Sweden’s 600 million kronor healthcare push has yet to show it shortened queues

More than 600 million kronor has been spent on Sweden’s national healthcare referral service, but it remains unclear whether the investment has helped any patient receive care sooner or shortened waiting lists.

Healthcare Minister Elisabet Lann said she wished the service’s development had moved faster. The government has also allocated 25 billion kronor for measures to reduce queues, separate from the referral system.

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I would of course wish that the development of the healthcare referral service could move faster.

The initiative was described in 2022 by then-healthcare minister Acko Ankarberg Johansson as groundbreaking. It was intended to help patients who had waited longer than the statutory care guarantee receive treatment in another region. The service was expected to launch in 2023, but did not begin operating until 2025.

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But because it is a search service, the e-Health Agency cannot follow up and quantify how many patients are referred.

Regions can now search for providers elsewhere when they cannot deliver care within the legal deadline. The service mainly covers capacity for cataract operations, inguinal hernia procedures and knee replacements. The Swedish e-Health Agency said all 21 regions use it, but added that it cannot track or quantify how many patients have been referred because it is a search service.

The experience varies among regions. Örebro said it does not use the service. Västra Götaland said it uses it when it lacks an existing agreement with clinics outside the region, but could not say whether the service had shortened any patient’s wait. Norrbotten uses it “to a limited extent.” Pia Krutrök of the region’s care-guarantee unit said the problem was that regions were not required to list their existing agreements, making the service less useful. She and colleagues in the other regions nevertheless said it could help if expanded.

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The problem with the service is that it is voluntary for all regions to enter their existing agreements. That makes it less useful.

The Swedish Association of Local Authorities and Regions remains skeptical. It says regions already have staff who look for providers elsewhere when they cannot meet care-guarantee deadlines, leaving them uncertain about the national service’s role. Patients also face limited information and support, while some regions require them to pay travel costs upfront and seek reimbursement later. For now, only healthcare staff can search the service, although Lann wants patients to be able to use it directly in the future.

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So the regions still find it difficult to fully see what role a national referral service would take.