The National Audit Office's report on digital doctor visits and locum doctors in the sick leave process
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
S supports the committee's proposal and argues that there is a need for national guidance to create uniformity between regions and healthcare providers when issuing sick leave based on digital doctor visits 1. S considers it expedient to provide the health and medical care system with national support in this matter 1. SD considers it positive that digitalization increases accessibility, but argues that the negative consequences of digital doctor visits and locum doctors for the sickness insurance must be addressed 2. SD wants the government to appoint an inquiry to follow up on Socialstyrelsen's development work based on Riksrevisionen's problem description 2.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Jessica Rodén (S)
Madam Speaker! I would like to begin by expressing my support for the committee's proposal.
The Swedish National Audit Office's report on digital doctor visits and locum doctors in the sick leave process
The National Audit Office has submitted recommendations to the government to take the initiative to develop clear national guidelines for the issuance of medical certificates based on digital medical consultations.
In its report, the National Audit Office writes that the lack of steering documents has resulted in regions and private healthcare providers having developed their own routines, which has meant that there is a lack of consistency in the routines between the regions and between different groups of healthcare providers within the same region.
Madam Speaker! Against the background of the rapid development within e-health, the previous government took a number of measures. With the bill on increased continuity and efficiency in care, the government initiated a reforming of primary care with a particular focus on accessibility, continuity, and participation. In the bill, the government assessed that care needs to become more digi-physically adapted and coordinated and, to a greater extent, build on continuity as well as individual wishes and needs.
In 2018, the National Board of Health and Welfare was commissioned by the government at the time to develop recommendations for which types of care and treatment are appropriate and not appropriate to handle via digital healthcare services.
In June this year, an investigator was tasked with assisting the Ministry of Social Affairs, among other things, to analyze whether there is a need to set specific requirements, for example quality requirements, on nationally active digital healthcare providers and to, if such requirements exist, propose how these requirements should be designed.
A specific investigation is also underway regarding the significance of the medical certificate in sickness benefit cases. This investigation shall, among other things, analyze whether and, if so, how the quality of the medical certificates can be further improved.
Madam Speaker! The fact that regions and healthcare providers have developed their own routines regarding sick leave during digital doctor visits absolutely indicates that there is a need for national guidance. Since sick leaves based on digital doctor visits can also be expected to increase in the future, there are reasons to improve the conditions for uniformity between regions and healthcare providers.
Socialstyrelsen has taken the initiative to develop the insurance medical decision support into a broader and more in-depth knowledge support for sick leave. This work includes highlighting when sick leave is appropriate and when it is not in connection with digital doctor visits. The previous government welcomed Socialstyrelsen's initiative and assesses that it is expedient to provide the health and medical care a national support in the issue of sick leave during digital doctor visits.
Mona Olin (SD)
Madam Speaker! The Riksdag submitted the Swedish National Audit Office's report on digital doctor visits and visits to locum doctors in the sick leave process to the then government on 22 March 2022. The then government subsequently returned to the Riksdag with a communication on 28 June 2022, which is addressed in the committee report that we are debating today.
In its report, the National Audit Office makes the assessment that the previous government has not paid sufficient attention to the consequences of the emergence of hired doctors and digital doctor visits for the use of the sickness insurance. It also appears that the consequences of the growing number of medical certificates issued by hired doctors or on the basis of digital doctor visits have not been followed up.
The National Audit Office has therefore recommended that the previous government take the initiative to develop national guidelines for the issuance of medical certificates based on digital medical consultations.
The National Audit Office also notes that there is a need for a national steering document that clearly formulates what shall apply for sick leave during digital doctor visits. According to the National Audit Office, the lack of a steering document has meant that regions and private healthcare providers have developed their own routines. There is a lack of consistency in the routines within the regions and also between different groups of healthcare providers operating in the same region. The National Audit Office believes that this could risk worsening the uniformity in the use of the sickness insurance.
The previous government states in the communication that Socialstyrelsen is working on developing the insurance medical decision support into a broader and more in-depth knowledge support for sick leave. For that reason, the previous government states that there is no reason to proceed with the Riksrevisionen's proposal.
Digital doctor visits and agency doctors have become an increasingly common feature within healthcare. The Sweden Democrats argue that it is positive that digitalization contributes to increasing accessibility in care. At the same time, it is important to note the negative consequences of digital doctor visits and agency doctors, which have now also particularly emerged regarding the use of the health insurance.
The Sweden Democrats view positively that the National Board of Health and Welfare is currently carrying out development work for a broader and more in-depth knowledge support for sick leave, as we believe there is a clear need to develop the insurance medical decision support.
To ensure that the mentioned deficiencies are addressed, the government should, in addition to ongoing measures, appoint an inquiry whose purpose shall be to follow up and analyze the Socialstyrelsen's development work based on the problem description found in the Riksrevisionen's report. We believe this is urgent in order to better be able to guarantee a patient-safe sick leave process during digital doctor visits and during visits with locum doctors.
Therefore, I would like to conclude by motioning for approval of the Sweden Democrats' reservation in the matter.
The deliberation was hereby concluded.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.