Public health

Thomas Ragnarsson (M)

Public Health

Madam Speaker! Today we are debating the Social Affairs Committee's report SoU15 Public Health, and I would like to begin by moving for the approval of the committee's proposed decision.

Madam Speaker! Public health is a complex area because it encompasses most aspects of life, and people's choices affect health in both the short and long term. We have very good conditions in our country to create and maintain good public health, but despite that, we have for a long time seen a trend that unfortunately shows that it is not particularly good. Both physical and mental health are deteriorating in both children and adults, and it is obviously a trend that must be broken immediately.

Madam Speaker! The Government sees the problems and is actively working to continue creating the conditions for a broader public health work. The basis is that there is an equal healthcare system with good accessibility and a clear mandate to work preventatively. It is one of the approaches in the work with good and close care. The basis for conducting a preventive public health work is a functioning primary care that is accessible, with a continuity in staffing.

We have for a long time built up a vaccination program for children and young people, which has had extremely good effects. Just the fact that we have almost eradicated a form of cancer via HPV vaccination is fantastic. There are strong forces for a similar program for the elderly, and the hopes for the investigation that was presented a while ago were great. But unfortunately, it did not yield as much as had been desired. We are probably in agreement that a such a program is needed, specifying when, where, and how we should be vaccinated with increasing age. There are today health economic calculations that show positive effects of such a program both for the individual and for society.

Madam Speaker! A functioning maternity and childcare system lays the foundation for continued good health. It is here that any potential problems can be caught at an early stage, and at the same time, expectant parents are educated and informed about the importance of creating healthy living conditions early in a child's life.

We see today children at a very young age who have tendencies towards overweight and even obesity, which we know will lead to major problems further ahead. Simple lifestyle changes with a balanced diet and exercise can prevent medical conditions that are potentially life-threatening. We also need to continue the information campaign on the importance of vaccinating children and young people, and this is especially important in vulnerable areas, where a certain skepticism towards vaccinations is seen.

Madam Speaker! The new leisure card that is planned will create the economic conditions for all children to participate in activities and association life, which is very significant. What has been seen in research is that children who participate in these types of activities have a greater tendency to continue with them even in adulthood. Participating in association activities has positive effects on both mental and physical health, which plays a major role given the mental ill-health that many experience. We also know through research that children and young people who are active have a reduced risk of mental ill-health. It has also been seen that children and young people who participate in association life have a lower tendency to end up in crime and exclusion.

Madam Speaker! The school plays an important role in this context, and with a little creativity, one could incorporate physical activity every day. There is no law of nature that says all lessons must take place in a classroom. One can hold the lesson outdoors or start the school day with some form of movement. Everyone who has done national service or military service knows what "BRAK" is, namely bonfire, back, arms, and knees. All conscripts started the day with: 20 minutes where they were and in the clothes they were wearing. I know that many believe there is no time for such in school, but it is a matter of priorities. From a societal perspective, this is an immensely important priority.

Madam Speaker! The state and the public must take their responsibility, but a great responsibility also rests on the individual. It is the parents' task to reduce screen time, stimulate physical activity, and ensure that the children eat well.

Unfortunately, we see however that people often take the easy way out to avoid conflicts and to save time. This is not something that society can solve. We can be helpful with knowledge, support and to some extent funding, such as the leisure card, but the implementation lies with the individual and their family. I must take responsibility for my life and the parts that I myself control, and there are no shortcuts to a long life. But to think about what one eats, drinks and fills one's free time with is still a step towards a better life.

(Applause)

In this speech, Johan Hultberg and Jesper Skalberg Karlsson (both M) agreed.

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

Karin Sundin (S)

Madam Speaker! According to the WHO, good public health means that health is as good and as equitably distributed as possible among different groups in society. We have good conditions for good health in Sweden, good sanitary conditions and a good economic standard. We have vaccination programs, and we have a good healthcare system from an international perspective. We have free education, free school lunches and school gymnastics. We have large and almost infinite opportunities to move and spend time in nature.

Generally speaking, we also live longer than ever and longer than people do in most other countries. The problem is that health is not particularly equally distributed among different population groups, which is what is the criterion for good public health.

The upbringing conditions of children and young people are of great importance for their physical and mental health throughout their lives. Now, over a long series of years, we have seen a sharp increase in psychosomatic symptoms such as anxiety and depression, sleep problems and stress among children and young people, not least among girls. We have also seen a sharp increase in neuropsychiatric diagnoses and more who are cared for in healthcare for drug-related problems, depression and eating disorders.

We see simultaneously, and perhaps not so surprisingly, a large proportion of students who do not succeed in school. We know that poor results in school affect both health and life situation far into the future.

