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Provision of care during a crisis – will it work?

Ann-Zofie Duvander and Minna Lundgren

In times of a heightened state of alert or war, the Nordic countries face major challenges in terms of planning for medical care and nursing services as well as social services. Such a situation affects people in need of healthcare and social services, organisations that provide healthcare and social services, and the women and men who work in healthcare and social services. The need for healthcare is likely to increase, but how responsibility for this will be shared is unclear. A fragmented and largely privatised sector faces major challenges, even without a crisis. The need for care for children and elderly relatives is also likely to increase. How those working in the sector balance these different needs, largely women who are already under pressure, will be critical.
The Nordic Council of Ministers has agreed on a cooperation programme with the aim of making welfare accessible to everyone in sustainable and inclusive societies (Nordiska Ministerrådet, 2024). Medical and nursing care for the elderly and people with certain disabilities are central to Nordic welfare, and it will be particularly important for these services to function well in the case of a heightened state of alert or war. As a result of Russia’s war in Ukraine, which began in 2014 and continued with a full-scale invasion in 2022, the security situation has changed and the Swedish government has decided to resume total defence planning. This means, among other things, that authorities that perform socially important tasks need to plan for their operations to function in the event of heightened alert or war, i.e. that operations must be maintained and able to withstand stress. In Sweden, the National Board of Health and Welfare is the authority responsible for health, healthcare and other care, and in recent years has been given several expanded assignments related to crisis preparedness in medical and nursing care (Government Decisions No. S2024/01060 and S2024/01055). Preparedness includes planning to ensure availability of personnel through total defence duty and wartime postings, a system that was introduced after the Second World War. At that time, the main focus was on wartime postings for men to perform duties in the Armed Forces in the event of war, while they had other jobs in peacetime. With the resumption of total defence planning, many authorities besides the Armed Forces have now begun to plan for how their operations will function in the event of a heightened state of alert or war, including through the wartime postings for personnel. However, major and radical changes have taken place in Nordic societies since the advent of total defence planning in the 1950s, not least that both women and men are now almost equal contributors to the workforce. In this text, we will discuss issues related to the need for and planning of medical care and nursing in the case of a heightened state of alert or war in today’s Nordic societies. We will start from the Swedish context, which we know best, but the issues we will discuss are also highly relevant in the other Nordic countries.
A recent report on staffing in civil defence (SOU 2025:6) addresses changes in the labour market, highlighting privatisation and the emergence of subcontractors in medical and nursing care, healthcare and other care as new challenges for total defence planning. However, the implications of total defence planning for a modern society, with a workforce consisting of both women and men, and thus mothers and fathers, are hardly problematised or discussed. In general we have in the literature hardly found any mentioning of the consequences of the fact that women and men today are both engaged in paid work and parenting. For society to be resilient and resistant in a crisis, we believe that aspects of gender, in intersection with other categories such as family situation, age, citizenship and rural and urban residence, must be taken into account. How effectively medical and nursing care for citizens will function in a society in a state of crisis or heightened state of alert needs to be viewed from at least three perspectives:
  1. Those in need of healthcare and other care
  2. Employers who are responsible for ensuring the provision of healthcare and other care
  3. Care providers, i.e. staff of various kinds and from different professional groups 
For all three perspectives, gender, in intersection with other categories, is central, and we will discuss the conditions for carrying out these activities in the event of a heightened state of alert or war. One example is that Early Childhood Education and Care (ECEC) provision for those who perform socially important activities should be prioritised (SOU 2025:6, Regulation 1991:1195). However, if extended working hours and limited holiday leave become relevant, there will be a need to define the workers affected and, among other things, what this means for the increased need for childcare (perhaps primarily with regard to ECEC). None of the above perspectives can neglect the individuals involved and what can reasonably be expected of them. Our discussion is by no means exhaustive but can be seen as an argument that realistic planning of how work is to be carried out during a heightened state of alert or war must take into account who is expected to perform various tasks, and here gender is a highly relevant factor.
