Swedish healthcare is world-class with regards to public health and medical results. At the same time, there are recurrent problems in terms of long waiting times, poor continuity, lack of coordination and limited person-centeredness. A fundamental problem, discussed ever since the mid-1940s, concerns the lack of resources in the primary care sector suffering from an insufficient number of general practitioners.
“Currently, there are a number of different models in place for the primary care sector, which is the result of circumstances rather than deliberate planning. The state needs to take greater responsibility for the transformation and long-term financing of the healthcare sector, rather than focusing on short-term, earmarked investments”, says Anders Anell, Professor at the Lund University School of Economics and Management.
In the SNS report “The Future Governance of Swedish Healthcare”, Anell argues that increased state funding should also have consequences in terms of governance. One example involves clearer national planning and competency management in order to offset the trend seen in recent decades with a declining proportion of general practitioners. He also proposes nationally regulating the choice of healthcare provider on the basis of two levels. The first level consists of signing up with a provider primarily offering digital healthcare services as well as physical visits when needed. The second level is offered to older individuals or after a referral and involves signing up with a physical clinic.
“Primary care centres find it difficult to address all needs, and in order to live up to accessibility requirements, certain patients may thus be excluded. Choosing healthcare provider in two steps results in both adapting to personal needs and to a person-centred approach. There are also better opportunities to develop the benefits of digital solutions, such as being readily available to a very large number of people. At the same time, it will be easier for primary care centres to prioritise medical support to the elderly care sector funded by municipalities, which is currently neglected”, says Anders Anell.
This report is published within the framework of the SNS research project Health care in the 21st century.
About the report
In the report “The Future Governance of Swedish Healthcare”, Anders Anell describes how governance in the Swedish healthcare sector has evolved over the past decades. He highlights the main problems and presents a series of recommendations on how governance at the regional and state level can be improved and how future funding should be designed to better address the challenges facing the healthcare sector. The report also contains a historical background of the challenges associated with this sector and previous attempts at addressing these.

Anders Anell is Professor of Business Administration at Lund University. He serves as Chairman of the Board of the Agency for Health and Care Analysis and has previously headed the Swedish Institute for Health Economics in Lund (IHE).
Download a summary of the report.
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