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The night nurses who take care of at least five private nursing homes in Gävle, do not only have to relate to the municipality and the region. Private nursing homes have their own medically responsible nurses, and the homes have agreements with various health centers.
– That more people have a responsibility for medical management is a difficulty we had with the choice of care, says Hans Karlsson, who today is municipal director in Arvika and is part of the information council of the Health and Care Inspectorate, Ivo and the Public Health Agency.
“It’s a model that more people should try,” says Hans Karlsson of letting the same director take care of both the care of the elderly and the health care.
Photo: Börge Nilsson
The ambiguity is greater than the choice of care reform in 2010. With the elderly reform in the early 1990s, most municipalities assumed responsibility for home health care and nursing home care, while physicians still belonged to the regions that were then called county councils.
– Then the county councils equipped their efforts for the elderly and thought that now the municipalities do this. But for municipalities, caring was only a small part of the business. There was a gap in which the concern for the health of the elderly was given lower priority, despite the fact that more and more people are aging and in need of more care.
If the same director is in charge of the care of the elderly and health care, the gap will disappear, at least organizationally. In Norrtälje, a municipal association, owned by the Norrtälje Municipality and the Stockholm Region, is responsible for primary care, local hospital care and most social services, including care for the elderly.
The Local Government Association’s own care company, Tiohundra AB, performs the activities that are not managed by private contractors.
– It’s a model that more people should try, says Hans Karlsson.
Norrtälje nursing homes have had far fewer COVID-19 infections and deaths than the region as a whole. Of course, there may be other reasons, but Bo Burström, professor of social medicine at the Karolinska Institutet, has received research funding from the Swedish Research Council to find out whether the organizational model has affected mortality.
– It will be interesting to see if he has played any role, he says.