During the Second World War, women replaced conscripted men in the labour market to some extent, but during the first half of the 1950s, strong economic growth meant that many families could live on one salary (Nermo, 2000). There was also resistance, especially to married women to be engaged in paid work, and access to childcare was very limited. To the extent that married women did paid work, their income was primarily seen as a supplement to that of their husband, with men’s higher wages justified by their role as breadwinners. Under these circumstances, the system of wartime postings required women to take primary responsibility for the home and children when men were called up for training exercises and in the case of war. This stands in sharp contrast to today’s society, where expectations of labour force participation are gender-neutral and social institutions such as ECEC and schools make this possible. The labour market participation for women aged 15-74 in Sweden in April 2025 was 67.1 per cent and for men 70.9 per cent . Among women engaged in the labour market, 15.8 per cent were temporary employed. Among men, the same figure was 13.2 per cent (SCB, 2025). Female employees are the dominant group in municipal and regional medical and nursing care for elderly, and many of them also bear primary responsibility for the home and family when the working day is over. Authorities’ current planning for the continued functioning of operations in the event of social crises and extraordinary circumstances such as war, will have a significant impact on many women employed in the public sector. Some of them may be assigned to wartime postings within the framework of their employment, while the vast majority are expected to serve at their regular workplace in accordance with their general national service. It is therefore very much a gender and equality issue how these employees will be able to fulfil their general duty of service and whether this duty conflicts with expectations of care in the private sphere.
First, we need to briefly go through some concepts that are important for this essay, the first of which is total defence duty. All Swedish citizens and permanent residents of Sweden between the ages of 16 and 70 are subject to total defence duty, which includes: 
  1. military defence service within the Swedish Armed Forces,
  2. civil defence service in rescue services and similar activities, and
  3. general national service.
Military defence service means that you have completed basic training in the Swedish Armed Forces and, in most cases, have a wartime posting (see below) for service during heightened state of alert or war. Civil defence service is the civilian equivalent of military defence service (Myndigheten för samhällsskydd och beredskap, 2025). These duties affect certain sections of the population, while general national service can include almost everyone of working age. During heightened states of alert, the government can prescribe general national service to ensure that socially important activities continue to function. General national service can therefore apply to all or parts of the country and to certain activities. Those employed in the public sector are generally expected to continue their regular work but may also be required to serve elsewhere. This is decided by the employer (for government employees) or by the Swedish Public Employment Service (for others). During heightened state of alert, general national service means, among other things, that employees do not have the right to terminate their employment.
Wartime postings are an important tool for systematically planning who will serve where in the case of total defence. Wartime posting means that a decision is made on where an individual will serve during a heightened state of alert or war. There are two types of wartime postings, the first of which is service under the act on total defence duty (1994:1809) and includes military and civil defence services. The second type of wartime posting involves employer planning. Employers who are responsible for carrying out socially important activities apply to the Swedish Defence Conscription and Assessment Agency to have their staff assigned to wartime postings in the event of a heightened state of alert. This means that the employer will call on certain employees in the event of a heightened state of alert or war. This is to maintain operations and ensure that employees are not called upon for other socially important activities. An employee can therefore be assigned to the Swedish Armed Forces within the framework of military defence service, to the emergency services within the framework of civil defence service or to their regular employer. Recently, the number of wartime postings in the country has increased. Between 2017 and 2020, the number of municipalities that checked whether people were available for wartime postings, or applied for wartime postings for employees via the Swedish Defence Conscription and Assessment Agency, increased from 19 to 120. In 2022, 15 regions and 105 municipalities had placed employees in wartime postings, and these figures increased to 19 and 163 respectively between 2022 and 2024 (Plikt- och prövningsverket, 2021; 2025). The number of municipalities and regions assigning personnel to wartime postings is thus increasing, but they are doing so in different ways. For example, Region Skåne has assigned all permanent staff to wartime postings, while Region Stockholm has assigned only those in key positions (Granestrand, 2023).
Medical care provided by regional authorities and healthcare and nursing care provided by municipalities are socially important activities that are required to meet society’s basic needs (Myndigheten för samhällsskydd och beredskap, MSB, 2023). Planning to ensure that these activities continue to function does not currently take into account circumstances or opportunities related to gender, family status, individual care commitments or other circumstances. But how do care needs change in a crisis situation? And what means are available to those responsible to ensure that these needs are met? And how will it be possible to fulfil the general national service for all of us, who are, of course, more than just ‘general individuals’?
We will begin by describing how needs for medical care and nursing care can change in a crisis situation.

