The organization of health and medical care

Christian Carlsson (KD)

Mr. Speaker! Swedish healthcare is good in many ways, but far too many people have waited too long for care or have someone close to them who has become stuck in the healthcare queues. It could be a mother, uncle, grandmother, or a close friend.

Accessibility within Swedish healthcare is lacking. There are too few care beds, and the care queues are too long, partly because the conditions for the staff are not always sufficiently good. This means that the person who is ill does not always receive care in time. The person who is ill is also not always met with equitable care.

The chance of detecting serious cancers at an early stage when someone's father has been affected, or the chance of getting in contact with child and adolescent psychiatry when a daughter's friend is unwell, differs greatly depending on whether one lives in Värmland, Västmanland, or here in Stockholm. It is neither reasonable nor fair.

The new bourgeois government's priorities are therefore about focusing on cutting the care queues, on getting more care beds, and on increasing state governance so that we can offer people across the entire country good and equal care in a timely manner.

Madam Speaker! How healthcare is organized is naturally central to the possibility of providing patients with the care they need. From the Kristdemokraterna's side, we have been clear that we want to abolish the regions' responsibility for healthcare and let the state take over the responsibility and the financing. We believe that the medical and technical development has simply outpaced today's model with 21 self-governing regions.

We are in agreement with our three coalition parties Moderaterna, Sverigedemokraterna and Liberalerna that the state's responsibility for healthcare shall gradually increase. A full or partial state ownership for Swedish healthcare shall now be investigated.

It is about, among other things, that national principles for compensation and fees need to be introduced. We need a strengthened follow-up of the healthcare's efficiency and quality reporting. It is, for example, about state agencies being given the authority to also audit the medical results.

Not least, we need a common digital infrastructure for Swedish healthcare. That as a patient today needs to sit and repeat their entire medical history at every healthcare visit is not reasonable. It is a matter of respect and dignity, but ultimately it is also about patient safety. It is about caring for those who are ill.

Madam Speaker! The most important thing in Swedish healthcare is the accessibility of good care. Swedish healthcare has the lowest number of care beds per inhabitant in the entire EU, and it is noticeable among the staff at the country's hospitals. We therefore need a national plan for more care beds, changed working methods, and better conditions for the staff if we are to seriously be able to shorten the care queues and increase accessibility.

All this is what the government is working for. In addition to the three billion, the government has doubled the investment to increase the number of healthcare beds. This involves 2 billion annually in the form of a performance-based compensation for those regions that, for example, meet the goal of removing overcrowding and reducing the number of avoidable healthcare injuries.

We also take the initiative for a national healthcare brokerage that makes visible where the healthcare capacity is in the country. We do this to give people more power in a situation where they otherwise often feel powerless. People should simply be able to choose to have the treatment or the operation performed elsewhere in the country, i.e., where they are able to provide the care to the person who is ill in a timely manner.

Mr. Speaker! The transition to good and close care needs to gain momentum now, and we need to expand primary care significantly over several years. As far as I can judge, there is a relatively large consensus on this. But the transition of Swedish healthcare needs to happen in practice, and it also needs to be more noticeable in the regions' budgets. A well-functioning primary care, in fact, constitutes the basis for an effective health and medical care system.

I am convinced that increased state governance of primary care's goals, reimbursement models, and monitoring could facilitate the transition.

The competence shortage in primary care must be addressed by improving the conditions for the staff working there. The National Board of Health and Welfare's target value is 1,100 inhabitants per specialist in primary care, and today, half of all specialists in general medicine are missing. This is obviously not sufficient.

The Christian Democrats' ambition is that, in the long run, there should be a fixed healthcare contact for everyone with a named doctor and district nurse and a cap on the number of patients both at an individual health center and for the individual district doctor. This would give district doctors and nurses a better working environment, create continuity and build relationships between patient and doctor, create security for the individual patient and, above all, give the doctor knowledge of the patient in order to be able to provide high-quality care.

When we now strengthen the organization of health and medical care, we take it as a given that the care chain functions better when doctors and patients know each other, feel secure, and have trust in one another.

