Several patients who sought assistance with nasal problems caused by poorly executed surgery on their noses at a Stockholm clinic have subsequently had corrective operations at the Karolinska University Hospital cancelled, SVT reports. The reason is a policy decision by the hospital not to put their resources into those kind of procedures.
Karolinska University Hospital has defended the move, saying that a better standard of care can be found in the private sector when corrective operations of a non-emergency nature are required.
“All patients should receive the best care from the most competent caregiver. Karolinska University Hospital studies all patients who come to us with this kind of injury to make a medical assessment. If the injury is of an acute nature, for example bleeding or a very serious respiratory issue, the patient is given care at Karolinska University Hospital,” Karolinska professor Pär Stjärna, head of the ear, nose and throat department told The Local.
“If the problem on the other hand is not of such a nature that emergency or highly specialized care is needed, the patient is then recommended – in order to receive the quickest and most competent care – to go back to the private clinic in order to have corrections made. The reason for that is that the greatest competency in aesthetic plastic surgery can be found in private care,” he added.
Questions have been raised about whether it is legal in Sweden to deny treatment in such a way. A legal expert at the country's National Board of Health and Welfare (Socialstyrelsen) told The Local that there are no legal grounds for ruling out treating an entire group of patients based on how their injuries were incurred.
“The county council has the possibility of prioritizing patients who have the greatest need of care, and could therefore deny a patient care if they judge that no need of care exists. On the other hand, there are not legal grounds for ruling out an entire group of patients on the basis that their injuries were incurred in a specific way, for example through cosmetic surgery,” Tesi Aschan, a legal advisor at Socialstyrelsen explained.
“It is not, according to the applicable law, possible to introduce a principle of responsibility for those patients who incurred an injury after being knowingly aware of risks. The patient should always be assessed based on the individual need for care,” the expert continued.
Karolinska University Hospital's Stjärna defended the legality of the policy however, and insisted that all assessments are still made on an individual basis:
“The system in Sweden is designed so that different caregivers have different duties; not so everyone carries out all treatments. If the patient, in connection with the operation, has emergency complications like severe bleeding or infections, the patient is taken care of by public healthcare for those emergency complications. We always make assessments from an individual patient's need”.
“Karolinska University Hospital's mission is highly specialized, for example cancer patients, traffic injuries and deformities,” the professor said.