Abolishing track changes could have serious consequences for Swedish healthcare

Debattartikel i engelskpråkiga The Local den 9 april.

Sweden is facing a growing shortage of registered nurses and other healthcare professionals. Despite this, the government has implemented changes which make it more difficult for qualified professionals to remain in the country. 

The decision to abolish “track changes” (spårbyte) – an immigration path which let rejected asylum seekers switch to a work permit as long as they met the conditions – means that individuals who are already working and contributing to Swedish healthcare are forced to leave the country just to apply for a new work permit. 

This decision could have serious consequences for healthcare and must be reconsidered.

Skilled healthcare professionals leaving Swedish healthcare would particularly impact the areas of women’s reproductive health, scientific laboratory analyses and radiology, key sets of knowledge to diagnose and treat diseases, as a large number of the staff in those areas are trained professionals born in non EU-countries.

One example is nurse Hamid, who has worked in Swedish healthcare for six years. His contributions have been invaluable. Now, due to the new legislation, he is being forced to leave the country.

Hamid told The Local: “I worked as a nurse during the Corona pandemic when many people were afraid for their lives, I took the risk of catching Corona in the hospital, I got Corona, I helped the Swedish society and now that the pandemic is over, they are telling me and my family that you have to leave! Where should we go? We have roots here after six years!”

In a situation where there is a dire shortage of registered nurses, it is unreasonable to expel competent professionals. We need more nurses like Hamid – not fewer. 

If Sweden continues to enforce restrictive policies that drive away experienced healthcare workers, we risk exacerbating an already strained healthcare system, leading to longer waiting times and reduced quality of care for patients.

Within the EU, Vårdförbundet (The Swedish Association of Health Professionals), a trade union and professional organisation of four registered health care professions, is clear in its stance: free movement as one of EU’s pillars is fundamental, and it should be possible to seek work in our professions without unnecessary obstacles, and in line with the requirements and intentions.

Sweden has historically benefited from international expertise in its healthcare sector, and maintaining a welcoming approach to skilled professionals is crucial.

When it comes to labour migration from countries outside the EU, it is equally important to ensure that recruitment is conducted in an ethical and sustainable manner. 

It is crucial to follow WHO guidelines, and we believe that recruiting from countries with an already strained healthcare system is wrong. At the same time, we must optimise the competence that already exists in Sweden and provide support to health professionals that are on their way to obtaining a licence to practise in our country.

The recent changes in migration policy, such as the increased work permit salary threshold, affect different professional groups in different ways. For members of the Swedish Association of Health Professionals, who are university educated and have salaries above the new threshold, the immediate impact is limited. However, the broader effects on the healthcare workforce could be significant. 

If assistant nurses and healthcare aides find it harder to meet the new requirements, their departure from the workforce could place greater pressure on nurses, midwives, radiology nurses and biomedical analysts,  among other professions. These changes risk creating a ripple effect that leads to an increased workload, greater stress, a higher risk of burnout for those remaining in the professions and ultimately even injuries. 

Swedish healthcare is already struggling from staff shortages, and implementing policies that make it even harder to retain qualified workers is counterproductive. 

Instead, we should be looking at solutions that strengthen our healthcare workforce. This includes ensuring that the work permit process is efficient, transparent, and fair. Expelling competent professionals who have already demonstrated their ability to contribute to Swedish healthcare does nothing to solve the underlying challenges facing the sector. 

We need policies that ensure the health system has access to the competence required to provide patients with the care they are entitled to. The government must consider how these changes impact not only individuals but also the healthcare system and society as a whole.

The government must take responsibility for the consequences of these changes. It is unreasonable for skilled nurses and other healthcare professionals who are already working in Sweden to be forced to leave due to rigid regulations. 

The Swedish Association of Health Professionals urges the government to reconsider the decision to abolish the track change and instead pursue policies that strengthen the healthcare sector’s skills supply. 

Sweden needs a long-term strategy to attract and retain healthcare professionals – one that acknowledges the valuable contributions of foreign-born workers rather than creating obstacles for them. 

Instead of restricting those who are already here and making a difference every day, we should be working towards a system that recognises their efforts, supports their continued employment, and ensures a sustainable future for Swedish healthcare. 

The above opinion piece was written by Jani’ Stjernström, deputy chair of The Swedish Association of Health Professionals