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

Yasmine Bladelius (S)

Madam Speaker! We are now debating one of the Social Committee's broadest reports. It concerns Report 12 Health and Medical Care Organization. In the report, all the motions written by Members of Parliament during the general motion period in the autumn and which concern the area we are now debating are collected.

It is evident that there is a great interest among the members of the Riksdag to discuss these important issues. The report addresses 120 different motions concerning primary care, choice of care, freedom of choice, accessibility, private health insurance, the right to an interpreter, and much more.

Madam Speaker! In all contexts where I get the opportunity to speak about Swedish health and medical care, I usually highlight the fact that we in Sweden have a healthcare system of absolute world-class quality. I intend to take the opportunity in this speech to also highlight all the outstanding doctors, nurses, and nursing assistants who work in our hospitals and who do everything they can to provide us with good care in a timely manner. The Swedish hospitals and the Swedish doctors are among the best in the world. The nurses and nursing assistants who work in our hospitals do so with their whole body and soul and with total dedication.

But Swedish health and medical care faces enormous challenges. We see recurring problems in the form of long waiting times for care, broken care chains, and declining productivity.

We hear the concern from the public: Will we get care in time? Will we have to sit in a rowdy emergency room for several hours without getting help? Will I have to lie in a hospital bed in the corridor and not be attended to? Will I have to stand back for someone who has bought their way past me in the queue?

Madam Speaker! We also hear the concern from the hospital staff: Will I be able to manage one more day? Will I need to run faster than I already do? Will I make a mistake in my duties because of the high workload? Will more of my colleagues resign?

Swedish healthcare is in absolute world-class status, but it is not a permanent state that we can take for granted. The fantastic healthcare staff cannot perform magic. They cannot conjure up more care beds and more colleagues from a magician's hat. They cannot run faster than they already do. They cannot pull coins out of their pockets to fill the holes in the regions' budgets.

That is where politics comes in. It is now that we must take responsibility.

There is a serious crisis in Swedish health and medical care. It concerns a widespread staff shortage leading to a widespread shortage of beds. It concerns a poor working environment for the employees and many years of underfunding of public care.

As many as 17 of 21 regions have budgeted with a deficit for 2023, and more than half of the regions state that the staffing situation during the summer will be as bad or even worse than last year.

Despite this, the government chose in its budget to invest twice as much on tax cuts for high-income earners as on general state grants to municipalities and regions, and not even close to what SKR considers is needed just to be able to maintain today's level.

In my home region of Skåne, the government, which consists of the Moderaterna, Kristdemokraterna, Liberalerna, and Sverigedemokraterna, presented a budget that entails cuts of over 800 million kronor on Skåne healthcare next year. In practice, this obviously means that staff will be laid off. This means a real "steel bath" awaits Skåne healthcare, which already has some of the country's longest care queues and which already has the worst accessibility in the country. It is, of course, completely unreasonable.

This is how it looks in many regions. Years of cuts, savings, and privatizations have gradually dismantled public healthcare. The bourgeois market experiments and privatizations have taken precedence over the patients and healthcare staff. There is a lack of order and organization in the healthcare.

Madam Speaker! If Swedish health and medical care is to continue to be of absolute world-class standard, it must be strengthened and given sufficient resources. We must take back control over the care to give the healthcare staff more colleagues and better working conditions, create new care beds and shorten the queues.

Care should not be a market, but instead we should expand the health centers and guarantee care based on need throughout the country.

The system of private health insurance is fundamentally unfair and leads to the wrong outcomes regarding who receives what kind of care and when. No one should be able to buy their way to the front of the queue in publicly funded healthcare.

The work with the primary care reform must continue, and the main rule should be that everyone shall have a fixed doctor contact in primary care.

Madam Speaker! For us Social Democrats, addressing the deficiencies regarding the work environment, working conditions, and competent staff in Swedish health and medical care is one of the most important challenges during the mandate period in order to resolve the long queues and the staff shortage.

