The organization of health and medical care

Christian Carlsson (KD)

Madam Speaker! The Christian Democrats' most important issues for this mandate period were to increase state governance so that people across the country can be offered equal and fair care and to push back the record-long care queues that were built up during the Social Democrats' eight years in power – this so that those who are ill can actually receive care in time.

The healthcare queues more than doubled during Magdalena Andersson's years in power. They were record-long even before the pandemic. We have therefore invested more than 25 billion on more healthcare beds and shorter healthcare queues, and we have established a national healthcare brokerage with the purpose that you as a patient should be able to turn to another region or to another healthcare provider if your own region cannot provide care in time.

We have also concentrated our efforts on certain diagnostic groups where we know that the care queues have been long, but where there has simultaneously been available care capacity in other parts of the country. The state has been prepared to pay for an increased number of operations regarding hernia, cataracts and hip replacements. The policy with a focus on accessibility has now had an effect.

When it comes to hip replacement surgeries, the number of people who have waited too long has decreased by 60 percent. The corresponding figure for hip replacements is that the healthcare queues have decreased by 55 percent. Overall, the trend has been broken. The healthcare queues have decreased by 28 percent so far during the mandate period, and what we can see is that healthcare queues are decreasing in the whole country except in the red-green governed Region Stockholm.

To continue shortening the queues, we want to proceed with a significantly sharper healthcare guarantee so that more people receive care in a timely manner, and we proceed with more targeted initiatives to shorten the healthcare queues. But it is a well-functioning primary care that constitutes the basis for an efficient healthcare system, and Swedish primary care therefore needs to be strengthened. More resources are needed for primary care, specifically for the country's health centers. Furthermore, initiatives on competence supply are needed so that more can be trained as general specialists, and primary care needs to be allocated a larger share of the healthcare budget.

We Christian Democrats believe that there should be a fixed healthcare contact with a named doctor as well as caps on the number of patients at an individual health center, as well as for the individual district doctor. This would give both district doctors and district nurses a better working environment, but above all, it would create the continuity and knowledge of the patient that provide the conditions for both security in the encounter with healthcare and high-quality care.

Having a fixed and named doctor means that the patient receives care from a person who is familiar with the patient's medical history and can offer more personal and effective care over time. This not only strengthens the relationship between doctor and patient, but it also contributes to better care outcomes and reduced unnecessary healthcare consumption through early detection and better opportunities to manage health problems. It is therefore important for us that all residents are registered with a fixed and named doctor who is responsible for the patient.

If we are to be able to continue shortening the healthcare queues, more general practitioners and a stronger primary care are needed, and we need more staffed healthcare beds. For that to be possible, it is absolutely crucial to manage the competence supply. The government has developed a national plan for competence supply during this mandate period, and this year the government is allocating 1 billion so that the regions can work according to the plan.

We Christian Democrats have also taken note of the Care Responsibility Committee's conclusions, which point out that the state needs to step forward and take greater responsibility for the staffing supply. The state should therefore be given the full responsibility to assess the need for and distribute the responsibility for providing training places between the regions.

More staffed care places is about improving the conditions for those who are ill to receive care in time. But it is also a question of Sweden's preparedness.

We therefore cannot have a situation, as in Sollefteå, where the military defense is being upgraded while regional politicians choose to shut down care and weaken the healthcare's preparedness. Sweden needs more care beds, not fewer. The state must be able to ensure that the upgrade of the military and civil preparedness proceeds in sync.

We Christian Democrats have therefore proposed a stop law for healthcare closures until the state has identified a basic provision of healthcare. The mandate to proceed with establishing a contingency hospital, for example at the Sollefteå hospital or Ljungby hospital, which are threatened with closure, shall be seen against this background and against the background of the security policy threats directed at Sweden. We find ourselves in the worst security policy situation since the Second World War.

Madam Speaker! The state should also be given the full responsibility to plan, dimension, and organize Swedish healthcare. Today's healthcare organization with 21 self-governing regions is not economically sustainable in the long term. Despite being self-governing with their own right of taxation, the regions do not sufficiently fulfill the mission to offer care in a timely manner, and people are also not met with equal care.

21 self-governing regions lead to an inefficient and bureaucratic governance, which means a waste of taxpayers' money. But above all, it leads to an unequal and unjust healthcare that leaves patients caught in the middle. Therefore, we Kristdemokrater say: Abolish the regions and let the state take full responsibility for and receive the mandate to govern Swedish healthcare.

(Applause)

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

Karin Rågsjö (V)

Madam Speaker! I have slightly different figures than the member does. A snapshot from January for the healthcare queues, adjusted for population, shows 6.24 patients per thousand inhabitants in Stockholm. Furthermore, it is 16.41 patients per thousand inhabitants in Skåne. That is how it looks, and in Region Skåne, KD rules together with the Moderaterna, Liberalerna, and Sverigedemokraterna – but that is enough said about that.

A 28 percent reduction in healthcare queues sounds fantastic. The thing is, nine regions had been excluded from that reporting. I think perhaps it would be good if you mentioned that every time you bring up those figures. I will leave this.

In 2024, you appointed an efficiency delegation. That sounds great. Healthcare is to become more efficient, and the regions shall be able to apply for funds there. This can also involve some bureaucracy. Here we can talk about exactly that, bureaucracy.

Madam Speaker! In that delegation that wanted to streamline healthcare, the director of the healthcare company Kry also sat, if I may put it that way. And he was elected at the same time as Kry was accused of incorrect invoicing of three regions and a few other minor things.

We have learned a lot about Krys' business model through Ekots gräv, which was 100 calls per doctor and day. Hello and wow – that was efficient. It is the taxpayers in the regions who have had to pay for this. The member knows that.

Is it really good and equal care based on need? What do the Christian Democrats think about that?

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

Christian Carlsson (KD)

Madam Speaker! I am pleased that Member Rågsjö wants to speak about the healthcare queues in Sweden. It can, in fact, be worth zooming out a bit and seeing how it has looked in Sweden. We had enormously long healthcare queues already during Göran Persson's time in power. Then Sweden got a bourgeois government, and the Christian Democrats' Göran Hägglund stepped into the Ministry of Health. One almost cannot believe it is true, but during the Alliance's time in power, we succeeded in halving the healthcare queues in Sweden.

What happened to Swedish healthcare policy when the left took over? During the eight years, the healthcare queues more than doubled. They were record-long even before the pandemic. So, these are not pandemic queues, but they are the Social Democrats' and the Left's healthcare queues.

What happened then when we took over again? So far, the healthcare queues have decreased by 28 percent. It is not that we are satisfied with that, but we hope to be able to continue improving this.

Is it a coincidence that the healthcare queues grow when S and Vänstern rule and are cut when the Christian Democrats rule? It is naturally not. We, in fact, focus on accessibility and on the patient being able to receive care in time. We rule in that way, and it yields results, which is pleasing. It is naturally also thanks to all the fantastic colleagues within healthcare, and many regions are also doing a good job.

Now we see that the healthcare queues have decreased by 28 percent. It is true that nine regions have not been able to be included in the statistics. They have, in fact, changed their record systems, and we want reliable figures. But we have used all the figures that are available. The trend is very clear: We have reduced the healthcare queues by 28 percent. It is only Stockholm that stands out in this situation. We naturally hope that the healthcare queues will decrease there as well. People should not have to wait too long for the care they are entitled to.

