Vårdval i Stockholm

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Stockholm County Council and challenges to tomorrow´s health care

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Vårdval i Stockholm

  1. 1. Stockholm County Council
  2. 2. General elections in Sweden Parliament County Councils Municipalities <ul><li>Democracy in three levels </li></ul><ul><li>General elections in Sweden on the third Sunday in September –every four years: elections to Parliament, County Council Assemblies and Municipal Councils </li></ul>
  3. 3. The Swedish Parliament (Riksdag) - national level <ul><li>349 members </li></ul><ul><li>Passes laws </li></ul><ul><li>Decides on state revenue (taxes) and expenditure </li></ul><ul><li>Responsible for - roads - railways, airports - police, courts - universities and colleges </li></ul>
  4. 4. County Council – regional level 18 County Councils 2 Regions <ul><li>Own parliament – County Council Assembly </li></ul><ul><li>Independent power of taxation and decisions </li></ul><ul><li>Responsible for - healthcare - dental care - public transport </li></ul>
  5. 5. Municipality – local level 290 Municipalities <ul><li>Own parliament – Municipal Council </li></ul><ul><li>Independent power of taxation and decision </li></ul><ul><li>Responsible for - residents’ social welfare and local environment - compulsory and upper-secondary schools, pre-schools - eldercare </li></ul>
  6. 6. Stockholm County 26 municipalities 2 million inhabitants <ul><li>Growth engine of great significance to Sweden </li></ul><ul><li>1/5 of Sweden’s population </li></ul><ul><li>Social, economic and ecological sustainability </li></ul><ul><li>Co-operation increases international </li></ul><ul><li>competitiveness </li></ul><ul><li>Environmental policy programme 2007-2011 </li></ul><ul><li>Culture grants and activities </li></ul>
  7. 7. Primary tasks <ul><li>Healthcare, dental care up to and including 19 years of age. </li></ul><ul><li>Public transport, including Färdtjänsten and Waxholmsbolaget. </li></ul><ul><li>Regional planning. </li></ul>
  8. 8. Facts and figures <ul><li>44 000 employees of which 90 per cent work in health care. </li></ul><ul><li>Health and dental care consitutes 2/3 of the budget. </li></ul><ul><li>The budget is SEK 70 billion for 2010. </li></ul><ul><li>1/3 of the health care is bought by SLL and performed by private suppliers of care. </li></ul><ul><li>50 per cent of the public transport is financed by taxes, and 50 per cent by ticket purchases. </li></ul>
  9. 9. Public transport <ul><li>SL: 700 000 passengers on a normal weekday. </li></ul><ul><li>More than half of all public transport journeys in Sweden are made using SL services. </li></ul><ul><li>Färdtjänsten: 3.5 million trips per year. </li></ul><ul><li>Färdtjänsten is of great social and practical importance for elderly and disabled passengers. </li></ul><ul><li>Waxholmsbolaget: 3.8 passengers per year. </li></ul><ul><li>The sea trafic is well integrated with the county’s public transport infrastrucutre. </li></ul>
  10. 10. Internationally groundbreaking research <ul><li>Co-operation with state-owned Karolinska Insitutet </li></ul><ul><li>The Swedish state and Stockholm county council together put nearly SEK 1 billion into research, development and education each year. </li></ul><ul><li>Focus on the translation of scientific discoveries into new, useful knowledge – for the benefit of the patient. </li></ul>
  11. 11. Cultural activities <ul><li>Support to cultural activities and regional associations. </li></ul><ul><li>Main financier of Stockholm Concert Hall. </li></ul><ul><li>Regional projects, such as Stockholm County Museum and Stockholm County Library. </li></ul>
  12. 12. County Council tax Tax revenue, general government grants and equalisation 79% Government grants and other grants 3% Patient fees and passenger fares 10% Other revenue 8% Revenue 2010: SEK 70 billion County Council tax rate 2010: SEK 12.10 per taxable SEK 100
  13. 13. Organisation and governance <ul><li>County Council Assembly: 149 members – elected every four years </li></ul><ul><li>County Council Executive Board: 19 regular members </li></ul><ul><li>150 boards, committees, sub-committees, companies, trusts, planning groups, etc. </li></ul><ul><li>Platform of the political majority determines the political focus during the four-year term of office </li></ul><ul><li>Dialogue, insight och contact details for county residents: www.sll.se </li></ul>
