Norway could suddenly open up to the private sector, in much the same way as Sweden has done, reckons Nina Torp Høisæter, Chief Executive of Norlandia Omsorg, Norway's largest private healthcare operator.

She says that, currently, just 2% of all nursing home beds are run by private operators, and that the Socialist government is opposed to any private involvement.

But she sees sign of change: "Care homes are run by the municipalities, not the central government, and with the economic downturn they are going to struggle. I have been touring quite a few of them, and they have the systems in place to monitor and measure performance and are interested in using the private sector."

This reflects the extraordinarily high cost of care in Norway. She claims that, in Oslo, each bed costs 550,000 to 600,000 NOK a year, excluding property costs.

Whilst the municipalities are interested, she admits that what is really needed is a change of government: "We have elections next year, and the Conservatives are ahead in the polls."

In Sweden, a change of government a year ago has led to a huge shift towards outsourcing, with industry sources estimating that 6-8bn SKr of business could transfer to the private sector in the next 18 months, mainly in the care home and domiciliary sector, but also in primary care.

Norlandia Ormsorg is owned 45% by FSN Capital and 45% by Hospitality Invest AS, the investment arm of big hotel chain Norlandia. In June 2007, Norlandia Omsorg nearly doubled in size with the acquition of Achima, a healthcare recruitment agency with sales of 200m NOK.

It is also building a pan-Scandinavian chain of patient hotels. Torp Høisæter says there are now 45 such hotels in Scandinavia, and that Norlandia is the main operator: "Many are tiny, but we run a big unit in Oslo with 130 beds." All are owned by adjacent hospitals who bring in Norlandia Omsorg as an operator either with an entrepreneur or contractor licence, with Torp Høisæter very much preferring the latter.

The hotels provide accommodation for ambulatory patients. Torp Høisæter says it is impossible to say how fast they will spread: "The hospital sector is very conservative, and normally run by doctors, so getting change is difficult."