Swedish health care and the patient
Views of a wife

Ture Berg, born 1927 in the North of Sweden, is an index person of present crisis of Swedish health care (cf 1). He was reared and trained in the same village as the 10-year younger author Torgny Lindgren (cf 2), as farm-hand, lumberer, teamster, taxi driver. and ambulance driver. The family moved to Umeå 1972. Ture continued as taxi driver and was forced into early retirement about 1990 due to ischemic heart disease and worn-out neck (cervical spondylosis), a typical occupational lesion of drivers. Ture received hip prostheses at Lycksele Hospital during 2003. The criticism (3) of Swedish health care by Ture´s wife is summarized and commented below.

Mrs Berg is critical to the queue system of Swedish health care; her husband was crippled due to worn-out hips. About December of 2001, the couple was aware that Ture needed artificial hips. Their general practitioner wrote the referral for operation in February 2001. From then, Ture had to wait for 15-25 months for the necessary surgical procedures. For surgical logistics, three months would be optimal.

The pain, the sleeplessness, and the lack of response from health care provided the worst part of the sufferings of the couple. Not even Mrs Berg was able to break through the walls of silence, in which Swedish health care has isolated itself. In fact, the waiting list is often the weakest link of Swedish health care, a mixture of approximately healthy persons, of patients in various states of distress, and people dying for other reasons. All waiting lists require sorting and prioritizing. Such functions are usually lacking. In any case, waiting lists without proper sorting provide a main cause of patient discontent in Swedish health care (1).

Sweden has numerous small hospitals like Lycksele Hospital. Such hospitals are suitable for elective surgery in office hours but not for irregular activities such as obstetrics. If people wish efficient health care, people must accept specialization and transportation. From such points, Swedish health care is in a process of transformation towards the needs of a modern post-industrial country. However, many politicians and lobbyists make a career by craving an obstetrician and two midwifes in all shrubs, instead of balancing resources and needs.

The Bergs are satisfied and grateful for the efficient handling of their trouble at Lycksele Hospital. Nevertheless, the health care of Sweden, basically of international top class, has a problem in communicating its virtues and limitations to the citizens. A summer locumtenens with university ambitions, a swift and skilled surgeon from a small rural hospital, managed to operate all patients but three on the waiting list for transvesical prostatectomy of a university department of urology. The three remaining patients were listed for surgery on the Monday morning, when Number Four in the hierarchy of urologists returned from vacation. The first patient had a cardiac arrest halfway to the surgical theater. The astonished urologist had to grab his pen and request a pre-operative resuscitation, which failed. The second patient had his cardiac arrest in the first stages of anesthesia. The third patient was already dying in the ward. The disgraced Number Four had to flee to a small hospital in a distant rural area.

1. Norberg B. Leadership and ownership. The Swedish crisis of health care [health]. Rondel 2002; 12. URL: http://www.rondellen.net/health12_eng.htm
2. Norberg B. The Torgny Lindgren Library [culture]! Rondel 2002; 12. URL: http://www.rondellen.net/culture12_eng.htm
3. Berg G. Hälsovården och patienten – en livskamrats funderingar [hälsa]. Rondellen 2004; 18. URL: http://www.rondellen.net/health18_swe.htm

Published February 26, 2004