Changed needs for medical care and nursing care during a heightened state of alert

War radically changes the way society functions. It has major consequences for both public and private activities and, of course, for all individuals. A key factor in a crisis or war situation is that the need for healthcare and other care is likely to increase (see, for example, SOU 2025:6). The crisis situation itself can lead to people being injured and needing both emergency and long-term care. Elderly care as well as other care is currently provided either at home in the form of home help services or in special housing. However, a large proportion of care is also provided by family members, who in a crisis situation may be forced to relocate or work longer hours. Relatives have taken on an increasingly important role in caring for elderly family members (Ulmanen & Szebehely, 2015), and there is a strong expectation by the public providers that that relatives carry out at least some of the care and contact needed. If relatives will not assist with some care, there is a risk that the elderly and others in need of care will suffer, or that home help service providers will become overburdened. This is already a trend in the Nordic countries where for instance the differences in access to public care between urban and rural areas are increasing (Rostgaard et al., 2022; Sjögren & Parding, 2024). In many municipalities in rural and sparsely populated areas, the older part of the population is overrepresented, and long distances can become even more problematic in situations where society is exposed to external stresses. This is likely true in all Nordic countries.
Furthermore, experiences from for instance Ukraine show that crises often lead to internal displacement within a country. Internally displaced individuals place a strain on local communities, and existing social services must continue to function even in situations of war and crisis. Vulnerable groups become even more vulnerable, such as children (Armitage, 2022), the elderly and individuals with disabilities (see, for example, Patarwy et al., 2023; Regev & Vasylchenko, 2025; Rosenthal et al., 2022) as well as those who are economically marginalised.
Membership of NATO may also have consequences for all Nordic countries, even if war does not take place in their territory. For example, NATO countries may need to assist with patient evacuation or a rapid influx of patients in the event of mass casualty incidents (see for example Socialstyrelsen, 2025).
These aspects affect the burden of and need for both healthcare and nursing care, but one area that is rarely mentioned in relation to crises is ECEC and other childcare. A well-developed, high-quality ECEC system is something that is now seen as an integral part of the welfare state, but it has a short history (Duvander & Nyberg, 2023). When childcare provision began to be expanded in the 1970s and 1980s, the goal was to create a universal childcare system that was equally available and beneficial to children across economic and social backgrounds. Intellectual stimulation was an important aspect in the provided childcare, but also at least one warm meal each day. In a crisis situation, it should be kept in mind that many children may need support of various kinds, including medical care. Experiences from COVID-19 also show how easily children’s participation is overlooked in periods of crisis, contravening a number of regulations to protect children’s rights (Kjellander & Sjöblom, 2023). At the same time we may all agree that it is crucial to care for the next generation during a heightened state of alert.
In sum, we can assume that the need for healthcare as well as other care will increase during a crisis, both because a larger part of the population will find themselves in vulnerable situations and because those who currently provide the unpaid care in the private sphere will likely have less capacity to do so. But what means, interests and responsibilities do those in charge, such as local authorities, regions and private care providers, have to safeguard these in many ways increased needs during a crisis?

