Elderly care

Malin Höglund (M)

Madam Speaker! Today we are debating the Social Affairs Committee's report 21, which concerns elderly care. I would like to begin by moving for the approval of the committee's proposal.

Madam Speaker! Many elderly people have built our country. They have worked, paid taxes, and contributed to the welfare we have today. They deserve elderly care characterized by security, quality, and respect. But we must be honest that elderly care in Sweden has problems. We see a shortage of staff, long waiting times for elderly housing, and a home care service that does not always suffice. It is not worthy of a welfare country like Sweden.

That is why the government and we Moderates have taken important measures to strengthen elderly care. But we are not at the finish line. The Moderates and the government are pushing forward for a policy aimed at giving our elderly better freedom of choice, higher quality, and a safer care. We want to create a world-class elderly care. But to reach there, reforms and decisiveness are required.

Madam Speaker! We are facing a demographic change. We are living longer, and the proportion of elderly people in the population is increasing. This is positive, but it also means increased demands on elderly care. We face challenges such as staff shortages. Thousands of assistant nurses and healthcare assistants are missing. More training places and faster ways into the profession are needed.

We are facing understaffing. The stress can be enormous, and the care time for each elderly person is decreasing. There is also a shortage of nursing homes. In some municipalities, elderly people are denied a place despite having a need for it.

We also see an insecurity. Many elderly people feel lonely and do not receive the support they need. We hear about alarms that no one manages to respond to and about elderly people who are left alone. Then we also have this issue with nutritional deficiency. Many elderly people who live at home and eat in solitude receive substandard food.

All of this must change. We Moderates have a clear plan to improve elderly care, and it is based on more freedom of choice and a more modern elderly care.

Madam Speaker! This is not worthy of a welfare country like Sweden. Therefore, we Moderates want to build upon the government's work and do more to create a world-class elderly care.

In recent years, decisive reforms have been implemented to improve elderly care. The elderly care boost (äldreomsorgslyftet) is a historic initiative that has made it possible for thousands to receive education and obtain permanent positions in elderly care. Through increased state grants to elderly care, we have provided more resources to the municipalities to improve working conditions and increase quality. National initiatives to reduce loneliness have been taken so that more elderly people can have the opportunity for social interaction and an active life. Increased cooperation between healthcare, elderly care, and civil society creates a safer and more cohesive elderly care. These are important measures, but we continue to push forward.

Madam Speaker! What distinguishes the Moderates' elderly care policy from other parties is our view on freedom of choice, quality, and responsibility. We believe in freedom of choice. The elderly should have the right to choose who shall provide them with the care and support they need. It should not be the municipality that decides everything. We prioritize quality over quantity. Elderly care should not just be about more places and more hands. It should be about better care and higher quality. We take responsibility for the economy. Welfare must be financed in the long term. We cannot build a system that risks collapsing in the future. Our elderly deserve better than rigid systems and bureaucracy.

Madam Speaker! Without a strong workforce, there is no elderly care. We need more training places and faster paths into the profession. But it is also important to retain the competence. Less administration is also needed. Let the staff do what they are best at: taking care of people!

Madam Speaker! The municipalities must take responsibility for building more elderly care homes. No elderly people who do not want to stay at home shall be forced to do so, and the elderly who have a need for special housing shall have that met. Home care must become more flexible and individually adapted. The elderly shall have the right to influence their own care and nursing. Digital supervision can never replace human care, even if it can be a complement.

Madam Speaker! No elderly care functions without committed and knowledgeable staff. The work environment is one of the biggest challenges we face today. Heavy lifting, stress, and exhaustion lead to high sickness absence. A lack of resources and support creates a work environment that causes many to leave the profession. We Moderates and the government want to improve the work environment by increasing staffing, so that the staff have time to provide care, and provide better working conditions through working conditions that make more people stay in the profession. We also want to strengthen leadership and management to create better organization and less stress. It is not reasonable for a manager to have 78 people under them. If we do not improve the work environment, we will not be able to solve the staff shortage, and then the entire elderly care faces a crisis.

Madam Speaker! The Government has taken important steps, but we also see clear problems in the municipalities. The municipalities are sounding the alarm about the lack of resources, while at the same time the municipalities have a responsibility and elderly people are being denied places in residential homes.

Madam Speaker! We are living longer, and more people need support and care in their later years. But it is not only the elderly who are affected, but also their relatives. In Sweden, over 1 million people are relatives providing care. They help a parent, a spouse, or a friend with care and support, often at the expense of their own health and finances. We must take this seriously. Therefore, the Moderaterna are driving a policy that strengthens elderly care and provides better support for relatives.

Madam Speaker! Thousands are forced to reduce their working hours or stop working entirely to care for an elderly relative. Stress and exhaustion are common. Many risk becoming ill themselves from the high burden. It leads to economic insecurity – relatives who stop working receive a lower pension and find it harder to support themselves. There is also a lack of information and support. Many do not know what measures they are entitled to or how they can get help. There are many municipalities in Sweden that do a fantastic job when it comes to initiatives for relatives, but more can be improved.

Madam Speaker! The Government is making investments by increasing state grants to elderly care. The municipalities have received more money to improve relative support and relief, which is very important. Through the development of national guidelines, the municipalities receive better guidance on how relative support should be offered and quality-assured.

Madam Speaker! The Moderaternas starting point is that every human being is unique and has their own wishes and interests. The right to decide for oneself is important regardless of age. In the autumn of life, one deserves better. The elderly deserve an elderly care where they themselves get to choose their care. Freedom of choice and quality in elderly care is important for us in Moderaterna. No elderly person should be forced into a certain form of care. The right to choose should be self-evident. Security and quality come before bureaucracy and political compromises.

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Nadja Awad (V)

Madam Speaker! I thank the member for the speech.

The quality of elderly care is the worst in ten years, according to the Socialstyrelsen's latest report released after the turn of the year. It is connected to the record-large cuts we see in municipalities all over the country under the government's and the Sverigedemokraternas leadership of this country.

Assistant nurses are sicker than any other professional group. They cannot afford to pay bills and put food on the table, and they are being laid off. Staff say in Kommunals' member survey that the insufficient staffing poses a risk to the elderly at least once a week. These cuts therefore affect not only the staff's working conditions and work environment but also the elderly's right to care and support.

What are the government and the Sweden Democrats doing then? Well, they are prioritizing tax cuts for the very richest. Prime Minister Ulf Kristersson has given himself a tax cut of 4,000 kronor a month, while the nursing assistant only gets a tax cut of 150 kronor per month. Often, this government and the Sweden Democrats want to abdicate the responsibility for financing and say that the municipalities have all the responsibility. But in practice, that means one must raise the municipal tax, the flat tax, for the pensioner, the nursing assistant, and the single mother.

