(cont. from § 6) Health care, medical care and social care (cont. SoU1)

Christofer Bergenblock (C)

Mr. Speaker! It will be a long day today with budget discussions.

I have a question for Member Hultberg. It concerns the illegally long queues that have been a problem for a long time in Sweden. It is one of the things that has also been mentioned earlier in today's debate.

The previous Social Democratic government chose to refer the problem to the Accessibility Delegation. The delegation arrived at a proposal for a new office in Stockholm responsible for a national healthcare system. Now, the newly appointed government chooses to dig further into the Social Democratic filing cabinets and dust off the proposal. They intend to establish an office in Stockholm that shall be responsible for administering the national healthcare distribution. This is to be done without anything else being changed in the structure of the healthcare system.

If this had been part of the Christian Democrats' wish to nationalize the entire healthcare system, it would have been quite natural, but now it is just another bureaucratic colossus being built up. It benefits neither the regions nor the patients.

Health care, medical care and social care

The alternative is to create a simpler system and make care times and quality available directly via 1177. My question to Member Hultberg is therefore: Why do the Moderaterna want to create a new centralist bureaucracy under state administration à la Socialdemokraterna instead of giving patients power and self-determination through an opportunity to themselves seek available information about queues and quality directly via 1177?

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

Johan Hultberg (M)

Mr. Speaker! I thank Member Bergenblock for the question. No, of course we Moderates do not want to create a bureaucratic colossus. That falls, naturally, on its own absurdity. Member Bergenblock's glasses must be very strong if he can see into the future and understand exactly what consequences the various reforms that we are now moving forward with will have for effects.

What we want to create, Mr. Speaker, is a strong position for the patient. We want, with the national healthcare mediation, to ensure that the individual patient can receive support in finding where in the country there are potentially shorter queues where they can receive their surgery or treatment faster. That is what we want to achieve with the national healthcare mediation.

But this is only one of the reforms we are making to shorten the healthcare queues, Mr. Speaker. As the responsible minister highlighted in the just-concluded question period, this is only a small piece of the puzzle in the work to shorten the healthcare queues. We continue with a very large investment in performance-based reimbursements to shorten the healthcare queues, and we are developing a national plan for how we can work with competence supply.

These questions are the more fundamental prerequisites for us to be able to shorten the healthcare queues, Mr. Speaker, and this is what we in M do together with our three coalition parties.

I can also take the opportunity to ask a question to Member of Parliament Bergenblock as to why the Center Party chooses to reduce the funding for health and medical care and for welfare. Is that really what will result in shorter care queues?

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Christofer Bergenblock (C)

Mr. Speaker! Member Hultberg is welcome to ask me questions as soon as I have finished my speech.

It pleases me that the Moderaterna also speak about wanting to create a stronger position for the patient in Swedish healthcare, even if perhaps this proposal does not do exactly what the member says. It is not more state micro-management we need in healthcare. That is not the solution to the queues, but rather to ensure that the regions have the right conditions. There, I share much of what member Hultberg says. We need billions of kronor.

We primarily need to expand the competence supply in Swedish healthcare and ensure that we can thereby have an efficient healthcare system where we reduce the queues. On the other hand, it has emerged earlier in the debate that the proposals that have been put forward risk making it even more difficult in Swedish healthcare and elderly care, precisely regarding the staffing supply.

I return to the question and would then like to say that in order to give the patient a stronger position and more power, I believe that what we from Centerpartiet have proposed is a better and, above all, a less costly idea. It is about utilizing the existing systems we have today through 1177 and ensuring that the information that already exists in the regions regarding the care queues and the quality of the specialist care is made accessible. In this way, one can personally assess how things look and also utilize the resources that exist in regions other than one's own.

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Johan Hultberg (M)

Mr. Speaker! Let me give praise to MP Bergenblock's home region, Halland, which is an example within Swedish health and medical care when it comes to accessibility. It is the result of many years of bourgeois rule with a moderate regional board chairman. Many regional politicians can go there on a study trip to see how one can shorten the queues in practice.

When it comes to the national healthcare mediation, we shall, of course, take advantage of existing structures. We are not to build up any bureaucratic colossus, but rather we shall take advantage of the systems that exist and build upon them. We may return to the exact details of how the national healthcare mediation shall be designed.

I can, however, reassure Member Bergenblock that we Moderates will always be at the forefront when it comes to strengthening the patient's position. We have done so at all times, if I may use that expression. We have been proactive in strengthening patient rights, and we will continue to be so now in a government position.