Responsibilities during crisis in a new labour market

The privatisation of areas of the welfare state that previously were public has increased over time. For example, in 2007, 26 per cent of all Swedish healthcare centres were private, a figure that rose to 47 per cent in 2023 (Sveriges kommuner och regioner, 2024). In central Stockholm, there are now only a few healthcare centres that are publicly run. This raises a number of questions regarding how responsibility is distributed and the possibilities to take on this responsibility.
The legal situation for private providers of healthcare and other care is unclear when it comes to operating during heightened states of alert or war, as the relevant legislation was introduced at a time when almost all healthcare and other care services were run by the public sector. There are also major differences between Sweden’s municipalities, where core municipal services have been privatised to varying degrees. In some municipalities, it may be as much as half of all activities, while in others the proportion of privately run activities is very small (Arbetet, 2024). Similar trends can also be seen in Norway (Ågotnäs et al., 2019) and Finland (Mathew Puthenparambil, 2018). What legal responsibility does a private healthcare provider actually have to continue operations during a crisis? Globalisation means that many of the private providers are international companies or foreign owned, and it is possible that these providers also have financial requirements and responsibilities to balance in other countries.
However, it is clear that ultimate responsibility for municipal and regional care recipients lies with the public sector, that is the municipality and the region. For example, were a privately owned nursing home to go bankrupt in a situation during which the government had introduced a heightened state of alert, the municipality would be responsible for ensuring the availability of functioning elderly care. This may lead to major challenges, not least as the municipality may not have the staff reserves available to do so.
In addition to the increased privatisation of welfare services, the employment types have become increasingly heterogenous. Perhaps the best example is the so-called gig economy, which involves companies and private individuals purchasing services from individual contractors via a range of platforms. A study from 2016 shows that 10 per cent of the Swedish population between the ages of 16 and 64 have at some point worked in this economy (Huws et al., 2016). Håkansson (2024) shows that the gig economy has also left its mark on the welfare sector, where many workers do not have permanent employment and must instead wait for requests from a range of employers. They need to respond quickly to short-term and immediate requests to get sufficient work opportunities. This set-up of services risks seriously affecting healthcare and other care in the event of a heightened state of alert. The reason is that the staff who are usually contracted for short ‘gigs’ often have several potential employers, having sometimes too few and sometimes too many job requests. They may also have been assigned other work through the Swedish Public Employment Service within the framework of general national service as well as to wartime postings by, for example, the Armed Forces. In addition, fixed-term contracts will affect the available staffing and such contracts account for about 15 per cent of all employment in Sweden (ekonomifakta.se), but likely a larger proportion in the sectors with which this paper is concerned. Employers can choose to assign fixed-term employees to wartime postings, but this will be much more difficult if they only have a short lead time for planned working hours.
Many of those engaged in home help services work for several providers. Loyalty to a temporary employer is not a given and, in the frequent cases of multiple employers, it is not possible to be loyal to several employers during a heightened state of alert. Those who are only employed on an hourly or on-call basis are also not covered by general national service, as they are only considered employees during the shifts they have agreed to work (SOU 2025:6). In other words, employers who are heavily dependent on hourly staff will face staffing challenges in the case of a heightened state of alert.
Perhaps one of the most difficult problems is gaining an overview of healthcare and other care needs and to make an estimate of the personnel required. Who will have knowledge of existing needs and those that arise? This is not easy, as needs are constantly changing, both regarding the elderly, medical and other care. Local authorities and regions have the responsibility, but as provision is largely private today, it will be difficult to get a comprehensive picture.
In sum, we can expect different employers to take on responsibilities in different ways, have different opportunities and perhaps different levels of willingness to organise the provisions that will be needed in the event of a heightened state of alert. Gaining an overview of the required and available workforce will be a challenge. Recruitment to the welfare sector is already a major problem throughout the Nordic region (Penje & Berlina, 2021). So, who are the people who work in healthcare and other care, and what possibilities and limitations do they have to carry out their work in a crisis situation? 