Yesterday, Hyresgästföreningen, Majblomman, Svenska Röda Korset, and Rädda Barnen presented their joint report Barnfamiljers ekonomiska svårigheter 2024.

The report reinforces the picture I have just described, but it focuses on the finances of families with children. Many have difficulty making ends meet. Four out of ten single parents and three out of ten cohabiting parents with low income have had to borrow money to be able to pay their basic expenses during the last half-year. This is a sharp increase from last year.

It is also more this year than last year who state that they have not been able to afford to buy nutritious food for their children. More have had difficulty buying clothes for the children according to the weather. More have difficulty paying for the children's leisure activities.

At the same time as the economic institutes predict brighter times for the Swedish economy and at the same time as the Finance Minister beats his chest over the fight against inflation, the finances of many families with children have completely collapsed.

Madam Speaker! The importance of economic conditions for people's health is clearly visible no matter how we approach the issue of public health. In my own hometown of Örebro, the differences in life expectancy are 13 years between women in the socioeconomically weak million program areas of Vivalla and Västhaga compared to women in the socioeconomically stronger Lillån. 13 years! It is an unimaginably large political failure.

We also know that the level of education plays a major role. Roughly simplified, the longer one has studied, the longer one lives.

Also, when measuring different groups' assessment of their own health, large differences are seen. With short education, one assesses one's health as poor or very poor. If one has higher education, post-secondary education, one assesses it higher. Health is about class and gender. It is also about persons with disabilities, the unemployed, newcomers, and hbtqi persons.

Madam Speaker! This is something we need to see and tackle if we are to improve Swedish public health. The overarching goal for the Swedish public health work is to create conditions for good and equal health for the entire population and to close the addressable health gaps within a generation. It is a very ambitious and tough goal.

If we are to get there, we must have a significantly greater focus on how we equalize the differences in people's living conditions than we have today. Measures are needed so that all Swedish families can afford to put good food on the table.

General support for families with children is needed, more in the form of child allowance and targeted measures such as housing allowance for those who are in the most difficult economic situation. It is incredibly much more important than lower taxes for those who earn the most or an increased deduction for luxury renovations, which we have unfortunately seen the current government prioritize over other things.

The right support needs to be put in place early so that more students can succeed in school. It is much more important than continuing to pump money into large free school corporations that convert school funds into dividend payments. It is much more important than a very hyped-up debate about whether the students in school should get their knowledge from screens or folders.

We need to look at children's leisure opportunities. All children should, of course, have the right to a meaningful leisure time. The solution to most of the problems in leisure issues right now is what the government calls a leisure card. It is an initiative that is hopefully intended to benefit all children and not just those children who already have a rich leisure life and wealthy parents.

There is a risk that children will not be able to utilize their leisure card depending on where they are located and whether they can afford to take the bus to the leisure activity. Therefore, we Social Democrats propose a review after one year to ensure that a reform regarding a leisure card truly hits the mark, so that the great resources we invest truly reach all children.

More measures are needed so that more people get moving, not least children and young people. It is important that the proposals from the Committee for Promoting Increased Physical Activity are also addressed. We must safeguard the association life and folk education, because we know that it strengthens the socioeconomically weaker groups in society.

And finally: We must have a healthcare system that steers towards the goal of good health and care on equal terms for the entire population. Then, the healthcare system must be able to handle the acute flow and at the same time work long-term, health-promoting, and disease-preventing.

That is not the case today in Sweden's healthcare crisis. Faced with gigantic budget deficits, the regions are now laying off their employees instead of recruiting new ones, and more are needed for the large tasks they have. With fewer employees, less will be done of that which is not absolutely acute.

According to SKR, 24 billion were missing in the country's municipalities and regions before 2024. The government has just added 6 billion. That covers a small bit but really not the whole way. At the same time, the four largest Swedish banks together made 180 billion in profit last year. We Social Democrats have proposed a special bank tax so that at least a small part of those profits should go towards creating a more equal society.

Madam Speaker! There is not a single measure that creates a good and equally distributed health. There is not a single decision that can solve all the problems. A multitude of different measures are needed.

I naturally support all the Social Democrats' reservations on the public health area, but I move for approval of reservation 1 under point 2 on equal health and reservation 11 on the leisure card.

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

Thomas Ragnarsson (M)

Madam Speaker! Thank you, Karin Sundin, for the speech!

I am a bit disappointed that we always end up in the discussion that those in power prioritize tax cuts, luxury renovations, and the like. It is actually not true. It becomes quite tedious to sit and listen to it all the time every time there is a debate, regardless of what it is about.

