Om läkarbehov och läkartillgång : En analys av läkarkårens uppfattning om läkartillgång och läkarbrist i Sverige under 1950- och 1960-talen

Sammanfattning: The purpose of the study is to understand whether, and if so why, the Swedish medical profession's position on the availability and shortage of doctors during the 1950s and 1960s could be interpreted as an expression of an overall common mentality within the medical profession. The start and end points of the study (1950 and 1970) cover the emergence of the Swedish welfare state. The emergence of the welfare state is the contextual background to this study and how that influenced the medical profession's social status and perception of the future role of their own profession. The source material for the study is mainly from the Swedish medical journal (Svenska Läkartidningen) and meeting minutes from various Swedish medical organisations, primarily the Swedish Medical Association (Sveriges Läkarförbund). Government public inquiries, government bills and the daily press have also been analysed. The analysis is based on three central proposals for action from the government to secure the future supply of doctors and stem the shortage of doctors. The proposals were the transfer of foreign doctors to Sweden, the expansion of education of doctors and the reorganisation of the Swedish health care system. The study shows that the argumentation from the Swedish medical profession against all proposals from the government consisted of several different rhetorical manoeuvres to exercise social closure. Another conclusion is that until the mid-1960s, both the Swedish Association of Young Doctors and the Swedish Medical Association acted mainly as professional associations, rather than as traditional trade unions regarding the expansion of the medical profession. From the mid-1960s, there are tendencies indicating that the association more began to resemble a traditional trade union. However, professional issues such as improvement in the profession, demands for exclusivity, social status and issues of legitimisation appear to have been more important throughout the period than more traditional trade union issues such as pay, employment conditions and the working environment. The professions' opposition to increasing the number of doctors, regardless of the method proposed by the government and responsible authorities, was characterised by a clear guild spirit. The study shows that the medical organisation arguments against the various proposals were driven by union strategies, attitudes, and norms and in some cases ideology. The mentality of medical professional representatives and individual doctors was influenced by the professional status of the medical profession with inherent norms and attitudes based on the doctors' self-perceived expertise and scientifically anchored professional identity. A central conclusion from the study is that the main rhetorical line of the professional representatives was that more doctors were neither desirable nor needed in the medical profession and therefore most of the arguments against an expanded medical profession were based on some form of protectionism. This was justified by the profession by using historical analogies and by conducting their own 'objective and scientific' investigations. A right-wing based criticism of society at the time and a fundamentally conservative view of the economy, the tax system and the expansion of the welfare state also served as rhetorical tools from the medical profession in the debate on the shortage of doctors.