My question to the member is: How much does the member think municipalities should increase the municipal tax by? How much more tax should residents in different municipalities be forced to pay to get good elderly care?

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Malin Höglund (M)

Madam Speaker! I thank Member Nadja Awad for the question.

Last time I checked, at least – and I have previously been a municipal councilor in Mora municipality – it was the case that a municipality is responsible for its own tax rate. If a municipality needs to raise the tax, the finances are not in order in the municipality. It is the municipality that is responsible for the finances and for the residents who live in the municipality. Last time I checked, it was that, at least.

Since then, the municipality has also been responsible for school, preschool, and elderly care. The municipality is responsible for its citizens in the municipality – at least the last time I checked. What the state does and what the government does is to create additional initiatives, such as Äldreomsorgslyftet and other things. In order to increase competence in the municipalities, the state can step in and do such things. But it is the municipality that is responsible.

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Nadja Awad (V)

Madam Speaker! I thank the member for the answer. It is true that the municipalities are responsible for determining their own tax rates and determining which priorities should be made in the various municipal activities. But because of how laws and regulations are designed today, elderly care is used very much as a budget regulator because other types of municipal activities are more rule-bound, for example, the school. Many times, the municipalities out there, regardless of party, prioritize that resources are primarily directed toward the schools' activities – perhaps with a focus on preschool – and then elderly care falls behind.

It is absolutely about how municipal activities are prioritized in the individual municipalities. But there, the Left Party believes that we need more of a regulatory framework within elderly care so that we can ensure that more and more people get the right to full-time and permanent employment and so that the number of employees per manager is limited.

It is also connected to how many resources the state should allocate to the municipalities so that the municipalities can invest in raising the lowest wages for, for example, the nursing assistants. It is about being able to hire more and invest in the working conditions and the work environment with the help of resources and with the help of increased regulation.

The alternative is to raise the municipal tax. The Member of Parliament obviously thinks that is the only alternative. One does not want to give the municipalities the increased resources that they need.

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Malin Höglund (M)

Madam Speaker! Thanks to Member Awad for the questions!

The Moderates are hardly a party that wants to raise taxes. But it is the municipalities that are responsible for their citizens and for taking care of them. This applies regardless of whether they attend preschool or school or are in elderly care.

The chairman mentioned a little bit about full-time. The full-time journey is something that is underway. Here, the municipalities are incredibly different. It is not 290 municipalities in balance. They have not come as far, rather there are municipalities here that are better and municipalities that are worse. It is very good with full-time within elderly care. It is the best thing that has come, I think.

That a municipality uses elderly care as a budget regulator seems very strange to me. In such a municipality, I would not want to live or work – and definitely not be a politician.

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Christofer Bergenblock (C)

Madam Speaker! The member said in his speech that for the Moderates, freedom of choice, quality, and responsibility are important parameters in elderly care policy. Let us dwell on the part that concerns freedom of choice.

Our elderly demand freedom of choice just as everyone else in society does. We want to be able to choose which health center we go to and which school we send our children to. We naturally want to be able to choose which companies we hire and where we live.

A survey was conducted by Vårdföretagarna and SPF Seniorerna last spring. It was presented in March a year ago. It was a rather large survey. They had asked 1,227 pensioners in the age group 85–109 years, in order to truly reach the target group, about how they viewed this matter of freedom of choice. Nine out of ten thought that freedom of choice was extremely important. They wanted the right to choose home care companies and which elderly housing they live in.

At the same time, it is noted in the report that over 1 million pensioners do not have that freedom of choice, not even regarding home care companies. In half of the municipalities, the possibility to choose home care companies is missing because they have not decided on the law on freedom of choice systems.

The member stated that freedom of choice is one of the most important parameters for the Moderates, but also that it requires reforms. Let me therefore ask the member if she can give a single example of a reform that the government has initiated to increase the elderly's right to freedom of choice.

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Malin Höglund (M)

Madam Speaker! Thank you, Member Bergenblock, for the question!

As I said in a previous exchange, it is the municipalities that are responsible for ensuring that there is freedom of choice for the elderly in the municipality. The municipality is responsible for its citizens.

Just as Member Bergenblock said, freedom of choice was a very important issue. Nine out of ten want freedom of choice. Why should it be that we get to choose everything our whole lives, but as soon as we get older, we no longer get the chance to choose? Instead, the municipality shall choose. It is someone else who is going to choose where I should live and what food I should eat.

One can talk with the elderly. My mother is 81 years old. She wants to continue to choose. She does, of course, still live at home. But she wants to continue to choose what food she shall eat. When the day comes when she is to move to a nursing home, she wants to decide. Sometimes she says: You can also decide for me. But then it is the family that decides. That right I do not want to take away from the elderly.

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Christofer Bergenblock (C)

Madam Speaker! There are somewhat different parts to this. When it comes to the great freedom of choice – which elderly housing or sheltered housing one chooses to live in, or which home care company one chooses – it is important.

Then the small freedom of choice is also important if you live in a senior housing facility or receive help at home. It is about being able to choose whether to have wine with the meal instead of milk, choosing what time you get up during the day and what time you go to bed, as well as choosing when you want to take a shower and when you do not want to do so. These are things that are self-evident for us.

Now, it is perhaps more the great freedom of choice regarding home care companies or elderly housing that I thought we should speak particularly about here, even though both parts are very important. Even though the municipalities now hold the great responsibility, we find ourselves in the chamber of the Swedish Riksdag. The question is well what can be done from the Riksdag's and the government's side to increase the elderly's right to choice. Obviously, there are very many who do not get that opportunity for choice today. It is because the legislator is not pushing as much as they actually can.

From the Centre Party, we want to legislate that LOV must be offered in the municipalities. If there are then companies that establish themselves, that is another matter. But it is not the municipality that should be the obstacle. We also want to see a larger investigation into how one can, in general, strengthen the freedom of choice for the elderly within elderly care.

My final question to the Moderates is: Are the Moderates prepared to support us in legislating the introduction of LOV in the municipalities?

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Malin Höglund (M)

Madam Speaker! Thank you, Member Bergenblock, for the questions!

Today there is a great deal of freedom of choice in the municipalities, but it is not in all of them. There is a difference between large and small municipalities, and there is a difference between the boards in the municipalities. I have visited quite a few special housing units in Dalarna but also in other counties. There, the freedom of choice exists. Do I want to get up at six in the morning, do I want to get up at nine, or am I one of those who wants to sleep until eleven? One can adapt breakfast and the different meals based on the individual.

