is the second largest with 3,500 members. The central board of the NMA has nine members, two general practitioners are currently represented in this board. General practitioners have a reasonable percentage of representatives in different parts of the NMA. The interests of general practitioners, both occupational and educational, arc brought through Aplf to the central board of the NMA. The structure of the NMA is meant to keep the different subgroups together, and all subgroups have their own secretariat integrated within the secretariat of the NMA.
NMA not only has an interest in union tasks, such as rates of payment and working conditions, but also has its own branch of the secretariat serving postgraduate education and specialty branches in all fields of medicine. NMA has also given the medical faculties at the universities resources to build up new educational centres, such as institutes and centres for general practice, community health and occupational medicine. A reimbursement tariff for general practitioners and private specialists is negotiated every year with the government/national insurance company. A part of the total reimbursement expenses are allocated to educational and quality improvement funds. These funds enable NMA to organise postgraduate courses and education independent of the pharmaceutical industry. NMA organises 60 different specialty branches of which 42 correspond to a medical specialty, including general practice/ family medicine. The Ministry of Health has authorised NMA to deal with and decide on applications for the approval of specialists in medicine.
The Association of General Practitioners
Aplf was founded in 1938, and for the last 25 years the secretariat has been integrated in the NMA's secretariat. Aplf has two main tasks:
union tasks, such as general practitioners' remuneration and working conditions;
continually work to improve the standard and quality of the general practitioners and their practice, including organising postgraduate education.
The central board of Aplf has seven members, each elected for two years by the annual genera] assembly. Every county has its chosen county representative, who represents Aplf on in the board of the County divisions of the NMA.The central representatives of Aplf are represented on the different committees of the NMA and herein fulfils part of Aplf trade union tasks. In addition to its own activities, Aplf uses ihe main secretariat of the NMA in different purposes and tasks towards the Government, the politicians and other trade unions.Aplf has a very long tradition in postgraduate education and has, since the foundation, had its own 'college of general practitioners' within the organisation. It has its own board of seven members. This part of the organisation work with different fields of general practice that influence the quality and educational standards of the doctors, the assistants and the way the practices are organised. The chair of Aplf's central board always participates in these meetings, and the chairman of Aplf's 'college-board' is also present at the central board meeting. Thus the educational and professional development discussed and decided for, if possible, can be integrated with the political goals of the organisation, and vice versa. Aplf also suggest all the members of the Specialty Committee for General Practice.After several years of hard work Aplf, the NMA and the Government introduced the specialty in General Practice/family medicine in 1985. This specialty has helpedtoraisequalityofcare provided by the Norwegian general practitioners and raise the wages for genera] practitioners.