We are also absolutely convinced that the answer to these challenges is not more privatizations, more austerity measures in our hospitals, or more private health insurance – or for that matter, further worsened working environments for healthcare staff when they are forced to break both confidentiality, ethics, and morals and report undocumented seekers of care to Migrationsverket.

Madam Speaker! A great person once said: Politics is will. For me, politics is constantly making choices. It is time to prioritize healthcare and its staff. I wish to move for approval of our reservation 1.

(Applause)

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

Thomas Ragnarsson (M)

Madam Speaker! Tonight we are debating the Social Affairs Committee's report SoU12 Organization of Health and Medical Care. I would like to begin by moving for approval of the committee's proposed decision.

Madam Speaker! The need to reform Swedish healthcare is perfectly clear. We are currently governed by the Health and Medical Services Act, which states that it is the responsibility of our regions and municipalities to ensure that care is delivered to those living in the respective municipality and region. The need to clarify the interface between the areas of responsibility of the state, the regions, and the municipalities is important, as we today see tendencies of patients falling between the cracks. Therefore, it is pleasing that we in the Tidö Agreement have agreed to investigate the issue thoroughly. However, the solution to Swedish healthcare problems is probably not further administration or central control.

Madam Speaker! It is easy to believe that organizational changes are always the solution to all problems, but the fact that there are currently ambiguities within the areas of responsibility leads to us having unequal care, depending on where one lives, and that the differences are large across the country. The same applies when the concept of highly specialized care is put on the agenda. Who decides what is highly specialized care, and what guidelines is one working according to? Here I believe that the state's responsibility needs to increase when it comes to specifying the highly specialized care and creating strategies and goals for the care that is to be provided. One also needs to take greater responsibility for the fulfillment of goals and for ensuring that specific strategies are followed.

However, it must not go so far that it affects the smaller hospitals' ability to handle the acute mission. Sweden's geography is special. From that perspective, all the acute hospitals that exist today are needed, partly to solve the accessibility issue, and partly to be able to save lives in the event of acute life-threatening illness or injury. We must be able to deliver good and equal care throughout the country based on the conditions that prevail.

Madam Speaker! There are several areas where the state could take greater responsibility, such as strategic work, highly specialized cancer care, a national helicopter organization, specific pediatric surgery, and other advanced surgery. The work on a national maternity plan and the establishment of a national healthcare brokerage is already agreed upon between the Tidö parties. We see that the differences in Swedish maternity care are marked, and obviously, this cannot continue. A greater responsibility needs to be taken when it comes to new technology and new forms of treatment that are now reaching the market on a fairly broad front. This specifically concerns the development of genome sequencing and precision medicine.

Madam Speaker! The healthcare of the future will be characterized by good and close care as well as increased digitalization, this in order for us to be able to qualify this activity in the future. The Tidö parties have therefore agreed on investments regarding the digital infrastructure within healthcare and investments in primary care and developed healthcare in rural areas and in sparsely populated areas. The principle of proximity and an expanded mandate for primary care will lead to better and more efficient care for the patient. There are already good examples today of how one can work in sparsely populated areas. We have the Glesbygdsmedicinskt centrum, which is a pioneer. There, they have taken the health centers in Västerbotten to completely new levels. Such a way of working also reduces the pressure on our hospitals where they can concentrate on their core areas. The right care shall be given in the right place.

Madam Speaker! Today we see a fairly large amount of mental ill-health among our citizens, and in the Tidö Agreement, investments are made in the area. On the one hand, one sees the need for a national strategy in the area, on the other hand, the need for a national coordination function is of the utmost importance.

Mental health is common in society. Despite this, it is still both stigmatizing and difficult to talk about. There are great gains to be had by ensuring that primary care has the resources needed to manage first-line psychiatry. This area is also something that the state needs to take an overall grip on, both when it comes to preventive work and the follow-up of how the regions manage their commitment.

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

Johnny Svedin (SD)

Madam Speaker! We are going to talk about the organization of health and medical care. It is a large and complex issue that absolutely needs to be investigated so that it can become as good as possible and we get the effect we desire.

