although public ownership of health centres is still the norm in many county councils especially in rural and sparsely populated areas the number of private providers increased significantly following the recent reforms in some county councils they are significant players in stockholm for example about half of all primary care providers are private although there are no robust evaluations of the impact of the reforms some positive impacts have been reported the recent reforms are reported to have increased primary care capacity reduced waiting times and improved access including for lowincome groups anell et al the increase in primary care providers notwithstanding relative shortages persist in rural areas because the expansion has occurred primarily in wealthier urban and more densely populated areas the reforms have also brought an increased focus on quality efficiency and transparency exemplified by the measurement and publication of information on performance to support patient choice for example through the open comparisons website and incentives to county councils and municipalities for quality improvement