I thought the member concluded their speech very well. I agree that we need to work on many different things, and we need to work together. The economy is tough. I am quite happy that we have worked with inflation fighting. Now we see that it is yielding results.

It will benefit families with children. It wouldn't have mattered how much money we had injected for families with children if we had had an inflation that ate up the money. Our purchasing power has deteriorated radically due to inflation. Now the fight is taking effect. I really hope that we will get down to normal levels again. It will make a difference.

When it comes to the leisure card, it has not yet been clarified how it is to be implemented. But in my world, one should obviously evaluate all types of investments in hindsight. Whether it is to take place after one or two years, I cannot answer. But it is of course clear that we shall look at whether the money we have invested in different projects has had the utility we intended. Otherwise, we shall adjust.

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

Karin Sundin (S)

Madam Speaker! To address the great inequality in society that we are talking about and, in the long term, improve the conditions for good public health, it is necessary to be able to hold several perspectives in mind at the same time. One must be able to manage the economic problems both in the long term and in the short term.

One must, of course, fight inflation. That can be done in different ways. The truth is that the government has prioritized an eighth job tax deduction, lowered taxes, and increased deductions for ROT and RUT. That is a prioritization you have made. It would be nice if you could manage to stand up for it.

One needs to create good conditions for the Swedish economy in the long term. But when one finds oneself in the crisis that we have been in and that we still are in in Sweden, one also needs to look at the situation here and now.

The families with children who are currently saying that they cannot afford to buy fruit and vegetables for their children will not be helped this weekend, this Easter, this summer by the fact that inflation will decrease in the long run. That is something a government needs to manage.

It is good that the Moderates are enthusiastic about all children's access to a rich and meaningful leisure time. You say that you intend to ensure that the measures hit the mark. In that case, you could have approved what the Social Democrats have proposed so that we can ensure that the reform will hit the mark and reach all children.

It would have been a way forward and a way to help in this situation. But the truth is that the willingness to cooperate is not particularly great from a government that says: Now we have solved inflation, and now we are going to lower the tax.

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

Thomas Ragnarsson (M)

Madam Speaker! A lowered job tax credit affects everyone who works. It is a goal we have: We must get people into work. A larger proportion of Sweden's population actually works, regardless of whether one is rich or poor in terms of money. We do know, however, that 400,000 people today stand outside the labor market but could work. We must stimulate people to come into work.

It is always said that we cannot afford this and that it costs a lot of money and so on. I am, believe it or not, actually quite interested in cooking. I cook an enormous amount of food and do a lot of shopping. For me, shopping means going and looking at the goods and trying to plan what I am going to do.

I can see that fruit and vegetables in general are very expensive, but there are seasonal goods that are very cheap. In Sweden, we have very many root vegetables. I use them a lot. It is incredibly cheap and you can make fantastic food with it, but it requires planning, an idea, and a little time for cooking. But you can cook a fantastic meal with Swedish ingredients that do not cost any violent amounts of money.

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

Karin Sundin (S)

Madam Speaker! I agree with the first point: It is extremely important that those who can work also work. It is through people's work that we build the conditions for welfare, prosperity, and the redistribution of our common resources. But this does not necessarily need to happen by those who have jobs also being paid for via the tax slip - not in a situation with such enormous gaps as we actually have.

I note that the Moderaternas response right now regarding the situation that many Swedish families with children find themselves in, where they say that they have to borrow money to be able to pay their most basic expenses and cannot afford to buy fresh vegetables for their children, is that it is because they do not plan well enough when they shop - that they do not buy carrots. We have also had a discussion in Sweden about the nutritional value of oatmeal.

Both carrots and oatmeal porridge are good food. But we must, as a welfare state, have higher ambitions than that: that the country's families with children should be able to put something else on the table and have a more varied diet than carrots and oatmeal porridge.

(Applause)

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

Dan Hovskär (KD)

Madam Speaker! I would like to begin by expressing my support for the committee's proposal in the report.

Good health is something we all need – to feel good inside and out and feel well-being. Sweden's public health work shall contribute to building up good health in the entire population through preventive health work.

There are great health gains to be had by investing in preventive public health work. An important part of the transition to a good and local care is to strengthen the health-promoting and preventive work. Calculations show, for example, that at least one-third of cardiovascular diseases could be prevented with changed lifestyle habits. Furthermore, according to the National Board of Health and Welfare, 69,000 people are affected by cancer every year, and in a quarter of these cases, there is a connection with unhealthy lifestyle habits such as smoking, alcohol, and dietary habits. It is unequivocal that active public health work provides great gains for the individual human but also for society.