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

Karin Rågsjö (V)

Madam Speaker! I wonder if KD has been visiting the USA and learned how to get ahead with falsehoods during an election year. 28 percent – that figure is not correct if you dig a little. Then it ends up at 8 or 13 percent, but we will leave it.

Christian Carlsson brings up Stockholm. I have mentioned those figures, and I think it is quite dishonest to once again bring up Stockholm figures that are completely false – I must say that.

Now I will move on to something else. I hardly have time, but I speak fast. You have also appointed the Productivity Commission, but sometimes things do not turn out as one had imagined. The Commission and the investigator Clas Olsson submitted proposals in 2025. They wanted to remove the mandatory part of the law on choice systems, which you introduced and which has entailed an extreme opportunity for all sorts of companies to advance in different ways. I will speak more about that later.

The right of free establishment has meant a free pass for criminal actors and so on. There are enormously many good private healthcare companies – that is not it. But you have opened the door and simply made it possible for dishonest people to take over healthcare.

They have also proposed that the regions should be exempt from paying for digital care. How does the member view that? Because it simply cannot continue like this. Ivo cannot become bigger and bigger to rectify the mistakes regarding the free choice of care. When Krys's doctors receive 100 patients each per day – this is just the beginning of the digging, I believe – it is clear that it is about some kind of structural error. Ivo cannot rectify that; instead, one must look at the legislation. The Christian Democrats refuse to do that. It may be because you have better contact with the healthcare companies than the Left and the Social Democrats do.

It would be nice if one took own responsibility for these four years instead of starting to talk about Göran Persson.

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

Christian Carlsson (KD)

Madam Speaker! Given the Left's track record regarding growing healthcare queues, I understand that the member wants to leave that discussion. But it is not acceptable to come with accusations of falsehoods.

We have reduced the healthcare queues by 28 percent. What does that measure mean? Well, it means that 28 percent fewer people are waiting longer than the healthcare guarantee prescribes. We have also adjusted it for seasonal variations, because we know that healthcare queues can vary very much during different months of the year.

They are the absolutely most reliable figures we have. So do not come dragging out accusations of falsehoods, Karin Rågsjö! Accept that when Vänstern rules, the healthcare queues grow, because you do not direct any focus but think that more money will solve the problems.

The Left's melody is: If we just take more of the taxpayers' money and put it into the welfare system, all problems disappear. You are against targeted investments to shorten queues. You only want to pour out money in general state grants. That is what doesn't work. Accept it! Accept that when we govern, more people receive care in time and when you govern, fewer do. It is very clear.

I want to try to manage to answer some of the other questions as well. When it comes to digital care, it is obvious that it is not functioning in a satisfactory way. We Christian Democrats have been clear that we want to abolish the digital out-of-county fee. Instead, we want the digital healthcare visits to be linked to the primary care centers, so that we truly strengthen primary care and can improve continuity. We shall take advantage of the innovative power that exists in the digital solutions, among the digital healthcare providers, but we need to strengthen continuity.

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

Christofer Bergenblock (C)

Madam Speaker! Thank you, Member Christian Carlsson, for the speech!

Parts of the Swedish healthcare system need increased national governance. This concerns, among other things, the pharmaceutical side, vaccinations, screening, airborne ambulance transports, competence supply, and forensic psychiatric care. All those areas are such that the Centerpartiet had as a starting point in the Vårdansvarskommittén.

The Care Responsibility Committee's work could have been good, if they had dedicated themselves to what was actually feasible and to presenting sharp legislative proposals within the area. But instead, a large part of the mandate period has been wasted on investigating a question of nationalization, which was dead on arrival from the beginning. This has resulted in that only now, when the mandate period is practically over, is an investigation of a new pharmaceutical system and an investigation on screening for our patients arriving.

There is still no competence supply investigation. There are also no investigations regarding airborne transport and forensic psychiatric care, because the Christian Democrats have wasted the time. What the Christian Democrats want to do is, in fact, to throw the entire Swedish healthcare system into a gigantic reorganization chaos with a director-general in Stockholm who is to rule over 350,000 employees and set the framework for what constitutes a rational hospital. If that were to become a reality, we would see a wave of closures within Swedish healthcare wash through Sweden.

My question to the Christian Democrats and Member of Parliament Christian Carlsson is: In what way would Swedish healthcare become better by being forced into a giant reorganization, instead of addressing the problems that actually exist?

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

Christian Carlsson (KD)

Madam Speaker! The Christian Democrats are the party in the Swedish Riksdag that over time has been clearest in our view that it is time to abolish today's 21 self-governing regions and let the state take full responsibility and receive the full mandate to govern Swedish healthcare.

We have the Swedish people on our side in that matter. We have Sweden's doctors with us in that matter. We appointed the Healthcare Responsibility Committee to be able to take a first step in the direction of our goal of state governance for Swedish healthcare.

What has been concluded in the Healthcare Responsibility Committee, namely the six areas where it is thought that the state should step forward and take greater responsibility, is a fantastically good first step on the way towards full state responsibility for Swedish healthcare. The work that the Healthcare Responsibility Committee has contributed is truly not dead on arrival. On the contrary, we have now received a basis that shows where there is a broad consensus in the Riksdag on how we can strengthen state governance and also ensure access to more equitable care for patients.

We have already seen several examples of such initiatives from the government's side. This concerns the new pharmaceutical investigation, for which directives have now been presented. It goes entirely in this direction. We have also presented assignments when it comes to vaccinations and screening. We have ongoing work in all these areas. We have laid a good foundation to be able to move forward towards state governance and offer people more equal and just care.

It is possible that this would be stillborn in Christofer Bergenblock's world, but we see great merit in the work that the Care Responsibility Committee has put in. We will take this further.

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

Christofer Bergenblock (C)

Madam Speaker! I do not know if the member is misunderstanding me, but this is the situation: Had one not spent time investigating a nationalization of Swedish healthcare, a new pharmaceutical investigation could have been commissioned as early as the autumn of 2022. Now it is being commissioned in the spring of 2026. An investigation of screening could have been commissioned in the autumn of 2022. Now it is being commissioned in the spring of 2026. And the other areas have not started being investigated at all.

The truth is, Madam Speaker, that Christian Carlsson and the Kristdemokraterna have wasted four years that could have been spent on the areas that actually needed stronger national governance, which we, therefore, have not received during this time. One was so fixated on investigating a nationalization of the entire healthcare system despite knowing that the starting point was that six out of eight parties would say no to it, which indeed was the case.

Furthermore, the analysis in the Healthcare Responsibility Committee's final report showed that there was no evidence whatsoever that nationalization would lead to better care, but rather the opposite. We can all see how it could affect Swedish rural areas and the countryside, where it is already difficult today to reach out with healthcare. There, we already have white spots between the health centers in primary care, and it is also difficult with the accessibility to inpatient healthcare.

If this were to be managed by a director-general in Stockholm, I do not think it will result in greater density between health centers or greater accessibility to healthcare, but it will actually be exactly the opposite – as it has been in all other contexts when we have nationalized Swedish authorities.

