Annual Report 2019 RS 2019–0242 2 Annual Report 2019 Chapter name Content Region Stockholm’s surplus gives us the Companies ......................................................................... 70 power to face the pandemic ............................................ 4 Landstingshuset i Stockholm AB ......................................71 Södersjukhuset AB ............................................................71 Statement by the Regional Chief Executive .................. 6 Danderyds Sjukhus AB ......................................................73 Summary of operational development ......................... 8 Södertälje Sjukhus AB .......................................................75 The Regional Group...........................................................12 S:t Eriks Ögonsjukhus AB .................................................76 Folktandvården Stockholms län AB ................................. 78 Important conditions for profit/loss and Ambulanssjukvården i Storstockholm AB ........................79 financial position...............................................................14 Stockholm Care AB ..........................................................80 Important events ...............................................................16 MediCarrier AB ................................................................80 Locum AB ..........................................................................81 Steering and follow-up of the regional AB Stockholms Läns Landstings Internfinans ................. 82 operations .......................................................................... 20 AB Storstockholms Lokaltrafik ........................................ 82 Goals and mission .............................................................21 Internal control .................................................................21 Local federations and foundations ............................... 84 Instructions ...................................................................... 23 Local federations .............................................................. 85 Foundations ..................................................................... 87 Good financial management and financial standing 24 Long-term sustainable economy ...................................... 25 Financial accounts ............................................................ 88 A sustainable Region Stockholm ...................................... 29 Profit/loss account ............................................................ 89 Region Stockholm shall be an attractive employer ...........31 Balance sheet Financial development within the health service............. 33 .................................................................... 90 Investments...................................................................... 36 Cash flow statement .........................................................91 Investments in committees and companies ..................... 36 Operation accounts .......................................................... 92 Expected development ................................................... 38 Investment accounts ........................................................ 93 Development over the coming year .................................. 39 Accounting principles ...................................................... 94 Committees ....................................................................... 42 Derivatives and hedge accounting ................................... 95 The Regional Executive Committee ................................ 43 The Healthcare Committee .............................................. 44 Notes ....................................................................................97 The Transport Committee ................................................ 49 Key performance indicators ......................................... 108 The Growth and Regional Planning Committee .............. 56 The Property and Service Committee .............................. 58 Auditor’s report regarding the County Council The Mobility Service Committee .......................................61 Executive Committee for 2019 .....................................109 The Culture Committee .................................................... 62 Abbreviations ..................................................................110 Health Service Steering Committee ................................. 64 Patient Advisory Committee ............................................ 65 Stockholm County’s Healthcare Area .............................. 65 Karolinska University Hospital .........................................67 The Audit Board ............................................................... 69 Figures in parenthesis refer to the corresponding period in the previous year, unless otherwise specified. Deviations may occur in tables and diagrams, as the figures have been rounded up from SEK thousands to SEK millions. Annual Report 2019 3 Region Stockholm’s surplus gives us the power to face the pandemic THE STOCKHOLM REGION, Sweden the economy entailed by the pandemic, and the world are facing significantly for example relating to the measures changed circumstances after the spread taken to reduce the spread of infection of covid-19 in a global pandemic that and to treat covid-19, but also measures reaps lives and affects all the economies in public transport, where the national of the world. The health service in strategy has led to considerable loss of Stockholm has carried out an impres- income, while we keep operating public sive feat in increasing capacity, not least transport services as before. Region when it comes to intensive care, in order Stockholm’s profit for 2019 is to provide the right care to a dramati- SEK 1,723 million excluding conversion cally increased number of patients. expenditure, which can be compared to The residents have significantly the budgeted profit for the year of changed their behaviours and adhere SEK 140 million. to the recommendations of the Public A balanced budget provides impor- Health Agency of Sweden to reduce the tant capacity to ensure a robust health- spread of infection. This affects both care system, with available health and businesses and the region’s operations. medical care of high quality and a In addition to the acute medical danger, secure and sustainable public transport primarily to the risk groups, there are that helps the county’s residents effec- apparent long-term consequences for tively get about their day. The changes in the national economy. People will see the expenditure equalisation that was their income sources and life work torn decided by the Riksdag (Swedish parlia- down as companies go bankrupt, many ment) in November 2019 has a massive will lose their jobs and the company impact on Stockholm already in 2020, revenues deteriorate. This will put a lot but will grow exponentially in the of pressure on the private finances and future. Region Stockholm is the region lives of many people. In addition, it most heavily affected by covid-19 in hollows out the tax base for the munici- Sweden. The Riksdag should therefore palities, regions and the central govern- immediately recall the above mentioned ment, and tax revenues are decreasing changes. The considerable increase in rapidly, which risks having significant the equalisation tax sets high require- long-term impact on the funding of the ments for financial economising in the welfare state. region’s committees and companies and The sound finances of Region now entails an even tougher challenge Stockholm, with bulwarks and sur- as a result of covid-19. pluses each year since 2007, has given The transition to a good local health- us the financial prowess to face the pan- care, for example in health centres, demic head on and make the decisions advanced home care, on-call doctors, that are necessary. At the same time, geriatric and other emergency care out- there is great insecurity regarding side of the hospital emergency wards whether the central government will be continued in 2019. During the year, the able to fully compensate the local number of appointments outside of the authorities of Sweden for the strain on emergency hospitals continued to rise. 4 Annual Report 2019 All emergency wards in the county, care building with 120 single rooms. sions have been reduced by 48 per cent. with the exception of Capio S:t Göran Region Stockholm’s public transport Just like the energy efficiency efforts, received a reduced number of visits. has been named the second best in the the reduced climate impact from anaes- In 2019, the highly appreciated local world, which is also seen in the record thetic gases has already exceeded the set emergency clinics had around the same number of people travelling by public targets. The region’s systematic efforts number of visits as the regular emer- transport in Stockholm during 2019. In to prevent antimicrobial resistance are gency wards. We can note that the addition, Stockholm residents are very successful. The use of antibiotics has region had short waiting periods in the satisfied with the public transport ser- continued to go down; in November health service in 2019 as well. vice. In order to meet the needs of the 2019, the use was the lowest in several During the year, extensive efforts growing Stockholm Region, there is a decades. have been made to turn the financial large expansion and improvement Region Stockholm is to be a more situation of