  14. 14. Distribution of seats 2006-2010 The Moderate Party 55 The Liberal Party 16 The Christian Democrats 9 The Centre Party 6 The Social Democratic Party 43 The Left Party 10 The Green Party 10 Majority Opposition
  15. 15. From decision to realisation Politicians: - manages and coordinates operations - draws up budget, sets tax rate, patient fees and public transport fares Daily operations: - healthcare and public transport (own or private contractors) - regional planning - R&DE
  16. 16. Vårdval Stockholm
  17. 17. Challenges to tomorrow’s health care <ul><li>Demographic trends </li></ul><ul><ul><li>Ageing population </li></ul></ul><ul><ul><li>Immigration </li></ul></ul><ul><li>New diagnosis and treatment </li></ul><ul><ul><li>New technologies </li></ul></ul><ul><ul><li>Preventive treatment </li></ul></ul><ul><ul><li>Traditional vs alternative medicine </li></ul></ul><ul><li>New illnesses </li></ul><ul><ul><li>Lifestyle diseases; obesity, burn-out </li></ul></ul><ul><ul><li>Pandemics and epidemics; swine flu </li></ul></ul><ul><li>New demands </li></ul><ul><ul><li>The new patient makes demands – quality </li></ul></ul><ul><ul><li>The new patient is well-informed and knowledgable </li></ul></ul><ul><ul><li>The treatment agency becomes ”discussion partner” </li></ul></ul>
  18. 18. Overall aim: care at close range <ul><li>Long-term planning for healthcare can be summarised in three words: choice, diversity and security. </li></ul>
  19. 19. Vårdval Stockholm <ul><li>Started January 1st, 2008 </li></ul><ul><li>Covers: </li></ul><ul><ul><li>General practitioners with home nursing facilities </li></ul></ul><ul><ul><li>Paediatric health care centers </li></ul></ul><ul><ul><li>Midwifery clinics </li></ul></ul><ul><ul><li>Maternity </li></ul></ul><ul><ul><li>Chiropody </li></ul></ul><ul><ul><li>Speech and language therapy </li></ul></ul><ul><ul><li>Hip and knee joints </li></ul></ul><ul><ul><li>Cataracts </li></ul></ul>
  20. 20. Aim <ul><li>To increase the patient’s influence on the care they receive, strengthen the patient’s rights </li></ul><ul><ul><li>” To move more power from the politicians to the patients” </li></ul></ul><ul><li>Increased accessibility </li></ul><ul><li>Increased diversity </li></ul><ul><li>Possibility to compare healthcare directly at www.vardguiden.se </li></ul>
  21. 21. Effects <ul><li>Better accessibility </li></ul><ul><li>Easier to choose/switch care provider </li></ul><ul><li>Increased level of quality in service </li></ul><ul><li>thorugh </li></ul><ul><li>Increased incentives to provide the best care possible </li></ul><ul><li>more care providers - 30 more health care centres today compared with 2006 </li></ul><ul><li>More appointments with existing providers </li></ul><ul><li>Increased competition </li></ul><ul><li>Money follows the patient </li></ul>
  22. 22. Listing rules <ul><li>Persons choose to register at a clinic </li></ul><ul><li>List of doctors or clinics </li></ul><ul><li>Rules governing doctors ceasing to practise </li></ul><ul><li>” Full lists” </li></ul><ul><li>Waiting lists </li></ul>
  23. 23. Renumeration <ul><li>Per listed person </li></ul><ul><ul><li>Person who has chosen to register at the clinic </li></ul></ul><ul><li>Per visit </li></ul>
  24. 24. Health care closer to home Ste p 1: Vårdguiden – the Healthcare Guide Ste p 2: Local healthcare Ste p 3: Hospital care
  25. 25. From medical advice to emergency <ul><li>Vårdguiden – the Healthcare Guide </li></ul><ul><ul><li>Advice and information round-the-clock </li></ul></ul><ul><ul><li>www.vardguiden.se </li></ul></ul><ul><ul><li>Telephone advice </li></ul></ul><ul><ul><li>Vårdguiden magazine 4 times a year </li></ul></ul><ul><li>Local healthcare </li></ul><ul><ul><li>Family doctor’s, healthcare centres, local emergency wards </li></ul></ul><ul><li>Hospital care </li></ul><ul><ul><li>Emergency and planned specialist care </li></ul></ul><ul><ul><li>Highly specialised care </li></ul></ul>
  26. 26. Facts and figures <ul><li>Everyday: 38 000 people visit healthcare providers </li></ul><ul><li>20 000 people visit a doctor </li></ul><ul><li>60 children are born </li></ul><ul><li>Ca 500 people have surgery </li></ul><ul><li>775 people admitted to hospital </li></ul><ul><li>Every month: The healthcare guide has 600 000 visitors online </li></ul><ul><li>Every year: 800 000 people contact the </li></ul><ul><li>emergency service </li></ul><ul><li>1.2 million people contact their local healthcare centre </li></ul>

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