The uptake of the reform is partly ideological, says the government's investigator. Photo: Jessica Gow/TT

Freedom-of-choice reform "should be mandatory"

5:03 min

Five years after the introduction of the law that opens up the health care and elderly care to competition, and allows the user - the citizens themselves - to choose service provider, the reform has been evaluated. The government's own investigator wants to make it mandatory for local councils to offer a choice in its welfare services.

The law that gives local councils the option to introduce competition into the health and welfare sector came into force in 2009. Each council can decide if they want to go ahead with it or not, but today 180 out of the 290 local councils have decided to do so.

Greger Bengtsson was chosen by the government to evaluate the scheme. Overall, he thinks it has been a success, because the right to choose is important to the beneficiaries.

Bengtsson has compared the councils that do offer a choice, with the ones where there is only one service provider. And he has not been able to detect any difference in quality or efficiency between the two, nor any significant difference in cost.

For many of the elderly, the vast amounts of service providers to chose from is however making the choice very difficult, says Ingrid Hjalmarson at the Stockholm Gerontology Research Center.

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