Madam Speaker! We Christian Democrats are proud that the government is now implementing our proposal on leisure cards, a historically large investment in an active and meaningful leisure time for Sweden's children and youth. The leisure card will give more children and young people the opportunity, in community with others, to access sports, culture, outdoor life, and association life. This will be an important reform to counteract physical and mental ill health and lay the foundation for more equal health.

The leisure card shall correspond to a value that children and young people in the ages of 8-16 years can use as payment for leisure activities within, for example, the sports movement, in outdoor organizations and in other organizations within civil society and in the cultural field. The leisure card will be launched during 2025, and 792 million kronor are estimated to be allocated annually for the purpose.

Madam Speaker! Furthermore, I want to highlight the need for sports for children in vulnerable areas. We know that children and young people in socioeconomically weak areas have historically participated in sports to a lesser extent than children and young people in socioeconomically strong areas. The difference between different socioeconomic areas is even greater when it comes to girls' participation in sports.

This is serious, and therefore the government decided already in March 2023, as one of its first sports policy measures, on 100 million kronor in a new permanent grant to Riksidrottsförbundet to develop sports activities for children and young people in socioeconomically disadvantaged areas. This initiative is already starting to show results, and the money is out in the system and in clubs and associations all over the country, which is very positive.

Mental health is furthermore a major risk factor when it comes to public health. Strong public health work within the area is important.

We are now strengthening the work against mental ill-health. The Government is implementing several measures to strengthen and develop the work within the area of mental health and suicide prevention. During 2024, we are investing nearly 1.6 billion kronor to strengthen the work of municipalities and regions with mental health and suicide prevention and to create conditions for good care and nursing through an agreement with Sveriges Kommuner och Regioner, SKR.

The agreement includes, among other things, measures to strengthen the mental health of children and young people and to develop primary care and child and adolescent psychiatry, BUP. A total of 800 million kronor is directed towards measures for children and young people.

We have also significantly increased the resources to increase the accessibility to BUP and ensure that children and young people receive care in a timely manner. During 2024, just like in previous years, 530 million kronor are being invested for this purpose, which is a record-high amount.

In addition to what has recently been reported, the government decided in January 2023 to task a special investigator to review certain issues within the suicide prevention area; the assignment has sometimes also been called an investigation on a crash commission regarding suicide. The assignment shall be reported to the Government Offices by October 1, 2024, at the latest.

Madam Speaker! Furthermore, the report raises questions about cancer and the preventive work to counteract cancer. Here I would like to mention the government's and Minister for Health and Social Affairs Acko Ankarberg Johansson's current work regarding the updating of the national cancer strategy. The government has recently appointed Professor Mef Nilbert as a special investigator with the assignment to submit proposals for an updated national cancer strategy.

A major development is occurring in this area, and much has happened since 2009, when the previous cancer strategy was introduced. The assignment also includes analyzing and proposing how health-promoting and preventive interventions within the cancer area can be coordinated with interventions in other areas. The update of the strategy is therefore important for the continued public health-promoting work within the cancer area.

Madam Speaker! I also finally want to mention something regarding the allergy issue. In February 2024, Minister for Health and Social Affairs Acko Ankarberg Johansson and the government decided to task Socialstyrelsen and Livsmedelsverket with developing a proposal for a national strategy and associated action plan within the allergy field in order to ensure a preventive, effective, and equal allergy care throughout the country. The agencies shall jointly report on the assignment during 2024 and 2025 and jointly submit the final report to the Government Offices by January 31, 2026, at the latest. We Kristdemokrater see it as important that a preventive, effective, and equal allergy care is ensured across the entire country, and a national strategy is needed for this.

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

Mona Olin (SD)

Madam Speaker! I want to begin by moving for approval of the Sweden Democrats' reservation 7.

Public health is a priority topic for the Sweden Democrats and the government. Much suffering can be avoided at the individual level and large costs can be avoided at the societal level by striking hard against negative trends and creating the right conditions for everyone to prevent ill health. A good public health is therefore a matter for the whole society, and politics has a clear role to play. Therefore, I can joyfully note that within the Tidö agreement, we have taken several important steps towards a stronger public health policy.

One of our greatest diseases of the people is mental ill-health, a sinister and deadly disease that unfortunately often passes unnoticed until it is too late. It is a matter of life and death, and I believe it deserves a large part of this debate.

After the reporting of the agency's mandate on 1 September 2023, a national strategy for mental health and suicide prevention shall be developed. A national research program in the area shall be established. A national coordinator with a collective responsibility for the suicide prevention work shall be appointed. Follow-up of patients with suicidal behavior should be a natural part of the care process. An accident commission shall be appointed when a person has committed suicide so that, among others, social services, school, police, and healthcare can investigate what happened and what could have been done differently.

