Costs will rather increase.

Area of Science:

• Health policy research
• Public health management
• Sociology of health

Background:

• Decommissioning of health services is an emerging area requiring policy and practice improvements.
• Understanding public reaction is crucial for managing large-scale service changes.

Purpose of the Study:

• To investigate public responses and arguments against an urgent, extensive health service decommissioning program in Sweden.
• To analyze the communication and rationale behind decommissioning decisions from the public's perspective.

Main Methods:

• Analysis of local media content to survey public responses.
• Categorization of public arguments into inductively developed themes.
• Examination of protest activities, including demonstrations and petitions.

Main Results:

• Public protest activities were largely uncoordinated, focusing on unique or remote services.
• Concerns raised included decision-maker competence, information adequacy, cost-saving claims, patient safety, and local impacts.
• Decision-makers struggled to communicate benefits and rationales, while the public valued services more inclusively than budget-focused decision-makers.

Conclusions:

• Implementing decommissioning programs despite public protest is feasible.
• Further research is needed on the long-term effects of decommissioning on health system legitimacy.
• This study provides evidence to enhance future decommissioning policy and practice.