This is an opinion text. The newspaper’s stance is independent social democratic.
When the government on Monday presented the extra money that will go to crisis care, I was not surprised. It turned out to be just as small extra government grants as was expected. Those six billion are for show. The government does not want to appear insensitive to the healthcare crisis, but it also does not want to seriously do anything about the problems.
So what stuck with me the most when the government presented its package for the spring budget was something else: the little word “efficiency delegation”. A word with so many syllables should be very suspicious. One could say that the word itself is in need of linguistic streamlining.
The idea from the government’s side is therefore that a government delegation should be appointed to try to find out how the regions can make their operations more efficient. As if that is not exactly what the regions are constantly doing, and have been doing for as long as anyone can remember and especially since the crisis of the nineties.
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So what stuck with me the most when the government presented its package for the spring budget was something else: the little word “efficiency delegation”. A word with so many syllables should be very suspicious.
In short, you can say this: The government must now create more bureaucracy to deal with unnecessary bureaucracy. It is as paradoxical as it sounds.
A main problem in all healthcare and social care is that very much of the business simply cannot be made more efficient. The time it takes for a scrawny eighty-year-old to take off his clothes at a doctor’s appointment can hardly be shortened at all. And the actual conversation with the doctor or nurse loses medical precision if it becomes more concise.
That applies not least to the alleged cost-saving proposal – which is now to be implemented in at least one region – to remove interpreters in healthcare. In the long run, this can increase healthcare costs, when patient and doctor understand each other less well and the treatments become incorrect and thus more expensive.
Sure, there is a lot of technology in healthcare that can always be made more efficient, and this is also happening all the time. But the heavy cost is and remains the staff. Getting it to work faster usually means in practice that it has to do a worse job. The classic example of the difficulties in streamlining service production is as follows: You can force a symphony orchestra to play Beethoven’s Fifth Symphony twice as fast to save money. But: It goes beyond the music.
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Photo: Fredrik Sandberg/TT
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It will be exciting to see what the government’s efficiency delegation comes up with one day. My guess is: Nothing. Presumably it results in some reports that say exactly what the regions already know.
But then to them the extra money that the government is now proposing. Is six billion enough? Yes, that’s enough. This is roughly how Ebba Busch answered the question of whether the extra six billion for the regions and welfare is enough. It is of course a response to better knowledge.
She knows it’s not enough. The prime minister knows that too. The deficits are large in a number of regions – not least in Dalarna – and news of staff reductions is like a stick in the hill. From Sweden’s municipalities and regions (SKR), the message has long been that the deficits are over twenty billion. And that’s just to keep operations at the current level, even though the current level is not reasonable.
It’s direct scandalous that the current government did not already announce last autumn that more, albeit not enough, money would come: Regions have been forced to plan in uncertainty about how much extra state funding would be allocated. The government’s actions have reasonably made all planning in the healthcare system more difficult.
How much money would really be needed? It depends on what political will you have. If redundancies are to be prevented and if at least the current standard – which in itself is quite bad – in healthcare is to be maintained, then it is around those 24 billion that are required. One should also consider state subsidies for care and social care as reasonable measures to counter an economic downturn with more unemployed people.
Prime minister Kristersson says he wants to “help” the regions. But the regions’ economy is and remains a national concern and thus a responsibility of the government. But the government comes with alms and a parodic efficiency delegation.