Something that the Sverigedemokraterna highlight in their committee motion is the issue of the prescription of psychopharmaceuticals to children and young people, which is increasing in connection with mental ill-health. There is a significant risk of dependency and risk of side effects with several of these preparations, for example benzodiazepines. We see a need for the healthcare's treatment methods to be continuously quality-audited and evaluated, and we believe that a clear strategy is required to reduce the increased prescription of psychopharmaceuticals among children and young people.

When we speak about children's mental health, we also mean that it is extremely relevant to investigate as soon as possible the possibility of integrating knowledge about mental health and ill-health into the curriculum, as that knowledge can be completely decisive as a preventive measure for young people at an individual level.

But mental illness obviously also affects the elderly. Today, approximately 20 percent of all elderly people - a growing age group - suffer from mental illness, and an important cause is involuntary loneliness. During 2024, the Government continues the three-year community initiative to prevent and counteract involuntary loneliness, which the Government announced in the budget bill for 2023.

Among older persons who have committed suicide, at least 70 percent sought healthcare one month before death and more than one-third during the last week before. In order to develop the psychiatric support for older persons with mental ill-health, it is important that primary care has access to the expertise of specialist psychiatry and that knowledge of mental ill-health among staff within primary care is strengthened through targeted educational initiatives.

I probably do not need to explain here the importance of physical activity for public health - it is obviously one of the lifestyle habits that has the most direct impact on well-being and the prevention of ill health. Here we can gladly see a positive trend among the population, according to the Public Health Agency's report for 2023.

I therefore also want to quickly bring up the leisure card as a concrete initiative for public health from us within the Tidösamarbetet. It shall give children and young people in the ages of 8-16 years increased access to sports, culture, outdoor life, and other association life. This is something that the youth will clearly benefit from, and we look forward to seeing it come into effect.

It is also pleasing that daily tobacco smoking is decreasing across all age groups. We can also see this in the Public Health Agency's report for 2023. This is not a given if we look around Europe. Everything points to the reason being a large range of less harmful alternatives. Even though nicotine itself has a health impact, it is important that the policy is pragmatic and minimizes the harms associated with tobacco and nicotine products.

Madam Speaker! We can observe that both the policy and many important trends are moving in the right direction. Public health is a political area that will always face problems and challenges, but the Sweden Democrats see reason to be optimistic. Policy shall create the conditions for good public health, and one way to do this is to support the individual in making healthy choices. Another way is to introduce quality-assured preventive public health work.

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

Jakob Olofsgård (L)

Madam Speaker! I would like to begin by expressing my support for the committee's proposal.

Everything starts in school. We all remember when we went to school. Or some perhaps do not want to remember that time. But in any case, it is in school that much of the foundation for our lives is laid. This applies in particular to our mental health.

Of course, upbringing conditions, home environment, and socioeconomic circumstances have a strong impact. But today, one thing has grown to affect our mental health enormously. It is the digital media that children and young people's screen time is about.

Preschool and school can provide children with proper socio-emotional development - that is, give children security, stability and stimulation, especially when this is lacking in the children's home environment. It is during schooling that mental health is affected, both positively and negatively.

There is a clear connection between your school results and how your mental health is affected later in life. Low grades can actually pose a risk for depression and suicide attempts later in life, according to the Public Health Agency.

Most schoolchildren in Sweden are doing well, but more and more are starting to feel worse. They are not satisfied with life, and they move far too little. This is where digital media and screen time have an impact. Therefore, the government's mandate to the Public Health Agency to compile knowledge and produce guidance and recommendations is very important. It is to be reported in June and December 2024.

But we are ten years behind the ball. This with children's and young people's screen time is a phenomenon that has grown over a long period of time.

Research shows that cyberbullying is twice as bad as parents believe. Research shows that girls fare worse than boys in every grade level. Girls have more sleep deprivation due to scrolling at night. Girls have also become more dissatisfied with their bodies after they have just scrolled on social media.

Madam Speaker! Research shows, on the other hand, that boys endure more mean comments in gaming chats and that boys play far too many digital games to a greater extent.

Groups that are more vulnerable are young people with NPF diagnoses, girls with low self-esteem, and children with lacking parental support. These groups run a greater risk of developing a screen addiction.

What does the research show then regarding those who have better mental health? What is it that is good? Yes – lo and behold – it is that they sleep more, exercise more, spend less time on the mobile phone and have a balanced use of social media.

This can only result in a single summary: The problems that children and teenagers always have and have to go through are greatly amplified by too much screen time and incorrect use of screen time. That is why we in Liberalerna have been clear that powerful measures are needed to help the schoolchildren.