Then there are other municipalities that are very rigid and want to pull the elderly up at seven o'clock in the morning because it has always been that way. In those cases, there is no freedom of choice. But there are municipalities that are good role models.

Member Bergenblock also highlights the issue of LOV in the municipalities. The Center Party wants it to exist. What does it look like then in the municipalities where the Center Party is involved in governing? That is the next question. Now, the member cannot answer that one. But it is a very interesting question. In the municipalities where I know the Center Party is involved in governing, it is actually nothing that one pushes particularly much on.

Then the next question is: Are there companies that want to come in? That can be difficult in small municipalities and naturally also in rural areas.

I think the question is interesting. In the municipality I come from, Mora, we have discussed it. We also govern together with Centerpartiet there. It will be exciting to follow this issue. But we need to have more freedom of choice for the elderly.

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Anna Vikström (S)

Madam Speaker! Thank you, Malin Höglund, for the speech!

I want to talk about the fact that the increase in the number of employed people in the coming years – those who will enter the labor market over the next ten years – is not sufficient to cover the growing needs in elderly care and health and medical care.

There is also very much to do to improve the work environment and working conditions. It is about skills development so that more people will want to and have the strength to stay in elderly care, as several speakers have spoken about here earlier.

But other state measures may also be needed so that employees can educate themselves and move from another industry to elderly care, for example within the municipalities. There may be a surplus of labor in certain areas, and it may be the case that there is an interest in switching but that in adulthood one does not have the possibility of living without a salary in that way.

We succeeded in influencing the government to retain the Äldreomsorgslyftet, which we introduced. That is good. But the government needs to do more to manage the situation regarding the competence supply in the future.

The warnings that have occurred and are occurring within health and social care – 6,098 last year and 659 this year up to February – are against the background that at the same time there are very large, completely unreasonable recruitment needs. This applies in particular to the long-term supply of skills and how it is affected. Many of those who have been laid off are within the municipalities.

What are the Moderates and the government doing to stop the cuts within elderly care?

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Malin Höglund (M)

Madam Speaker! Thank you very much, Member Vikström, for the questions!

The supply of competence is the greatest challenge; I think everyone sitting here in the chamber tonight knows that. The full-time journey has been important so that more people can live on their entire salary and be able to stay in the profession. Leadership is incredibly important. Within preschools, there is a principal training for those who are to be leaders and principals. But there is nothing such in elderly care, even though one often has an enormous number of employees under them there. It is not reasonable, and it is a workplace environment issue in itself.

Education is incredibly important. The municipalities are responsible for the education, both the upper secondary and the post-secondary. In a neighboring municipality to mine in Dalarna, there were three people who applied to the nursing assistant program – three people! This was in Älvdalen municipality, and it concerns three different municipalities. It will not be able to help and contribute to the competence that is needed there.

The elderly care boost is and has been incredibly important. It ensures that more people have stayed in the profession.

The warnings that have occurred have largely been due to the fact that those who have not been trained have been removed, say those I have spoken with. Instead, they are given a chance to educate themselves and return to the profession. We need fast tracks into elderly care, whether it is a three-year upper secondary education or shorter post-secondary adult educations. But several of those I have spoken with have, therefore, warned those who have not had education.

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Anna Vikström (S)

Madam Speaker! Thank you, Malin Höglund, for the answer!

Full-time work and leadership are important areas. But when it comes specifically to the transition from one profession to another, Äldreomsorgslyftet will not be enough. Here we are talking about a completely different type of support from the state to be able to manage a change when it concerns a workforce that wants to change jobs.

I would like to be clear and say: We know what the government prioritizes, and it is not elderly care. I must say that I am horrified by the large-scale layoffs and the number of terminations occurring within municipal elderly care. I actually did not believe it was as much as it is.

I really hope that the member is aware that it looks this way. It looks like it is the bourgeois municipalities that find it easiest to make these cuts, at least from what I have seen. It is not exclusively so, but it is to a large extent that way.

I also see ahead that you have reductions in the budget for 2027 of approximately 2 billion, Malin Höglund. It might be the Äldreomsorgslyftet that is removed, and then we are in a rather problematic situation when it comes to the supply of competence.

The general state grants to the municipalities were far too small. We added 6 billion more. You talk about wanting to make certain changes, but there is no money. What you are allocating is pocket change for relative support. Relative support is very important, but it is nothing that changes the situation and stops the resignations.

What does the government want to do, in concrete terms, to stop the serious warnings and cuts that exist within elderly care?

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Malin Höglund (M)

Madam Speaker! Thank you, Member Vikström, for the questions!

I think that this government takes elderly care issues very seriously. We have a Minister for Elderly Care. It is clear that we take the issues seriously.

We do, however, need to make the work more attractive so that people choose to stay in the profession and so that more choose to enter the profession. They must see that it is flexible and that they get to do different things. Here, the municipalities have a very important role in ensuring that more apply to the health and social care program. Perhaps one could let year 7 and 8 do internships within elderly care. In my home municipality, we have had summer interns from year 9 and year 1. We lowered the age to year 8 to be able to give the students an insight. Now they can come out and look and do an internship to then perhaps apply to a health and social care program.

The elderly care boost shall not be removed in the coming years, at least as far as I know. Member Vikström might know something else, but that is definitely not the case. The elderly care boost is an important reform to educate more as people build upon their knowledge. If one has been a care assistant, one can build upon that knowledge.

Member of the Executive Board Vikström raises an important point: relative support. It is incredibly important for those who want to stay at home longer. One might have a husband or a wife who is demented but still finds a way to solve everything so that the person can stay at home. But then one needs relief. There needs to be some activity in the municipality where one party can be so that the other gets some free time and can do things they want to do and also recover. Relative support is incredibly important.

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Anna Vikström (S)

Madam Speaker! I move for approval of reservation 9.

In September last year, the film *Så länge hjärtat slår* was released, which is based on the care assistant Stine Christophersen blowing the whistle on the pandemic management at a private nursing home. New research has also emerged regarding the staff's own experiences of covid-19 in nursing homes. I am truly pleased that the consequences of the pandemic within elderly care have been made visible recently from the perspectives of the elderly, their relatives, and the employees. We need to be reminded, because there is still very much to be done for elderly care to become better.

But I also want to say that I am fundamentally impressed by how elderly care in special housing has developed into what it is today, with home-like environments and activities based on ability and will. I am impressed by how the staff, who are often nursing assistants, have built up the operations with great professionalism and competence.

One example is Ekerö, where I recently met elderly people and staff within elderly care. My impression was that the elderly people we spoke with really appreciated the operations, that the staff were well-educated, and that there were nurses and rehabilitation resources as well as good processes for training on welfare technology.

