Sweden’s longtime refusal to impose a general lockdown has seen it portrayed as an alternative “model” for coping with the pandemic. Yet death rates in its care homes have been appalling — and as a scandal that broke last month highlighted, much of the blame lies with the breakup and privatization of the country’s once-mighty public services.
by Anton Ösgård
Part 4 - Mass Privatizations
Most people working in the Swedish health care sector are underpaid and overworked, especially those employed in the elderly care home sector. The labor market in Sweden has been progressively deregulated, and precarious contracts are becoming the norm in the already disadvantaged care sector.
Jobs there have increasingly become reserved for the most exploited people in Swedish society — in many cases, immigrants living paycheck to paycheck. They are forced to accept contracts that do not meet their household needs, compelling many of these workers to take on multiple jobs, often in the same sector. What’s more, these workers are more likely to live in cramped apartments, oftentimes with other people working in low-paid service jobs, and more likely to be exposed to the virus.
In summary, the people working in the care sector are more prone to be exposed to the virus, unable to stay home if exhibiting symptoms (for fear of losing their jobs), and also go from care home to care home.
Added to that, only half of the workers have access to personal protective equipment (PPE) such as face masks, making transmission near inevitable. The people most likely to be exposed to the virus care for the people who need the most protecting — revealing the impossibility of maintaining a partial lockdown for only the vulnerable.
In Stockholm, where the spread of the virus has been most severe, we also find the highest number of care home workers on limited, precarious contracts. There is, however, a differentiation within Stockholm’s care homes, between the ones run as private, for-profit businesses and the public ones.
Unsurprisingly, the former more frequently offer bad working conditions. The private facilities that now make up half of the sector in the capital employ fewer workers per patient, and fewer of the workers who are there have a medical background. Even before the pandemic, the health care sector at large was struggling to keep up, and the crisis is now threatening the functioning of the whole system.
This is the result of a long onslaught against socialized care, brought on by processes of neoliberalization. In the start of the pandemic, when it became evident that the worst-off patients in the COVID-19 emergency wards needed respirators to survive, it came to public attention that Sweden did not have nearly enough of these lifesaving machines.
In the early 1990s, hospitals nationwide maintained a stock of two thousand respirators, and an equivalent number of additional respirators were available in emergency stockpiles. But now, the total number of available respirators is one-tenth of that, with none in stockpile. The number of intensive care units in Sweden is the lowest in Europe per capita — half that of Italy — and since the 1990s, all of the country’s thirty-five military hospitals, intended to be taken into use in the event of a crisis, have been closed.
Sweden also has chronic shortages in medicine, after the privatization of the pharmacies and dismantling of the state stockpile. Added to that, the state’s own vaccine production has been privatized.
All in all, the previously consolidated, socialized health care system has been smashed to pieces, turned into discrete units in competition with one another. Swedish COVID-19 patients are now reliant on a global network of just-in-time production, on wards made “efficient” by cutbacks and lower staff density, instead of the previously well-prepared, meticulously planned system that guaranteed care even in the face of multiple possible crises.