More value for money and less political control
- Organising for better healthcare and dental care across the country.
Resources and results
Despite major investments in healthcare, the results are not living up to expectations. Sweden spends around SEK 700 billion annually on healthcare, equivalent to around 11% of our GDP - 30% more per capita than the OECD average. We have more doctors (4.3 per 1 000 inhabitants) and nurses (10.7 per 1 000) than the OECD average, but far fewer hospital beds (2.0 per 1 000 inhabitants compared to the OECD average of 4.3). The figures thus indicate a well-financed sector. Yet the system is characterised by long queues, unequal access and large regional differences. Ambition Sverige wants to see a more unified, government-led and professionally organised healthcare system, where resources are used efficiently and patients get the care they need - no matter where in the country they live.
Shorter queues save lives and resources
Thousands of patients are currently waiting for treatment, operations and procedures. According to the October 2024 report by the Swedish Association of Healthcare Professionals, 89,435 people had waited longer than the care guarantee in August - the highest number since records began. Waiting times vary greatly depending on where you live. We believe that the care guarantee should not only be respected, it should be tightened, with a maximum of 60 days for surgery or specialised procedures, regardless of where you live. This is entirely possible if we work together nationally. We want you to be close to an emergency hospital; healthcare should be available where life happens.
Emergency hospitals must not be so far away that people die on the way there
Since 1961, 39 emergency hospitals have been closed, and today only around 57 remain, many with limited emergency functions. As healthcare is centralised, distances are getting longer and safety is unevenly distributed, especially for those living in rural areas.
Sweden needs more care places
During the pandemic, the shortage of care places became painfully clear. Many elderly people were denied basic medical care that could have saved their lives and instead received palliative care. According to the National Board of Health and Welfare, there is a shortage of almost 2,000 beds every day, equivalent to around 12 per cent of the need. Sweden also has one of the lowest numbers of beds per capita in Europe, leading to overcrowding, stressed staff and patients being discharged too early. Building more beds is not just a question of care, it is a question of national preparedness and defence.
Giving birth should feel safe
When you're expecting a baby, you need to know that care is close by, that the maternity ward is staffed and that help is not far away when you need it most. But today, the reality is different. Maternity units are closing, capacity is decreasing and many people risk travelling long distances or even giving birth in their cars. Childbirth care is a fundamental right.
Ambulance services are the first line of defence in saving lives
When an accident or illness strikes, you need to know that help is on its way quickly and safely. But today, ambulances are standing still due to staff shortages. The ambulance is not just a vehicle, it is a rolling emergency hospital and a lifeline for the community.
Sweden should have equal healthcare
We are a country where everyone pays taxes, so healthcare should be equally accessible to everyone regardless of municipality or region. In a debate article in Göteborgs-Posten, Ulf Ljungblad and Christer Enkvist, among others, pointed out that at least 10,000 patients die unnecessarily every year in Sweden. This corresponds to 27 people every day. This shows that inequality in healthcare is not just about accessibility but about life and death.
Multi-level organisation
Today, health care is organised into central government, 21 regions and 290 municipalities. All these levels are politically governed, which in practice means 21 different regional and 290 municipal solutions. In total, there are around 4 600 regional politicians, which is an average of 219 politicians per region.
The role of the state is mainly regulatory, while the regions are the main operational level, responsible for primary care, hospital care and dental care. Regions are financed through regional taxes (11-12 per cent). Since 2000, regional taxes have increased by around 17 per cent, but it is unclear whether citizens have received correspondingly better care and services. The municipalities are responsible for elderly care, home care and school health, among other things.
Key authorities are the National Board of Health and Welfare, the Public Health Agency of Sweden, the Swedish Medical Products Agency, the Swedish Inspectorate for Health and Social Care (IVO) and the Swedish Agency for Health and Social Care Analysis (MYVA). The Swedish Association of Local Authorities and Regions (SALAR) acts as an interest and employer organisation for all regions and municipalities.
Our vision for Swedish healthcare
Ambition Sverige wants to see increased state and professional control of Sweden's healthcare. This can best be achieved with a state-led system where healthcare is primarily governed by medical expertise built on a scientific and experience-based foundation.
Health care is nationalised and a new coordinating authority is created
The state takes over the taxing rights for Swedish healthcare. Funds are then distributed, after negotiation, to the regions and state hospitals.
A new national expert authority, the Health Service Board (HSS), is established by merging authorities. This authority will be led by people with a medical background, mainly doctors. The HSS will be responsible for the national coordination of specialist healthcare and for dialogue and negotiations with the regions. It is tasked with developing clinical guidelines, forecasts and plans for future needs of doctors and nurses. The HSS sets the framework for the national hospital plan. The authority will also manage a national healthcare database with compiled and accessible information for both professionals and the public.
Reduce the number of regions
Ambition Sverige wants to reduce the number of regions from the current 21 to six larger units, with a total of seven regional hospitals. The aim is to reduce administration and free up resources for core activities. Political governance will remain in place to ensure accountability, but day-to-day leadership will be based on medical expertise. Regions will be tasked with responsibility for regional hospitals and specialised healthcare, but also to sign agreements with private specialist hospitals and clinics. All citizens should be able to choose a family doctor, and access to general practitioners should be ensured locally.