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

Christian Carlsson (KD)

Madam Speaker! Christofer Bergenblock's assumption that it would be wasted time is based on the idea that the issue would be dead. It is not. The Christian Democrats continue to push the issue of abolishing today's regions and letting the state take over the responsibility. In that process, we have shaped six areas that could become a natural first step. In that process, the Sweden Democrats have joined the Christian Democrats' line. This means that there is a majority in the governing government support that actually wants to let the state take full responsibility.

This will naturally become a negotiation issue after the election. How large steps in that direction can we take during the next mandate period?

Why is this important then? Well, it is about the fact that today it can take twice as long for a patient to go from diagnosis to treatment when it concerns a severe cancer disease, depending on where the patient lives. In Västmanland or Gävleborg, it takes twice as long as in Uppsala, for example.

With today's self-governing regions, it took more than a decade from the time the first region introduced the newest colorectal cancer screening program until the last region did so. These are inequalities and injustices in healthcare for which there is no popular acceptance. That is why both Sweden's doctors and the Swedish people agree with the Kristdemokraterna, that the state should take over the responsibility for Swedish healthcare.

We will continue to work with this. It is something we are going to the election on, and we will continue to push for state control. We do that for the patients' sake, so that one can receive fair and equal care regardless of where in the country one lives.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! I would like to begin by moving for approval of reservation 12.

Today we are debating the organization of healthcare. It may sound technical, but at its core, it is about something much greater. It is about trust in care, about justice in society, and about what kind of Sweden we want to be.

Behind every structural and organizational issue are people: the elderly person waiting to receive care, the family with children who cannot get in contact with the health center, and the nurse running between patients without being enough. That is exactly why it is not sufficient to lean back.

Madam Speaker! One of the absolute biggest deficiencies in the Swedish healthcare system today is the lack of continuity. For many patients, there is no permanent doctor, no one who knows their history, and no one who takes responsibility over time. It is not worthy of a welfare country like Sweden. We must do much more in this area.

We Social Democrats want to change this with a clear goal: that a permanent doctor in primary care shall apply to everyone. It is not just about security. It is about quality, efficiency, and ultimately lives. If one looks at our neighboring countries, for example Norway, which has permanent doctors and has also followed up on the reform, one sees that having a permanent doctor extends the life of the individual human being. Continuity means so much in accessibility, in the encounter, and also in the treatment over time.

That is why we have also pointed out the way forward. It is about a health center lift, a strong primary care, and a national structure where the state takes a greater responsibility. Today, the system is fragmented, and it is many times the patients who pay the price.

Madam Speaker! At the same time as people are waiting for care, we see how unserious actors are exploiting the system. Welfare crime is not just a marginal problem, but it is directly system-threatening and jeopardizes trust in our common healthcare system. Our common tax money that should go to care, staff, and patients ends up in the wrong pockets. It is unacceptable. We Social Democrats are clear: Criminals must be removed from welfare.

Here, the government has abdicated its responsibility. The situation in Swedish health and medical care requires stricter legislation, better control, and the possibility to shut out unserious actors who abuse the system. But it also requires of us as legislators that we dare to see that today's system with fragmentation and lack of follow-up has opened the door for something that leads us away from what we say in broad agreement that we stand up for, namely the fundamental principles of healthcare regarding equal care and receiving care based on need.

It is the responsibility of politics to close that door and deal with a development where unserious or directly criminal actors roam free in Swedish healthcare.

Madam Speaker! The report also contains questions about privatization and choice of care. Here we need to be honest. We see a development where market thinking is allowed to take precedence over needs. Privatizations and choice of care have in some cases led to poorer coordination, increased costs, and a healthcare system that is not distributed based on need. Establishments are governed more by where it is profitable to establish themselves than where the needs are greatest. It is not an equal healthcare, and it is something that we need to see. It is not just an opinion from me as a Social Democratic member, but it is the reality all around in our country.

This development becomes very concrete when one looks at what has now been revealed. Just take this week's review in Sveriges Radio, Madam Speaker, where doctors testify about how they receive a bonus if they maximize the number of patients up to 100 patients a day. The system steers towards short and simple visits, while patients with greater needs are referred further to someone else. This is not efficient care of good quality, but a conveyor belt that has a single purpose: for a large healthcare provider to earn as much money as possible.

It makes me furious, and I think it should make all social policy makers furious. We pay tax to collectively build a strong and accessible healthcare system with high quality across the entire country that meets every patient based on their needs. But here we see a system where both patients and doctors are caught in a squeeze, where accuracy and medical quality are punished and where volume and tempo are rewarded.

Still, the government chooses not to act. On the contrary, they even promote the same type of actors in their own contexts. That says something about the direction.

For us Social Democrats, there is a completely different goal. Healthcare resources shall go to healthcare. You should be able to go to a health center and get the right help in time, usually from a regular doctor who knows you and your situation. When the health center is closed, you should be able to access healthcare digitally as a complement to the regular doctor and the health center you have, not as a replacement.

That is how we build a healthcare system that hangs together. We Social Democrats do not say no to private actors; we say yes to order and clarity. The model we have today is not a model that favors what we have collectively in politics said our common healthcare should achieve. Healthcare shall be governed based on need, not by a market logic, and the public sector must have control.

If this were a single audit, a single revelation, one could think: Sure, there is a downside that we need to handle moving forward. But this is recurring, which shows that the issue is acute. For several years, the Social Affairs Committee has pointed out that we need to do something about this development. Yet, nothing is happening.

Madam Speaker! Another development that is concerning is the increase in private health insurance. When more people jump the queue, the legitimacy of the entire system changes.

Swedish healthcare is based on a simple principle: The one who needs care most should receive it first. It is not the one who can pay or the one who has a better health insurance who should receive care first, but the one who has the greatest needs. We can never accept a development where we get an A-team and a B-team within healthcare, for it is the beginning of something that risks undermining our entire common welfare.

Madam Speaker! Swedish healthcare stands at a crossroads. Either we continue on the path already taken with more fragmentation, increased disparities, and growing problems. Or we choose another direction: stronger primary care, a fixed doctor for everyone, and a crackdown on welfare crime – a healthcare system governed by need and not by a market.

We Social Democrats have chosen our path. It is about restoring trust, strengthening the welfare, and ensuring that healthcare is there for everyone and not just for some.

(Applause)

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

Jessica Stegrud (SD)

Madam Speaker! ”Jessica, there is a mother who would very much like to meet you when you get here.”

I was to lecture in a small town in northern Sweden, and the proposal came from Sven, who had invited me. Mom was, according to information, very eager, and a few days later I sat in a small conference room in the small municipal building opposite a mother and her mother – a grandmother.

The woman was the mother of an eleven-year-old girl who had rapidly left earthly life a little over a week earlier. I was, of course, hesitant to have a meeting with a mother in acute grief, but she had explained how important it was for her, so now I sat there – in the eye of the grief. I heard about how the daughter had suddenly fallen ill, about how the grandmother had called for an ambulance and, while waiting for help, bravely followed all instructions from 112, how she had done everything she could to keep her little grandchild alive until the ambulance arrived. It took over 40 minutes, and her life could not be saved.

Now the mother, who is herself active in healthcare, wanted to tell me how bad the situation is with access to ambulances and emergency care if one lives in her area. She had already warned long before the daughter's death about how bad it had become and that it was only a matter of time before something really serious would happen. Now, the absolute worst thing a parent can experience had happened to her.

