Tag: Hallengren

Home away from home, or not

home services may be denied for summer guests
pic: senioradvice.com

In another ripple in the wake of Covid, several municipalities have petitioned the government to be able to deny summer residents (people moving to the summer houses for the summer months, for example) the home services they’re granted in their home municipalities. Many parliamentarians understood and agreed with the municipalities, and on the 3rd of June a majority said that the government must temporarily change the law and allow municipalities to deny services. But yesterday, the government said no, the municipalities must provide these services by law. This has caused consternation and anger on the part of these municipalities. Some have now said they’re ready to go their own way and ignore the law.

Home services cover a lot of things. Municipal employees are sent out to homes to help elderly, sick and/or injured with things like cleaning, shopping, getting dressed, taking a shower, making the bed, cooking food, accompaniment on shopping rounds or just helping with a walk, and more. What clients can get help with depends on their needs – there isn’t a ready-made list. Furthermore, different municipalities can grant different help: One municipality can say that a client can get help with their shopping four days a week while another might say something different. One municipality can grant 10 hours of help a week without being any more specific about what tasks the person is to get help with. It’s not free – there’s a price list for each activity and the prices can vary per place. However, it’s subsidized, and the monthly maximum price, for the user, is currently just over 2000 SEK.

This is not the real cost of the services though, and the municipalities say they can’t afford it. When people who normally receive services in their home municipality move for the summer, the summer municipality takes over the responsibility for them, including the manpower and the cost.

Lena Hallengren, Minister for Health and Social Affairs, explained the no by saying changing the law was just too complicated a thing to accomplish in a short time: It can’t be done in a wave of the hand, but needs a thorough inquiry and an impact analysis (DN.se).

Not good enough, say several municipalities. “We’re going to continue saying no” said Orust town councilor Catherina Bråkenhielm, DN reports. “We’re holding the line and denying home services for the time being” said town councilor Mats Abrahamsson.

Not even the Swedish Association of Local Authorities and Regions (SKR) is happy with the government: The muncipalities “don’t want to say no to summer guests, but they don’t have the staffing. They’re also worried about a higher local infection rate now when the government has lightened up on restrictions,” noted Gregor Bengtsson, coordinator for elderly care at SKR. There are about 60 who are saying no, Bengtsson says.

The consequences of the municipalities’ actions are at this moment still unclear. Bengtsson says the they might be investigated by the Swedish Health and Social Care Inspectorate (Inspectionen för vård och omsorg, IVO) and that some have been reported to the Office of the Parliamentary Ombudsman (justitieombudsmannen, JO). More immediate effects, though, are going to be felt by the elderly or ill, who have been granted assistance in their home area, and who are asking for it – as allowed by law – also when they enjoy the summer away from home as well.

When a covid vaccine becomes available

Who gets the vaccine?
pic: verywellhealth.com

Yesterday afternoon, Reuters reported that Astrazeneca had signed a 400 million dollar contract to supply “european countries” with 400 million doses of an eventual vaccine. However, not all countries were actually in on the deal, and it’s unclear what the arrangement means for Sweden.

The contract is for a vaccine called AZD1222, developed at Oxford, that isn’t at all fully developed and tested yet, but is expected to be perhaps ready for delivery at the end of the year. Germany, France, Italy and the Netherlands are the countersigning parties, in a constellation called “Europe’s Inclusive Vaccine Alliance”. In another contract, Astrazeneca has another deal for 1.7 millions doses with the US, the UK and India.

SVT reports that, so far, Sweden has no similar deal. Minister for Health and Social Affairs Lena Hallengren, however, came out yesterday to say that Sweden is in intensive negotiations with Astrazeneca and other vaccine developers. As for the deal that the other European countries have made, it is still unclear as to if these countries were out for themselves or whether the deal they signed is meant to help all or any other European countries. When asked specifically whether Sweden was any kind of partner to this, Hallengren said that the signing countries should come out and say what the story is: “The ambition is to see to it that other EU countries are a part of it, but speed has been needed.”

It was only at the end of May that Sweden came around to the realization that maybe a vaccine deal might be a good thing. The strategy they put together consists of a “continued international cooperation” and the nomination of a vaccine coordinator (!) with a mandate to see that Sweden’s needs are taken care of. The Public Health Agency of Sweden (Folkhälsomyndigheten) has been given the responsibility to prioritize the vaccine’s distribution when it becomes available.

Seeing, perhaps, that these measures are likely ineffectual (bordering on pathetic) the government announced Sunday that it has upped the stakes a bit. From originally only granting a limit of 350 million kronor for “preparedness investments” (bereddskapsinvestering), the Public Health Agency has now been given permission to loan up to 2 billion kronor. “When a vaccine becomes available, the means to procure it must also be available” said Minister Hallengren.

This may mean that Sweden has come to understand that Sweden’s municipalities do not, and have not had, the muscle or the weight to bid against other countries when trying to purchase supplies: Sweden’s system of decentralization has meant that every municipality has had responsibility to get its own supplies. It was only lately realized that the municipality of Västerås doesn’t quite have the purchasing power that buying for the entire country of say, Austria has. To give a heavy purse to the Public Health Agency to swing with for Sweden, if it’s not too late, will help.

Furthermore, any vaccine doses that are procured shall be evenly distributed around the country: “it makes no difference where you live” proclaimed Hallengren. Sadly, it has been all too apparent in the case of Sweden’s elder care, that when supplies are limited, a reckoning of your importance is indeed taken into account.