The majority of hospitals should be publicly run, but there should also be a variety of private specialist clinics and health centres. Local anchoring should always be favoured. Company-run chains with centralised control should only be given the opportunity to provide care in Sweden in exceptional cases.
Municipalities
Municipalities have their own right to tax and are responsible for care of the elderly, home care, school health and also prevention and rehabilitation. The division of responsibilities between regions and municipalities should be clarified.
With the above vision, we create a more professional, efficient and governmental management of health care. We reduce administration and bureaucracy, focus on operational activities and increase the possibility of more equal and accessible care throughout the country.
Health care today
In the short term, healthcare needs to be streamlined and made more accessible to citizens. We have long queues for care, citizens have difficulty reaching primary care and contact is often via digital means. ”Healthcare apps” are not appreciated by all citizens. A population increase of 2 million people over the last 25-30 years, some with different needs and different cultures, places higher demands on primary care/specialist care. This results in higher costs that are not fully compensated by higher revenues.
Administration and bureaucracy should be minimised in favour of operational activities. Ambition Sverige believes that the state must take greater responsibility for the regions' results. This can be done through more independent audits, increased coordination and governance, and better long-term rules pending the major reorganisation described above.
Human resources, training and leadership
The lack of beds is a major problem. Overcrowding has more than doubled in ten years. The main reason is a shortage of nurses, which means that beds cannot be kept open. Almost all regions now report a shortage of specialist nurses, with midwives being one of the most obvious examples.
A crucial factor for the future of healthcare is a sustainable human resources policy. Despite various initiatives, many nurses choose to leave the healthcare sector for other industries with better conditions. Detailed management has increased, which has also contributed to doctors choosing to leave Swedish healthcare. The increase in staff in the regions has mainly taken place among managers and administrators - not among healthcare professionals. Leadership is needed that focuses on operational efficiency rather than values. The education system needs to be reviewed. We need to take greater national responsibility for specialised training for doctors and nurses. Nursing assistant training should be strengthened with a greater focus on practical skills.
Systemic issues
Ambition Sverige wants healthcare to use common IT systems. This applies, for example, to medical record systems, patient registers and data management in radiology and pathology, which should be coordinated nationally.
Use of medicines and side effects
Today, around 10% of emergency hospitalisations among older people are due to adverse drug reactions. These are sometimes misinterpreted as new diseases, leading to incorrect treatment and unnecessary hospitalisation. The problems stem from both a lack of guidelines and limited resources in primary care. Ambition Sverige wants to reduce the routine prescription of medicines by focusing more on the underlying causes of the disease.
Reforming dental care
Oral health is crucial to the health of the whole body, but Swedish dental care is currently significantly more expensive than medical care. Ambition Sverige believes that dental care should, as far as possible, be covered by the same conditions as other medical care. Therefore, we want both the treatment fee and the high-cost coverage for dental care to be equalised with that of medical care. The same fee levels should apply to everyone, including asylum seekers.
Paediatric dental care needs to be strengthened by increasing the minimum reimbursement level for private dentists per child treated. This remuneration should be adjusted in line with cost developments. The conditions for private dentists should be equalised with those for private doctors. Excessive supervision and connection fees for private dentists should therefore be abolished.
Defence budget - preparedness in peace and war
New emergency hospitals, more ICU beds and stronger healthcare infrastructure are part of Sweden's civil defence. Investing in healthcare saves lives even in peacetime and strengthens preparedness in war. In addition, building hospitals and care facilities favours the productive economy and creates long-term strength for Sweden. Redirecting parts of the defence budget to healthcare is not weakening defence, it is building Sweden's real defence: the security of its citizens, in peace and in crisis. Saving human lives must apply both in peace and in war. That is why healthcare is a central part of Sweden's defence.
Focus on preventive health
Finally, a stronger focus on preventive health is needed. This includes investments in antenatal care, breastfeeding support, interventions for ADHD and lifestyle changes that can reduce future illnesses. Increased co-operation between regions and municipalities on public health would reduce the use of medicines, improve health and thus reduce healthcare and societal costs.
Ambition Sverige will work for:
- Reducing waiting lists through more resources, better coordination and increased efficiency. More beds, a care guarantee with real incentives and more patient time per doctor.
- Ensuring access to emergency hospitals across the country. No one should have to risk their life because the hospital is too far away.
- Guaranteeing a place in hospital at all times - there should be enough beds both in times of peace and crisis.
- All families should have safe access to obstetric care. No one should have to give birth in a car.
- Ambulance services should work across the country. When minutes make the difference between life and death, help must arrive on time.
- Health care should be equal throughout the country. Everyone pays taxes, so everyone should have the right to the same care, regardless of where they live.
- Streamlining and reducing the number of government agencies through mergers and the creation of a Health Services Board (HSS).
- Radically reducing bureaucracy within the regions and increasing the autonomy and influence of healthcare units and their staff.
- Taking greater national responsibility for training specialist doctors and nurses. More nurses need to be trained and nurse training should be improved.
- Regions to facilitate more private, physician-led options. Public and private care should be treated equally.
- Increasing knowledge about complex adverse drug reactions. This will help reduce misdiagnosis and unnecessary hospitalisation, especially among the elderly.
- Reducing the indiscriminate prescription of medicines by requiring a more in-depth analysis of the cause of the disease.
- Swedish dental care should be subject to the same fees and coverage as medical care.