Sweden’s healthcare crisis deepens amid huge deficits

Forthcoming cuts to psychiatric care at Sweden’s largest hospital could lead to more deaths, 29 doctors from the hospital have warned, in the latest example of the country’s deepening health crisis.

The Sahlgrenska University Hospital in Gothenburg is the largest acute care hospital in Sweden and one of the largest in Europe in terms of staff, employing around 17,700. This year, though, a record €1.5 million needs to be saved, an amount that corresponds to 2,000 employees.

The savings plan was classified in December – now parts of it are emerging as negotiations with the unions get underway. Psychiatry was the first to report about the consequences last week.

“When Sahlgrenska’s psychiatric care now has to save €8 million, it will hit an already very vulnerable group of patients with a high need for hospital care. Swedish research shows that when the number of care beds is reduced, the mortality rate increases among our patients,” 29 doctors from the department protested in an opinion piece on 23 January.

Critical mental care units in danger

Two hospital wards for patients with psychosis, high suicide risk, severe depression, or life-threatening drug addictions, as well as a daycare reception, are now facing closure.

Speaking to Euractiv, Hanna Kataoka, a senior consultant psychiatrist at the Sahlgrenska University Hospital and chair of the Swedish Medical Association in the Västra Götaland region, voiced serious concerns:

“The cuts mean a disaster as our hospital care is already very slim after the pandemic, and there is a lack of specialist doctors, for example.”

According to Sahlgrenska’s CFO, Anders Glansén, the downsizing will be the biggest in the hospital’s history “if today’s economic conditions do not change”, he told Euractiv. But the outlook is grim.

In the meantime, the hospital management hopes to mitigate the impact by shifting care to smaller regional hospitals, increasing the number of mobile teams that work with hospital patients cared for at home. They count on politicians to expand primary care.

Assessing the impact of the budget cuts

Four people – including Anders Glansén and the chief physician – are now assessing whether any of the austerity measures on the management’s list would pose a safety risk to patients.

“We are not going ahead with efficiency measures that mean we are worsening patient safety,” he told Euractiv.

However, Hanna Kataoka fears there could be no such guarantees.

“The hospital care is so slim due to lack of care beds that we already can’t admit all patients that we would want to as doctors. And patients are sometimes discharged prematurely to give space to more seriously sick patients.”, she adds.

Deficit-plagued regions

The western Swedish region is one of the 21 regions that run the country’s healthcare sector, a majority of which is now bleeding money.

“According to our estimates, 17 regions will have deficits totalling more than € 2.1 billion in 2024,” Annika Wallenskog, the chief economist at the Swedish Association for Local Authorities and Regions (SKR), told Euractiv.

This is due to a rapid increase in healthcare costs because of high inflation, rising pension costs, and a growing patient burden, according to Wallenskog.

So far, savings equivalent to a total of 5,300 jobs, including Sahlgrenska’s, have been announced across Sweden.

Some emergency departments in acute care hospitals have also been hanging in the balance. One of them, in the municipality of Lidköping, which has a population of more than 40,000, had to close in November despite large protests. The nearest acute care department is now 50 kilometres away.

At the same time, the government may propose more state funding for the sector this spring, according to recent statements by Finance Minister Elisabeth Svantesson and Prime Minister Ulf Kristersson, both conservatives.

By then, it will be too late to stop the cuts in the regions, Wallenskog said in a comment.

In Stockholm, various acute care hospitals will have to save almost € 90 million this year, but only on administration.

“So far, the regional government has kept health care out of the picture. But I am afraid this will change”, Johan Styrud, a consultant surgeon at the Danderyd’s Hospital and chair of the Stockholm section of the Swedish Medical Association, told Euractiv, adding:

“The economic situation in the regions is going to be incredibly bad this year, with high inflation and high deficits, so it’s going to be really tough.”

At the hospital in Danderyd where he works, emergency department overcrowding and lack of nursing beds remain a major challenge.

This is despite establishing new coordination and steering groups, called Task Force Acute Flows and Tactical Forum Operation, to improve the number of care beds.

“What we need is more capacity. We still have patients who spend 24 hours on a hard stretcher in the emergency room, and this is especially hard for elderly people with many health problems,” said Johan Styrud.

 [By Monica Kleja, edited by Vasiliki Angouridi/Zoran Radosavljevic |]


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