We are now putting forward a proposal to move the power from the internet giants' algorithms so that parents themselves, together with their children, can own the power over the screen. This is the proposal that the default setting for a child's screen use should be the simple thing that one sleeps at night and goes to school during the day. This is not a given. For many children, it really is not a given today.

Madam Speaker! According to the UN's World Happiness Report, a report on happiness that recently arrived, it is no longer a given that the young generation is happier than their parents or grandparents. It has been so previously, but now young people in many parts of the world are unhappier than their parents. One of the major reasons cited is precisely digital media.

We are aware that we cannot legislate happiness. We cannot legislate meaning for children and young people. But in politics, we can create conditions for the mental health of school children and for them to feel better. This is what this government wants to do, and the Liberals will do more so that school children feel better. For example, an inquiry has now been commissioned on the mandate of school health, which is an incredibly important piece of the puzzle so that more of our school children can have better mental health. They actually deserve a happier life. We all do.

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

Nadja Awad (V)

Madam Speaker! In a welfare society, public health is closely linked with measures to increase equality. The active, systematic and long-term public health work aims for the population to be able to live longer and healthier lives regardless of class, gender or ethnicity.

This vision of public health work that takes its starting point in human dignity is fully shared by the Left Party. The work to break the differences in health and life expectancy that class membership entails today is a central part of this vision. Also, the work to eliminate the differences in health between men and women constitutes an important fundamental pillar in the Left Party's view on public health.

An active public health effort is an investment in the health and well-being of future generations. Few other tasks can be considered more pressing in a welfare society than the society working for a general well-being among the population.

At its core, it is about the population's right to live free and prosperous lives with the security that society has made its resources available to promote a healthy existence. In this way, the individual's and society's responsibilities for good public health interact. Through collective efforts, improved public health is possible.

Early interventions to promote good public health are of the utmost importance. Today, the health inequalities between different groups in society are very large, even at young ages. This risks leading to the health inequalities persisting even later in life with ill health as a consequence.

Society's efforts to increase equality in public health work need to be further strengthened, not least among children and young people. Fundamentally, this issue is about all children having the right to good health and a healthy existence. Vänsterpartiet safeguards all children's and young people's right to public health measures that strengthen well-being and simultaneously equip them for good health later in life.

Children's mental health also faces difficult challenges. Increased mental ill-health in combination with higher demand for care means that a large proportion of our regions cannot meet the care guarantee for children and young people with mental ill-health. Thus, the principle that an initial assessment should be made within 30 days is being neglected. In 2022, less than half of those who sought care within child and adolescent psychiatry received an initial visit within 30 days.

In order for care to become adequate and yield results, the right healthcare provider and the right level of care must reach the patients. In order to avoid risking that children in need of psychiatric care fall between the cracks or have to wait too long for interventions, certain measures need to be taken.

An important measure, according to Vänsterpartiet, concerns the cooperation between different healthcare interventions functioning and that there should be clear guidelines and boundaries between BUP and other instances.

Promoting and preventive measures lead to better health, learning and education, and to less social exclusion. The basis for the preventive work is to identify health risks before they have had time to develop into illness or ill health.

Preventive programs such as screening, vaccinations, or general health checks have been shown to provide great health benefits for society and the individual. These programs can advantageously be further developed, especially with the aim of reaching families and thereby being able to offer them support in various forms at an early stage.

For Vänsterpartiet, it is, as said, important that children's and young people's right to easily accessible, equal and equivalent health and medical care is strengthened. The Government should therefore, according to Vänsterpartiet, appoint an inquiry with a mandate to produce proposals on how regions and municipalities should develop the preventive work for young people in the risk zone for mental ill-health. Therefore, I move for approval of reservation 14.

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

Mona Smedman (C)

Madam Speaker! Taste the word public health. Let it roll around in your mouth for a moment. If I had been Carl Jan, I would have spoken about a lovely oral experience. Now, I am obviously not Carl Jan, so I will content myself with stating that public health is a concept that leaves a good taste in the mouth.

Public health is the foundation for creating sustainable and inclusive societies. Working health-promoting and preventive is a strategic choice to meet the future's welfare, staffing, and financing. In Sweden, we have generally seen good public health, and we have had that for a long time. Life expectancy is increasing. Did you know that there are approximately 2,600 people in Sweden who are over 100 years old, most of whom are actually women? Of course, it is pleasing that we are getting older, that we are living longer, but it also presents new challenges.

