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purpose will approximate SKr250-300 million, which authorities believe will provide all Swedish municipalities with adequate treatment facilities by 1975. Of the approximately 1,300 purification plants with biological and chemical purification Sweden now has, only 50 are considered of high efficiency. About 330 three phase plants are under construction or projected.
The discharge of oil and other refuse at sea is forbidden in Swedish territorial waters. In order to combat the discharge of sulphur dioxide in the air through the extensive use of oil for heating purposes, the sulphur content of heating oils is now limited by the law of 1969 to 2.5% by weight. Following the new law on environmental protection, directives and norms are presently being drawn up for air purification in industry. Rules have also been imposed to reduce the discharge of motor vehicle exhaust. Beginning in 1971 carbon monoxide and hydrocarbon discharge was to be reduced to prescribed levels. The new environmental protection law also applies to industrial and traffic noise. As early as 1967 the government declared that supersonic civil air traffic would not be permitted over Swedish territory if the noise from such aircraft proved adverse to health. All of these measures reflect the growing concern for environmental protection. This concern for the environment is also demonstrated by Stockholm's hosting the United Nations Conference on the Problems of the Human Environment in 1972.
5. Public health administration
Public health measures in Sweden are directed by the Ministry of Social Affairs. The ministry has direct control over the National Institute of Public Health; the National Board of Occupational Health and Safety; and the National Social Insurance Board, the supervisor of regional insurance funds. The ministry also coordinates with other national and with international organizations on matters of social welfare and health. International coordination is maintained, for example, with the United Nations Educational, Scientific, and Cultural Organization (UNESCO) in the provision of health facilities and training of personnel in underdeveloped countries, and with the World Health Organization, notably for providing medical education in Sweden and abroad.
The National Board of Health and Welfare, which was established in 1968 as a result of a merger of the National Social Welfare Board and the National Board of Health, is the central administrative authority for matters relating to social welfare, medical care, and the supply of pharmaceutical products. Approximately 95% of all health care is under the jurisdiction of this board and its associated public bodies. In addition to licensing all medical doctors, the board establishes qualifications for, and gives licenses to, dentists, nurses, pharmacists, and others working in health-related fields. It also oversees physicians, pharmacists, and dentists with private practices to insure that they meet government policies and standards. Authority for functional implementation of board policies is delegated to the provincial councils. These councils, one in Stockholm and in each of the 24 provinces, are responsible for hospitals, dental health services, and medical officers within their areas. The county medical officer and his staff represent the national board and perform supervisory and inspectional functions for the board.
6. Medical care
The quality of medical and paramedical personnel in Sweden is excellent, and training compares favorably with that in the United States. Most directors serve as full-time or part-time public health officials; only a few devote all their time to private practice. The total number of physicians, however, is inadequate for the needs of the population. In 1969 there were 10,380 doctors, or 1 doctor per 770 inhabitants. The 1967 ratio of 1:850 compares with figures of 1:860 in the United Kingdom, 1:850 in France, 1:750 in Norway, 1:710 in Denmark, 1:650 in West Germany, and 1:650 in the United States. With increased numbers of students being admitted to medical schools, the physician to population ratio in Sweden is expected to improve to approximately 1:450 by 1985. Most physicians tend to settle in the more developed, urban centers, causing a marked shortage of qualified medical personnel in rural and sparsely populated areas. In many rural areas such shortages on hospital staffs have caused an unreasonably large workload in daily medical care. The Swedish Medical Association has established group consultation centers throughout the country in order to obtain a better geographic distribution of physicians.
The number of medical facilities is sufficient to provide adequate medical care for the population. In 1968 there were 729 general and specialized hospitals, with a total of 115,390 beds, a ratio of 146 beds per 10,000 population. In the past decade the emphasis has been on the construction of larger, well-equipped hospitals in the large population centers and the gradual reduction in the number of peripheral facilities. A striking example of the advantages to be derived from this trend is accorded by Dunderyd Hospital (Figure 21), situated a few miles north of Stockholm and administered by the Stockholm
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