Expert says regions may have unlawfully waived SEK 375 million

Nine Swedish regions may have acted unlawfully when they waived SEK 375 million in contractual penalties after supplier Cambio failed to deliver the Cosmic medical records system on time, procurement expert Andrea Sundstrand told SVT. The regions signed supplementary agreements instead of claiming the penalties.

Sundstrand, an associate professor of public law at Stockholm University, said a public body cannot simply waive money it is entitled to receive. She said the decision could amount to unlawful state aid or otherwise give one supplier an improper advantage.

Mats Lundin, chair of the Sussa collaboration, said there was no established assessment that the regions’ actions amounted to unlawful state aid. He said their aim was not to benefit Cambio, but to make the decision they considered best for healthcare, patients and taxpayers.

The regions waived the penalties to secure delivery of the system, according to Sussa’s former operational chief, Niklas Lindberg. In police questioning, he said the penalties could have driven Cambio into bankruptcy and that officials believed they needed to save the contract and obtain a product without disrupting services elsewhere in Sweden. Lundin said pursuing the penalties could have led to a lengthy legal dispute, a new procurement and very high costs.

The supplementary agreements prompted strong reactions within the regions. A legal review commissioned by Sussa officials concluded that they could constitute an unlawful direct award. A regional employee sent the review to the Swedish Competition Authority, and Sussa’s leadership reported the employee to police for alleged breach of confidentiality. Prosecutors later dropped the preliminary investigation and described the report as “shameful”.

The Competition Authority found that the regions had carried out an unlawful direct award. An administrative court cleared them, but the Administrative Court of Appeal later ordered the regions to pay a total of SEK 90 million in procurement fines. The Supreme Administrative Court is due to review the ruling.

In May 2026, the government announced a review of failures in Sweden’s medical records system procurements. The E-Health Agency is to present its findings to the government by November 9, 2026.