Investigation and consultation assignment regarding post-infectious diseases at Karolinska University Hospital
The Moderates, Christian Democrats and Liberals are concerned about the consequences of the left-wing government's earlier decision to close the last specialised clinic for patients with ME/CFS. Now comes the next step in the process, when the left-wing government wants to place an investigation assignment regarding ME/CFS together with the postcovid clinic.
In February 2023, the Moderates, Christian Democrats and Liberals demanded that the matter that was then under consideration should be referred back to be supplemented with a proper impact assessment and a structured plan on how primary care, psychiatry and investigation units should be structured, how financing should take place, and how the care of the patient group should take place before the phasing out of care choice specialised rehabilitation for long-term pain and exhaustion disorder, which also includes the treatment of patients with ME/CFS. This did not happen and now the left-wing government is proposing that Karolinska be given an investigation and consultation assignment regarding post-infectious diseases.
The patients who currently receive care under the health care option have been referred there by primary care. The left-wing government has already chosen to pull the rug out from under these patients and wants to send them back to primary care, which risks hitting a fragile patient group consisting largely of women. With increased competence and more support from the assessment unit, primary care can certainly provide more care for the group suffering from exhaustion, but this is also based on the existence of clinics with special expertise to deal with this group. To abruptly terminate the agreements with all existing care providers and push a fragile and complex patient group into primary care, or specialist psychiatry, in less than two years' time, however, we see as risky and something that does not benefit the patient group. The previous investigation describes that 2/3 should go to primary care, but not in what way or with what resources should be provided to primary care. Primary care needs to be able to afford to employ those who are to treat these complex patients, and adequate guidelines are needed.
The region's academic primary care centre (APC) has an important role in both education and research in primary care. Collaboration with other regions where research on post-infectious conditions takes place, such as Östergötland, would also be preferable to use resources more efficiently.
In April 2023, the Government commissioned the National Board of Health and Welfare to develop national knowledge support for post-covid and other post-infectious conditions. The assignment includes a comprehensive national knowledge support for diagnosis, care and rehabilitation of post-covid and other post-infectious conditions aimed at both primary and specialist care, as well as social services. This is an important step in the right direction.
In the light of the above, we therefore propose the following in addition to the mandate for investigation and consultation.
Proposal for an additional decision
The Health and Medical Services Board decides the following:
1. to ensure that the knowledge and experience of staff in specialised clinics is documented before it is lost. It should be given space and job opportunities in a limited number of health centres. This way, this knowledge can be gradually transferred, so that more people can provide competent care for ME patients in the future.
2. intensify research on ME and post-covid, now that particularly favourable and unique opportunities have arisen from the global pandemic, where new treatment options and causalities should emerge.