Mr. Speaker! Member Bergenblock ducked the question I asked, so I shall have to take a reply to Bergenblock later when he has given his speech.

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

Karin Rågsjö (V)

Mr. Speaker! There are things that are not mentioned in either the budget or the Tidö Agreement, Johan Hultberg, for example, money for the private sector. It is always an interesting discussion to take up.

A study has been conducted: How is the private healthcare and care sector in Sweden doing? It is doing great! During 2021, the private healthcare companies' profit increased by 7.3 billion kronor from 2020, and it reached 141.7 billion in profit. That is a considerable sum, isn't it?

In Sweden, the market is completely unregulated when it comes to the freedom of establishment, in contrast to, for example, Denmark. The freedom of establishment is also strengthened by the ties that can exist between companies and politics in various ways. It has also increased inequality. This has been seen in various investigations.

Is this matter of freedom of establishment something that is causing friction, or is it something that should roll on? I am very "Stockholm-centric," which Johan Hultberg knows from before, and here in the Stockholm region, it has gone very far. The healthcare companies have been allowed to rule. It is teeming with health centers in Stockholm city, that is, in the inner city, while one might need to take a day off work if one is to go to the gynecologist and lives in, for example, Haninge. So that is how it looks.

I think that precisely this issue regarding the freedom of establishment is an important question. My question to Johan Hultberg is: Will anything happen with it? Will you look at Denmark? Denmark is a country we look at in various respects. In Denmark, they have succeeded better precisely when it comes to the freedom of establishment.

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Johan Hultberg (M)

Mr. Speaker! Thank you, Member Rågsjö, for the question! It is always fun to debate with Member Rågsjö, because then the debate often becomes ideological, and that I welcome. We need to talk about what ideological starting points we have for the policy that we pursue.

As a Moderate, my primary starting point is always the individual human being. We shall have a health and medical care and a welfare that originates from the individual person. Against that background, I conclude that it is important that one as a patient has a freedom of choice and that one as a worker in health and medical care has a freedom of choice when it comes to employers.

Mr. Speaker! A ranking was recently released regarding which healthcare providers are most appreciated by nurses. I can state that it was several private healthcare providers that ranked highest and were the most popular. This is something that I think the public actors must reflect on: How is it that the private actors are more appreciated by the healthcare workers? How can they be emulated? Can one perhaps cut bureaucracy and in other ways make oneself a more attractive employer?

My answer to Member Rågsjö is that we are happy to look at Denmark. Denmark has more state governance of health and medical care. One has more national leadership, which is exactly what this newly appointed government will drive.

We will work purposefully to shorten the queues, increase accessibility and strengthen the individual patient's position.

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Karin Rågsjö (V)

Mr. Speaker! I think the government and the Sweden Democrats should look specifically at Denmark in this matter. There, they do not have this type of freedom of establishment.

If the member and I were to get tired of politics, we might perhaps feel like opening a health center together. Where would we open it then? We would open it where people are the healthiest and not the sickest. That is actually how it looks around the country.

There are many other wise regions that have not followed in Stockholm's footsteps. They may not have been opponents, but they have seen the conditions.

The Speaker speaks about the little person. I also think about the little person and the possibility of equal care for all people in Sweden. Care today is not equal. Rather, it is unequal. Freedom of choice is good, but it is the patients who should choose. But when it comes to the freedom of establishment, it is the companies that choose where they shall establish themselves. It has not been fortunate in all cases. It has not been fortunate in those regions, specifically Stockholm, where one opened the door for the entire market and said: Go!

I actually think it is politicians who should ensure that health centers establish themselves in areas that have, for example, neglected health. Perhaps more health centers were not needed in Lomma, in central Gothenburg, or in central Stockholm. These health centers might be needed in completely different places. It is perhaps there that the investment should be made to achieve better health generally. It is, after all, this that we work for: equal health.

For us, the freedom of establishment is a major issue. It has drifted away, and there must be conditions for Sweden to look at other countries in this matter. Look at Denmark! There, it is not the companies that decide where they should establish themselves. That is done based on completely different conditions. One looks at where the needs are. It is not a bad thing. It is also about the Health and Medical Services Act.

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Johan Hultberg (M)

Mr. Speaker! We Moderates will never have the planned economy starting point for our policy that the Left Party has. We will stand up for that as a patient one should have a freedom of choice when it comes to healthcare providers, and we will stand up for that we believe it is good that there is a diversity of actors within Swedish health and medical care.

I am of the firm opinion that diversity when it comes to providers also creates diversity when it comes to what one can receive for care and what opportunities there are for healthcare workers to choose where they want to work. I and the Moderaterna will not take the initiative to remove that diversity.

