How does the Swedish healthcare system work?

Ask The Local: Every week we will be answering readers' questions about Sweden. This week, Janey in Stockholm wants to know how the healthcare system works.

I’ve been in Sweden five years, and still haven’t needed to visit a doctor. But it occurred to me the other day that I’ve got no idea how the healthcare system works. Where do I go if I fall ill, and what will it cost me?

Janey, Stockholm

The Swedish healthcare system is run by the counties (‘landsting’). They provide heavily subsidised care, although a small fee is charged for most services.

In an emergency, the procedure is straightforward: call 112 and ask for an ambulance, or get yourself to a hospital emergency room (‘Akuten’).

For non-emergency situations, the way healthcare is organized differs from county to county, so the best way to get initial advice is to call your county health department directly.

Many counties have a dedicated phone line to answer questions about healthcare. Some such phone lines simply give basic information such as where to find your nearest health centre or hospital. Other phone lines, such as Stockholm County’s ‘Vårdguiden’ service (08-320 100), are staffed by nurses and offer basic medical advice as well as practical information. Like most public services in Sweden, the staff answering the phones should be able to advise you in English.

In non-emergency situations, your first port of call will be a doctor’s surgery (‘husläkarmottagning’) at a local health centre (‘vårdcentral’). Vårdguiden or your local equivalent will be able to direct you to your nearest facility. It is usually necessary to be registered with the doctor and to book an appointment in order to be seen.

To ensure you receive the best possible care when you need it, you should register with a doctor at the first opportunity – and before you actually need it. At some surgeries you may be put on a waiting list before being registered with a doctor, but all doctors are obliged to see you in an emergency – whether you are registered or not.

Getting an appointment at a doctor’s surgery can be a tricky business in some areas. Many surgeries only answer the phones for restricted periods – say, between 8am and 9am. Anders Fridell, spokesman for Stockholm County Council, says this is a problem of which the authorities are aware and which they are trying to solve.

If you have difficulty getting through to your surgery on the phone, the advice is to turn up in person and ask for an appointment. Some surgeries also have open surgery times, when patients can turn up without an appointment and wait in turn to be seen.

In some areas, local health centres are complemented by local emergency rooms (‘närakuten’), where you can turn up with problems that need urgent attention, but which are not serious enough to warrant going to the emergency room. This system is being phased out in Stockholm, according to Anders Fridell, but some such local emergency rooms still exist.

Foreigners legally resident in Sweden are entitled to healthcare on the same terms as Swedes. Illegal residents and visitors have to pay for the full cost of their care, however, so if you are in Sweden temporarily ensure that you have proper travel insurance (or, if you are from another EU country, that you are carrying a European Health Insurance Card).

Those legally resident in Sweden have to pay fees when accessing healthcare. These range from 140 kronor for a visit to a doctor to 200 kronor for an x-ray. Costs are capped at 900 kronor a year for doctor’s visits, and similar low amounts for other medical care. Patients are issued with ‘high cost cards’, which help ensure they don’t cough up more than they have to.