The Center Party has on several occasions and in different forums highlighted the issue of elderly healthcare programs. In Sweden, we are good at child healthcare programs and maternity care programs, which is very positive. That is, after all, the start of life. But now it is indeed time that we become really good at caring for the health of the elderly, at providing people with individual and preventive health work even in the autumn of life?

Then one can ask the question: What is it for an elderly healthcare program that we are proposing? Well, it actually concerns three things: conversation, vaccination, and screening.

A year ago, Christofer Bergenblock stood in this very rostrum and stated that the Center Party wants to supplement with health consultations from the age of 70 onwards. Now, in 2024, there is a targeted state grant for municipalities to apply for specifically for this. But it is aimed at the very oldest who do not live in special housing or have home care. It is good that this state grant exists. But is it not important that the state is involved in financing public health at all ages? The health consultation is an excellent opportunity where one can reflect on eating habits, physical activity, as well as tobacco and alcohol habits in order to prevent things that can lead to poorer health and diseases. It is also a good opportunity to catch those who need support and help in other ways.

Another way to prevent ill health among the elderly is to develop a national vaccination program against the diseases that we know pose a great risk to the health of the elderly. As I said earlier, we are very good at child healthcare, where part of it is to vaccinate children as protection against dangerous diseases. In the same way, we should offer the elderly good protection against the diseases that risk becoming serious and often life-threatening when the body's own resistance has diminished.

An important part of this is that the state shall be responsible for determining which vaccinations shall be offered. The state shall also bear the cost. It should not depend on whether the region is rich or poor whether you shall receive the vaccinations that you need. It is perfectly reasonable, Madam Speaker, that we shall have equal healthcare across the entire country.

Screening for various diseases is also something that must be offered to a greater extent even to those who are older. For you understand that breast cancer does not stop at the age of 75, but the screening does - the mammogram. Centerpartiet therefore argues that a screening program was needed even for those who are older, for example to detect breast cancer.

Madam Speaker! Good preventive work gives more elderly people an increased quality of life and better health. It can be the difference between life and death.

I will bring up the preventive work. It is often said that one should pull off the bandage. I think that the bandage preferably should not be needed at all. The government talks, in my opinion, far too much about tougher measures and stricter punishments. If one has committed a crime, one should of course receive a punishment. But preferably, one should not even come to the thought of committing a crime. That is where the preventive public health work comes in, and there civil society plays a decisive role. Think of all the fantastic associations with their leaders who guide children and young people and who help the young people in their life journey to become good global citizens. There, children and young people can learn to cooperate, show consideration, understand democratic processes, and be part of a community. It is when one is left without a community that things can go wrong. It is then that one can much more easily be lured into wrongdoings such as criminal behavior, or for that matter, end up in mental ill-health.

Madam Speaker! Public health is preventive. Public health is equitable. Public health is living conditions. Public health is lifestyle habits. Public health is public education. And public health leaves a good taste in the mouth. Public health is not just a goal but a powerful tool for creating inclusive societies. But public health must be seen from several perspectives, and also from an equality perspective. How do we create public health for all throughout life, and how does the government contribute to this work? Public health is a broad concept that spans all areas.

As you understand, I could stand here for several hours and highlight as many perspectives as I want, but I will spare you that.

I naturally stand behind all the Centerpartiets reservations, but I move for approval of reservation 6 from Centerpartiet and Miljöpartiet regarding vaccinations.

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

Mats Berglund (MP)

Madam Speaker! I want to begin by saying that I support the Environment Party's all reservations in the report but move for approval only to reservation 5.

I stand here with a manuscript that is largely written by Ulrika Westerlund, the Miljöpartiet representative in the Committee on Social Affairs, who is currently traveling on behalf of the Riksdag.

As a member of the Committee on Social Insurance, I myself feel a certain sense of ownership over the issues we are discussing here today, namely public health issues, and I would like to start in that direction. There is, in fact, a clear connection between public health and our social insurance systems, our safety nets. For example, sickness insurance is supposed to kick in when one is too ill to work. It is something that one should be able to expect in a welfare country like Sweden, but unfortunately, it does not always do so. All too many are disqualified too early or denied compensation. It is serious.

I spent a large part of my time during the previous term, together with the government, on this. We investigated new legislation, submitted propositions, and repaired parts of the sickness insurance. But we did not quite finish. I had wished that the Tidö government had continued this work. I had wished that at least the Sverigedemokraterna would have some kind of ambition to try to deliver on their very clear election promise. But that has not happened, and it does not seem to be happening either. After the election, it has come to a complete standstill. There are reasons for that, and it is the bourgeois definition of the work line that is causing trouble here. It is about pushing sick people out of the insurances through the progressively tougher requirements and conditions in the rehabilitation chain rather than rehabilitating people back to health and work capacity for real.