We will continue to work on strengthening the patient's position. We will continue to work on shortening the queues. We will continue to work on tackling the fundamental and major problems that the outgoing government was unable to deal with.

We are now taking important steps in this budget to shorten the queues by investing in a performance-based compensation. I regret that Vänsterpartiet completely removes the three billion that we are investing in this. If Vänsterpartiets budget alternative had won the majority's approval here in the chamber – I am grateful that it hardly will – it would have meant that the queues would have become even longer and that the patients would have had to wait even longer for their care.

Mr. Speaker! As I said in my speech, we now begin the work of shortening the queues, strengthening the patient's position, and implementing a long series of reforms to strengthen accessibility and ensure that we can all receive the care we are entitled to and that we can receive it in time.

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Christofer Bergenblock (C)

Mr. Speaker! For the past two years, the parliamentary debate on the health and social care area has been dominated by the pandemic and its consequences. The pandemic is still not over, and there is still every reason for caution. But society has opened up, children go to school, relatives are allowed to visit their elderly, and fathers are allowed to be with their babies in the maternity ward even after childbirth.

What have we learned from the pandemic then? Well, we have learned that there are structural problems in Swedish healthcare and elderly care. We have learned that the staff is our most important resource, and we have learned that we must spend our money on the right things. The latter brings us back to the topic of the day, that is, the state's budget for health care, medical care, and social care.

For the Center Party, it is central that we have a healthcare and care system that is accessible to everyone regardless of age, gender or place of residence, which is based on the individual's needs, which gives each person self-determination and influence and which maintains high quality in all parts of the country.

Mr. Speaker! Sweden has generally seen good health and medical care, but it is not without challenges. Healthcare today does not have the same accessibility across the entire country, and the quality can differ between different regions. Those who want to make it easy for themselves naturally call for nationalization in such a situation, but a gigantic reorganization of Swedish healthcare is absolutely the last thing the care needs. The important thing is that the right care is handled at the right level and that the patients experience the care as seamless.

Municipal health and medical care has become increasingly important and a larger part of care in recent years. However, deficiencies are still perceived in the interface between the municipality and the region, where the individual—often an elderly person—ends up caught in the middle. Our elderly should be able to receive extensive care at home—whether it is in their apartment, in their house, or in an elderly care home—without having to travel to the health center or the hospital unnecessarily. When one is in need of emergency care or maternity care, it should be available within a reasonable distance from home. When one is in need of specialist care, it should not matter which region or healthcare provider performs it.

In Centerpartiet, we do not believe in gigantic centralization reforms or in increased bureaucratization of healthcare. On the other hand, we believe in utilizing the resources that exist in a wise and efficient way. Therefore, we want to see a comparison service for waiting times, availability, and quality that is channeled via 1177. This gives the individual the right to self-determination and faster specialist care without spending money on building up new bureaucratic institutions in Stockholm. It is good for the healthcare queues.

The part of the healthcare where we see the greatest need for investment is, however, primary care. It is through an easily accessible primary care that one guarantees preventive work and that the patient is guided correctly in the care chain. Unfortunately, we see that the availability of health centers is deficient in some places and that it is simultaneously difficult to recruit doctors. Centerpartiet sees that primary care needs to continue to be strengthened during the coming years, and there is an extra large need in rural areas. Therefore, we resource-strengthen primary care with 200 million kronor more than what the government does during the coming years.

Furthermore, the Center Party has long worked to have more so-called orphan drugs included in the pharmaceutical benefits. It is not reasonable that patients do not get access to effective medicines because the patient groups are too small. Why should the person affected by, for example, spinal muscular atrophy not be granted access to subsidized medicines when they are actually available? The Center Party therefore allocates 100 million kronor in a special initiative for orphan drugs.

Mr. Speaker! Getting old in Sweden should not be associated with worry. On the contrary, it should be associated with joy over being able to master one's own time after a long working life and over being able to do the things one has put off and dreamed of before age takes its toll. When support is needed, one should know that elderly care works and that healthcare delivers. The focus should be on the individual and not on the system. Healthcare and elderly care need to be organized and coordinated better than what is the case today. All around Sweden, however, there are many examples of municipalities and regions as well as non-profit and private healthcare and care providers who have faced the problems and solved them. We must take advantage of these good examples.