As healthcare is organized today and has been for a long time, it is clear that something must be done, because it cannot continue like this. Long care queues, unclear directives, staff leaving due to a highly deficient work environment, and not least a municipal health and medical care that has been left more or less to its own fate are just some of all the less flattering problems healthcare struggles with.

It is time to do something about this. We Sverigedemokrater see many areas that need improvement. Among others, we see the importance of introducing an accessibility requirement for ambulance care, which has an immensely important role in the care of sick and injured patients in the acute and often life-threatening stage. The chances of survival are directly related to the time from when the injury occurs until the patient comes under qualified care.

In recent years, the time from the alarm until the ambulance arrives at the injured person has increased. It is not acceptable that seriously ill and injured patients should have to wait a long time for an ambulance and thus risk their lives, especially not in a stage where they are already incredibly vulnerable and exposed. In a number of countries, there are statutory availability requirements and targets for how seriously ill or injured patients should be reached within a certain time. In Sweden, there are no such clear targets or requirements on how great the availability of ambulances should be, which we consider to be a deficiency. Sverigedemokraterna works for this to be reviewed. Everyone should have the right to good care in a timely manner in a welfare country like Sweden.

We Sweden Democrats, together with the government parties, have high ambitions and many important steps in the work to strengthen Swedish health and medical care. In the Tidö Agreement, it states, among other things, that an investigation is appointed with the mandate to analyze and highlight the advantages and disadvantages as well as provide proposals on the possibilities of introducing a partial or full state ownership in the long term.

The investigation shall also consider the advantages and disadvantages of the regional organizations' geographical areas, based on, for example, today's six healthcare regions. The investigation shall be carried out in close cooperation with representatives for patients, professions, regions, private healthcare providers, and academia with the aim of achieving a healthcare system that is given better conditions than today and offering good and equal care based on the principle of need. Not least, the investigation shall present feasible proposals.

Regarding the issue of management and monitoring of state funds, the following is stated: "National principles for compensation and fees are introduced. These shall be based on the principle of need and that a medical assessment is made so that the patient reaches the correct part of the care. The State takes overall responsibility for the management and monitoring of state funds for healthcare."

In addition to these two measures, there are a further 22 points in the Tidö Agreement that are to be implemented or are well on their way to being implemented. They are divided into eleven clusters or areas, which ensures that the proposals have a good spread across many areas.

In addition to the Tidö Agreement, we in Sverigedemokrater see that further measures need to be taken during the upcoming mandate period. As the largest party in the government coalition, we will work to clarify a distribution of responsibility where the state receives a more overarching role. This is extremely important for the future of Swedish health and medical care.

We consider, for example, that there should not be a right of interpretation in recommendations from Socialstyrelsen. As it is today, for too many regions, they do not fully comply with what Socialstyrelsen recommends, which results in uneven care across the country.

I, as a member of the Sweden Democrats, believe that a clear state intervention is needed to truly make a difference in Swedish healthcare. Sweden has a long tradition of having a strong healthcare system at the forefront, and this must constantly be the goal when we all in the Committee on Health and Welfare go to our offices. Here I mean that the coalition parties, with the Tidö Agreement as a basis, have an important four years to manage well. And I am completely convinced that we will do exactly this.

Madam Speaker! Swedish healthcare needs to become good again. With that said, I move for the approval of reservation 7.

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

Karin Rågsjö (V)

Madam Speaker! Before the election, all parties spoke about the need for more healthcare beds. Do you remember that? Now I wonder: Will there be more healthcare beds? It is about staff, so I am skeptical.

Healthcare is running at a deficit across the whole of Sweden. This is due to the very marginal state subsidies from SD and the government. In some regions, the deficits are as large as 10 percent of the total budget. By refusing to provide the money that is required, the SD-dependent government shifts the costs and the debt onto the regions. This hits the staff hard and, of course, also the patients.

