First judgment on charges of alleged bribery in the Swedish healthcare sector

31 October 2007

Gustaf Anselmsson, Per Svanteson, Sara Sparring

The distinction between proper and improper rewards from the pharmaceutical industry to doctors and clinical staff is unclear and has been in much debate in recent years. However, the first judgment on charges of alleged bribery in the Swedish healthcare sector has now been delivered by a district court.

A Swedish prosecutor from the National Unit Against Corruption filed charges of bribery against three doctors and four representatives from the pharmaceutical and medical implant industry. The doctors were employed at an orthopedic surgery, one of them as the manager of the clinic.

In 2003, the doctors organised a bus trip to Prague for 42 members of their clinic staff. The purpose of the trip was to visit an orthopedic surgery and have an internal conference. The clinic manager asked the two other doctors to contact a number of pharmaceutical and medical implant manufacturers (the “Manufacturers”) in order to ask for contributions to help finance a part of the trip. The Manufacturers were contacted by employees from the clinic, which later received a total of €7000 from, among others, the four representatives charged in the prosecution.

The prosecutor alleged that this financial contribution constituted a bribe. Furthermore, the prosecutor alleged that it was the doctors who initiated contact with the representatives and those same doctors who decided which pharmaceuticals and implants to purchase for use at the clinic. With reference inter alia to these alleged facts, the prosecutor argued that the financial contribution should be considered as an improper reward for the doctors‘ performance of their duties.

In the judgment (case no. 3260-06) delivered on 18 September 2007, the District Court of Jönköping acquitted all defendants. The court started off by referring to the preparatory work of the Swedish Penal Code which states that the interpretation of the concept “improper reward” should not be broad. A reward is, according to the preparatory works, normally not considered improper if the reward constitutes a natural and useful aspect of the receiver’s performance of his/her duties. Business lunches and field trips are examples of rewards which the legislator refers to as generally proper. Recreational trips, on the other hand, are generally considered as improper rewards. The financial value of the reward also affects the reward’s appropriateness and luxurious field trips are accordingly, in general, considered improper.

In this case, the financial contribution covered only a part of the participants’ travelling expenses. Divided between all the participants, the financial contribution amounted to €170 each. After examining all the relevant evidence, the court held that the Prague trip should be considered as a mere field trip and accordingly the financial contribution was not to be considered an improper reward. The case has been appealed by the prosecutor to the Göta Court of Appeal.