Caring for the severely handicapped has turned into a market worth Euros 2bn a year in Sweden which is now attracting outsiders. Norlandia Care, the largest Norwegian care group is trying to hard to grow its market share here for instance. It is not hard to see the attraction. There is almost no capital involved as care is in the individuals home and the state pays Euros 25 an hour.

Personal choice has become the mantra in Sweden and that includes everything from primary care to who looks after you if you are handicapped. This alone has created a market worth an estimated Euros 2bn a year, according to marketleader Humana, which is majority owned by private equity player Argan Capital. Humana chief executive Per Granath says this is separate from the less specialised market for domiciliary care, looking after the elderly in their own homes which is some 3-4 times larger.

Granath reckons around half the market is met by municipalities, with the private sector holding 35% and the rest in the hands of cooperatives. He reckons that the overall market growth, which has been very fast since inception in 1994, will slow to as little as 5-10% as remuneration rates rise more slowly (4% in 2009, 2 % in 2010) and assessments of the needs are restricted. However, he thinks that the private sector will continue to grow its marketshare: "Although private companies get exactly the same money per hour delivered, we achieve much higher client satisfaction, higher employer satisfaction and we still manage to be profitable, whilst a majority of the municipalities lose money."

The cost per individual varies depending upon the number of hours of care to which they are entitled, but he says the national average is 4,500 to 5,000 hours a year. As standard remuneration is 247 SEK (Euros 24), the average yearly cost per individual is around SEK1m (Euros 100,000).

The Independent Living Institute placed Humana first with 1,350 clients, Frosunda with 1,100 clients, Olivia (540), Särnmark (200) and VH Assistans with 170 followed by Norwegian interloper Norlandia (120). At SEK1m per capita that suggests that the top six have no more than half the total private sector share.

Granath puts Humana’s success down to its approach: “The individual has the right to choose supplier, meaning that the individual is our client. We focus very much on each individual’s situation and listen to his/her needs and desires. By doing so, we have managed to reach very high levels of client satisfaction (97 % of our clients have declared that they gladly recommend us to other individuals in similar situations).”

He adds: “We are also very cost conscious, keeping close track on our overhead costs. With considerably lower overhead costs than the municipalities, we can offer higher salaries to the personal assistants and also higher cost allowances, giving the client the opportunity, for example, to travel with his/her assistants and having the costs for the assistants paid for by us.”

Humana sales, SEK 1.3bn in 2008, should hit SEK 1.6bn in 2009 and SEK 2bn in 2010.