As has been said, there are many elderly care homes and home care services in Sweden that offer integrated care of high quality. But the quality is uneven across the country, and there are deficiencies regarding medical competence and coordination. For this, regulation and resources are required.

It is usually elderly people with multiple illnesses and complex care needs who live in special housing. There are also more people who have those conditions. Unfortunately, they are affected by the fact that the medical care and treatment still show extensive deficiencies. This applies, among other things, to medication management, end-of-life care, and the assessment of the patient's health status to perhaps call a nurse or doctor. Municipalities are expected to be able to manage more and more of the healthcare that previously was the responsibility of the regions.

Against this background, Madam Speaker, a new journey must now be undertaken to improve the municipal health and medical care provided within elderly care.

The S-led government took the initiative for an investigation into a new elderly care law. It submitted several proposals for legislation aimed at strengthening healthcare for persons in elderly care, including regarding permanent doctor contact, permanent care contact, 24/7 access to doctors and nurses, strengthened rehabilitation responsibility, and also the management and coordination of municipal healthcare. But SD and the government chose to stop the introduction of an elderly care law, shelved the investigation and instead appointed, for unclear reasons, a new investigation.

The Social Democrats want the government to present a bill to strengthen health and medical care within elderly care. I do not, however, have very high hopes, as there has been silence from the government regarding its own proposals within the elderly care area since the beginning of the mandate period.

Madam Speaker! The previous S-led government began the great work of lifting, securing, and modernizing Swedish elderly care. We took the initiative for a protected professional title for nursing assistants and an investigation on sustainable competence supply within care and elderly care. We took the initiative for Äldreomsorgslyftet, a state grant for competence supply of the staff, and for a sector grant from the state that went directly to elderly care. We also developed a central support for language assessment, introduced a permanent care contact with more.

The employees' work environment and working conditions are, however, not good enough, which makes it difficult to recruit and leads to nursing assistants and healthcare assistants choosing to quit despite saying that they actually love their job. Furthermore, more employees are needed than are actually available. The situation is even more concerning now, as despite the large recruitment needs, staff within health and social care are being laid off and dismissed.

Last year, 6,098 employees within health and care were laid off across Sweden; this year, up until February, 659. In Rättvik municipality, for example, 60 care assistants within elderly care and LSS were laid off in February. Despite the fact that Region Stockholm did not lay off healthcare personnel, over 2,000 were laid off in the county by other employers, private and municipalities, for example Förenade Care in Österåker and Anooni in Sollentuna. Haninge municipality dismissed 17 healthcare assistants just before Christmas. This indicates that there is a lack of state funding for welfare in a time of crisis.

Madam Speaker! An activity that should be built up is being dismantled instead. It is high time for more reforms within elderly care. We see, however, that the government prioritizes other things, for example, tax cuts, over the quality of elderly care, and there is reason for the concern that several have expressed: that the needs of elderly care have been sidelined.

We want the Äldreomsorgslyftet to be extended. We want to continue to strengthen the nursing assistant's role and the medical competence and improve competence development. We want language requirements and language training to be implemented as soon as possible. We also want the proposals in the national plan for the healthcare sector's competence supply to be taken forward by the government.

A strong elderly care is, like childcare, an important tool for an equal and equitable society where it is possible to combine paid work with care for one's loved ones. We Social Democrats want elderly care to maintain high quality across the entire country, be based on the elderly person's needs and right to self-determination, and be staffed by properly trained personnel with a good working environment and secure employment conditions.

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Roland Utbult (KD)

Madam Speaker! I would like to begin by expressing my approval of the committee's proposal in the report. I am replacing Dan Hovskär today, who has fallen ill. I shall try, in a few short words, to explain as best as I can what the Kristdemokraterna stand for.

We Christian Democrats want to build a society where people can age in security and dignity. The elderly should be able to live an active life and have influence over their everyday lives, be met with respect, and have access to good care and nursing.

I believe we can all sign off on that wording. It is, in itself, nothing new. Elderly care is one of our most important areas, quite simply.

An important word that possibly distinguishes us from some or some parties is the word freedom of choice. We believe in freedom of choice for the elderly. We believe that it is important. I am not at all surprised that nine out of ten people over 85 years of age want to be able to choose care. There is no reason to believe that the elderly would differ so much from the rest of the population. It is clear that one wants to be able to choose housing or who will come to one's home to help with cleaning or cooking.

There is a labor shortage in elderly care, while the group of elderly people over 80 years of age is expected to increase. Decisive action is required to improve the conditions for staff within elderly care and strengthen the possibility of recruiting more staff. It is urgent to reduce the occurrence of split shifts.

Another deficiency is the language barrier, which can impair safety and well-being. Therefore, the Tidö parties have introduced language requirements for staff. Older people must be able to understand and make themselves understood. It is important for medical safety and for the work environment.

The government is also investing in the dementia area and recently presented a national dementia strategy where, for the first time, there are clear goals to follow up – all so that people with a dementia diagnosis can live a dignified and meaningful life.

The government wants to counter involuntary loneliness among the elderly. It is also an area that is very important. Involuntary loneliness is a painful feeling that can be linked to both physical and mental ill health. When the great football legend Gunnar Gren died in 1991, I remember the newspaper headline: He died alone and abandoned. The trophies probably lost their value when loneliness struck in his life.

We know that the sense of coherence and having a task is the meaning of life, from a human perspective – all according to the renowned psychologist Aaron Antonovsky.

There is an expression that has etched itself into my mind, and that is the expression "direktare". What is it then? Yes, "direktare" is a form of funeral process where the deceased's body is cremated immediately after death without any form of ceremony or funeral ceremony. There is no viewing of the deceased, no funeral ceremony with guests, and no immediate burial. Direktare – what a terrible expression, and what a terrible situation.

Let me conclude my short summary that I have presented here. For us Christian Democrats, the situation of the elderly will also continue to rank high on the agenda. The issue is a central part of our party's political DNA, and it shall continue to be so.

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Mona Olin (SD)

Madam Speaker! Today we are debating SoU21 on elderly care. For us in the Sverigedemokraterna, a secure and dignified old age is a very important issue. Those who have built up Sweden's welfare deserve the best possible care and support, regardless of where they live. The elderly should be able to live an independent life under secure conditions, with respect for self-determination and privacy. They should feel participation and community and be treated with dignity.

Care shall be characterized by security, continuity, and accessibility, with special housing that is staffed around the clock. An individual plan shall be established from day one to ensure the right interventions from the beginning. We also want elderly care to have a stable workforce to avoid care recipients meeting too many different employees.

All over the country, there are many committed employees who work hard every day and do a fantastic job to provide the best possible care and support to our elderly. But we are all aware that there is a shortage of professionally trained staff in the field, and the need is expected to increase in line with demographic developments. The state, employers, and private providers must cooperate to strengthen the supply of competence and improve the quality of care.

