The year of 2016, healthcare accounted for almost 10.9% of Sweden’s total GDP, which corresponds to almost 478 billion SEK. A significant part of an organization's expenditure is linked to procurement, but in the context of procurement in public sector there is not enough research done, and the studies that have been done indicates that there are opportunities for improvement. This study has focused on direct procurement, and the purpose is, therefore, to increase understanding of direct procurement in Swedish healthcare and to formulate recommendations that streamline the process of direct procurement.

This work was a multicase study, interviews were conducted with four employees in three different regions who worked with procurement linked to healthcare, in addition to these interviews, requests for other material relevant to direct procurement were sent out to several other regions. The findings were analyzed and discussed with the help of a literature review.

It was discovered early in the work during the interviews that resources were not prioritized for direct procurement. Direct procurement is always carried out if it is allowed, and it is permitted if the value of the procurement does not exceed SEK 586 907 if there are no special reasons. These amounts are governed by the Public Procurement Act (LOU), and in addition to this limits there are many other parts in LOU that the public sector must relate to - and the laws and regulations set are the main reasons why the purchasing process in the public sector is more complicated than in the private sector.

A successful purchasing function is characterized by, among other things, team-based structure and good cooperation between the different parts of the organization. One part of the study's contribution is that digitization should be seen as a performance area and success factor in public procurement. The public sector has a socio-economic responsibility, but because of LOU, it is not easy to stimulate local economic growth, as an example. In this study, several recommendations have been proposed, for instance, to become more cost-effective, and to how the problem of socio-economic responsibility may be circumvented without risking committing violations of the public procurement laws. One recommendation is digitalization of the process to increase efficiency in several performance areas. Another recommendation is to work closer to the suppliers and the customers to, as an example, encourage innovation and sustainability.