Individuals working in healthcare are not just anyone

Today’s labour market is in a state of constant change. There is currently a high level of unemployment due to the economic downturn, but the labour force participation is also high, not least because women in the Nordic region participate in the labour market to a high degree. The labour market is largely gender segregated and women often work in typical welfare sectors such as education, healthcare and other care, where provision must also function in the event of a crisis or war. An overwhelming majority, 87 per cent, of registered nurses in Sweden are women (Socialstyrelsen, 2024). Another example is that there is a predominance of women in the dental profession and an almost equal distribution of women and men who are registered doctors (Socialstyrelsen, 2024). The most common profession in Sweden is nursing assistant, and 89 per cent of the country’s nearly 130,000 nursing assistants are women (Statistics Sweden, 2023).
While female labour force participation is high in the Nordic countries, there is a significant discrepancy between foreign-born and native-born women, with a large proportion of foreign-born women, especially newly arrived, not in employment. In Sweden immigrant women seem to face greater obstacles to establishing themselves in the labour market than immigrant men (Landell, 2021). In theory, those who are outside the labour market can be called upon for general national service during a heightened state of alert, and thus be assigned to work in areas such as healthcare and ECEC, where needs can be expected to increase. A parallel can be drawn to the fact that during the Second World War many women served in a ‘reserve labour force’. However, the problems of applying general national service to people without relevant education, experience or service should not be underestimated.
The high employment rate amongst women in Sweden and the Nordic countries could lead to a larger pool of workers available for wartime postings and also to more workers who can serve in a location other than their regular place of work within the framework of general national service. However, employed women are also the ones who often have main responsibility for homes and children, responsibilities that are unlikely to diminish, but rather increase, during a crisis. As a result, they will often not be able to be deployed or serve in another location, as wartime postings or the conditions of war in general sometimes require. As there is still a skewed gender distribution of responsibility for children, it is likely that women will take on greater responsibility during a heightened state of alert, while also working in critical welfare sectors that are necessary for society to function. It is therefore remarkable that the many investigations and reports engaged with the question on how Sweden will manage staffing needs in a time of crisis do not shed more light on how the issue of private care should be resolved.
During the COVID-19 pandemic, some ECEC were forced to close for periods due to staff shortages. In these cases, children of parents working in essential services were given priority for places at other ECEC that remained open. How will this affect those who are not in permanent employment but regularly take on temporary work with different employers? If those parents are not provided ECEC for their chidlren, it will present a setback for medical care, nursing as well as other sectors that recruit according to the ‘gig principle’, as these parents will need to look after their children instead of taking temporary gigs. Even before the COVID-19 pandemic, a clear division was visible in the labour market, with the conditions for vulnerable groups and those in stable situations with permanent employment becoming increasingly distant (Eriksson et al., 2017). This situation should be understood from a gender perspective, as it is mostly women who have the insecure jobs and who will also likely take on childcare responsibilities if ECEC is limited.
Although gender equality in the private sphere has increased, many women continue to bear primary responsibility for childcare and other household tasks. Jobs in medical care and nursing are not particularly flexible in terms of working hours and opportunities to work from home. Flexibility in employment has proven to be a salient issue for gender equality in relationships in which couples are raising children together. In more restricted professional fields, part-time work among women remains a common way of managing the tension between work and family life (Öun & Grönlund, 2022). Among the members of the Swedish Association of Health Professionals, 34 per cent work part time (Vårdförbundet, 2025). The main reason for this is the intensive workload in healthcare, followed by the need to have more time for family. It can be assumed that the workload in healthcare will increase even more in the event of war and, at the same time thatprivate responsibilities will not decrease. A higher proportion of men are assigned wartime postings in the Swedish Armed Forces, which may entail service in another location. The consequences may be that private childcare responsibilities will be even more gender unequal.
Looking back at the Second World War, the resistance to married women working resulted in long shifts for the usually unmarried nurses serving in war zones around the world. Today, the situation has changed radically, and many women working in health care and other care have children at home, which likely will affect their ability to work long shifts. The demand for ECEC and schooling during inconvenient hours may have to be considered.
Another aspect of public services is public transport. Access to efficient public transport affects people’s ability to get to work. About 60 per cent of the country’s population over the age of six use public transport regularly and women more so than men (Svensk Kollektivtrafik, n.d.). If public transport services are reduced, it will affect the possibilities to get to work, particularly for women and those in sparsely populated areas.
In sum, how to meet the growing need for both workers and care for children and others in the private sphere risks becoming a battle over resources, a battle in which the reserves are limited. To pay attention to this competition over resources will help us to ensure that the most vulnerable are protected. Women are at risk of finding themselves in difficult situations, facing demands from employers and, more or less explicitly, demands to provide care in the home. Below, we discuss additional factors in the private sphere that may affect workers’ abilities to fulfil their general national service.