It was a heavy but rewarding meeting, a meeting that reminds us to continue working for our – the Sweden Democrats' – vision of a good and close, secure and equal healthcare for everyone, regardless of postcode.

Madam Speaker! This is the situation in various parts of the country. There are long distances, few ambulances, and closed emergency and maternity departments. When people in Sweden become ill, they should be able to rely on that care is there in time and with high quality. It should be a self-evident matter in a country with the world's highest taxes and relatively large resources.

But the reality unfortunately looks different. Swedish healthcare is still far too unequal, and many patients are forced to wait far too long for ambulance, diagnosis, and treatment. I say this despite the fact that the healthcare queues during this mandate period are now actually decreasing. The investments and targeted efforts that we have made have begun to yield results in practice, and we now finally have a clear trend towards shorter healthcare queues within several important areas.

Despite this success, of course, we are not satisfied. This is only a step on the way. It simply should not depend on where in the country one lives. One should be able to get quality care when one needs it. It is fundamental for so many things, such as being able to live and work in rural areas.

But, Madam Speaker, it still looks the way it does. Why, one might wonder. We mean that it is fundamentally about how Swedish healthcare is governed and organized. Today, 21 regions are responsible for large parts of the healthcare. This means that decisions are made in many different places, that priorities differ, and that resources are used in different ways. The result is a system that is difficult to oversee and difficult to coordinate, and where the patient's needs often fall into the shadows.

We mean therefore that the state must take a clearer responsibility for the management and follow-up of healthcare. A stronger national coordination is necessary to ensure that care becomes more equitable and more accessible. When people are waiting for operations or treatments, regional boundaries should not stand in the way, but rather one should be able to use the capacity that actually exists somewhere in the country.

That is why it is important to continue the path towards a national healthcare coordination that allows patients to utilize available capacity. In the same way, the healthcare guarantee needs to be strengthened so that patients can receive help more quickly from another healthcare provider if their own region is unable to provide care in a timely manner.

It is also a matter of priorities, Madam Speaker – about how the regions use their taxing rights and how they allocate their resources. We Sverigedemokrater consider that core activities, not least healthcare, should be prioritized. But I am receiving quite remarkable reports about rather excessive investments in culture, environment and climate, Madam Speaker, as well as a good deal of other things that are not regional core mandates.

It can be about support for companies on non-commercial or non-viable grounds, completely substandard projects pushed through with the fantastic argument that the EU co-finances it, and a project economy where individual projects are also waved through and not followed up particularly well. In the category of strange priorities, I can mention Eid festivals, recording of sounds in libraries, and that millions are spent on cloning trees. On an aggregated level, this does not contribute to an efficient use of public funds.

Madam Speaker! Sweden is a beautiful, elongated, and in some parts very sparsely populated country. Providing high-quality care across the entire country has its challenges, and even though we are not to compromise on either ambitions or quality, we need to open up for new solutions. We need to use new technology, such as AI, mobile devices, and drone transport or other technical solutions. Innovation is one of Sweden's strengths, and we must encourage that, not least within healthcare.

Healthcare capacity is also a matter of preparedness and security. In a situation where Europe is characterized by increased uncertainty, we must have a healthcare system that can handle crises and serious situations. A strong and well-functioning healthcare system is part of our society's resilience, and we Sverigedemokrater believe that preparedness can and should go hand in hand with the motto that the whole country shall live. Let well-functioning, strategically placed hospitals – for example the one in Sollefteå – remain and be developed instead of being decommissioned!

Madam Speaker! One cannot speak of healthcare without mentioning the most important resource of them all, namely the staff. It is about doctors, nurses, nursing assistants, and many other professional groups. Many are well-educated, experienced, and above all dedicated to their jobs and the patients. They are people who meet people in difficult situations and ensure that the care functions despite sometimes tough and challenging conditions.

Providing healthcare with qualified staff who stay over time should be part of the thinking on good preparedness, Madam Speaker. We should simply be more self-sufficient regarding qualified labor. But the fact is that bad politics has instead made us more dependent on labor immigration. It sounds good – yes, according to the Center Party, there seems to be nothing better than filling all care sectors with staff from all corners of the earth. It doesn't matter if one can speak Swedish or actually wants a decent wage, as long as one gets here. But is this really a long-term solution, Madam Speaker? No, it is not.

Care needs to maintain high quality and continuity, and there need to be colleagues who can communicate. The staff must be able to and want to stay in their jobs. In the long run, we must achieve a higher degree of self-sufficiency even within this area. We need to improve working conditions, reward staff who have worked for a long time, and ensure that those who have received training do not choose other professions.

Care's resources must also go to patient-facing work in the first instance, not to bureaucracy or digital infrastructure projects that cost billions and have to be shut down before they have even been put into use.

Regarding the staff, I also want to say finally that no one – absolutely no one – should have to be afraid to go to work. More and more emergency admissions are forced today to have both security gates and guards, and some staff cannot have name tags due to the risk of threats and reprisals. Gang and organized crime has eaten its way even into the institutions that are created to help seriously ill and injured citizens. So we shall not have that, Madam Speaker.

That is why, during this parliamentary term, we have implemented historical initiatives and legislative changes in the areas of crime and migration. The next step, which is ongoing, is to eliminate organized, often imported, welfare crime. If we are to be able to deliver good and close care to all citizens in the future, crime must be removed. It is about not draining welfare of resources and trust.

Madam Speaker! It takes time to turn an ocean liner, and it takes time to achieve a paradigm shift. But even in this matter, we have now come a good way. Sweden is slowly but surely on its way to becoming safe, free and Swedish again.

With that, I move for approval of the committee's proposal for a decision.

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

Christofer Bergenblock (C)

Madam Speaker! Thank you, Member Jessica Stegrud, for the speech!

The Sweden Democrats campaigned in large parts on securing things in Sweden's rural areas. When the election was over, they ensured that fuel prices were lowered; I cannot take that away from the Sweden Democrats. At the same time, the prices are now roughly as high as when the Sweden Democrats took office.

After the fuel price reduction, however, it ended. The roads have not become better in our rural areas, and the healthcare has not become better in our rural areas. The elderly care has not become better, and the school has not become better. The interest simply faded from the Sweden Democrats' side.

Now, one has been in power for four years, and the accessibility to healthcare in our rural areas has not improved since the Sweden Democrats took office. Still, it is only one-fifth of the residents in our rural areas who consider themselves to have a permanent doctor contact in healthcare, compared to one-third in the country as a whole. When it comes to patients who die in a condition considered to have been treatable, the frequency is still twice as high in our rural areas as in our metropolitan areas. It is, of course, not reasonable.

At the same time, we see that it is significantly harder to meet the competence needs in our rural areas than in our urban areas. We see that resources are unevenly distributed and that one still does not have the access to airborne ambulance transports that one should have – despite the Sverigedemokraterna having been in power for four years.

Madam Speaker! My question is: Why has the accessibility within healthcare not improved in our rural areas after the Sweden Democrats have had nearly four years to rectify this?

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

Jessica Stegrud (SD)

Madam Speaker! I thank Member Bergenblock for the question. It was a very interesting exposé of the years that have passed since we gained some influence, I must say.