At the same time, the demographic development and the changed age structure in the population place completely new demands on health and medical care. As more elderly and multi-morbid people are to receive their health and medical care, a significantly greater geriatric competence is required with more specialist-trained nurses and doctors. Centerpartiet wants to see a development of preventive health work. We want to see an increased geriatric competence within care. We also want to see expanded screening - even of the elderly.

Mr. Speaker! In 1994, LSS was introduced. This was a radical freedom reform for very many people with different forms of disabilities. Today, the law is pushed to its limits, and the intentions are no longer fully followed. Rights differ between different parts of the country; this applies primarily to personal assistance.

The principalship investigation currently underway is to present its final report on March 1 next year, and at that time, a unified state principalship will be proposed. The question has not been whether personal assistance should be granted a state principalship, but rather how this is to be done. Therefore, I have found it difficult to understand why the government and its coalition partners cannot clearly put their foot down and say that this will occur during the current parliamentary term. Exactly how it is to be done is being addressed in the investigation and will be scrutinized by the referral bodies before the bill can be written, but that it will occur, the government should be able to provide an answer on already now.

For the Centre Party, it is a self-evident matter that society should be accessible to everyone and that everyone has the right to be a part of the community. Therefore, we want to see an integration of a disability perspective within all policy areas and an increase in ambition which means that all political decisions must be reflected by a disability perspective. It is about civil liberties and rights. Swedish politics regarding disabilities is largely based on a rights perspective, but there is a lack of focus on opportunities and all people's ability and will to contribute, regardless of functional ability. Not least, it is important that children and young people with disabilities are allowed to participate in society on equal terms as their peers.

Mr. Speaker! The Centre Party is a decentralist party and has a strong confidence in regions and municipalities. It is therefore why we do not believe in large-scale centralization projects or increased bureaucratization. Right decisions should be made at the right level, but experience says that it is at the local level that one is closest to one's residents and has the best knowledge of the geographical and social conditions. Therefore, we also want to avoid targeted state grants as far as possible.

We understand very well that as a government, one wants to demonstrate decisiveness by distributing small sums here and there. Every small part is naturally important, but no consideration is taken for the local conditions and needs. Furthermore, we have been able to see that small rural municipalities are continuously disadvantaged because they rarely have the time or resources to devote to applications and follow-ups. As a former municipal politician, I am therefore pleased that we are allocating 4 billion more than the government in general state grants and letting municipalities and regions make the prioritization of where these funds do the most good in their various operations.

Mr. Speaker! In conclusion, I want to say that I naturally stand behind the Center Party's budget motion in its entirety. I also stand behind the specific statement that we have submitted in the Committee on Social Affairs.

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

Christian Carlsson (KD)

Mr. Speaker! Certainly, there is much that could be said. However, there is an initiative that the Centre Party wants to make that I am particularly interested in, namely the investment of 15 million kronor on competence-enhancing measures for professionals who meet children. This is certainly good, but one can calmly say that it stands out in the Centre Party's budget.

The Center Party saves over 5 billion on expenditure area 9 Healthcare, medical care and social care. It is not only the investments in more care places and a national healthcare brokerage that disappear, but it also affects the parenting support and the investments in our children and young people. The investment in preventive work within child and youth healthcare in the form of home visit programs within BVC also disappears. The Center Party scraps the leisure card for children and young people, which was intended to give them the opportunity to participate in sports and leisure activities even if they come from a socioeconomically disadvantaged family. Particularly serious is that the Center Party also wants to cut back on the social services' interventions when it comes to social work.

I cannot make sense of this. When the Center Party now makes an investment - admittedly a very small one, but still an investment - in competence-enhancing measures for professionals who meet children, why do they otherwise conduct a policy that leads to fewer meetings with these children? Why is the Center Party not prepared to prioritize children and young people?

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Christofer Bergenblock (C)

Mr. Speaker! I thank the member for the question. The Centre Party is ready to prioritize children and young people, and we do so in a number of different ways. Not everything is about spending money with the help of targeted government grants, even though we do so on a small scale in that specific area.

The government has instead chosen to spend a lot of money on, for example, the leisure card, and that may not be the highest priority from the state's side in the situation we find ourselves in today. The municipalities have a great responsibility for children's and young people's access to leisure activities, and this happens primarily through civil society.

Centerpartiet has pushed for increased physical activity in schools, which is an important part of children's opportunities to move. We have also pushed to help not only children and young people but also students in their mental well-being when they have problems in that area.

What is interesting, however, is that the government and its coalition partners choose to dabble with targeted state grants in area after area. As a municipal politician, one knows that those funds will run out after a couple of three years, and after that, they are no longer there. This causes very many small municipalities to simply choose not to apply for these grants. The large municipalities that do apply use the money for a limited time, and then those activities usually disappear. It does not provide the continuity and stability that is needed in municipalities and regions in Sweden.

