DN has revealed that in the past six years, 32 children have come into Nya Karolinska urgently with such serious and life-threatening bleeding complications, after throat operations that they needed treatment with anesthesia. The basis is based on a medical record review carried out by a former medical expert doctor in the Stockholm Region. 30 of the children had undergone surgery in private clinics in ear-nose-throat care. In more than half of the cases, the national guidelines had not been followed.
Medical experts in Region Stockholm therefore wanted to move certain procedures for children between 0 and 6 years old from the choice of care to emergency hospitals. The reason was that small children are particularly fragile, have a smaller blood volume and can more easily get quick help in hospital if complications arise. The proposal is also about securing training for anesthesiologists for children. It would also mean a shrinking business for private actors.
However, the issue was locked in the S-led board at the end of the term. S, MP and V were behind the experts' proposals, while the Center Party wanted to postpone the decision until after the election.
At the Health and Medical Services Board's meeting on 29 September, the Center Party presented its own proposal. It meant that children between the ages of 0 and 3 must be operated on in hospital, while the rest of the case is sent back to the administration for continued dialogue with healthcare providers and patient organizations before a definitive decision.
- The administration can continue to work on a basis for revision. We see that the service statement confuses certain concepts in an unfortunate way. There will be some factual errors, says Karin Fälldin (C), member of the health and medical care board.
In what way is it a factual error?
- It says on the medical record review that it has been medically unjustified care. But when the administration has received follow-up questions, they have answered that it has been the wrong level of care in some cases, and in some cases the wrong surgical technique. Is it really an increased patient safety risk? We cannot know that because it is a factual error, says Karin Fälldin.
Before the case was to be clubbed at the health and medical care board, all parties were courted by a reference group for private healthcare providers, who wanted a certain decision, DN can reveal. The reference group has written to individual members that they want children 0-3 years to be operated on in emergency hospitals.
"And otherwise, we want you to send the case back for new preparation and dialogue with us healthcare providers," wrote the group's spokesperson, specialist doctor Petter Olsson, who works for the healthcare provider Meliva, in an email that DN has seen.
The reference group for the private care providers has been included in the revision work of ear-nose-throat care choices that the health and medical care administration started in 2024. But according to Petter Olsson, the group has had little opportunity to influence.
"However, we only saw the finished proposal on September 17. At that time there was no opportunity to influence it within the process. That is why we turned to the politicians who would make the decision," writes Petter Olsson in a response to DN.
The choice of care means that the private care providers take on so-called simpler cases, the emergency hospitals patients with known increased risks.
According to the private actors, it is not scientifically substantiated that children between 3 and 6 years of age benefit from being operated on in an emergency hospital and refer to reported data in the national tonsil register on bleeding after surgery.
The private caregivers were heard. Prior to the decision, the Center Party sought support outside the center coalition, including from the Sweden Democrats.
- Yes, they contacted us, says Britt-Marie Canhasi (SD), member of the health care board.
The center party sees no acute patient safety risks.
- If you carry out the revision and discontinue care, it will affect many patients, not just children, says Karin Fälldin.