To make the profession more attractive, the staff's working conditions must be improved. Inflexible schedules, split shifts, and unwanted shift work take a toll on both body and mind. Employees within healthcare should have greater influence over their working hours and the right to both full-time and part-time employment, which benefits both them and the operation.

Madam Speaker! For the vast majority of people, the opportunity to choose is a fundamental freedom, regardless of life situation or age. This also applies to the elderly, where freedom of choice plays a decisive role. By giving the elderly and their relatives greater influence over what care and support they receive, their right to decide over their own lives and their everyday lives is strengthened.

The possibility of choosing a healthcare provider and the availability of private options within elderly care is a positive development that contributes to better quality and increased adaptation to individual needs. It is, however, crucial that all healthcare providers maintain a high quality standard regardless of whether the care is run in private or public hands.

The Sweden Democrats believe that quality should always take precedence over price in the procurement of elderly care. When the elderly themselves get to decide who shall assist them in everyday life and provide them with the care and service they need, both self-determination and satisfaction increase. Therefore, we believe that what is set out in LOV should be available in all municipalities throughout Sweden. The right to choose one's own housing in old age should be as self-evident as the possibility of choosing one's grocery store, one's pharmacy, or one's health center. To retain control over one's life choices, even in the autumn of old age, is a matter of dignity and respect.

Madam Speaker! The language requirement in the Tidö Agreement is expected to strengthen elderly care through increased patient safety and a better working environment for the staff. The Sweden Democrats have been a driving force in this issue. The Ministry of Health and Social Affairs was tasked with investigating and producing proposals on how a language requirement could be implemented, and the proposal is now out for consultation.

Violence against the elderly is completely unacceptable and must be taken most seriously. Studies show that the perpetrator is often someone in the elderly person's proximity, such as a partner, a relative, or care and nursing staff. At the same time, the elderly underreport their exposure to violence, which makes it difficult to detect. The underreporting may be due to the fact that their dependence on the perpetrator for, for example, care and nursing stands in the way and complicates the situation.

Unfortunately, it occurs that staff within elderly care subject care recipients to various types of violence. We have repeatedly read about care recipients who have been subjected to violence or abuse by healthcare employees who, despite previous convictions, have been employed within elderly care. Stricter controls of the criminal record register could have protected many elderly people from these horrific abuses. It is therefore of the utmost importance to introduce clear requirements and regular checks for everyone who works, practices, or studies within elderly care – both upon new employment and on an ongoing basis during employment. The goal must be to prevent, to the greatest extent possible, persons with a history of violent crime from working with our elderly.

Madam Speaker! An ever-increasing proportion of the aging population is affected by dementia, and it is important that methods and ways of working are adapted to suit the target group. We think it is positive that a new dementia strategy was presented in January. It implies, among other things, that the interventions of social services and health and medical care for persons with dementia diseases shall be adapted to the individual's unique circumstances and needs. The interventions shall be coordinated to promote health and prevent ill health. Staff within both social services and health and medical care shall work based on evidence and proven experience. Furthermore, relatives of persons with dementia shall be offered support and knowledge to be able to perform voluntary relative care in a sustainable and effective way.

The four keywords for palliative care are proximity, wholeness, knowledge, and empathy. Therefore, it is crucial that staff within elderly care have the right competence and access to the necessary resources and tools to be able to identify and meet these needs – both at an early stage and in the final stage of life. Good palliative care should be available to everyone who needs it, regardless of location or diagnosis. The majority of those who receive care within elderly care have palliative care needs to some extent. It is necessary to investigate the possibility of introducing a national responsibility for palliative care and ensure that tools and knowledge support are available so that a relevant and person-centered palliative care can be integrated into elderly care in an effective way.

I would also like to take this opportunity to move for approval of our reservation 8 under point 7 regarding specifically palliative care in elderly care.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Anna Vikström (S)

Madam Speaker! Thank you, Mona Olin, for the speech!

The Sweden Democrats are really trying to make it sound like elderly care is important to the party. I thought so too in the debate last year. But we know that elderly care is not included in the Tidö Agreement, which sends a clear signal to everyone who reads it that it is not prioritized.

On the contrary, the Sweden Democrats do not seem to have any major problems with large-scale notices and staff reductions occurring within elderly care, even when SD is involved in governing locally.

I cannot see any proposals that confirm that the Sweden Democrats think elderly care is important. By that, I do not mean words but concrete political proposals that lead to decisions. What I see is that layoffs and notices continue within elderly care, which is incredibly concerning.

A lot is happening under the radar, even in the media. Not much has been written about it, but I hope the member is aware of how it looks.

It leads to a worse working environment and worse working conditions, when we, on the contrary, need to reverse this to get more people who want to stay to be able to manage. They actually like their work very much but cannot manage it in practice.

The government has now come quite far in reforming and building up elderly care, in order to address the deficiencies that were uncovered during the pandemic. What do the Sweden Democrats want to do to stop warnings and layoffs within elderly care?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Mona Olin (SD)

Madam Speaker! Thank you, Member Anna Vikström, for your question!

Yes, warnings and staff reductions are ongoing within elderly care. All that activity takes place under municipal management and does not fall under the government. The government has supported both regions and municipalities through Äldreomsorgslyftet. Very much money has been put into that which the municipalities can use to secure their staffing. It is difficult for the government to step in and direct if municipalities choose to actually reduce their staffing levels.

However, I truly agree with Member Vikström that it is extremely important that we try to get people to see the positive aspects of working in elderly care. We often forget to highlight the good examples. There are many people who have worked in elderly care for both 30 and 40 years and who love it. But we never hear those stories. They must come forward so that more young people will become interested in approaching the profession. It is important to try to highlight them so that we get an influx of labor to elderly care.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Anna Vikström (S)

Madam Speaker! Thank you, Mona Olin, for the answer!

I can agree with the last thing the member said; we really should highlight positive examples. I mentioned earlier the film that premiered last year and which even received an award at the Guldbagge gala, I believe it was. Another fantastic film is called Det omätbara, which I recommend everyone watch. It is precisely about the care on the floor and what fantastic, fine work employees do in contact with the elderly, the sick, and children, and within LSS. We really should listen to that. It is completely correct.

But when it comes to the big picture and what we here and the government must think about is whether the care has sufficient funding. It does not. The general state grants that were omitted by the government and SD could have had a very large effect on the layoffs that we now see spreading across the country and which mean that elderly care is going in the wrong direction compared to what we said during the pandemic.

