2006 study tours of Switzerland and Sweden

From June 11–15, 2006, a delegation from Alberta, led by the Honourable Iris Evans, then Minister of Health and Wellness, traveled to Switzerland on a study tour at the invitation and expense of the Swiss government. From June 16–21 the delegation traveled to Sweden.

Study Tour of Switzerland, June 11–15, 2006

From June 11 to June 15, 2006 a delegation from Alberta, led by the Honourable Iris Evans, Minister of Health and Wellness, traveled to Switzerland on a study tour, at the invitation and expense of the Swiss government. The delegation was composed of:

  • Honourable Iris Evans, Minister of Health and Wellness
  • Alyssa Haunholter, Executive Assistant to Minister Evans
  • Mark Kastner, Communications Director, Alberta Health and Wellness
  • Neil Wilkinson, Board Chair, Capital Health
  • Dr. Chris Eagle, Executive Vice-President and Chief Clinical Officer, Calgary Health Region
  • Sheila McKay, President, College and Association of Registered Nurses of Alberta (CARNA)
  • Annette Trimbee, Assistant Deputy Minister, Strategic Directions Division, Alberta Health and Wellness

The delegation approached the study tour recognizing that Alberta shares some challenges with Switzerland in terms of health system management. Delegates anticipated that sharing experiences with their Swiss hosts would provide them with the opportunity to see how the Swiss are addressing some of those challenges, and to discover new and innovative approaches to the challenges we face here in Alberta.

Switzerland’s health system, like Alberta’s, has at its foundation, a premise that all citizens should have access to basic services. Both jurisdictions are concerned about current spending levels and the rapid rate of growth in health system costs. Both jurisdictions would like to see more health promotion and illness/injury prevention activities occurring so that population health is improved, and preventable demand on the health system is reduced. Albertan and Swiss health officials are exploring ways to ensure appropriateness, in terms of funding and use of health services and products.

Switzerland’s population is culturally and linguistically diverse. Health services use differs according to both culture, and geography. For example, the French speaking population are heavy users of the health system compared to the German speaking population. Urban dwellers tend to use the health system much more heavily than those living in disconnected rural valleys.

There are also notable differences between Alberta and Switzerland. Alberta is a province within a federal system, and Switzerland is also a federation. However, the organization and practice of government differs immensely between the two jurisdictions. Switzerland’s population is more than double that of Alberta, but Alberta occupies 16 times more land than Switzerland. Government, demography and geography shape the health system and have an impact on the solutions considered appropriate.

Alberta and Switzerland do not have the same issues in terms of infrastructure, technology and workforce resources. Alberta faces waitlists and labour shortages; Switzerland is in quite a different situation.

Ultimately, the study tour was comprehensive, well planned and very productive. The Swiss hosts took great care of the Alberta delegation, and provided exposure to diverse perspectives. Delegates interacted with federal and cantonal politicians, officials, hospital administrators, clinicians, insurers and business representatives. Meetings covered key issues such as health system governance, accountability, financing, wellness, workforce, and pharmaceutical policy. The delegation also had the opportunity to tour the University Hospital Centre of Canton Vaud, in Lausanne.

Study Tour of Sweden, June 16–21, 2006

From June 16 to June 21, 2006 Honourable Iris Evans, Minister of Health and Wellness, and her Executive Assistant, Alyssa Haunholter traveled to Sweden on a study tour.

The Minister went to Sweden to learn about the successes and challenges within the Swedish health care system. Minister Evans met with Swedish policy makers of all levels: government and health care officials; research institutes; and independent government agencies. By sharing Alberta’s experiences in health care with her Swedish colleagues, the Minister hoped to discover novel and innovative solutions to the challenges facing Alberta’s health care system.

Sweden ranks second behind Switzerland among OECD countries in the performance of its health system. Sweden’s extensive social welfare traditions have typically provided a supportive environment for an evolving and thriving system. While the Swedish health care system is 85 per cent publicly funded, health costs account for only 8.7 per cent of GDP, which means that Sweden’s total health expenditures are lower than Canada’s on a per capita basis.

The political organization of the health care system in Sweden is similar to Alberta’s. Both have a central government that works with associated regional governments. The Swedish health system is governed at three levels. The central government in Sweden lays down basic principles for health services through laws, the most important of which is the Health and Medical Services Act of 1982. It requires that good quality health and medical services be provided on equal terms and be easily accessible to all. Under the Act, responsibility for health services rests primarily with the country’s twenty-one county councils which levy taxes and operate almost all the services provided. At the local level, two hundred and ninety municipal authorities are responsible for elderly care, disabled care, and support for long term mental illness.

Alberta and Sweden face some similar challenges within their health systems. Access problems are common to many health systems, especially those that try to provide universal health coverage while also trying to manage costs. The goals of the Swedish health care system continue to be equitable coverage for the whole population, access to new medical technologies, and provision of resources to those with chronic illness. These goals have contributed to increased demands on the system from the population, both current and potential patients.

Overall, the Minister’s tour of Sweden was well organized, comprehensive, and very informative. They were greeted warmly by all of their Swedish hosts, and learned a great deal about many aspects of the Swedish health system.