Therefore, more money needs to be allocated to general state grants instead, and that is exactly what the Center Party does. We invest 4 billion more than the government.

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Christian Carlsson (KD)

Mr. Speaker! I respect that not all parties consider investments in children and young people to be the most prioritized issues, but unfortunately, it is not only children and young people who are affected by the Center Party's policy, but also the elderly.

When the Center Party chooses to cut the budget, they target the stimulus grants within the elderly care area. They also want to scrap the initiative to counter involuntary loneliness among the country's elderly. In total, the Center Party wants to abolish 5 billion kronor compared to our allocation, and what they add in general state grants means, in practice, only 2.4 billion.

So, this is not about whether there should be targeted state grants or if they should be general. It is about the fact that there is no other party in the Swedish Riksdag that is prepared to deprioritize and cut as much in the resources that are to go to healthcare, elderly care, and social care as our children in the Center Party.

The Center Party's policy hits children and the elderly, but it will also hit children and the elderly in the Swedish countryside - be that certain.

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Christofer Bergenblock (C)

Mr. Speaker! The Centre Party's policy gives municipalities and regions more power to distribute the money they receive. That is why we want to move from targeted state grants to general ones.

It is no news that this is what the municipalities are requesting. They do not want any small-scale tinkering that often results in very little money in the end for the individual municipality. They want general state grants, long-term perspective, and the opportunity to themselves assess where the money does the most good. Is it further investments in civil society, association grants, or further investments in elderly care and healthcare in the region?

We in the Center Party believe that municipalities and regions should have that opportunity. One should have trust in municipalities and regions and in the politicians who are there. I know that the Christian Democrats do not have that trust, because they fundamentally want to nationalize the entire regional Sweden and the entire healthcare system. Then it is clear that one understands that they also have no trust in regional politicians. In the Center Party, we have that trust. Then we should also help them in the right way, for example by making more information available on 1177.

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Johan Hultberg (M)

Mr. Speaker! I did not receive an answer to the questions I previously asked of Member Bergenblock. Therefore, I repeat them. Let me begin with that.

Why does the Centre Party want to save on health and medical care, social services, and the expenditure area that we are now debating? It is a substantial cut that MP Bergenblock and his party are proposing.

Mr. Speaker! I note that the government which Member Bergenblock previously supported and was a prerequisite for, namely the red-green one, did not deliver in the area of welfare. There were longer queues and deteriorations in a long series of areas.

I was also surprised earlier when Member Bergenblock almost scoffed at the fact that we want to set language requirements within elderly care. I also understood from what Bergenblock then said that it is apparently with labor immigration that one is to manage the staffing within elderly care. I just want to ensure that it really is what the Center Party envisions. Is it through labor immigration that one is to secure the welfare and manage elderly care? Is it not with language requirements that one is to secure the competence and quality in elderly care?

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Christofer Bergenblock (C)

Mr. Speaker! I will begin with the final part. I noted that Maria Malmer Stenergard just now answered a question during the question period and actually said that in no way should obstacles be placed in the way of staff who are in Swedish healthcare, regardless of where they come from. She was very clear. But that is not what is written in the Tidö Agreement. There it says that in different ways, one should make it more difficult for precisely labor immigration.

Swedish healthcare should not be built on labor immigration, and neither should Swedish elderly care. But we must not tear down the structures that exist today, nor should we take staff from regions, municipalities, or private healthcare and care providers because they have origins in another country. 75 percent of those who are labor immigrants in Swedish healthcare and care today are below the floor that the government intends to introduce at 33,000 kronor, and that means one loses a large part of the staff within healthcare and care in Sweden.

Regarding the budget, it is as I said earlier, that we prioritize general government grants over targeted ones because we have confidence that municipalities and regions use the money in a wise way and place them where they are best needed. It is Center Party, decentralist policy.

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Johan Hultberg (M)

Mr. Speaker! Now, it was elderly care that I highlighted. Let us nevertheless state that it is very fundamental that an elderly person should be able to feel secure that they can communicate with the care staff they meet, often in a rather vulnerable situation if they are dependent on home care or home nursing care or live in a residential facility for the elderly.

We can also observe, Mr. Speaker, not least based on the Corona Commission's evaluation during the pandemic, that the language issue in particular was a quite serious quality deficiency then, and that it contributed to poorer quality in care. It was also a patient risk.

