A full or partial state responsibility for health care – patient and family perspective

The purpose of this report is to highlight views from the patients’ perspective on the Swedish state’s role and responsibility for health care. Experienced patients/experts have contributed to the content and recommendations. The report is written by Catharina Barkman and Helena Conning, Forum for Health Policy. December 2023.

Can a full or partial nationalization of the health services be a cure for Sweden’s health care crisis? A Swedish parliamentary investigative committee is trying to find an answer. The health crisis has been fueling a debate in Sweden for quite a long time over whether the state should reclaim the healthcare services mandate from the 21 regions that have been in charge since the 1980s.

The committee will examine, on behalf of the centre-right government, whether full or partial nationalisation should take place in the coming years and, if so, what steps Sweden should take along the way. But in June 2025, the committee will present a series of scenarios on whether the state should take over all or part of the health care mandate or whether nothing should change. This report from Forum for Health Policy gives presentation of how patient organizations and patients view the question of full or partial nationalization.

There is a concern among patient representatives that a major reorganization will take too much energy and that it will have a negative impact on patients and relatives. They emphasize that the conditions look different around the country and that local adaption may be needed. The importance of participation, person-centred care and knowledge-based care is emphasized. Likewise, the importance ot taking advantage of patients’ and relatives’ experiences to a greater extent. Clearer national governance in strategic areas is highlighted at the same time as possible ways to create the conditions for more equal, cohesive, and accessible care. The patient’s perspective must be included in the entire process. The control mechanisms that exist at the national level today have not had the desired effect on the health care system. The Patient Act and the investment in the transition to local care are examples that have not proven to provide desirable results.

  • Strengthen care for people with chronic diseases to avoid hospitalizations.
  • Make it easier for patients to seek care throughout the country. In a survey from the Network Against Cancer most of the patients in the survey stated that they were prepared to seek care in another region to avoid queues.
  • Build a digital health care platform with real-time information about available healthcare capacity that both medical staff and patients have access to.
  • Allow patients to book care online in other regions.
  • Demand an IT infrastructure in health care that enables the sharing of patient data in a seamless way for the benefit of patients and staff.
  • The state should appoint one government agency responsible for IT infrastructure in health care.
  • Accessibility to health care must be improved and the statutory care guarantee must be fulfilled with demands for concrete results in the regions.
  • Strengthen the support for family and relatives who take great responsibility for patients.

For more information see the Swedish report: https://healthpolicy.se/wp-content/uploads/2024/01/Rapport-statlig-styrning_patientperspektivet_final.pdf