Individuals are often part of a family

Like most other countries, Sweden has seen major changes in family dynamics. Perhaps the most important one to have consequences for resilience in the workforce for medical care and nursing, is that parental separations are relatively common. According to Statistics Sweden (SCB statistikportal), in 2024, 73 per cent of all children aged 0-21 lived with both their original parents, while the rest lived with one parent and sometimes another adult in the household. Approximately half of children who are registered with one parent live alternately with their parents, and the absolute majority of those living with one parent live with their mother. However, the statistics are uncertain and reflect a fluid situation in which living arrangements change with children’s age and other events in the lives of children and parents. Reconstituted families are relatively common, and at least one in ten children live in such a family. From an adult’s perspective, it is not unusual to have children with different partners. Today, there is also greater variation in the way families take shape, including same-sex parents and parents who have chosen to have children on their own.
What significance do family dynamics have in terms of wartime postings and general national service? If one parent is deployed to another location for general national service, it will increase the burden on the parent who remains at home. Moving with a partner may be impossible, as it is not possible to resign if the government has prescribed general national service. This can entail many logistical difficulties and hardly considers the child’s perspective, as their access to both parents is limited. The situation can also be complicated by differing age groups of children within the same family or household and everyday planning that involves parents living apart. For many, it is simply the case that the care puzzle is compli­cated and each person in the household (and in a broader sense, the parental constellation) is more vital and needed, and thus more difficult to cover for. In a typical case, we can compare an old-school nuclear family with a mother who works part time or as a homemaker and a father who is deployed in a wartime posting, with today’s fulltime working parents who have their children alternately and live with new partners and additional children in new constel­la­tions. It is clearly more difficult to do without the care of such a mother and/​or father compared to a father from a 1950s single-income family, who was certainly needed but who’s care responsibilities could be covered to a greater extent by the mother, whose primary responsibility was care. Equal parenting is an important aspect of public policy in the Nordic countries and is often seen as a success, perhaps especially as fathers have taken on a greater role in caring for their children. In a crisis or war situation, shared parenting needs to be considered. Will fathers today agree to leave their children if they are deployed to a war­time posting in another location? How will the children experience being separated from a parent for a long period of time?
Another important factor to consider is the prevalence of occupational homogamy, i.e. the trend for women and men to form couples with someone in the same profession or industry as them. This is particularly relevant when both adults in a household work. It is common, for example, for military personnel to live together and have children with other members of the armed forces or in similar professions. Other examples include the fact that a quarter of all doctors are married to another doctor (and a tenth live with a nurse) and 15 per cent of all police officers are married to another police officer (Widegren, 2016). These are examples of professions that are particularly important for society’s resilience during a crisis.
What happens if a parent and worker deployed to a wartime posting needs to serve in another location, for example at a temporary field hospital, and their partner is also involved in socially important work? How does this affect the other parent’s ability to perform their duties? Whose work is most important? The register of wartime postings exists to ensure that one person is not assigned a posting by several organisations at the same time. However, we know very little, if anything, about multiple wartime postings within the same household, or wartime postings for parents who do not live in the same household. What happens to the children if both parents are expected to serve in locations other than their place of residence? As mentioned, it is likely that this is common given the high proportion of homogamous parents. In addition to affecting individual families, this also affects the functionality and resilience of society, as public services may face challenges of unknown scope in terms of utilising as planned personnel deployed to wartime postings.