SD is therefore agreeing to large tax cuts for high-income earners instead of investing in elderly care. It is also a time of crisis in the population. Many have problems paying rent, buying food, and paying for their medications. This applies in particular to pensioners with low pensions. These are, therefore, completely wrong investments.

I would also like to get an answer as to what happened with the language initiatives. Our government submitted two completed investigations concerning language within elderly care. But neither of them was taken further. Instead, a new investigation was commissioned. I want to know why.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Mona Olin (SD)

Madam Speaker! Thank you for the question, Member Vikström!

There were completed investigations regarding language requirements. But at the ministry, it was considered that more aspects were needed in the investigations, regarding the consequences if one chooses not to improve one's language skills. Therefore, a new investigation was commissioned.

We will have to see how it looks when the referral responses come back. But I am convinced that with all the activities and approaches being taken to ensure that the staff within elderly care actually improve and raise their language skills – I do not mean that everyone must be at a very high level – we will get quite a good way toward making the care safer and the workplace a better environment.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Malin Danielsson (L)

Madam Speaker! For a long time, prejudices about the elderly have characterized our society. But research actually shows that 70 is the new 50. The person who is elderly today lives a completely different life than the person who reached retirement age 50 or 60 years ago. But our image of being elderly remains in many ways in a bygone era, even though one sees clear signs that it is about to change. Among other things, more people work long after they have passed 70, and it has become more common with companies that offer services performed by seniors and so on.

Our view on elderly care also unfortunately sometimes reflects our view on being old. During the first part of the 1900s, the focus was very much on care. When it shifted to care in the home in the 60s instead, the home care of that time was carried by housewives who worked for a symbolic wage.

We have come quite far from that. Today, the focus is on living life throughout the whole life and how we are to make the healthy years more and make self-determination greater when we need more help. Still, that somewhat old ageism shines through here and there when it comes to how the elderly are treated, and they are then treated as a collective.

Madam Speaker! An area where elderly people have been treated as a collective to a considerable extent is within that which we are debating here today: elderly care. The same solutions are offered to everyone, often with a slightly patronizing pat on the head.

A report from the Institute for Human Rights released last year was titled Home is Somewhere Else. In that, the HR Institute studied elderly care from a rights perspective.

The right to freedom and protection against deprivation of liberty for those living in a nursing home is actually a human right. But that human right is not always fulfilled within elderly care. A woman in the report says: "I have lived here for over a year and the times I have come out are few and far between. It is incredibly boring."

Another human right highlighted in the report is the right to dignity. A former self-employed person who now lives in a senior housing facility describes how her right to dignity is met: ”If I call for help because I need to urinate, I might have to wait two hours, and by then it is too late.”

It is a human right not to be subjected to inhuman or degrading treatment or punishment, which, translated into rights within elderly care, means that one should not be neglected, for example, with a wet diaper during the night.

Older people are all too often seen only as their age and not as entrepreneurs, chefs, members of parliament, stamp collectors, or any of the other things we identify as. We are reduced to being old and not people with fundamental rights, and it is actually discrimination and ageism.

Madam Speaker! That is why the skills boost that is now taking place within elderly care, thanks to Äldreomsorgslyftet, is so important. Likewise, it is important that the transition that is now taking place through the new Social Services Act, which aims for care to become more preventive, easily accessible, and knowledge-based, also covers elderly care so that we do not have separate legislation for elderly care.

Another important issue for increasing the elderly's opportunity to live life throughout their lives is to offer good welfare technology. With the help of technology, one can regain some of their independence. Camera technology has developed to such an extent that those who choose to have a camera in their apartment in the special housing can have it set up according to their specific wishes and needs. It can, for example, be set up so that it notes when you enter the toilet, and if you have not come out within a given number of minutes that you have agreed upon with the staff, the staff receive a ping on their mobile and can check on you to ensure that everything is as it should be. This provides increased independence and security for the elderly, and instead of waiting outside the door, the staff can spend time sitting down and talking with someone, playing games, or taking someone out for a walk.

Some municipalities, such as Lund, have come very far when it comes to welfare technology, while others are only in the starting stages. Therefore, the assignment to the National Board of Health and Welfare to map and analyze experiences of welfare technology within elderly care is incredibly important so that good examples can be spread to more.

Finally, Madam Speaker: Even if the healthy years increase, the need for care for many increases with advancing age. Not least for the elderly, it is therefore important with the primary care reform that the Liberals have long advocated for. This will provide security and continuity for the patient and ensure physician involvement in municipal healthcare and care.

The municipalities' possibility to employ doctors is another important issue for us, in order to ensure a well-functioning elderly care. Today, there are obstacles for the municipalities to employ doctors in elderly care, which means that more than a quarter of Swedish healthcare is conducted as municipal activity without medically trained specialists. Geriatricians and general practitioners should be able to be employed at nursing homes and by municipalities. There are many good proposals in the investigation report Strengthened medical competence in municipal health - and healthcare, which arrived shortly before the turn of the year. Among other things, a possibility for municipalities to employ doctors is proposed there. We look forward to eventually being able to treat that proposal here in the Riksdag.

With this, I vote in favor of the committee's proposal in the report.

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Nadja Awad (V)

Madam Speaker! The cuts within the Swedish welfare system continue, and elderly care is no exception. Several governments have not taken their financing responsibility towards the municipalities and provided the state grants that the municipalities need. But this government, together with the Sverigedemokraterna, has delivered historical cuts to the entire country's elderly care, which means that elderly care is in a greater crisis than ever before.

The quality of elderly care has fallen over ten years, according to the National Board of Health and Welfare. Hardly any of the observations, points, or proposals in the Corona Commission's over 300-page report on elderly care during the pandemic have led to measures from the government and the Sverigedemokraterna. This means that elderly care is in a state at least as vulnerable as before the pandemic and is therefore also equally exposed to new crises. The situation within elderly care has thereby also reminded us of the inequality and disparity that prevails.

Right now, there are too few staff members working in elderly care considering the needs today but also for the future. Given that the number of people over 80 years old will increase significantly, it is important to take measures now to have a preparedness for future needs of both competence and a sufficient number of employees. More than 65,000 people will need to be employed within elderly care until 2033, shows a new report from SKR, Sveriges Kommuner och Regioner.

Without staff, it falls on the relatives to take increased responsibility, and it is a fact that women are overrepresented both among staff and among those who take a great responsibility for elderly family members. An expanded and well-functioning elderly care is therefore a prerequisite for an equal society.

Resources must be allocated so that new staff can be hired, and both resources and increased regulation are needed to improve the staff's working conditions and work environment so that care staff are attracted to work within elderly care across the country. Today, nursing assistants are twice as sick as any other professional group in Sweden. Elderly care then hardly becomes a workplace that one wants to be at or stay at for a longer period.

