Private emails link regional negotiator to later Cambio job

SVT reports that Cambio’s chief executive privately contacted the operational lead for nine Swedish regions during sensitive negotiations over a health records system. The exchange came before the regional official later joined the company, prompting a procurement expert to describe the situation as a clear conflict of interest.

The emails were sent on the evening of September 28, 2023, after a heated meeting between the regions and Cambio. Officials from two regions had criticised the company for failing to deliver under the contract. That evening, Cambio CEO Rami Avidan emailed the regions’ operational lead, Niklas Lindberg, asking for a private email address. Lindberg replied 51 minutes later: “Hi, of course.”

The contents of any subsequent private correspondence are not known. Neither party has made the emails available. Lindberg told SVT that after exchanging addresses, they did not communicate that way again until May 2024, when he “sounded out the possibility” of a job at Cambio.

Lindberg remained in a key role for the Sussa regional collaboration until April 2025, when he joined Cambio as a programme director. Andrea Sundstrand, a procurement expert at Stockholm University, told SVT it was a clear conflict of interest. Someone interested in working for a company they are negotiating with should not take part in those negotiations, she said, because it could disadvantage the public authority.

Lindberg said he understood that sharing his private email address could appear inappropriate and that he would act differently now. He said all communication concerning Cambio, Sussa and the regions had taken place through official channels. Avidan told SVT he could not remember why he had asked for Lindberg’s private address.

Lindberg’s then-manager, Västerbotten regional director Tommy Svensson, said exploring a possible future job was acceptable, but that unofficial communication about negotiations would be inappropriate. Lindberg is now responsible for introducing the Cosmic health records system in Stockholm and Gotland on behalf of Cambio.

The regions decided in December 2018 to buy the system from Cambio under a contract worth nearly 4.4 billion kronor, covering ten years with an option to extend. The deal affects about 2.5 million residents across nine regions. Implementation began in autumn 2024, after delays that included problems with deliveries.

Healthcare staff have raised concerns about patient risks following the rollout. A review by SVT’s Uppdrag granskning, published on April 29, identified 3,210 incident reports mentioning Cosmic. Of those, 646 had a clear connection to the system, including incorrect treatment or medication and missing referrals. The review also found seven deaths in which Cosmic was mentioned as a contributing factor, though not as the sole cause. Cambio said it had not been informed that errors in Cosmic had been identified as the cause of a patient’s death.