In order to maintain today's staffing density and quality, resources must therefore increase at the same rate as we see the population and the elderly increasing. It is quite easy to read this in various tables and so on. We believe that at the national level, there is a lack of sufficient governance to increase the number of care beds, ensure the design of specialist care, and promote medical research, which unfortunately has regressed.

So, SD and the government: Release the funds that are needed, and present a long-term plan for how healthcare is to be financed! The alternative is to tell staff and patients to grit their teeth so as not to jeopardize the venture capitalists' profits or the wealthy's tax cuts. Take the need for welfare to heart! It is extremely important.

The Swedish economy is in crisis. The regions and municipalities, especially the regions, have major economic concerns. I have already mentioned this. Therefore, Vänsterpartiet is investing an extra 8 billion for the regions in its spring budget. One could say that it is a kind of rescue package for healthcare.

Healthcare is suffering from a staff shortage, which has not improved and can be life-threatening for patients. Ivo reports that heart patients are being cared for in the corridors, and hospitals are handing out pot lids to patients to use as alarms. It is completely incredible. Let municipalities and regions - temporarily or for the time being - use targeted funds as general funds! Replace it for one year, during this crisis!

Then the state must guarantee long-term conditions for municipalities and regions. Index the state grants so that they follow the cost developments! Otherwise, we will be in a difficult position.

Madam Speaker! When it comes to primary care - good and close care - I wonder what is happening with it. Is the close care in fact relative care?

We have decided that all patients shall be listed with a designated doctor at their health center who, at best, is entered in the medical record and disease history. We proposed that each doctor should be responsible for 1,100 listed patients - that was our proposal from a unanimous committee. The figure today is instead over 2,000 patients per doctor at most health centers. Research has shown that a fixed doctor contact leads to lower mortality, and it would also save a lot of money for the regions.

The large differences in public health that exist between different classes, where those with lower education live shorter lives, can best be addressed with good primary care. How is it going with this important work? Not so well, says the Agency for Health and Care Analysis, which has released a report. The number of specialist doctors in general medicine is decreasing, and the work environment problems are significant.

Just as with the climate crisis, we cannot afford to wait any longer; we must do something. Where is the long-term perspective and the plan? We want the state to take over the responsibility for doctors' general and specialist rotations. We need a long-term economic national plan for basic education, further education, and continuing education within healthcare – quite simply a national primary care reform. State resources must be provided that can guarantee the long-term funding of the health centers.

Introduce establishment control in the law on freedom of choice! The healthcare companies have the right to establish themselves wherever they want, and then it is usually in places where people are rich and healthy. This undermines the Health and Medical Services Act.

Active outreach is super important. Outreach health checks should be trialed. And we want to see a national basic mission to clarify what specialist competence a health center should have. It is about equal care throughout the country.

Madam Speaker! I move for approval of reservation 14.

The system of private health insurance is not only unfair and leads to the wrong outcomes when it comes to who receives what care and when, but the system is also cost-driving. If I have an insurance, I want to use it, don't I? Then I want a second opinion almost every time, and that costs quite a lot.

At the same time, the private healthcare providers have an interest in selling as much healthcare as possible. It is not reasonable that it should be permitted to design insurance policies that conflict with the Health and Medical Services Act. We want to ban private health insurance within publicly funded care, that is, the care that has agreements with the regions and which therefore has two doors in – one for us without insurance and one for them with insurance. And you can understand who gets care first; that is what has been looked at.

Now I will move on to something completely different. The prescription of psychopharmaceuticals, especially anxiolytics and antidepressants, to children and young people has increased significantly in Sweden. Today, the research is quite divided regarding what can be done, what the effects will be, and what the long-term consequences of children's use look like.

In order to avoid risking that children in need of psychiatric care fall through the cracks or have to wait far too long for interventions, we need to do much more. An important measure is that cooperation between different healthcare entities functions and that there are clear guidelines and boundaries between BUP and other entities. It is, however, the case that more children are treated within child and adolescent psychiatry than within primary care and school health services. The queues to BUP are growing. This is something we must look at. Early preventive interventions are needed when it comes to child and adolescent psychiatry, and other doors in must be found.

