The opinion piece by Jonas F Ludvigsson and Hugo Lagercrantz, published in DN Debatt on December 24th, asserts that the greatest gift for children is residing in Sweden. However, they argue this sentiment rings hollow when considering the current state of healthcare access for Swedish schoolchildren. The authors contend that the 2010 Education Act effectively stripped schoolchildren of their right to medical care during school hours, dismantling a previously robust system based on medical expertise and evidence-based practices. This system has been replaced with a nebulous focus on “health,” a responsibility now solely shouldered by school principals. This shift represents a significant departure from the prior model, raising concerns about the adequacy of care provided to children within the school environment.
The core issue highlighted by Ludvigsson and Lagercrantz lies in the transfer of responsibility for children’s healthcare from medical professionals to school principals, who typically lack medical training. This paradigm shift places an unreasonable and potentially dangerous burden on principals, expecting them to assess and address complex medical needs without the necessary expertise. The authors argue that this new system effectively abandons children medically and psychologically upon school entry, severing the crucial link to primary care and child and adolescent psychiatric services previously available within the school setting. The seamless care pathway established through child health centers and maternity clinics abruptly ends when a child begins school, creating a concerning gap in healthcare provision.
This alteration in the provision of school healthcare, according to the authors, contradicts several articles of the UN Convention on the Rights of the Child, which guarantee children’s right to healthcare and protection regardless of their location. Furthermore, it deviates from the World Health Organization’s (WHO) guidelines emphasizing the importance of continuous medical care from birth throughout a child’s education. Sweden, a nation often lauded for its commitment to children’s rights, is portrayed as falling short of international standards and principles by implementing this policy. The authors suggest that this change reflects a concerning disregard for the medical needs of school-aged children.
The consequences of the 2010 Education Act, according to Ludvigsson and Lagercrantz, are already evident. They point to a decline in children’s overall health attributed to undetected or delayed treatment of medical conditions. The authors also cite an increase in mental health issues and inadequate support for students with chronic illnesses. In their view, the current system creates insurmountable challenges for children and their families, as detailed in Ludvigsson’s book, ”School Healthcare That Disappeared and the Fatal Consequences of the 2010 Education Act.” The authors argue that the current system is failing vulnerable children and requires immediate attention.
The central question posed by the authors is: Why was the right to medical care for schoolchildren abandoned? They argue that the assumption that medical knowledge and evidence-based practices become unnecessary simply because a child turns six and starts school is illogical. The authors advocate for the reinstatement of a model where children’s health and care needs are managed by qualified medical professionals under the purview of the Ministry of Social Affairs and the regional healthcare authorities. They also point out that primary care has not been tasked with filling this gap, further exacerbating the problem. The authors propose a return to a system prioritized by medical expertise.
Ludvigsson and Lagercrantz conclude by suggesting that the true gift for Swedish children would be the restoration of their right to safe and accessible healthcare, overseen by school doctors in collaboration with principals. They emphasize that principals alone cannot fulfill this mandate and that child healthcare should not cease upon school entry. They urge a return to the pre-2010 model, where healthcare was a continuous presence throughout a child’s education. The authors appeal to Sweden to uphold its reputation as a champion for children’s rights by rectifying this oversight in the Education Act and ensuring that all children receive the necessary medical care they deserve. They believe this is essential to maintain Sweden’s standing as a global leader in child welfare.
