Sweden’s healthcare budget ‘severely underfunds’ sector, doctors warn

The Swedish government’s budget for its strained healthcare sector will be far from sufficient for the next year, stakeholders have warned, raising the alarm about potentially severe implications for the entire public health sector.

Last January, a one-year-long national supervision of 27 emergency hospitals across the country showed a range of capacity problems within Swedish healthcare – often leading to overcrowded care wards.

Local press reported about patients who use spoons and pans to make themselves heard in hospital corridors, unattended deaths, and a lack of specialised doctors and nurses.

The Health and Social Care Inspectorate concluded that the downsizing of the number of available care beds has gone too far, resulting in safety risks for patients.

In the wake of such warnings, the centre-right government’s 2024 budget proposal was under a harsh spotlight when it was tabled on 20 September.

State contributions are key as the 21 Swedish regions, which manage healthcare separately, estimate having common budget deficits amounting to €2 billion in 2024, according to a forecast from The Swedish Association of Local Authorities and Regions (SALAR).

The government now proposes adding €550 million to the national healthcare sector, which is just over a third of the nearly €1.4 billion the proposal allocates to the welfare sector.

Finance Minister Elisabeth Svantesson (Moderate party/EPP) explained that the budget overall needs to be “tight” because of high inflation.

The main stakeholders in the sector welcomed additional support but emphasised that it is far from what is practically needed.

“The exceptional investment in health care that was promised shines with its absence,” said Sofia Rydgren Stale, the chairperson of the Swedish Medical Association, the doctors’ union.

Similarly, the Swedish Association of Health Professionals, a union for nurses and midwives, fears the consequences will be very harsh for the healthcare system.

On a political level, the biggest opposition party, the Social Democrats, also voiced their concern.

“For the second year in a row, the government proposes a budget which is severely underfunded when it comes to regions and local authorities,” Fredrik Lundh Sammeli, party spokesperson for health issues, told Euractiv.

“This is very serious for health care and several regions are now planning to make cuts,” the Swedish politician added. An example is the Region of Sörmland, where 400 employees in health care risk losing their jobs.

Impact on hospitals

Annika Wallenskog, chief economist at the Swedish Association of Local Authorities and Regions, stated that “pandemic contributions” are rolled back in the budget for next year – corresponding to a loss of several million euros for the regions.

“In order to cope, some regions are discussing how to decrease inflows of patients to the emergency departments, and in some cases, regarding minor hospitals, they are thinking of closing them,” she noted.

Deputy Premier Minister Ebba Busch and Health Minister Care Acko Ankarberg Johansson, both Christian Democrats, said they are well aware of the challenges the sector is facing.

“This is reflected in the actual waiting times for surgery and treatments, which now vary between 33 to 140 days, depending on which region a patient lives in,” Busch told journalists at a press conference.

“If that is to succeed, we need to secure the competence supply. Employees in healthcare need to want to stay at their jobs and have the energy to do this important work. And it will not simply be enough with the applauses that they got during the pandemic,” she said, referring to the much-publicised evening rounds of applause from citizens during COVID-19.

Busch underlined that the responsibility to organise the health care lies in the regions as based on the Swedish management model, they can independently increase local taxes or use reserve funds, she noted.

The budget proposal will be discussed in Riksdagen, the Swedish parliament, in the autumn and a vote is expected in December.

Meanwhile, the government is exploring whether nationalising Sweden’s public healthcare sector – or parts of it – would be a good idea for the future.

(Monica Kleja | Euractiv.com – Edited by Vasiliki Angouridi and Nathalie Weatherald)