That is why I think it is an important reform that we announce in the Tidö Agreement that language requirements should be introduced within elderly care. I am surprised that the Center Party cannot agree to that, and that the Center Party does not think that our elderly should be able to expect that the staff they meet within elderly care have sufficient knowledge of the Swedish language.

Mr. Speaker! Member Bergenblock says that the Center Party prioritizes general state grants over targeted ones. That is true to a large extent, but all in all, it is the case that the appropriations that the Center Party has for health and medical care and for welfare are lower in total, even when looking at the fact that the Center Party increases the general state grants. I therefore state that the Center Party prioritizes increased aid over making investments in Swedish health and medical care, shortening the queues, and strengthening the quality within elderly care.

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Christofer Bergenblock (C)

Mr. Speaker! The fact is that the budget is a whole. The member is right in that.

The Center Party takes responsibility in a long series of issues where the government completely ducks. It is not just the aid, as the member mentions. It is the climate, where the politics are being completely slaughtered. It is the business sector, where there are no major investments. It is the countryside, where there are also no investments from the government's side. These are issues that the Center Party has prioritized.

We have also made prioritizations within the welfare sector, and there we have chosen to focus on the general state grants instead of the targeted ones.

It is also what the ministers in the member's government themselves are requesting. I read an interview with Anna Tenje, our Minister for Older Persons, where she said the following: "The municipalities themselves are the ones who know what gives the best 'bang for the buck'. I would really like to clear up the number of targeted state grants." She said this a few weeks ago in one of the interviews she gave, and I hope that is the direction that will guide things moving forward. This is also a party colleague of the member.

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Ulrika Westerlund (MP)

Mr. Speaker! Health and medical care is a constantly important area that affects us all. Much of the ill health we see today can be prevented, and much depends on how we design our society.

There are parties that argue that the solution is for the state to take over responsibility for the entire healthcare system. Miljöpartiet does not consider that to be a good solution. It is not a gigantic, resource-consuming reorganization that healthcare needs. Instead, healthcare and care need to be able to continue developing based on the needs that exist in different parts of Sweden, but the state support needs to be increased. For us, it is important to increase the general state grants to municipalities and regions so that they can make their own prioritizations.

That the government has chosen to set its contribution to Sveriges kommuner och regioner at a level that is less than one-third of what they themselves state is needed will lead to further deterioration in an already vulnerable social sector such as healthcare.

The most important issue for health and medical care is the staff's working environment. In order for more people to seek out the profession and want to stay, and to make the working environment stably better, Miljöpartiet wants to make a permanent state-funded major initiative that shall be dedicated to more employees and enable higher wages. The working environment problems in healthcare and care are stress-related due to too much pressure and too few employees, and right now a vicious circle is occurring that needs to be reversed powerfully and long-term. The issue of the shortage of care beds is also connected to this. When there is no healthcare staff, there are no care wards that can be open.

In our budget motion, we have made a number of initiatives within the expenditure area that we are debating here. I will focus on some of these. These concern the workplace environment boost for staff within health and social care that I just spoke a bit about, the recovery bonus for staff, and our initiatives on personal assistance, on improving the work with quality registers within healthcare, and on contraceptives for young people.

I also want to mention a little about the concern that exists among many who work in healthcare, because it appears from the Tidö Agreement that those who need interpreters in healthcare cannot be sure of getting them in the future if they cannot pay for them themselves. It also states in the Tidö Agreement that a reporting obligation or an information obligation may be introduced where authority personnel may become obliged to report persons who are in Sweden without permission. Even though it is mentioned that exceptions from the information obligation need to be investigated further, for example when it concerns healthcare, the government is sending signals with these proposals that are very worrying.

Mr. Speaker! Miljöpartiet wants to build a society that is sustainable for both people and the environment. It requires a strong welfare state and that female-dominated professions are valued higher once and for all – it is both a welfare issue and an equality issue. It is high time that the state takes greater responsibility for the working environment and the conditions within healthcare.

Temporary initiatives of various kinds are not enough. The government has, for example, proposed a construction with a bonus linked to how many care beds are established. We see this as a flawed way of thinking that leads away from the real problem, which is the staff's working environment, working conditions, and wages. Healthcare is facing major challenges. More colleagues were needed in both healthcare and municipal healthcare and elderly care to create a good working environment for the staff with a calmer pace and increased attractiveness for the profession.

According to several trade and professional unions, there is great potential in that a considerable number of people could be lured back with better conditions. Vårdförbundet has, for example, in a work environment report from this year, pointed out that if the work environment were healthier so that everyone could manage to work full-time, it would correspond to approximately 790 more midwives, 470 more biomedical analysts, and 7,645 more nurses. It would be very good if those people could be lured to stay in their professions.

