»Government care not a solution for everything«

Claes Rehnberg, Sofia Rydgren Stale, Irene Svenonius, Lisa Pelling and moderator Lisa Kirsebom. Photo: Anna-Cajsa Torkelsson

The Tidö agreement already showed that the government and the cooperation party Sweden Democrats wanted to investigate how the state could take more responsibility for health care. In June it became clear that the matter will be examined by a parliamentary committee, consisting of the Riksdag, but with Vårdanalys director-general Jean-Luc af Geijerstam as chairman.

But will healthcare be better and more equal if the state takes over responsibility? That was the main theme of a panel discussion in Almedalen on Thursday.

The Medical Association, which has long demanded more government control, was positive, while the Swedish municipalities and regions, SKR, for example, showed less happy faces.

Another person not thrilled about the news is Lisa Pelling, director of the Arena Idé think tank.

– I think we can all agree that nationalization, or even just more government control, is sometimes emphasized as some kind of solution to everything. But it is clear that there is reason for SKR’s concern that the solution to many problems will be held before them in anticipation of this one salutary nationalization solution that will provide good care for everyone, the accessibility problems and the lack of care.

She pointed, among other things, to Great Britain, where care is under the state.

– There you have the same problems as we do, with equality and accessibility.

She also emphasized the democratic aspect.

– Who decides whether BB can stay in Sollefteå? Are they the ones who live in Solleftea? Or is it a politician in Stockholm, in the Riksdag? Democratic control threatens to end up far from the citizens, Lisa Pelling said.

The president of the medical association, Sofia Rydgren Stale, opposed it.

– The regions often talk about rapprochement between voters and elected representatives. At the same time, most people do not even know who is the chairman of the regional board in their own region. The closeness they like to refer to may not exist in reality, she said.

She believes that greater state responsibility would make it easier to solve the problems in Sweden’s healthcare system.

– It is Sweden that needs doctors, not region X or Y. We see that the state needs to step forward much more clearly and take responsibility for the whole thing, she said.

Stockholm’s opposition councilor Irene Svenonius (M) agreed and wanted everyone living in Sweden to feel like they live in the same country, with the same access to care.

Another question that was raised was what will happen to the regions if the management of care is transferred to the state.

– It remains to be seen, but you cannot have any political level – neither municipalities, nor regions, nor the state – just like that. If we conclude that a changed leadership is best for the citizens, we should not just give in that idea out of concern for us regional politicians, said Irene Svenonius.

Hopes and fears were also discussed. Several panelists hoped that more government governance would lead to a better supply of skills in the long run.

– Today the regions can decide for themselves what they think is the right number of AT, BT and ST places and we see that the number of services is falling year after year. But if we don’t have assistant doctors today, we won’t have specialists in the future, said Sofia Rydgren Stale.

One of the concerns was an “even heavier administrative superstructure”, where much of the current reporting obligations would be retained but more would be added.

– Administration, follow-up and documentation can become a kind of self-fulfilling machine that only consumes time. It’s a cloud of worry, she said.

The medical journal 27-31/2023

(updated 05-07-2023)

Anna Popplewell

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