Opinion: Neglected Västra Götaland shows that the state should take over

Västra Götaland Region’s failed Millennium medical-records project has become, in Göte Gunnarsson’s view, the clearest argument for abolishing Sweden’s regions and placing healthcare under state control.

The project collapsed on November 12, 2024, despite auditors warning for years about serious shortcomings. The region proceeded with the planned launch when the calculated cost stood at 5.5 billion kronor. Assessors now believe replacing the system could cost twice as much. Västra Götaland has also approved 657 million kronor in contractual termination costs to Oracle, a decision Gunnarsson says shows how poorly the procurement was handled. The regional director was dismissed, but he argues that many more people should have been held responsible.

Gunnarsson questions how Västra Götaland can spend 77 percent of its more than 80 billion kronor budget on healthcare while employing only 7,000 assistant nurses, 11,000 nurses and 6,000 doctors among its 57,000 employees. The region is one of Sweden’s largest employers, larger in staff than Volvo Cars in western Sweden, although Volvo has a much higher turnover. Healthcare queues frequently exceed the 90-day guarantee, he writes, while cuts often target the staff providing care. He says difficult working conditions drive employees to leave, work in Norway or take temporary agency positions.

The contributor also criticizes the political structure. Sweden has 21 regions, and Västra Götaland has 15 regional councillors. Its regional executive board is run by 149 paid part-time politicians, while few voters know the names on regional election ballots. Gunnarsson says the region’s 11.48 percent tax rate means a person with an annual net income of 400,000 kronor pays more than 44,000 kronor a year to the region. Yet politicians repeatedly ask the national government for more funding. He points to nine other regions using the Cosmic records system at much lower cost and says the comparison was ignored. In his view, the region has become an unwieldy structure that should be replaced by equal state-run healthcare.