As a way of looking ahead to EUREGHA’s General Assembly 2023 in June, we interviewed our Swedish colleague and Head of Office at Region Östergötland‘s Brussels office, Isabelle Johansson. She gave us an insight into their health policy priorities, she discussed Region Östergötland achievements of the past five years, and how it has been preparing for and working with the Swedish Presidency of the Council of the European Union. 

We will have EUREGHA’s Annual General Assembly in the capital of Östergötland, Linköping. Of course, we talked a bit about what to expect during our upcoming visit, which will definitely include a sweet taste of Swedish traditions.

1. Can you tell us a bit about the Östergötland EU Office and your role there?

All Swedish regions are represented in Brussels but, compared to some other regional representations, our office only represents the region of Östergötland. The office is part of the regional government, which means we are following EU policies that regional governments in Sweden oversee, such as regional development, public transport, and the biggest chunk of it is healthcare. Our office has two full time employees and two fulltime interns, so a team of four. This office was established in ’96, just a year after Sweden became an EU-member. It’s part of a unit for international collaboration, with another three colleagues back in Sweden, supporting the whole region of Östergötland.  

2. That’s quite nice. So you, you’ve actually had a presence in Brussels for quite a long time already and healthcare has been part of the package for you since day one?

Yes it has, but over the years it has come and gone a little bit and for some time the office was part of the regional development agency so they only worked with that. Then, 2015 we became part of the Region Östergötland and healthcare became part of our portfolio again. Nowadays there is a strong push to work on healthcare issues on EU level as well, so it will probably stay as an important topic for the office for the foreseeable future.

3. How does the Swedish Council Presidency affect your activities this period?

Day-to-day perhaps not so much but leading up to it there was a lot of added work. At least six months before starting but even a year beforehand we started to see what was ahead of us. Without a doubt, a lot more spotlights on Sweden and the EU in Sweden, and therefore also on us. We are asked more often to help explain the EU and what it does for the region. We are experiencing some added workload, that’s for sure.

4. What are Östergötland’s regional priorities in health policy?

Broadly, I would say that the consequences of the pandemic are still a challenge. Within healthcare systems, the staffing situation around healthcare professionals was already an issue before and now even more so. People are leaving the healthcare profession because the workload is so high and they might feel they are not having a good work environment. So how do you balance that? One the one hand we need to get through the backlog of waiting lists caused by the pandemic, but on the other hand we have a healthcare workforce that is quite exhausted and might look to other sectors. I think this conundrum is the biggest challenge for us right now and I think that goes for many other regions too. We are also looking at better preventative care and the potential of using new digital tools to alleviate some of the burden off of healthcare workers. Our priority for now is to make sure we have enough competent healthcare personnel to provide great care for our citizens. During the pandemic, the amounts of work that needed to be done escalated but now I think there is strong political will to take steps in trying to improve work conditions, but it takes a lot and it’s not cheap either. And for the longer term, we also focus on NCD’s, things like demographic change and people living with comorbidities. It’s important not to forget about long-term issues just because you have something very urgent to handle. I think it might be similar to what other regions are experiencing.

5. Which health-related achievement(s) from the last 5 years are you particularly proud of as a region?

How our nurses, doctors, and other healthcare professionals handled the completely new situation that the COVID19 pandemic brought on. People were still being well looked after. Healthcare workers just rolled up their sleeves and went to work and I think everyone in that sector should feel extremely proud because this was something no one has ever lived through before. We came out on the other end and felt like, OK, there are things that could have gone better but in the bigger picture, we are still standing. Sweden was also heavily criticized and there were a lot of questions about the Swedish approach, but now there has been a study showing morbidity in Sweden was actually the lowest during that period. This means our healthcare system was able to deal with this shock in a way that didn’t require lockdowns. Of course, hindsight is a bliss, but it feels good to know that given our circumstances and capacity, this was probably the right approach for us. Obviously, there were things that could have been done much better also in Sweden. For example, hospitals and primary centers are governed by the regional level, while elderly care is on municipal level so that created some difficulties. But in crisis, things also tend to move forward faster. We had needed more ICU spots for years and suddenly within about a week, we had more ICU spots. Digital transformation also got boosted. Where there is a will, there is a way, so I also think there is some silver lining to it.

6. Can you give us a sneak peek of what’s in store at the EUREGHA Annual General Assembly this year in Linkoping in June?

Hopefully, nice weather! Two days in Linkoping, the biggest city of Östergötland, and we have dedicated the full first day to study visits. First, we’re going to visit a healthcare center that has set themselves up as a one-stop-shop where you can find a lot of different medical expertise in one spot. This means the patient only needs to go to one place to receive care from specialists in different fields, which is kind of unique. Then, we’ll go to our University Hospital for a study visit at the center of Medical Imaging and Visualization to get a taste of the truly excellent work they are doing. This is a world leading center built on a very interesting collaboration between the hospital, the university, and a regional company in medical devices. Day two is reserved for everything related to the General Assembly, but combined with lots of Swedish fika and elements of Swedish tradition. We hope it’s going to be a nice experience. Visiting Sweden people might typically end up in Stockholm or Goteborg, or all the way up north to see the Northern Lights, so I think Östergötland is a place not many people have visited before. It’s a really beautiful spot, it’s going to be fun showing people around.

7. What do you hope EUREGHA members will take home after their AGA visit to Östergötland?

I hope that by uniting everyone again in person, the network continues to grow stronger and we feel part of the EUREGHA family. Strengthening the connection between members. I also hope they will understand our region better, what we do well but also what our challenges are, so we can figure out together how to help each other move the healthcare sector forward. It’s easier to understand each other when you know where priorities and decisions might come from. Hopefully, members will leave with a lot of motivation to keep working in this European, collaborative way. And maybe they will leave with a bit of a sugar high on all the fika we’re going to give them! That’s a big part of Swedish culture; you always have a fika in the afternoon. It’s like a coffee break but with something sweet next to it. 

8. Finally, so we can all learn before our visit, what is the correct pronunciation of Östergötland?

It can be challenging for non-Swedish speakers, yes! Obviously, we have our special letters in Swedish, so the O with two dots is pronounced a bit differently and the G is kind of soft [ˈœ̂sːtɛrˌjøːtland]. [click here for pronunciation example]. To be honest, I don’t ever expect anyone to pronounce it correctly; I’m always surprised when someone comes close to it. We know it’s not the most international sounding name, but we like to think it’s kind of a regional delicacy in the sense that it makes us a little bit special. And the same counts for Linköping , it’s pronounced as lɪ̂nːˌɕøːpɪŋ (lin- chœ – peeng). Swedish is not the easiest language to pronounce for sure, so no hard feelings for people that end up saying it in any other way. It’s all good, we welcome everyone.