This is a very bad policy. A better policy, which Miljöpartiet stands for, is about having a functioning and secure health insurance and, through strong preventive work, strengthening the population's health and in that way, through important public health work, reducing the inflow into both the healthcare and health insurance systems.

Mr. Speaker! Miljöpartiet wants to see an increased focus on public health issues. Better public health would, in the way I mentioned, reduce costs for both healthcare and health insurance and would likely also result in a smaller climate footprint. But the most important thing is, of course, increased quality of life, that more people get to live better lives. We all want to live long and stay healthy, but many of us need support to more easily be able to make the right and good choices.

Miljöpartiet is not alone in these thoughts. Many social actors are considering different solutions. For example, a report from the Nordic Council was recently released which suggested that the entire Nordic region should jointly introduce higher taxes on meat and sugar, and Cancerfonden has for a long time proposed a targeted tax on sweetened drinks. Exactly which measures should be taken can be discussed for a long time, but for Miljöpartiet it is clear that measures at the societal level are required. We cannot place the entire responsibility on the individual.

The Green Party wants Sweden, just like other Nordic countries, to have a public health act. Such a law would contribute to a clearer regulatory framework regarding the responsibility for public health work at local, regional, and national levels. The public health perspective and public health work would be highlighted much more clearly and achieve greater impact, with noticeable effects.

Mr. Speaker! Unfortunately, we still see large geographical and socioeconomic differences regarding health, despite the fact that we have worked with these issues for a long time. A public health act would clearly contribute to counteracting this.

But while waiting for a public health law, which can take time to develop and implement, there are other faster measures. We need urgent, powerful measures to promote, for example, physical activity and measures to improve mental health. We need to strengthen the preventive work for young people in the risk zone for mental ill-health. We need targeted investments to reach people in socioeconomically vulnerable groups with health information and with tools to improve their own health. We also need to raise the requirements for all regions to conduct systematic preventive health work.

Miljöpartiet thinks that the government should act to create equality and counteract health inequalities.

Mr. Speaker! In addition to the general work, I would like to mention some specific areas where measures are needed. In the report, there is a broad motion from Miljöpartiet regarding the work to counter HIV/AIDS. Sweden must strengthen the HIV prevention work. In accordance with the goals in Agenda 2030, the world's countries shall individually and in cooperation work to eliminate new HIV infections by 2030. To fulfill our international commitments, the government must ensure that the upcoming national strategy against HIV/AIDS establishes that the goal for eliminating new infections in Sweden by 2030 still applies.

The Public Health Agency submitted its final report on its assignment to prepare a basis for the government for an updated national strategy to counter HIV/AIDS in early May last year. The basis shows, among other things, that there is now an increasingly heterogeneous patient group in Sweden and that a number of challenges remain.

Sweden has good conditions to reach the so-called 95-95-95 targets in Unaids global strategy for combating HIV 2021-2026, but today we do not fully reach the targets. The 95-95-95 targets mean that 95 percent of those living with HIV should have a diagnosis and know their status. Of those, 95 percent should have access to effective antiretroviral treatments, and of those, in turn, 95 percent should have achieved viral suppression that makes the risk of virus transmission so low that it has no epidemiological relevance. The 95-95-95 targets contribute to fulfilling the goals in Agenda 2030, and Miljöpartiet therefore argues in the motion that the government shall ensure that the national strategy against HIV/AIDS also clearly states that the goal is to fulfill Unaids' 95-95-95 targets by 2026.

Public Health

The national strategy must also include a clarification of civil society's contributions: that they are completely necessary to achieve the goals and that the organizations need to be able to work long-term. The strategy must also ensure that everyone who comes to Sweden, including those who immigrate as family members, gets access to health and medical care, testing, diagnosis, and treatment. Also, everyone who is in Sweden and belongs to a risk group must be included, and it must be ensured that they receive the correct treatment. The queues for assessment interviews must be shortened.

Mr. Speaker! In conclusion, I just want to mention the need for vaccination programs. We have for a long time been successful in vaccinating our children, but now other groups and perhaps the entire population must join in. Swedish researchers have been successful in developing new vaccines for, among other things, covid and cancer. But we must also ensure that the population receives the vaccines that are needed, especially risk groups, naturally.

We believe that the government should return with proposals for how the vaccination programs can be expanded and become broader, more accurate, and equitable across the entire country. For that, Mr. Speaker, is also a way, to end where I began, to reduce the influx into both healthcare and health insurance.

(Applause)

The deliberation was hereby concluded.

(A decision was to be taken on 3 April.)

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