We can also see a clear tendency to medicalize normal reactions in children and young people. It has contributed to an increased healthcare consumption, and we must follow up on this in a "tight" manner. We can see an increase in diagnosed depression and anxiety disorders and that the prescriptions of antidepressant psychopharmaceuticals have increased for children and young people, as well as contacts with BUP. We want an initiative to be taken for a national review of the entire development before it completely slips out of our hands.

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

Anders W Jonsson (C)

Madam Speaker! The report we are debating tonight concerns the organization of healthcare. It is an area where 120 different proposals have been submitted by the Members of Parliament. In the committee, we agree on quite a lot, but on 45 points there are reservations – of which 20 come from the Center Party. I do not intend to go through all 20 reservations at this late hour, but instead, I will highlight some of more principal importance.

The first question, of course, is about how healthcare should be organized moving forward. There are some who have a simple solution, namely that if we just nationalize Swedish healthcare, all problems can be solved. The answer to every question about problems in healthcare then becomes to nationalize, to let the entire Swedish healthcare system with hundreds of thousands of employees be governed by a director-general on Kungsholmen in Stockholm. That solves all problems.

This government has said that they should at least look into the issue, even though the interest seems to be somewhat limited from the other parties. I can understand that because there is a great deal of research in the area. The latest major research review was conducted by Ratio, which is the business sector's research institute. In the report The Myth of Centralization, the conclusion was that if one wants to create complete chaos in Swedish healthcare, one should carry out a massive reorganization where everything is placed under state control. Not least, it would be good for all administrators. In a comparison with other countries that have a completely state organization, it was estimated that as many as 250,000 administrators might be needed. For us, this is instead about the need for more national governance of Swedish healthcare – but no major reorganization.

There are, however, a number of concrete areas where we must ensure that we change healthcare. One area is what we learned from the pandemic, namely that the care of our oldest citizens functions poorly. If one as an elderly person lives in a nursing home or has home care in their home and becomes acutely ill, the alternative is, unfortunately, an ambulance trip of five to ten miles to the nearest emergency hospital where one then has to lie on a stretcher and wait for a number of hours before receiving help. There, we must reorganize care so that the very oldest who have home care can also receive an acute medical assessment around the clock.

There are problems in the Swedish healthcare system, and we do not need to create new ones, but unfortunately, this government has chosen to create additional problems. I am speaking about, for example, the reporting obligation. Healthcare personnel shall be tasked to report, by calling the border police, if they find a seriously ill patient who does not have the last four digits. And the possibility of using an interpreter in healthcare shall be restricted.

In this report, I move for approval of reservation 10. It is a reservation that the Riksdag may declare that it shall also in the future be free of charge to use an interpreter in healthcare in Sweden in a situation where one does not master the Swedish language.

Another area in need of major changes is primary care. Even though Sweden has a healthcare system that performs in absolute world-class terms, as many different surveys show, primary care is a problem. There, we are in the middle of a major reform, and we are moving towards closer care. But much suggests that one of the challenges will be to ensure that we get competence in primary care. Competence exists already today, but we are to get nurses and doctors who want to work in primary care.

It is about lowering the thresholds for moving from other healthcare to primary care. Working in primary care must be one of the absolute best jobs within the entire healthcare system; a limited number of patients, getting to work with the entire spectrum of diseases and ages, and following patients over a long period. But unfortunately, the conditions in primary care today are such that people do not seek to work there.

We in the Center Party have presented a number of proposals on how one could increase the attractiveness. Much is about making it easier for young nurses and doctors to establish themselves privately in Swedish primary care. We see that the private companies have an easier time attracting labor.

In this report, we have a proposal, which we have reserved ourselves on but which I have not voted for, to steer so that the smallest unit in primary care shall be a doctor and a nurse. That would make it possible for many younger people to start a clinic. Today, it is required that one employs a large number of people and has own capital of up to 10 million to start a clinic.

