DN Debate. The national care guarantee, causes irreversible damage

The statutory national care guarantee has now been around in one form or another since 2010 (SFS 2010:349). It stipulates that the first meeting and some selected interventions in highly specialised medical care shall be rectified within three months. The underlying idea is good and the goal of the guarantee is to reduce waiting times in health care.

Unfortunately, an undesirable consequence of the introduction of the care guarantee, as it is designed today, the undanträngningsmekanism it generates. Less serious diseases take the resources from a serious, chronic condition where the damage that occurs leads to permanent damage and reduced quality of life.

Let us take ögonpatienten Elin as an example of the care, which represents many similar cases. She is an otherwise spirited 75-year-old who a few years ago was diagnosed with glaucoma (see box), for which she receives treatment in the form of eye drops.

Had the patient in our example had the good fortune to stay in, for example, Västerbotten, she would likely come in time to its control, and a large part of her damage on the field of view had never occurred.

In case of glaucoma, it is important to regularly check ögontrycken, and are therefore called Elin periodically to ögonmottagningen for the controls. Now she has because of waiting times have not received any checkout time in over two years and gets the tragic news at our last visit that her eye pressure is severely elevated and she lost half of her field of vision. She will be a year and a half late to his halvårskontroll. Elin lives in west yorkshire. Had the patient in our example had the good fortune to stay in, for example, Västerbotten, sweden, where waiting times to glaukomsjukvården is short, she would likely come in time to its control, and a large part of her damage on the field of view had never occurred.

the aegis of the care guarantee the design has caused major felprioriteringar in health care. In the selected example diseases of the eyes, it is only the first meeting and cataract eye operations included in the guarantee. The absolute majority of the patients covered by the care guarantee, in other words, either no disease at all or have an eye disease that can be cured without irreversible loss of vision. Thus, it is obvious that the choice of diagnoses covered by the care guarantee, are not done on medical grounds.

Within the eye diseases related to the large non-priority groups of patients such as glaucoma, diabetes and age-related changes in the macula, which together constitute a significant proportion of all visits within ögonsjukvården. In many cases, there is no curative treatment for these patients, and delayed the controls is therefore at risk of causing irreversible vision loss and, in some cases, blindness.

Now is a review of the care guarantee and this article prompted politicians regardless of partifärg to change existing health care guarantee, which only includes the first meeting and selected interventions. They are asked to refrain from making the same mistakes as in the past where top-down focus on the individual, and often less serious, ailments, in some cases, have pushed away resources from more serious chronic diseases that cause irreversible damage.

in Order to avoid that the less severe diseases are prioritised over serious and that the patients that Elin do not need to suffer irreparable damage as a result of a sick-care system needs to the governance of today's health care is changing fundamentally:

1 Nationalise health care. To let the state take over the finansieringsansvaret would promote a more equitable health care in Sweden. It could allow a more inclusive distribution of resources within the country and ensure that patients suffering from the same problem, can expect the same quality of care regardless of place of residence in Sweden. A shared financial responsibilities could also provide greater opportunities for cost savings by joint procurement of everything from medications to medical equipment and it systems.

2 Change the current health care guarantee. Today's national health care guarantee where the focus of the first meeting or action of often harmless ailments should be fundamentally changed. This is because it can lead to crowding of patients with chronic, incurable but often treatable diseases which threaten irreversible damage that could have been prevented if they had come to care in time. Health care guarantee in and of itself is not evil, but the face rather than a national health care guarantee, which also includes visits and measures of patients with chronic diseases. This needs to be done in consultation with specialists in each medical area, so that the priority becomes based on medical need and not what may be considered popular.

3 Bet on the right use the skills. Care needs to be streamlined and organized so that employees ' skills are utilized in the best way. There are many important tasks within the health care system that does not require medical expertise. In today's medical care often perform highly skilled employees such as doctors and nurses this information because it for a long time been a gradual reduction of the staff who do not have college education. By focusing on increasing human resources which are not further trained, doctors and nurses focus their time on patient care.