Primary care was supposed to be expanded – but despite investing billions, little has happened

Historically, hospitals have been the core of Sweden's healthcare system. But the system has repeatedly been criticized for being inefficient, and in 2018 the government of the day took the initiative for a change.

Good and local care is a goal for the transition and the idea is that primary care should be the base and hub of care. For 2019-2023, the country's municipalities and regions have received SEK 28 billion in state funds for the purpose – but the transition is slow.

Primary care has not received more resources

According to the Swedish Agency for Health and Care Services Analysis, the work so far has mainly focused on developing overall strategies, but there are still few effects of this in the operations. Nor has more financial resources been allocated to primary health care.

"It is worrying that the regions have not yet provided primary care with the resources needed for the goals of the transition," says Caroline Olgart Höglund, head of analysis at the agency.

Increased patient inflow

A recent report from Ivo highlights shortcomings such as the fact that collaboration between municipal and regional health and medical care does not work, and instead of a reduced inflow to emergency departments, the authority's supervision indicates in some cases an increased inflow.

"It's not surprising that patients go to hospital if you have primary care that can't meet the need," says Peder Carlsson, head of department at Ivo.

Conflicting signals

Ameli Norling is head of the health and medical care section at the Swedish Association of Local Authorities and Regions. She believes that the work on the transition has yielded results, including in the form of changed working methods.

But she believes that providing more resources for primary care is a challenge given the financial deficits that lie ahead. She believes that they also receive conflicting signals:

"At the same time as we are making primary care the hub, we are getting strong signals that we are going to strengthen hospital care. And it's hard to secure resources for the whole.