"Not very when they are employed in the public sector," according to private providers who say that this is precisely why they are brought in as outsourcers or recruitment consultants.

According to Karsten Ramløv Svendsen, chief executive of Transmedica, the big Scandinavian recruitment specialist, public sector psychiatrists see an average of two patients a day in Sweden, 2.4 in Denmark and just 1.8 in Norway. Pyschiatrists who are recruited by Transmedica and who work for the public sector on contracts see an average of six.

The figures for public sector family doctors or GPs are not much better, claims Svendsen. He says: “In Sweden it is perfectly normal for a GP to see just six patients a day. GPs who are on contracts see 20.”

In the Stockholm area private operators have been allowed to set up new GP practices and it is interesting to note how far what Svendsen says echoes remarks made by Yonna Olsson, head of Proxima, which is setting up such practices: “It is all about increasing the number of patients that a family doctor sees from 8-9 a day to 15, where you can make a small profit. You need to see 12 patients a day to break-even. In some cases, doctors are seeing 25 patients a day. But, to do that, you have to shorten the consulting period to 15-20 minutes and Swedes aren't used to that - they are used to saving up their problems and then visiting the doctor with 4-5 issues! We have to show them that they can come more regularly and have shorter visits.”

What I find interesting in all this is how the private sector is apparently being brought in through the backdoor to address productivity issues which the authorities seem to be unable to resolve directly with public sector employed doctors.

Of course, there is a reverse side to this coin, which is that recruitment consultancies who have doctors on short-term contracts can force up prices in countries like Denmark where there are severe shortages of all medical personnel. Recruitment is also very big business in Finland as small municipalities in the far North try to collar staff.