By strengthening the basic staffing, the staff can provide care of good quality while simultaneously having time for competence and professional development during working hours without wearing themselves out, becoming ill, or being forced into early retirement. Increased resources to municipalities can also enable them to invest in raising the lowest wages – which are overrepresented among nursing assistants and healthcare assistants.

Furthermore, it is about an insufficient regulatory framework. There is a reason why cuts affect the staffing in elderly care. Much other municipal activity is more strongly regulated by law. The lack of regulation of the conditions for elderly care linked to staffing and competence levels has created a situation where elderly care is used as a budget regulator when revenues are insufficient.

The proposal for national staffing guidelines concerns the number of full-time employees per elderly person, the number of employees per manager, the right to permanent employment and full-time work, and that 100 percent of the staff shall be professionally trained in health and social care or undergoing training. Care assistant training shall be the minimum education level in elderly care, regardless of the intervention.

Split shifts within home care, with a long unpaid break in the middle of the day and stress-inducing minute-by-minute management, is something that is obsolete and must be removed.

Vänsterpartiet also wants a sustainable labor market where people can manage to work until retirement age without being worn out prematurely. Shorter working hours – a general reduction in working hours – with maintained wages would be a decisive step in such a progressive and freedom-expanding development. The upper class's contribution for house cleaning costs more than a reduction in working hours for everyone. This is an incomprehensible prioritization by the government and Sverigedemokraterna.

By investing in the staff, one also invests in ensuring that the elderly receive elderly care according to their needs. Then, the staff and the elderly can spend more qualitative time with each other. By adding more resources to elderly care, more elderly people will have the opportunity for a place in special housing. Today, the elderly have to wait relatively long to move to elderly housing in relation to their needs and remaining life expectancy. For many, this means a long wait before they can receive the care and nursing they need. This can determine whether they live longer or not.

With more resources, more regular activities, more flavorful and nutritious meals, better premises, and more beautiful interiors are also offered. This creates social contexts and breaks the loneliness.

Real investments affect the elderly's right to care and treatment. We read daily about neglect in municipalities across the country, and we cannot have that.

Real investments affect the staff's working conditions and work environment. We read daily about how nursing assistants cannot afford to pay their bills or are taking sick leave.

It must be possible to trust elderly care, both for those who need support, care and nursing and for their relatives, and also for staff who need good working conditions.

Finally, Madam Speaker, privatizations and the pursuit of profit to create economic efficiency within elderly care have resulted in many substitutes, lower staffing levels, high staff turnover, and poorer wages. The elderly are not seen as individuals with their own needs but as units in an already underfunded welfare system or in a welfare system that is to generate a financial surplus for the shareholders in private companies.

Even in the municipalities where the Moderates rule, LOV, the Act on Freedom of Choice, is being abolished. Vänsterpartiet does not criticize the right to freedom of choice – Vänsterpartiet criticizes the pursuit of profit within the welfare sector. Profits shall not be made at the expense of the staff's health, well-being, and wallet. Profits shall not be made at the expense of the elderly's well-being and life expectancy.

Vänsterpartiet naturally stands by all its reservations, but I would like to move for approval of reservation 9 regarding the working conditions and working environment in elderly care.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Christofer Bergenblock (C)

Madam Speaker! Initially, I would like to move for approval of the Centerpartiets reservation 5 under point 3 on increased freedom of choice for the elderly.

I believe that we all in this chamber agree that everyone should have the right to a good life even in the autumn of life. One should be able to live with the assurance that when loneliness sets in or abilities begin to fail, there is a society that provides the help one needs.

It can be about being able to get an opportunity for community through activities at our study associations or pensioner organizations. It can be about getting help from home care when one can no longer really manage to take care of oneself in the same way and perhaps needs a helping hand. It can be about home healthcare helping with medication and nursing when one comes home from the hospital after a hip fracture.

It can be about there being a sheltered housing unit to move to when one no longer feels safe in one's own home, or that a place in a special housing unit is available when dementia means one can no longer manage in an independent residence. Most of us assume that all of this works, but it is far from always the case.

The number of elderly people in society is increasing, and we see a large increase particularly among those who are 80 plus. This will place demands on home services, home healthcare, adapted housing, and places in special housing in the future. At the same time, it means that more people must work within elderly care in the future, that new technology must be used to a much greater extent, and that administration and bureaucracy must instead be reduced.

Not least, Madam Speaker, it is a great challenge regarding the supply of personnel, a challenge that has been further exacerbated by the government's ban on labor immigration from third countries.

One of the most important measures to achieve more worked hours within elderly care is to reduce the sickness absence rates, which today are at very high levels – within some groups even over 10 percent. There are several measures that are important to address this problem. Perhaps the most important concerns the leadership within elderly care.

We know that deficiencies in leadership often lead to a poor work environment. At the same time, the leadership must be possible to perform. Many managers within health and social care can have up to 40, 50, 60 or 70 employees. It then goes without saying that it becomes very difficult to see each one of them and to give each one of them the help and the support they may need in their work.

From the Center Party's side, we also want to see a state-run management training within elderly care, in a similar way as we currently have a headmaster training within the school world, this in order to give all managers good conditions to fulfill their mission. But we need to reduce the number of employees per manager within elderly care.

It is also about that as an employee one should have the opportunity to choose between different employers. As an employee within elderly care, one must be able to choose who one wants to work for and whether it is in private ownership or in municipal ownership. In fact, it is such that most surveys show that the work environment is often perceived as better with private actors. But that is not what is most important, but what is most important is the diversity for those who work within our care services. Not least, it is also important to have the opportunity oneself to move forward and start one's own company within, for example, home care.

Madam Speaker! From the Center Party's side, we also want to stand guard for strengthening the elderly's opportunities for freedom of choice. We have heard several parties speak warmly about freedom of choice during the debate in the chamber today. It has been the Moderates, the Christian Democrats, and the Sweden Democrats. I certainly believe that the Liberals also think it is important with freedom of choice. But it also requires political decisions. That is what is missing from the government.

Surveys have been conducted showing that the elderly want the right to choose home care companies and assisted living in the same way as one has the right to choose a health center. Today, the development is going in the wrong direction. Several municipalities are instead choosing to restrict the elderly's right to freedom of choice.

Centerpartiet has previously wanted LOV to be offered within home care in the entire country in all municipalities. But now we also want to see a broader investigation into the right to choice and how it can be developed so that it does not only concern home care but also specialized housing and other parts of the care area.