Miljöpartiet therefore wants to introduce a completely new complementary structure where the state takes an enhanced responsibility through permanent support at a high level.

The state should make an investment that is increased by around 10 billion per year for the next three years to transition from and by 2026 to a permanent state support of 40 billion per year. It shall go to the country's regions and municipalities and be allocated for new hires and enable higher wages. More people should want to apply for healthcare, and more people should want to and be able to stay.

Mr. Speaker! Since 2021, there has been the so-called recovery bonus, an initiative that Miljöpartiet has pushed through and which is funds held by Socialstyrelsen that can be applied for by workgroups within healthcare and elderly care who want to test new methods of work for an improved work environment. This can include working time models. The purpose is to take advantage of staff groups' own development ideas and give them the opportunity to test these. The recovery bonus was introduced in the summer of 2021 on a smaller scale. From 2022 onwards, 1 billion kronor is allocated annually. In addition to this, 300 million kronor has also been added to reduce or remove so-called split shifts, which of course is also valuable.

We want to strengthen the bonus with an additional 1 billion for more funds that can strengthen this development. We also believe that the government should work to make the model better known. I will be interested in following up on how the funds have been used locally and regionally and how they could have contributed to continued development through ideas and proposals that have come from the staff groups themselves.

Mr. Speaker! Despite the fact that we have long had laws against discrimination of persons with disabilities and despite the fact that Sweden stands behind the UN Convention on the Rights of Persons with Disabilities, much remains to be done before words match reality. I can understand that there is sometimes a fatigue among people in the "movement" over how slowly things are progressing.

One important area, for example, is that people with disabilities must be given the same opportunities as the rest of the population to enter the labor market. Having a reasonable income provides the basis for good living conditions. But then other things, such as personal assistance, must also function.

Miljöpartiet is one of the parties that clearly stands behind the idea that all basic needs must be seen in their entirety, which several of the government parties also did in opposition. I really hope that they stand by that.

Miljöpartiet also wants to raise the flat-rate compensation for personal assistance. For assistance to function in a good way, the working conditions for being a personal assistant simply need to be good enough. The low level of increase that the government is making with 1.5 percent is not enough. Many assistance companies are warning that the low increases are depleting their possibilities to recruit and retain assistants and to conduct serious work.

The template level concerns which salaries one can offer and being able to value employees, provide guidance and training, and so on. Therefore, the template level in itself is important for a well-functioning and serious sector.

Miljöpartiet considers that the compensation should be increased by 5 percent. Our proposed increase is intended as a first step on the way towards being able to close the gap that has arisen after a number of years with far too small an increase, which has made it impossible to reach collective levels for wages for personal assistants.

In the Tidö Agreement, there are also worrying passages regarding the right to assistance that risk putting people in need of assistance in a kind of Catch-22. The government parties and SD want to investigate a model for qualification for welfare, including the assistance allowance. Work is an example of what leads to qualification. This will put many people in need of personal assistance in a very difficult situation – without assistance, no possibility to work.

Mr. Speaker! In Sweden, there are approximately 100 national quality registers for different parts of healthcare, including for childhood cancer and gynecological surgeries. The model is financed through an agreement between the state and SKR. These registers are central for us to be able to monitor quality and ensure the effects of the care. The registers shall include measures that have been taken over time so that it is possible to make assessments of whether a certain care provides optimal effect.

Miljöpartiet wants the funding for the Gender Dysphoria Register to be secured, which today has no money at all despite that Socialstyrelsen has emphasized the importance of follow-up of the care provided. We therefore want to allocate funds to ensure that the register can function.

We also want to task Socialstyrelsen to work towards the establishment of a new national quality register for endometriosis. Likewise, there is a need for a quality register for abortion care. This is important not least because abortion care is expected to change radically in the future, with increased access to home abortions, and safety and follow-up will become extremely important. In connection with this, we also want the regulatory framework to be changed regarding which professions can provide information to the registers as well as what type of data it concerns. For that purpose, current legislation should be reviewed. We want to increase the appropriation to Socialstyrelsen by 10 million kronor per year.

Mr. Speaker! Miljöpartiet believes that contraceptives for everyone up to 26 years of age should be free of charge. Today, it looks different in different regions. This is not favorable for equality or for young people's opportunity to have good sexual and reproductive health. We want to allocate support so that it looks the same across the entire country.

