"I would of course wish that the development of healthcare mediation could proceed faster," says Minister of Health Elisabet Lann (KD) in a comment.
She emphasizes that the government has spent SEK 25 billion, in addition to the healthcare agency, on shortening waiting lists.
In 2022, then-Minister of Health Acko Ankarberg Johansson (KD) described the initiative as groundbreaking and as a way to provide patients who have waited longer than the care guarantee requires with care in other regions. At the time, it was said that it could start in 2023, but it ended up being 2025.
Now the regions can search for healthcare providers elsewhere when they themselves cannot provide care within the statutory time limit. It is possible to search for capacity primarily for cataract surgeries, inguinal hernias and knee replacements, in what is called the healthcare mediation service.
Don't know
When asked by TT whether any patients have received care so far through the agency, the E-Health Agency replied that it is used in all 21 regions.
"However, since it is a search service, the E-Health Authority cannot follow up and quantify how many patients are referred," the authority writes in an email.
TT has asked three regions - Norrbotten, Västra Götaland and Örebro - whether the service has been able to provide patients with faster care in another region.
Region Örebro states that it does not use the healthcare mediation service.
Region Västra Götaland says that it is used when the region does not already have agreements with clinics outside the region, but cannot answer whether any patient's wait has become shorter via the service.
In Norrbotten, the service is used, but "to a small extent".
The problem with the service is that it is voluntary for all regions to enter their (existing) agreements. Then it will not be very useful, says Pia Krutrök at the healthcare guarantee unit in Norrbotten.
But she, like colleagues in Örebro and Västra Götaland, believes that the health agency can be useful once it has been expanded.
Skepticism at SKR
The Swedish Association of Local Authorities and Regions (SKR) is skeptical about the government's care mediation. The regions already have staff who look for care providers elsewhere when they cannot provide care within the limits of the care guarantee, according to SKR.
"So the regions still have difficulty fully seeing what role a national agency would play," writes Johan Kaarme, director of the department for health and social care at SKR.
One problem for patients who want to have a procedure in another region is a lack of information or support. Some regions want patients to bear the cost of travel and be reimbursed afterwards. This can cause patients to decline.
So far, only healthcare professionals can apply to the healthcare mediation service. In the long term, Minister of Health Elisabet Lann wants patients to be able to do so as well.
The Tidö Agreement between the three government parties M, L and KD and the support party Sweden Democrats states:
"Establish a national healthcare agency under state control to cut queues in healthcare."
Available capacity is reported and enables patients, who have received a medical assessment and are waiting for care, to choose to have the treatment or surgery performed elsewhere in the country if they so wish.
A system of state funds for this purpose is being developed with clear governance and follow-up so that the financial incentives for shorter queues are strengthened."
The healthcare guarantee is a statutory right, patients must:
Contact primary care within 0 days.
Get a medical assessment within 3 days.
Get a first visit to specialized care within 90 days.
Receive surgery or other specialized care within 90 days of the decision on treatment.
Source: Swedish Municipalities and Regions (SKR)