We are talking about accessibility in rural areas. When it comes to healthcare, for example, C was involved and largely shut down Sollefteå hospital. It is very interesting that one stands here and talks about accessibility after having been part of that. Instead, we have fought – and are still fighting – hard to ensure that the region does not do this. We believe that the region should make completely different priorities. For example, it spends more on performing arts than it spends on Sollefteå hospital. Is that the right priority?

When it comes to priorities, I can also note that C is the party here in the Riksdag that wants to spend the least on healthcare. It is quite fascinating, nevertheless.

What else do we have? Yes, when it comes to the supply of competence, it is a dilemma. Just as I said, the long-term goal is to get well-qualified staff to stay in healthcare – and want to be there.

Then I believe, for example, that the wage floor we have introduced for labor migration actually benefits us in the long run. One should not be able to dump wages just however. If you want qualified people who can speak Swedish and who have the right education and commitment to the profession, you have to set the wage accordingly. It is incredibly important.

Madam Speaker! The member also mentioned this regarding what we have done for the rural areas. Good heavens, we have lowered taxes for ordinary people. People have more to live on. If it were not for our policy when it comes to, for example, fuels, the prices would have been enormously higher now with the Center Party's policy.

Furthermore, the Centre Party wants to strangle the entire countryside and rural areas with its extreme climate goals. Despite the fact that Sweden is at net zero regarding emissions, including the forest, and is the best country in the world in this area, they want to continue to punish, above all, the countryside and farmers through extreme climate goals.

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

Christofer Bergenblock (C)

Madam Speaker! If I were to give a broad exposé of what has happened during these four years, we received in the member's answer a number of minimalistic remarks on various matters.

Let me stop at one of these things. The supply of skills is one of our major problems. The government has actively worked to complicate the supply of skills throughout Sweden, but it has hit our rural areas particularly hard. There is a nursing home in Harads outside of Boden that had to close an entire ward because of the wage floor that the government has introduced.

But – and now I turn to those of you watching the speech on TV – note that the Sweden Democrats are now saying that a wage floor of 33,390 kronor, which is what will apply from June 1, is also a reasonable wage floor for everyone working in Swedish health and medical care. I think it is absolutely excellent that one wants to raise the wage to that level.

The average salary within LSS, elderly care homes, and home care currently stands at 29,980 kronor. Now, a promise has been made that all those salaries shall be raised, not only for immigrants, which was previously the demand from the Sverigedemokraterna, but for all of those who are otherwise, according to the Sverigedemokraterna, being wage-dumped.

I believe that the most important thing we can do now to manage the competence supply within Swedish health and medical care is to make use of all the labor we have there today – ensure that people feel secure in their jobs and know that they will still have them tomorrow – and ensure that new employees arrive.

Regarding the Center Party's initiatives, we have made very specific ones in our budget. We have allocated 2 billion kronor for more doctors in our rural areas. We have allocated 1 billion kronor more than the government for ST-doctors across the country.

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

Jessica Stegrud (SD)

Madam Speaker! No, I believe the member misunderstood me. I am not claiming that everyone should earn a certain amount of money. I am, however, claiming that it makes it easier for people to stay. If one earns a decent amount, one becomes more motivated to stay in a rather tough profession.

You do not want any wage floor at all, however. It can be any wages at all, as long as they come from somewhere else in the world. It doesn't matter, so to speak, with Center Party policy.

These years have been spent largely on cleaning up after Center Party politics in the form of mass immigration and total lack of requirements. One has not had control over who has entered the country. We have imported both a need for care and increased crime, and there, one targets the welfare area.

The Speaker mentioned LSS. It is truly an area that has been affected by imported organized crime under the Center Party's influence over power during these eight years. To stand here and talk about order and tidiness and about allocating resources to the right things is, I must say, at least bold.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! I thank Member Stegrud for the speech. There was quite a lot to rebut, but I will nevertheless try to stick to a few larger parts.

The Speaker points out that the situation within healthcare is serious, that it faces great challenges and the like. At the same time, the priorities of the Sweden Democrats and the government during the mandate period have truly put healthcare in an incredibly tough position. You could have used the mandate period to carry out major investments and be the guarantor for welfare that the Sweden Democrats promised the voters to be. The reality, however, is completely different. You have chosen to prioritize lowered taxes for those with the absolutely highest salaries instead of ensuring resources for health and medical care.

It also cannot have escaped anyone that this parliamentary term has truly entailed enormous challenges. Already at the beginning of the parliamentary term, the regions pointed out that the cost crisis we have all lived under hit healthcare very hard.

In healthcare, the staff are the absolute most important. That was the member inside. It is also the staff who, during this mandate period, have had to pay the price because the situation has been extremely tough. The staff are on their knees. The regions have had it incredibly tough.

My question is: Why did it become so much more important to lower the tax for the richest than to provide those funds to the welfare system that would guarantee a stronger health and medical care, which was the Sweden Democrats' promise?

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

Jessica Stegrud (SD)

Madam Speaker! Thank you for the questions, Fredrik Lundh Sammeli!

I want to give the member the right in one matter: It has been a very tough period, and very much is about priorities and what we spend the money on.

The Leader of the Opposition says that resources have been drained. Then I must say that few things have drained Swedish taxpayers and individual people as much of resources as the mass immigration policy, the totally irresponsible mass immigration policy that you have more or less stood for for decades.

The same applies, for example, to the shutdown of nuclear power. Few things have entailed such a wealth transfer and made it so incredibly much more expensive to live and operate in Sweden. This applies to both companies and ordinary households. There, we can talk about priorities.

Furthermore, the member's party has grumbled and praised all these billions that have been invested in completely hopeless projects, for example Northvolt. It becomes a bit strange. In the end, it is the same resources we have to distribute, quite simply.

I also heard that the member in their speech earlier spoke about crime in the welfare system and that it must be stopped. Yes, we at Sverigedemokraterna completely agree with that. The problem is that nothing was done in that area during the Socialdemokraternas last eight years in power – nothing! I have spoken with Försäkringskassan. I have spoken with the police. I have read report after report. The Socialdemokraterna did nothing about the matter during their eight years in power! It is appalling.

In conclusion, Madam Speaker: The pace of reform has never in modern times been as high as during the years we have had influence in the Government Offices.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! I would like to start where the member finished. The pace of the reforms is one of the problems this mandate period. It is not the number of reforms that determines whether they are good reforms. This government is throwing out reform after reform that is poorly prepared, which has poor underlying data, which the Council on Legislation (Lagrådet) saws at the heels, and where the effects on area after area are difficult to oversee. This will be the reality for this chamber and a future government to handle for a long time to come. To beat one's chest over the high pace of reforms will probably leave a bitter aftertaste.

Politics is clearly about will and choice. It is clear that the Sweden Democrats did not become a guarantee for the welfare. Instead, they prioritized lowered taxes for those with the highest incomes. For some party here in the chamber, lowered taxes is often the answer to everything. For the Sweden Democrats, immigration is the explanation for all problems.

We come from a committee where we have looked at and delved into elderly care. There are, thank goodness, people from other parts of the world who carry half of the Swedish elderly care.

There are definitely challenges, but I believe that with the demographic development we have ahead of us, we should be glad that people are coming to Sweden. We need to get better at integrating them and making them a part of society. That is important, but it does not cover the need.

