Patientsäkerhet och kvalitetssäkring i svensk hälso- och sjukvård : En medicinrättslig studie

The aim of this dissertation is to map and examine the regulation and the division of responsibilities in the quality assurance system in Swedish health care. The system includes actors of various kinds, all with different responsibilities aimed at ensuring that patients are provided with health care of good quality. The actors who are examined are both the internal actors such as health care providers and health care personnel, and the external actors, consisting principally of the National Board of Health and Welfare (Socialstyrelsen), the Medical Responsibility Board (Hälso- och sjukvårdens ansvarsnämnd) and the local Patient Committees (patientnämnder). The point of departure is the goals and demands stipulated in the Health and Medical Services Act (1982:763). Furthermore, section 31 in this Act explicitly stipulates that the quality of health care shall be guaranteed and systematically and continuously developed. Chapter Three in the new Patient Safety Act (2010:659) also imposes a duty on health care providers to systematically work to ensure a high level of patient safety. Other necessary conditions are the health care personnel’s education, demand on authorization and the obligations and duties stipulated by law. The National Board och Health and Welfare has an important role in the system, controlling that the health care providers as well as the personnel fulfill their obligations and duties. One of the main conclusions is that the set of regulations concerning health care and quality assurance needs to be revised in order to become clearer, more logical, more applicable and more accessible. Another conclusion is that the actors who supervise the internal actors must make sure that the legal tools available are used when needed. In short, the control system must also work effectively