For most of us, it is still a self-evident fact that we can choose which company we hire, which school the children attend, and where we want to live, and it should be just as self-evident when we get older. But freedom of choice is also about the life one lives: to be able to shower when one wants, to be able to choose when one wants to get up or when one wants to go to bed, and to be able to decide for oneself whether one wants to drink wine or milk with dinner in the evening. People's right to shape their lives must apply to the whole of life.

Exactly five years ago, on March 11, 2020, the first COVID-19 death occurred in Sweden. On the same day, WHO stated that we were affected by a pandemic. In 2020 alone, over 9,000 Swedes died in the wake of the pandemic, many of whom were specifically elderly. Many of these were residents in our elderly care homes.

Despite the fact that it was the elderly who were to be protected the most, that was where society failed the most. The criticism that came from the Corona Commission in its final report in 2022 was stinging. In addition to a lack of resources and competence, it was noted that the possibility of obtaining advanced care at the elderly care homes was largely non-existent.

Centerpartiet has since pressed for this to be rectified. On the one hand, there must be access to equipment for, for example, oxygenation and intravenous drip in our elderly care homes as well as competence to handle the equipment; on the other hand, it must be the doctor who goes to the elderly care home when the need arises instead of the elderly person being transported to the emergency department. The requirements to make medical assessments must be strengthened.

This is also reinforced by the investigation presented in the autumn regarding strengthened medical competence in municipal health and medical care. It points out many important proposals and measures that need to be implemented. The question now is when sharp legislative proposals will come from the government's side. They should have arrived a long time ago.

Madam Speaker! Certainly, we face challenges ahead in Swedish elderly care, but at the same time, there are good opportunities to make it better. Through strong leadership and better conditions, the work environment can be strengthened. Through technical aids, time can be spent on nursing instead of on monitoring. Through increased freedom of choice, the well-being of the elderly can increase. Through the right to secure housing and the opportunity for activities, isolation and loneliness can be broken. Through reinforced medical competence, the right care can be obtained in time, directly where one lives. In this way, we can strengthen the right to live a good life even in the autumn of life.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Nils Seye Larsen (MP)

Madam Speaker! I would like to begin by moving for approval of reservation 1, under point 1, Future elderly care, from S, V and MP.

I am quite new to parliamentary politics. But there is something that I can do as a municipal politician, which I have been for many years, and that is elderly care. It is something that is important and that is often discussed in municipalities.

Let me make it clear that our elderly deserve an old age with dignity. They are the ones who have built the prosperity that we live in today. They are the ones who have laid the foundation for the Sweden we have today. But we face great challenges. The demographic challenges, with an aging population, have been well known for a long time.

Here I want to emphasize the inequality regarding the conditions for the municipalities all around Sweden. I will describe it briefly. I represent one of the four northernmost counties in Sweden. The four northernmost counties in Sweden represent an area corresponding to over half of the country. 8 percent of Sweden's inhabitants live there. But if you remove the largest municipalities, it is an area that is larger than England. 140,000 inhabitants live there. That is a halving since the 50s.

It is an aging population. Over half in many of these municipalities are 50-plus. They are also municipalities where the median income is almost 10,000 kronor lower than in the country. They are municipalities that have some of the country's highest municipal taxes so that they can afford to finance the welfare. They are municipalities that lack employees, people who can work. They have a significantly lower unemployment rate than in the country. They face great challenges.

I want to raise this, because I hear many times about what the government wants to do for elderly care. People talk about the municipalities' responsibility. I can say that municipalities are very much aware of what is needed for good elderly care. We need more employees. We need a better working environment. We need to be able to offer better employment conditions for our employees. We need to have more managers, and we need to be able to invest in competence development.

But all of this is based on having the prerequisites. More resources are needed. That was why we in Miljöpartiet had a significantly larger allocation for general state grants to our municipalities and regions. These are funds that they would have needed in order to be able to do something about the tough situation that many of these municipalities are in.

I want this to be remembered. It is not that the municipalities are dodging their responsibility, but they are in an incredibly difficult situation. If this development continues, it means that elderly care and the conditions for being able to offer elderly care to our elderly, who deserve good elderly care, will vary enormously in our realm. This is something that we in Miljöpartiet view with great concern.

I have a small focus on one more thing. I have seen that in debates there has been a lot of talk about this with language requirements. It is something that we have also encountered up in Umeå.

It is obviously important that one should be able to make oneself understood at one's workplace, and it is important that we can invest in language development. Just as when we had the Minister for Elderly Care visiting the Committee on Health and Welfare, it is after all almost 70 percent of the employees within elderly care in Sweden who have a foreign background or foreign origin.

But sometimes I can think that there is a tone in the debate – I have not heard it here, but I have heard it at the municipal level – that lacks a certain respect. I can take Umeå as an example. Had we not had the refugees who arrived in 2016, we would have had enormous difficulty managing the situation when covid hit. Many of these people do a fantastic job and are passionate about helping our elderly. They deserve our respect and our appreciation for being there and doing this job now when we lack Swedish employees within elderly care.

Of course we shall invest in language development. We shall be able to set requirements. But we shall supplement it with educational initiatives, because we need our employees who have come here and who want to do their best to help our elderly and give them a dignified old age.

In conclusion, there is one thing that worries me. I must raise it. It is this issue with the subsistence requirements and now also the abolition of the track change. It affects our municipality. There is a clear discrepancy here between the statistics we have been presented with by Migrationsverket and the reality that, for example, our elderly care in Umeå is dealing with. That was also why, for example, Boden and several other municipalities were so critical of the way the track change was abolished for those people who already have work permits in Sweden.

Many of them actually work in health and social care. I have a personal assistant, for example, who will now be deported because of this. Umeå actually wrote a letter and pleaded with the government – which has been done for a long time – to review these maintenance requirements. These are, in fact, wage requirements that are far above the general wage requirement for the employees.

If the municipalities had had infinite amounts of money, if the government had wanted to scatter a lot of money, one might have managed with such high wage levels. Hopefully, we will get to a point where we can raise the wage levels for those employees who do an invaluable job within elderly care, but we are not quite there.

In elderly care in Umeå alone, up to 50 employees have already been lost. An additional 100 risk being lost. We have historically low unemployment. We do not have more. If these helping hands disappear, there are no others who can step in.

I still hope that one can review this regarding work permits for the invaluable employees that we actually have in elderly care.

Much needs to be done to strengthen our elderly care. We need to invest. I truly believe in the future of elderly care and the motion that has been written by the Socialdemokraterna. I also believe that we need to take with us, for example, what we in Miljöpartiet raised about the transition support. It is about looking at what we can do for specific investments to improve the working environment for our employees. It is about looking at different working time models that allow our employees to actually sustain their working lives.

Thank you for the debate today!

(Applause)

The deliberation was hereby concluded.

(A decision was to be taken on 19 March.)

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