Will medical care and nursing services function during a crisis?

For society to be resilient, and for crisis and war planning to be realistic, consideration must be given to who lives in Sweden and with whom they live and have formed families. Traditionally, wartime postings affected almost exclusively men. Now that women are part of the workforce, it is impossible to ignore the care needs that must be met in the private sphere: the care that those outside the workforce (typically housewives) previously provided. In addition, we are working longer into our older years, and care assistance from grand­parents is often not possible as their participation in the labour market is also needed.
A large proportion of the population is gainfully employed, and we are accustomed to viewing this as something positive; it is actually the fulfilment of an important political goal. There is no doubt that women’s participation in the labour market has led to increased gender equality, economically independent women and more financially secure children. Equally, labour force participation has undoubtedly led to meaning, dignity and independence from family and state. High labour force participation has also been a positive for economic development. Now that the female labour reserve has largely been utilised, crisis planning must take this into account. There is no one to take care of children and the elderly in need if everyone is expected to work even more than they do in peacetime. Unless everyone works more, it may be difficult to meet increased needs, especially in healthcare and other care. It is the same women who are expected to perform these intensified tasks. This raises questions about the sustainability of current planning.
The Swedish total defence system has never been tested in a real-life situation, and the challenges we describe here are therefore hypothetical. Today, we see that it is still unclear to many in the population what laws apply in the event of a heightened state of alert or war. Those who have been assigned to wartime postings should have been informed of what this entails, but it is not always certain that this is the case. Many individuals are also unaware of the general national service. In addition, mobility in today’s labour market is so large that even if an employee is fully aware of their situation, it can be difficult for employers to keep track of their employees’ circumstances and any commitments they may have to other organisations, as information about individual wartime postings is not public. Furthermore, neither employers nor the Swedish Defence Conscription and Assessment Agency have information about those in relationships in which both partners are assigned wartime postings, possibly entailing deployment to another location. This makes realistic planning difficult. One possible consequence is that the responsibility falls on the employees them­selves, who must balance their duties with other needs, such as caring for children and other relatives with needs.
The work of dealing with crises in general, but in particular in medical care, nursing and other care, is not yet systematised, coordinated or planned in detail. When this work is undertaken, we would put forward the same risk that applies to the sector even in the absence of an acute crisis: when there are insufficient resources, the most vulnerable may suffer most. This is critical in medical care, nursing and other care, as these activities mainly deal with people in need of assistance. It is also more difficult to get an overview of needs today. Those who work in healthcare and other care also have commitments outside work, and if they are not given the possibility to take care of these, they may be unable to fulfil their duties or wartime postings. This will result in the workforce either becoming exhausted, or choosing the most urgent needs of care, most likely private care, or to conditions that lead to children in need of care having less access to their parents in situations characterised by crisis and unrest, i.e. situations in which children have greater need for security. These are issues concerning gender equality in work and care, issues regarding the child’s perspective, regional differences, older and younger parts of the population, individuals with different family situations and with different economic situations. Is there anyone who exists outside of these characteristics who will be able to guarantee the provision of healthcare and other care in a situation of crisis or war?
  • Without taking into account how the labour market and family responsi­bilities have changed, there is a risk of underestimating the challenges of a heightened state of alert within planning for medical care and nursing.
  • Who is responsible for ensuring that healthcare and other care needs are met? Who is even able to get an overview of these needs?
  • Who is expected to work during a heightened state of alert and how are they able to balance family responsibilities with increased demands on service?
  • How can realistic planning take into account the fact that most people working in healthcare and other care are women, who also have significant responsibilities in their private lives?

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