My follow-up questions are partly why one prioritizes lower taxes over strengthened healthcare, and partly why one has not done more of what the Vårdansvarskommittén concluded, if one now means that the state should take over the responsibility.

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

Jessica Stegrud (SD)

Madam Speaker! Yes, what can one say? I hope that the Social Democrats do not come to power this autumn. There is a total lack of reality grounding in the analysis of what has happened in Sweden over the last 10–20 years and of the problems we have now. The Social Democrats take no responsibility whatsoever, even though they in internal and also official reports admit that mass immigration has been a major problem – which they have contributed to, among other things out of fear of appearing a bit Sweden Democrat-like. It is utterly fascinating.

If we are to speak of economy, the government and the Sweden Democrats have, during this mandate period, implemented the largest dental care reform in modern times at all. Now, every person aged 67 and up can afford to go to the dentist, and it has created much better economic conditions for that group. The goal is that during the next mandate period, everyone shall be able to afford to go to the dentist regardless of what problems one has. I do not know how many emails I have received from happy pensioners. They have sent along their receipts. "Look here, Jessica! I could afford to go to the dentist. I paid 1,000 instead of 10,000 kronor," and so on.

We have lowered the tax for Magdalena Andersson. That is true. But above all, we have lowered the tax for people with completely ordinary jobs. A police officer and a nurse, for example, now receive 5,000 kronor more per month. That is a lot of money for ordinary people.

Regarding the idea that everything is the fault of immigration, I instead blame the politicians and the political decisions. Totally irresponsible politics have been conducted without requirements for integration and so on. That is why we are in this situation, and that is why the pace of reform is high. I am incredibly proud of all the reforms we have managed to push through in this area, in the crime area, and in the migration area. We are on the right track again, quite simply.

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

Karin Rågsjö (V)

Madam Speaker! I shall pick up a few questions from this enormous ball of yarn. I am thinking about the healthcare personnel. Several reports have come from Arbetsmiljöverket and Försäkringskassan that they are going to their knees. It is very clear. What do the Sverigedemokraterna think about that? We would have liked to see a long-term healthcare preparedness and not such short-term measures as this government and SD have worked with. Long-term conditions were needed to look forward.

Speaking of crime, not everything is the immigrants' fault, as the member says. Yesterday, Ekot broadcast an investigation into Kry, where doctors have worked on commission. To take 100 visits per day sounds extremely efficient and also provides a bonus. But everything is paid for with our tax money. I find that interesting. I want to know SD's position on this type of deviation. A criminalization has occurred. One can cash in if one does something about this, that is, regulates the market. What is your interest in regulating the market? That is what I wonder.

The Productivity Commission has submitted a report where it is clear that they want to release the choice system LOV when it comes to health centers because they have seen that it is dysfunctional. It is wonderful that more than the Left Party see it. It is also a question to the member, Madam Speaker: How do you think regarding this? It is a very large amount of money that is draining out of the welfare in that way. What can be done about it, does the member believe?

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

Jessica Stegrud (SD)

Madam Speaker! Thank you, Karin Rågsjö, for the questions! No, it is not the fault of the immigrants or of immigration. It is the Left Party's fault. I can be very clear on that. Again: It is due to the policy. I do not blame things on individual groups but rather on politicians who have been totally irresponsible and headless in their policy. Many of them belong to Vänsterpartiet. That is just how it is. No responsibility whatsoever has been taken.

It is so easy every time to say that it is immigration's fault. But no – it is the Left Party's fault. Karin Rågsjö and others have stood for an irresponsible immigration policy with all the consequences it has entailed. It is you who have opened the door wide for all kinds of crime.

Regarding the review of Kry and that type of activity, we are actually in agreement. Avarter must be removed. The Sweden Democrats are for a market in the sense that there should be several actors. Public municipal activity is not free from concerns. It is not always efficient and is also not protected from crime in any way. I have many examples of that. But if we are to have a market or a sector with several actors, the avarter must be removed. There we must move forward and look at the problems.

Just as I said to the previous member, we are actually taking measures when it comes to, for example, welfare crime. It was astonishing to come to this committee and find that nothing had been done during the previous eight years. Absolutely nothing! A large part of the work during this mandate period consists of cleaning up after previous totally irresponsible policy.

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

Karin Rågsjö (V)

Madam Speaker! SD previously had a completely different approach to the healthcare market and the school market, but after approaching these actors, they have also changed direction in these issues. It is quite obvious regarding the healthcare market issues.

Demographics are always interesting. There are more and more elderly people. Fewer children are being born. I am very grateful for the people who have come here and work in health and medical care. Of those working in health and medical care in Stockholm, 25 percent have an immigrant background. These are doctors, nurses, and other healthcare staff. It is thanks to them that we manage this.

It is not surprising that the Sweden Democrats will continue with the immigration issue as the big thing ahead of the 2026 election. But SD does not talk about what happens if all immigrants were to leave. They might feel that they do not dare to stay in this country and that they could be kicked out at any time. Then we are left standing there.

Madam Speaker! I still wonder about the situation of healthcare staff today. How does the member think forward? Healthcare staff have truly suffered during these four years due to insufficient budgets for the regions. The regions have had enormous economic problems because we have lived in a recession that the government has made even worse. What does the member say to the healthcare staff who are sitting with their ear to the ground and listening to this?

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

Jessica Stegrud (SD)

Madam Speaker! I thank you once again for the questions.

The chairman makes it sound as if the regions are not getting anything, but they are getting billion after billion. That is just how it is. It is about how one prioritizes. I mentioned a few things before. One perhaps does not need to spend money on Eid festivals, on recording audio at libraries, or on 7 million for a cloned tree. It is perhaps better to spend it on healthcare. Priorities are a keyword here, quite simply.

It is true that many immigrants or people with an immigrant background work in elderly care and healthcare. If I may say so, Madam Speaker, I do think it is a rather colonial thought that it would be so good. We are supposedly to bring people from all corners of the earth so that they shall perform the so-called simple jobs – I do not think they are always simple jobs – within the care sector. What is that? It is not a society I want, in any case.

One also seems to have completely missed the insecurity that it has created for all elderly people who cannot understand those they seek help from. It could be a doctor or some form of care personnel. It is an incredible situation of insecurity. This is not a long-term solution.

With that said, there are fantastic people of all ethnicities and from all possible places who do an excellent job. I always harp on about it. But it is no long-term solution to rely on labor immigration, to lower wages and to lower requirements. It just isn't that. It ultimately leads to ever worse quality, and that is exactly where we sit today.

There was so much in the member's reply to take up, so I lost my way a little bit. I still think I summarized it all quite well.

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

Nils Seye Larsen (MP)

Madam Speaker! I actually envisioned an exchange that concerns the organization of health and medical care. There has been too little talk about healthcare in the exchanges, I think.

The reason for my remark is the opening story, which was moving and is part of the situation that we see. It concerns the northern regions, where I live. It is a reality that many experience out in Sweden's very sparsely populated areas.

What I lack and what I would like to know more about concerns what the Sverigedemokraterna have concretely done during the four years they have had the power to improve the healthcare situation, the access, the competence, and the care out in our sparsely populated regions. It is my absolutely most important question.

