25 Nov. – layoffs causing anxiety

clouds gather over South Hospital
pic: stockholmdirekt.se

It seems to be going around. “It” being hospital staff being laid off.

First it was the two Karolinska hospitals- the old one Karolinska University Hospital, and the new, but disaster-prone, New Karolinska Hospital in Solna. This newest hospital in the country was going to be the bestest and most specialised care available for money. (Bestest isn’t a word, but the superlatives used in describing the hospital ran amuck when the hospital was being built.) Alas, they have no money. After the cost of building the new hospital came to twice the original estimate (and it still doesn’t work well – see lack of sterilized instruments, specialised child care but no play rooms, phones not working, and the list goes on), Stockholm region couldn’t cough up any more money to cover the hospital’s budget deficit this coming year. Three weeks ago, the hospital administration gave notice to 600 doctors and nurses’ aides – this even after it gave notice to 550 administrative positions earlier this spring (SvD.se/Karo).

Today, both Danderyd Hospital and South Hospital (Södersjukhuset) gave notice they’re letting personnel go – 100 jobs at Danderyd (so far undetermined which categories), and 25 doctors, 25 nurses and 25 others at South Hospital.

Göran Stiernstedt, chair of Region Stockholms common board for Danderyd, South and Södertälje hospitals, said the budget deficit is to blame. Cutting staff was the only way to manage the budget, he explained. “I understand if patients are concerned. It is our ultimate goal that care will be affected as little as possible” Stiernstedt wished aloud to SvD. “But there are no guarantees that the personnel retrenchment (åtstramningen) won’t go unnoticed. There is that possibility. It can’t be avoided.”

Left party care spokesperson Jonas Lindberg called it a complete catastrophe. Also the main opposition party in Stockholm, the Social Democrats, took issue: Opposition counsellor Aida Hadzialic (see this post) said that the notices can be a threat to patient safety. “I’m seeing all the warning lights blinking. Care for the sickest patients in Stockholm is threatened. Patient safety is threatened – there’s a wave of notices being given at our hospitals at a time when we know staffing is a problem” (DN.se/Karo).

Even Moderate party Stockholm veteran, responsible for finance, Irene Svenonius called the situation serious – and she’s one of the major players in the issue. “Naturally, it’s a serious situation when a hospital must let people go to manage a budget deficit. And they must redimension their operation in regards to the agreement they have with the health and hospital board” (DN.se/Karo).

(By the way, substitute her “And” for “But” and the sentence makes more sense. This rhetoric trick is making the rounds from schools to businesses.)

Green party Environment and Public Transport counsellor Tomas Eriksson added his voice to the issue, saying he understands if Monday’s announcements cause worry, but: “At the same time, the hospital runs a deficit, and more care is being moved closer to the patient level – it isn’t tenable. The resources need to move as well” (DN.se/Karo).

But back at Kommunal, the largest union in Sweden and the main union for health care workers, managers were angry. Anne-Li Rosengren, a negotiator for Kommunal representation at South Hospital, got word of the notice only in the morning. “It’s been a couple of hours since I heard. At first, I was sad. Now I’m mad as hell (fly förbannad)” (SvD.se/South).

Sweden has one of the highest number of doctors per capita, although this varies a lot by region (see a report here). It also has some of the longest waiting times for surgery, and the fewest number of hospital beds per capita in Europe (see this report).

Oct. 20 – yes we have no syringes

no planned surgeries
pic: sverigesradio.se

A half dozen hospitals throughout Sweden remain at crisis levels (stabsläge) through the weekend and at least through Monday, as basic supplies have still not been delivered. Crisis level has meant that scheduled operations have been put on hold for the time being, in order to ensure the availability of supplies for critical and emergency operations. The basic supplies that have particularly been delayed are such items as syringes, washcloths and needles.

Currently, hospitals in Västmanland, as well as others in the regions of Örebro, Uppsala and Dalarna, have rescheduled all planned surgeries. Almost a hundred operations at Uppsala hospital, and 42 operations in Dalarna, have been postponed (SvD.se/hospitals). Not all hospitals have been affected however, such as at Akademiska Hospital in Uppsala. As Margareta Sandback, the admin in charge of supplies there, who made sure there wasn’t a shortage, put it: “I’ve been here before” (Svenska Dagbladet, Oct. 20, p. 2).

Other hospitals and admins were completely taken by surprise. On October 1, the company in charge of delivering supplies to hospitals changed from Mediq to Apotekstjänst. Apotekstjänst has explained that they were taken aback by the number or orders that came in, and added that the hospitals must have been low on supplies to begin with (DN.se/hospitals).

Hospitals have been reaching out to the previous company Mediq as well as other suppliers, looking to shore up their stocks. Meanwhile, a committee has been formed to look in to creating some sort of supply warehouse to increase preparedness “There hasn’t been an economic possibility for this earlier” said Mikael Köhler, chief surgeon at Akademiska Hospital (DN.se/hospitals).

Of course, questions arise as to whose head should roll. Lawyers (jurister) at Region Uppsala are looking into it, but insist that they are not looking to sue or to change companies. “Maybe later we can look at who’s right or who’s wrong,” said Anne Nilsson, head counsel, “but right now it’s about getting supplies” (DN.se/hospitals).

updated: Although Akademiska Hospital in Uppsala previously had no trouble with supplies, by Tuesday morning they had had to reschedule a whole lot of operations – SvD must have gotten that wrong. In more news on this topic, the CEO for Apoteksstjänst – the company which has not delivered, in more ways than one – resigned on Monday. It hasn’t helped a bit.