Göran Stiernstedt: “We are the world’s worst at continuity”

Failed investments in primary care, an unreasonable system with online doctors and a public failure at coordinating the healthcare IT system. Göran Stiernstedt does not mind his language when describing the shortcomings of today’s healthcare system. “It makes me extremely frustrated,” he says.

Göran Stiernstedt is a well-known profile in Swedish healthcare. With a background as an infection specialist, associate professor, hospital director, deputy county council director, head of care at SKR, state investigator, national coordinator of care utilisation and today Chairman of the Board of the Karolinska Institute, he knows healthcare from every angle, and he is not happy.

He believes that we should complete the transition to a more primary care-oriented healthcare, although he nourishes little hope that this will happen in the near future. Instead, he notes that despite all the words, Sweden invests relatively little in primary care.

“We need a healthcare system that can keep people feeling secure, and that is not what we have today. Security is about continuity and accessibility, and we are pretty much world worst on continuity,” he says.

In 2019, as a state investigator, he proposed that online doctors should be integrated into physical primary care in a reformed choice of care, and he maintains this opinion.

“I am grateful to online doctors for speeding up the digitalisation of healthcare, but the current system is unreasonable. In my world, digital appointments do not constitute a separate healthcare system, but they are rather a tool to be integrated into a security-creating system based on continuity and accessibility.”

You were also a member of the Corona Commission. Can we learn anything from the pandemic when it comes to designing the healthcare of the future?

“I hope so. Among other things, it has shown the need for more national governance. Is a system with 21 regions efficient? No, I think the pandemic has shown that it is not, for example, when it comes to testing.”

Göran Stiernstedt emphasises that one of the government’s most important tasks in healthcare is to create a solid infrastructure, and this, he says, has failed miserably. Not least, this applies to the lack of standardised IT systems allowing information to be exchanged across organisational boundaries.

“It makes me extremely frustrated because ensuring a functioning IT infrastructure is one of the biggest favours that the government could do for healthcare.”

“The other failure area is the supply of skills; to ensure access to the right kind of skills. There is much to be done in this area, especially with the lack of specialist nurses.”

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