My second question concerns the problem we have with welfare crime. The online doctors constitute a problem, but we also see that there have been problems with, for example, health centers that have been operated or owned by criminal actors. We see the same problem in the school market and several other markets that have been opened up. It is quite obvious that there is a major challenge here.

Are the Sweden Democrats prepared to work to take back control in the public sector to reduce the problem of welfare crime?

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

Jessica Stegrud (SD)

Madam Speaker! Let me begin with welfare crime. It is incredibly concerning. There is currently a major assignment with an investigation that will soon deliver concrete measures on how we can deal with this, and it concerns all areas within the welfare sector.

This is a major problem, because it drains resources from the welfare system. It means that people who, for example, should have received care do not receive it because the money goes elsewhere. It undermines confidence in the entire system. In the long run, we will not have many resources to distribute if this continues.

As I mentioned before, I am saddened to see how little has been done in this area during previous terms, despite all sorts of authorities having flagged and warned. A good deal of investigations have also been lying on the table.

Making Sweden safe again is truly a Sweden Democrat focus. Get rid of crime in all areas!

Unfortunately, I do not remember the member's first question. I will have to take it in the next round.

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

Nils Seye Larsen (MP)

Madam Speaker! That was actually the most important question. It originated from the narrative. I will take it again.

It is perhaps the case that the member does not remember, for I am unsure whether the member's party even has concrete measures that have been taken or want to be taken in this situation.

That is the situation in several of our northern counties and municipalities. One has not seen any particular amount of initiatives for improved welfare out in our sparsely populated municipalities.

The supply of competence is a huge challenge. The image that we just have to try to get more of the able-bodied population to want to work in health and social care does not help in Västerbotten. We lack people in all professional fields. There, retired mechanics and engineers continue to work in the companies because these professional groups are missing. If we were to get more to want to work in healthcare, it would only increase the needs in other sectors.

What have the Sweden Democrats concretely done to improve access to healthcare in Sweden's sparsely populated regions? What have the Sweden Democrats concretely done to strengthen the supply of skills? That is probably the most important question, and I would very much like to have an answer to that.

I also wonder about another thing. Now that we are aware of the problem with, for example, private actors within healthcare and online doctors who are under great scrutiny, why has nothing happened in the last four years to address the problem? Despite seeing the problems with, for example, primary care centers with criminal connections, one does not want to compromise on the statutory right of establishment under any circumstances. That is something I would like to get an answer to.

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

Jessica Stegrud (SD)

Madam Speaker! Thank you, the member, for the questions! I will try to answer them. I notice that I am a bit tired today.

What have we done for the rural areas? We have, among other things, fought hard so that Sollefteå can keep its operations. It is once again about priorities. The region there spends more on performing arts than what is spent on Sollefteå hospital. I mean, therefore, that it is not just more money from the state that saves this. One must also prioritize oneself.

We are, however, very open to new forms of cooperation. It can be cooperation between municipalities or with other regions. We have been on a somewhat similar line there, that is, that one either reduces the number of regions or cooperates.

In practice, we have invested in skills supply in healthcare. This year alone, it has been nearly 1 billion. Direct investments have also been made.

At the same time, we are in a vicious spiral. Staff working in healthcare today have to take a very large responsibility when colleagues do not have the right qualifications. It can be about language, but it can also be other things, such as not having adequate education. It becomes far too heavy. It is not just about the paycheck but also about how one works. It is a spiral we must get out of, and it takes time. But we are open to new forms of operation.

Then a question was asked about the health centers. First and foremost, health centers are being closed down. A considerable amount of that is happening now. It must, of course, be done in a legally secure manner. I have spoken with the Prosecution Authority, but they are overloaded. We are also allocating more resources there.

Cases such as these are sometimes uncovered, and despite there being amounts of evidence, it takes time. There is a queue in the system. We hope that it will ease.

But once again, all deviations and all crime must be removed. We must have better controls. I still want to raise a warning finger. Just because it is carried out in a public capacity does not mean it is free from crime. We have many examples of that. We need to get this in order everywhere.

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

Karin Rågsjö (V)

Madam Speaker! Good and close care – how close is it? In 2022, the National Board of Health and Welfare established 1,100 inhabitants per doctor as a national target value. The latest mapping from the Agency for Health and Care Analysis shows that around 30 percent of the population has a regular doctor contact at a health center.

Vänsterpartiet believes, just like Läkarförbundet, that the issue must be prioritized higher. The government should intensify the work to reach the established goals regarding a fixed doctor contact. Long-term perspective is required in healthcare, not the short-term measures that the government and SD have worked with.

The state must take greater responsibility for the financing of healthcare and provide more resources to the regions, especially to primary care. The state grants must become more long-term and be increased every year, so that the health centers can hire doctors, of course, but also psychologists and nurses. The goal is to double the number of doctors at the health centers so that everyone can have a regular doctor, and for that, one must have a long-term roadmap. An important part of this will be significantly expanded education of general practitioners across the country and that the state covers all costs for the specialist training.

More resources also mean a better working environment: more colleagues, the right to full-time employment, reduced working hours, and paid professional development. Furthermore, one should ensure that the health centers located in rural areas or in places with poorer health have very good resources to be able to meet the needs. I move for approval of reservation 5 in this context.

The Act on Freedom of Choice was introduced in 2009, and the market elements are most prominent in large cities, specifically Stockholm. The entry of market logic into Swedish healthcare has meant that, in essence, very many healthy, well-off individuals are given the opportunity to over-consume care. This has been examined in various investigations. At the same time, it turns out that patients with poorer health and poorer finances, the elderly, and people with large care needs have been pushed down. In that case, the system must be reviewed.

The increased involvement of private actors and the introduction of choice models also give rise to greater bureaucracy as the need for control has increased maximally. Vänsterpartiet believes that choice should apply to those who need care and nursing, not for private companies. The truth is that the healthcare companies' choice has not directly been about patients getting to choose their care, but rather about private healthcare providers getting to choose their patients. Most other countries have long since realized that freedom of establishment in healthcare is a very bad idea.

Our conclusion is that enough is enough. This must be regulated in different ways. We have seen deviations. We have seen shell companies that have skillfully exploited the system and the loopholes in Swedish healthcare to simply drain the regions of money – most recently, the other day, it concerned Kry. This has been going on for a long time. These are not new things, but they have just continued to roll on. And it is the taxpayers who are left holding the bill.

We have seen private health centers and vaccination centers, large and small, repeatedly caught in fraud and trickery for the purpose of making a profit or laundering money. This is extremely unpleasant; it is system-threatening, quite simply.

There are very many well-functioning, good and appreciated private health centers in Sweden. But the idea that the good examples would disappear because the public sector regains control over this does not hold up. It simply needs to be regulated.

Sometimes things do not turn out quite as one imagined. When the Tidöregeringens investigation, the Productivity Commission, recently submitted its report in October 2025, there were a number of proposals that Vänsterpartiet has pushed for for several years on the list. Among others, the investigator Clas Olsson wants the mandatory part of the law on choice systems, LOV, for health centers to be abolished.

The free right of establishment in primary care has led to worsened cost control, over- and under-establishment, and more or less free rein for criminal actors to drain the region's coffers. This is confirmed by the investigation. We welcome this; a thorough review of the law on freedom of choice was needed.