The last thing I want to bring up is the question of doing something for the freedom of choice for patients that would also reduce the queues in Sweden, that is, to move forward with the proposal that the Alliance parties pushed already in the 2014 election. It is about giving patients the right to seek inpatient care anywhere in the country. It would create opportunities for patients to choose hospitals where higher quality and shorter queues are offered. If we could achieve those rules of the game, it would become possible for a number of actors to increase their capacity. It is with genuine disappointment that I see that the current government has dropped the idea and instead has dusted off an old Social Democratic proposal, namely that it is sufficient to start a care bed brokerage in Stockholm – an office where the regions can contact and ask if there is available capacity anywhere in the country. Everyone listening to the debate understands that it will not lead to anything at all. Structural changes are required here.

I move for approval of reservation 10.

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

Ulrika Westerlund (MP)

Madam Speaker and dear colleagues this evening! We are debating the organization of healthcare.

Access to care is unevenly distributed. For Miljöpartiet, it is self-evident that a gender and equality perspective should permeate all healthcare and care. Equivalent care regardless of, for example, gender and socioeconomic factors should be a matter of course. The differences that exist today between women and men within healthcare can manifest in different access to care, different waiting times, and different access to high-quality treatments or medicines. For example, studies show that women, to a lesser extent than men, get access to good care in the event of a heart attack because women often show different symptoms than men and are sent home to a greater extent while the men are admitted. More research is needed on women's diseases and health.

The inequality in healthcare is also expressed in that care aimed at women all too often is prioritized lower than care aimed at men. Studies have also shown that healthcare staff's perceptions and opinions about women and men have an impact on how they are treated in healthcare. Women must express more pain to receive the same treatment, and so-called women's diseases are still seen as something that women are expected to live with instead of diseases that can be treated.

Women are therefore not taken seriously and are stigmatized. Many are forced into a multi-year struggle to receive a correct diagnosis and treatment for common problems, for example endometriosis, vestibulitis and birth injuries. We need a feminist perspective on public health.

Miljöpartiet therefore sees a need for all regions to openly report on how equal the healthcare is. This can concern what the queues and the quality in women's healthcare look like and how the healthcare system works to make healthcare more equal. Gender-disaggregated statistics shall always be available.

Madam Speaker! Care shall be solidary and equal. Everyone shall feel secure that welfare is accessible when they need it, regardless of what their private finances look like. Care shall be based on the patient and the Health and Medical Services Act. The publicly funded care shall be able to ensure care through an improved care guarantee.

Today, there are large health disparities that must be reduced. This requires both more structural public health interventions and better opportunities to support individuals who want to break unhealthy habits. Those who have the greatest need for health and medical care should be given priority in care. When private health insurance is allowed to utilize resources within the framework of publicly funded care, this principle risks being eroded. The hospitals are publicly funded and should not have a fast track for private insurance patients. Care must always maintain a high quality and have good accessibility, so that the perceived need for private health insurance decreases.

Madam Speaker! It is clearly impossible to discuss the organization of healthcare without touching upon some of the points in the Tidö Agreement that affect healthcare. Most attention has perhaps been given to the issues regarding the obligation to report and limited interpretation support. The chairman of Vårdförbundet, Sineva Ribeiro, has expressed that the proposal regarding the obligation to report during meetings with undocumented patients contradicts professional ethics and would affect the possibilities to create trusting healthcare meetings and provide good and safe care. The proposal to remove the right to an interpreter further complicates the professional practice in healthcare and entails obvious patient safety risks. The alleged savings will quickly be eaten up by additional healthcare visits or healthcare injuries. The right to health applies to everyone, and the fundamental principles of healthcare are clear. Care shall be provided with respect for all people's equal value, and those with the greatest needs shall be given priority in healthcare.

I stand as usual behind all of the Green Party's reservations, but I move for approval only of reservation 31, which concerns the importance of equal and equitable healthcare. I have also noticed this evening that we have missed supporting reservation 10, which was put forward by the Center Party. It will be a challenge for me to alert my party colleagues to this during the vote next week.

The deliberation was hereby concluded.

(A decision was to be taken on 10 May.)

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