Dramatic courtroom scene depicting Swedish court's ruling against regions for illegal Cosmic contract addendums, with symbolic fines of 10 million kronor each.
Dramatic courtroom scene depicting Swedish court's ruling against regions for illegal Cosmic contract addendums, with symbolic fines of 10 million kronor each.
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Court rules Cosmic addendum illegal – million fines for regions

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The Administrative Court of Appeal in Gothenburg has ruled that addendum agreements to the Cosmic contract for nine regions, including Region Dalarna, violated the law. Each region must pay 10 million kronor in procurement penalty fees following Tuesday's ruling. The Competition Authority prevailed after the Administrative Court had acquitted the regions.

The Administrative Court of Appeal in Gothenburg issued its ruling on Tuesday against nine regions in the Sussa collaboration, including Region Dalarna, Blekinge, Gävleborg, Halland, Norrbotten, Sörmland, Västerbotten, Västernorrland, and Örebro. In 2022, the regions signed addendum agreements to the original 2016 Cosmic contract, where Cambio won the procurement for the journal system. After delays, the regions opted for a new agreement with extended delivery time instead of claiming compensation from Cambio, which the Competition Authority deemed fundamentally altered the procurement and constituted illegal direct procurement. The Competition Authority began investigating in summer 2023 following a tip. The Administrative Court in Karlstad acquitted the regions in autumn 2025, but the Court of Appeal overturned the decision, imposing 10 million kronor per region—the maximum possible fee at the time of the claim. Court president Johan Sanner stated: “De har varit så pass stora så att det inte längre är samma avtal som leverantörerna hade att ta ställning till när upphandlingen annonserades. Det är en otillåten direktupphandling. Ett typfall som man ska se allvarligt på.” Cambio has previously committed to covering the fines. Elin Norén (S), chair of the regional executive in Dalarna, said: “Det vi behöver göra först nu är att läsa domen och sätta oss tillsammans med de andra Sussa-regionerna och komma fram till om vi ska överklaga till högsta förvaltningsdomstolen, eller inte.” Moderates in Region Dalarna criticize the S-led majority that signed the agreement in 2022 despite warnings from the region's lawyers.

Hvad folk siger

Discussions on X focus on criticism of the nine regions for breaking procurement laws in the Cosmic addendum deal, with the Gothenburg Administrative Court of Appeal imposing 10 million SEK fines each. Users highlight taxpayer costs, lack of personal accountability for officials, and some allege connections to former PM Göran Persson via Cambio's ownership. Sentiments are overwhelmingly negative, decrying public sector waste.

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Illustration of Cambio Healthcare executives paying Region Dalarna's fines for the Cosmic procurement scandal, with disapproving Konkurrensverket observer.
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Cambio to pay Region Dalarna's fines in Cosmic case

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Nine regions, including Region Dalarna, avoid paying 10 million kronor fines each for the illegal procurement of the Cosmic journal system. Supplier Cambio Healthcare will cover the costs per prior agreement. Konkurrensverket criticizes the arrangement but will not act in this case.

All regions in the Sussa collaboration, including Region Dalarna, are appealing a Kammarrätten ruling imposing 10 million kronor fines each. The ruling concerns a supplementary agreement on the Cosmic system. The regions are deemed to have erred in the handling.

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In the ongoing Sussa Cosmic contract saga, regions including Region Dalarna are appealing the Kammarrätt's recent decision to uphold million-kronor fines (10 million SEK each) over a supplementary agreement for the Cosmic journal system. After winning in administrative court, they lost on Konkurrensverket's appeal. 'We believe we are right,' says Sofia Jarl (C).

Region Dalarna is investigating a case where a patient died waiting for surgery due to a delayed summons. Dalarnas läkarförening links the incident to flaws in the Cosmic electronic health record system. The event occurred before year-end, shortly after the system's rollout.

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Following Region Dalarna's decision to raise BUP compensations by 25 percent, Moderate politicians—backed by the region's political leadership—propose an additional 25 million kronor to further increase compensations and introduce a new operational agreement. The proposal was presented in a press release on Monday.

Region Dalarna has managed to cut costs for hired personnel by 40 million kronor in one year. The 21 percent reduction is partly due to a stop on hiring nurses, though exceptions are still allowed.

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Region Dalarna is dissatisfied with the alarm chain for its ambulance helicopter, which is frequently dispatched on missions that are rejected or aborted. Region councilor Sebastian Karlberg (S) calls it poor use of resources. Despite criteria to reduce false alarms after ten years of operation, cooperation with SOS Alarm remains unsatisfactory.

 

 

 

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