Mr. Speaker! Miljöpartiet has presented a consolidated budget proposal with proposals for a sustainable society, for a sustainable future for both humans, the environment, and the climate - not least regarding the area we are debating here today. A budget shows what is prioritized in politics. It does not matter if a party or a government constellation is for something in theory if it does not leave an impression in concrete investments. In our budget, we have made investments in, among other things, the working conditions of healthcare personnel and improvements to personal assistance. The government has chosen a different path.

I refer to our special statement, where we describe our policy and our budget in its entirety.

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Johan Hultberg (M)

Mr. Speaker! Debate is fun, isn't it? I would like to highlight a couple of questions. I joked earlier here in the chamber about recommending that Member Rågsjö from Vänsterpartiet tune in to one of the commercial channels and watch the program Lyxfällan. I saw in the TV listings that it is actually broadcast at 18:00 tonight, so I also recommend that Member Westerlund watch the program.

The Green Party's budget is, - listen and be amazed, Mr. Speaker - almost even more inflation-inducing than the Left Party's. A full 275 billion, the Green Party proposes to be borrowed over the coming years. This would further contribute to the very serious inflation we have in Sweden right now, which causes, for example, the pension costs for the municipalities and regions to spiral so that they have difficulty making the resources suffice.

I want to ask Member Westerlund how she views the fact that you have taken on the gold watch, that you are not pursuing a responsible economic policy but are fueling inflation with the budget motion you have placed on the floor of the Riksdag - if it were to become a reality.

Then, Mr. Speaker, I also want to ask another question to Member Westerlund. In the Green Party's proposal, you remove the targeted initiative on more care beds that the government is undertaking. I must, Mr. Speaker, ask Member Westerlund: Does she not hear the alarms from the emergency rooms about the shortage of care beds? Does she not hear how the staff time and again sound the alarm about the shortage of care beds and how it leads to patient safety risks and pressures the staff? Does she not hear the alarms, Mr. Speaker?

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Ulrika Westerlund (MP)

Mr. Speaker! I can begin with the last question I received from Member Hultberg. I assume it is appropriation 1:6 that is being referred to. There, it is minus in the Miljöpartiets budget compared to the government's; that is entirely true. But this is because it is the performance-based care places that are included within this appropriation. We want instead to increase the general state grants, which is evident from another budget item that is much higher than the reduction we have made on just this appropriation. It is therefore a consequence of us not wanting to see the performance-based supplement but having chosen another way to achieve the same effect that Member Hultberg just referred to. We see that there are major problems in the healthcare staff's work environment and work situation, and it is also this that the vast majority of the investments in our budget are about - to address them. However, we have chosen to do it in a different way. That is therefore the answer to that question.

Regarding the budget in general, we have been told that it is inflation-driving. We have made large investments in renewable energy production and energy efficiency, and it is such things that in the long run will lower energy prices instead of them continuing to increase. We also make certain tax increases that dampen the rate of inflation.

Furthermore, Miljöpartiet is of the opinion that the climate transition is so important that we cannot pause it. If we do not fix the climate - trying to come up with various measures aimed at this - it will cost us incredibly much more in the long run.

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Johan Hultberg (M)

Mr. Speaker! The risk with the policy that Miljöpartiet pursues is, I would say, that one pauses investments in the long term. If one pursues as expansive a policy as Miljöpartiet does, one fuels inflation. That means that in the long term we will have lower tax revenues and a poorer economic development. The regions and municipalities will have a poorer economy.

This will make it more difficult to make investments in welfare and, for that matter, the other important area that Member Westerlund mentioned, the climate. How will we be able to afford to be persistent in our investments in the climate in the long term if one pursues such an expansive policy, where one does not take responsibility for the economy? That question still deserves an answer, but I understand that Member Westerlund is at a loss for an answer.

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Ulrika Westerlund (MP)

Mr. Speaker! I believe I gave Member Hultberg an answer, even if we perhaps do not fully understand each other. The tax increases that we propose, among other things, are inflation-dampening, in our opinion.

It is a bit ironic to hear the climate mentioned by a person from a party that is part of the government that has presented a budget where large amounts of money, approximately one-third of the reform space, are allocated to measures that will accelerate the climate catastrophe. It is very difficult for Miljöpartiet to take this into account when we present our budget. In that, we have tried to make interventions aimed at braking the climate catastrophe and the development that we unfortunately see, so that in the long run, fewer interventions will be required. But it requires that we make investments now, and that is reflected in our budget.

The deliberation was hereby concluded.

(A decision was to be taken on 20 December.)

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