Animosity but also success in Sweden

Fines for delayed discharge could improve the life expectancy of
older people, reduce the number of hospital admissions and save
money to invest in other parts of the health service if it has the
same success here as in Sweden.

The English system, due to begin operating in shadow form from
October before money starts changing hands in January, is based on
the Scandinavian model, which was introduced 10 years ago.

Marianne Olsson, senior project director for the Federation of
County Councils in Sweden, said the reforms had caused a “lot of
animosity” between the health and social care sectors but that the
results had been positive.

Life expectancy for men and women had increased by 2.3 and 1.5 per
cent respectively during the past decade. Older people now spent 30
per cent less time in hospital, and the number needing intensive
supported housing had also reduced by a third, said Olsson.

This had been achieved during a period in which health spending in
Sweden had fallen from 8.8 to 8.5 per cent of GDP.

“Fewer people are now seen in hospital but they receive better
care. The money and beds freed by better social services have
improved older people’s health,” she said. However, Olsson warned
against social services and the NHS getting into “turf wars” and
power struggles over who controls the system.

“I am not sure I’d advise that way of doing things. Regional and
local agreements are the way to go,” she added.

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