The DN of the Debate. The health care crisis is created by the organization, and management

with health Care costs and the financial is a highly topical issue. 19 of the 21 medical service regions runs at a loss, as a part of a very large deficit. The two that didn't make it (the city of Jönköping and Halland, sweden) has recently raised the income tax rate, which, in large part, the handle, and the financial statements in 2019. Now, the announced substantial cost savings, may not always be thought out.

the Reasons for the increased costs here include: demographics (more older people), more expensive health care (technologies and drugs), and the increase in demand. In other words, it is inevitable that the costs are on the increase – do you think the employers ' organisation Swedish association of local authorities and regions (social mobility), and regional and national political and administrative leadership.

Much of the operation has also been made more efficient with the new technology. In spite of this, access to office visits and surgeries a low. Where do the resources go?

the Gigantic project is set up and ends after a few years, without any measurable effects of what has been done.

this is Often a sensible use of resources is more important than the funding. It is all too easy to ask more of such a need is often distracted by continually bickering. In the health care sector affecting the organisation and management is, unfortunately, often, unnecessary costs a way. The following items are in the context of the material.

1 , Fragmented care, lack of regional co-operation. , the 21 regions are competing with each other for skilled personnel, and a team of highly specialized health care, mimicking the for-profit companies, through a variety of channels of communication, and the varumärkesstrateger, founded the great hospital buildings and invest in expensive technology. There is no analysis of the country's needs and how they can be met. The greatest concern arises when the primary is not able to be staffed with a permanent doctor, and instead of letting a large group of hyrläkare to move out of the country, the result of which is high cost, poor quality of care, and the worsening of expertise within the group, who had little training, and peer support. This inequality in health care, where those who need it most have the least ability to choose, a permanent care contact.

2 , Hazy power structure, and also the struggle for power between politics, government, and HEALTH. , which is the familiar " knowledge is power. The control is even more powerful. Power, today the company is run by a bureaucracy, power is red tape. 9 per cent of the country's gdp for the public administration, and more than 200,000 people are employed in it. This is the bureaucratic jättebrasa requires a lot of fuel. The left hand doesn't know what the other is doing.

This leads to the production of more studies, laws, regulations, and ordinances. Some are self-contradictory, and is hardly useful in practice. The gigantic project is set up and ends after a few years, without any measurable effects of what has been done. An example of this is the ”National system of kunskapsstyrning, which is being carried out of the DEBRIS by taking a huge amount of resources from the core business. The results will probably be poor. Many of the local initiatives is not just the number of people employed, but also in much of the rest of the staff's time.

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the Lack of real expertise in the wiring system. , more and more sjukvårdsledningar is characterized by the people who make the chefskarriärer and end up in an administrative logic, in which the policies, plans, powerpoint presentations, and the chatter of the substitutes for the knowledge of the business. You are doing be happy with the vision, credentials and values, and anything else that sounds good. Loyalty to the leadership, and the karriärshänsyn can easily take the upper hand. Decisions are made without an understanding of the complexity of its activities. Chefskarusellen at a higher level faster and faster. Organisationsminnet is the short or non-existent. The criticism of the core is kept away by the growing services, which serves as an air bag between the professions and management. That's when the frustration grows, and the driver removed the key from the public health services.

A general reduction in the administration and control of the dokumentationshysteri seems to rarely be the case.

4 , over-Reliance on the digitisation and online accessibility of over documentation, procedures, and guidelines. In a cross-överadministrerad, and the fragmentation of existence, so the more the lyrics. These have to be organized and to be able to be made text-searchable. It produces, in its turn, to yet more texts. Today's Medicine, recently wrote about the sahlgrenska's papers, which are expected to have taken a 140 årsheltidstjänster to write, and which was unfit for use. The answer to this chaos is called artificial intelligence, which will lead to great efforts without any analysis of the expected impacts. An overall decline in the administration and control of the dokumentationshysteri seems to rarely be the case.

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a failure of policy and management to make the limits of the range. in a world In which all people at all times will have, the costs will spiral. Health care is not a right, but rather should be guided by the needs and setting clear priorities. This will require an original social contract, and a clear direction. When it is not, so it will not be as professional groups, to take their responsibility. The market sees the potential to meet the requirements of accessibility, and to create strange hybrids of medical care, such as a stand-alone digital services, which are not coordinated with other health services.

the Healthcare industry will probably need to get rid of the state. However, even now the need of the health and sjukvårdsledningar in the regions with a better expertise in the organization and management, perhaps at the expense of the compliant people, who are more loyal to authority than that of the core. Even at the lower levels, should be a lot of things can be done. It requires critical thinking, reflection, and reduction of functional stupidity, and to trust to the professions and, not least, of integrity and of courage.

A senior doctor described it as, ”this organization is marinated in idiocy,” which captures the general frustrations of the professional groups.

the Healthcare industry is a complex one to make. Increase in the resources of the drowning light of the complexity and diversity of the expensive ”solutions” that create more problems than they solve. An experienced practitioner has described it as, ”this organization is marinated in idiocy,” which captures the general frustrations of the professional groups. Urgently required is to make use of the methods of the dumhetsbekämpande organizations, and communities. Lines, project teams and other stakeholders, should be called into question when they want to carry out the monumental changes of which ”everyone” should be forced to work with a set of themes, regardless of whether it is warranted or not.

the Problems arise in large-scale systems, in which the forces of the central positions, and with little understanding of the specific activities, as well as initiates and maintains such a thing, which sounds good, but in many places, undermining the core of the business. More resources of money and sometimes on that.

the Solution to healthcare's problems are hardly all the more a better thought-out and reasoned approach to the business. This can in part be achieved through the odlande of the negative capabilities: the ability to review and challenge the vested interests and the silotänkande and on the basis of the efficient use of resources. When you reinforce a critical sense of the will of the diversity of the standard concept, värdegrundsprat, and large-scale solutions are to be replaced by more time on operational improvement, with a focus on the core business, to engage in effective health care.