A large part of psychiatric care has been outsourced by Stockholm City Council. Carema has won two contracts, worth a total of Skr 2bn (€200m ) over seven years, to provide psychiatric and addiction care in the south-east Stockholm area.
Cooperative Praktikertjänst has also won a contract of half this size for North Stockholm. The contracts are part of a change programme to improve psychiatric services and to launch the first big pyschiatric outsourcing contracts in the country. Stockholm and other Swedish counties are also outsourcing primary and elderly care on a massive scale.
Kenneth Wall, director of communications at Ambea, said that Stockholm City Council was not pleased with the way psychiatric care was being run by the public sector: "They want more production and lower costs." David Phillipson, who heads up specialist care at Carema, said the council wanted a move away from psycho-dynamics to an evidence based approach. He said the council also wanted better access to professionals.
Psychiatric care is around 8% of the Swedish healthcare budget. Asked whether more contracts would follow, Phillipson said that this depended on whether Carema and Praktikertjänst delivered successfully. Other sources said that companies who tendered for the contract included Capio and Aleris.
Carema claims to have won over 40% of the outsourcing contracts in Sweden this year, including, in July, a 9 year elderly care contract in Stockholm worth skr 3.5bn (€350m), the largest healthcare contract ever awarded in the country.
The Carema contracts provide psychiatric care for 225,000 inhabitants. The addiction care, run by Carema Specialist Care, will undergo a major decentralisation to local clinics, and thus Carema will focus a great deal on local changes. Accessibility will be improved by better opening hours and mobile home visiting teams.
The non-institutionalised psychiatric care in south-east Stockholm will be run by Carema Hjärnhälsan AB, the new joint venture between Carema and Hjärnhälsan, a small private psychiatric firm with 20 staff, which has won contracts in Southern Sweden.
We will carry an interview with Stockholm policymakers and academics on these changes in future issues.