There is also a very strong healthcare lobby around this. One must also look at that a bit, in some way – how its tentacles reach politicians and others. The companies join together and want to keep the system. What are we to do about that?

The Christian Democrats have always called themselves the government's healthcare party and often and willingly speak about the state needing to take a greater responsibility. But in this issue, responsibility is conspicuously absent. The Productivity Commission also proposes that the regions should be exempt from paying for digital care that takes place in other regions, the controversial out-of-county fee. Perhaps that is something this government could have addressed during these years. The current system has laid the foundation for the online doctor companies' ability to carve out gold in Swedish healthcare. They have been extremely good at it.

Madam Speaker! Often, individuals with addiction problems fall between the cracks. There must be opportunities for persons with addiction problems to receive treatment also for psychiatric conditions within the regions' psychiatry. Research results show that drug users or persons with addiction prefer to seek help within the health and medical care. Only 5 percent prefer to seek help within social services.

In most comparable countries, healthcare is organized in a completely different way than in Sweden. They also have lower mortality rates. This issue has been addressed very clearly in the report of the Co-morbidity Inquiry, From Parts to Whole, which was presented in 2023. We have waited a long time for something to happen, and now it is moving forward. We are very happy about that; it is late but welcome. But we want to see a bit more action.

For Vänsterpartiet, it is obvious that it is the healthcare need, not the size of the wallet, that should determine who receives care first and to what extent. Private health insurance is part of the problem with profits in welfare. A far-reaching, ideologically driven privatization line and a pursuit of profit have characterized healthcare. This is clearly not compatible with either the principle of human dignity or the principle of care based on need. The system of private health insurance is not only unfair and leads in the wrong direction. It can also become very cost-driving since those with insurance often demand a second opinion.

Furthermore, it works in such a way that in very many cities and municipalities in Sweden, for example in Stockholm, where I live, you get a question when you call private actors who have an agreement with the region: Do you have an insurance, press 1 – do you not have an insurance, press 2. These are, for example, health centers and specialist clinics. But regardless of whether you have an insurance or not, it is the same staff working there. It is not that 20 new doctors come running, but it is the same operation one enters. It then becomes a sorting where those with insurance, of course, go first. That is obvious; they have paid for this.

We want the government to take the initiative to ban private health insurance within the publicly funded care. I therefore move, Madam Speaker, for approval of reservation number 13.

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

Thomas Ragnarsson (M)

Madam Speaker! Today we are debating the Social Affairs Committee's report SoU16 Organization of Health and Medical Care. I would like to begin by moving for the approval of the committee's proposed decision.

Madam Speaker! The Swedish health and medical care is a complex operation to organize. At the same time, we have 21 regions that are to solve this in the best way. Given the geographical differences that exist, while the number of citizens within each region differs significantly and there are problems of varied nature in different parts of the country, the accessibility issue has been a major problem. There, however, we can now see a trend break regarding the queues.

This government is not satisfied with that. We have greater ambitions than that and will continue the work of reducing these queues. Unfortunately, we can state that today's healthcare organization does not meet the requirements in the Health and Medical Services Act regarding offering patients good and equal care. It is largely linked to geographical challenges and a lack of governance and management.

Madam Speaker! The geographical differences are not something that has emerged now. This knowledge has existed for a long time. The difference is that the Moderate-led government, together with its coalition partner, has now taken the issue seriously and pointed out a number of areas in the Tidö Agreement. They are now investigating how the state should take greater responsibility so that the patients involved receive better and more equal care. In the Care Responsibility Committee, it was concluded that a nationally managed healthcare system is not the solution to the problem. I consider that to be a wise conclusion, given the previously mentioned geographical and demographic challenges, which differ across the country.

Madam Speaker! The Moderate-led government considers the issue so important that the area has been specially highlighted in the Tidö Agreement. We are well on our way to resolving issues that should be at the national level, such as a national plan for skills supply, the establishment of a national healthcare brokerage, a national plan for how the shortage of healthcare beds shall be eliminated, expansion of cooperation in regional centers, reforming the digital infrastructure in healthcare, a national maternity plan, expansion of primary care, continued development of cancer and childhood cancer care, equal healthcare and research on women's diseases and health.

Madam Speaker! These are examples of areas where the state should take a clearer responsibility for health and medical care. The healthcare crisis that we see needs to be broken down and analyzed carefully. But there are some points that are already known today. Close leadership is absolutely crucial for an operation to function. Unfortunately, over the years we have seen an increasingly centralized management structure in the regions. This has had major negative consequences for how the care functions, which in itself speaks for the fact that further centralization of the management structure would have further negative consequences.

Madam Speaker! It is easy, in a situation where something is not working, to start looking at organizational changes. We politicians, but also civil servants, have an enormous over-reliance on precisely organizational changes. But if one looks at other operations that have taken the step towards a centralized organization, one can observe that the result is quite disappointing.

What I often miss in the debate is the foundation. Where is the patient perspective? It is something that we should all reflect on. Instead of building an organization that patients should adapt to, we should look at the patients and build the organization based on their needs. It is not reasonable that we today have patients who fall between the cracks or end up in care queues, which leads to continued deteriorating health or, in the worst case, death. It is not reasonable that someone is denied a treatment that then turns out to be available in a neighboring region. These types of differences are completely unreasonable. It is here I see the great gain with increased state involvement and increased state governance.

Madam Speaker! In order to achieve better equitable health, level structuring in highly specialized care is absolutely necessary. The regional collaborations, such as the regional cancer centers that exist today, need to be expanded. Patients generally have no major problems with moving, but for them, it is more important to receive help. This is currently made impossible by the regions' autonomy, administrative hurdles, and economic discussions, things that are actually completely uninteresting for the patient seeking care. In this, a national healthcare mediation plays a very large role.

Madam Speaker! We have in this country one of the world's best healthcare systems. I have said it before, and I say it again, because I truly mean it. But we are burdened with organizational and structural problems that ultimately risk affecting the patient. This is not acceptable.

That is why we need to make changes in organization and governance while simultaneously increasing the follow-up on how care is provided and how state funds are used. But these changes need to have the patient at the center, and we need to create a political consensus on how we shall continue to develop Swedish healthcare and increase patient benefit.

I know that there are those who believe that more money for the regions is the solution. But to put money into a dysfunctional system is meaningless. That money ends up in the notorious black hole. As long as one cannot track the utility of the money, it should not be distributed.

(Applause)

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Christofer Bergenblock (C)

Madam Speaker! I thank Member Thomas Ragnarsson for the speech. It was in many parts a very wise and good speech, and I can agree with almost everything that was said. Not least do I share the Member's view that the idea of nationalizing the entire healthcare system is stillborn – it is not a path we should take. This has been investigated by the Healthcare Responsibility Committee.

At the same time, it is the case that the Moderaterna stood behind the investigation in the Care Responsibility Committee, which has resulted in many reforms that are important for Swedish health and medical care being delayed throughout this entire mandate period. We already knew when the mandate period began that we needed to review the system for medicines and vaccinations and that a clearer state responsibility needed to be taken. Had the Moderaterna and the government appointed an investigation on this when they came to power in the autumn of 2022, that investigation could now have been completed, the bill treated in the Riksdag, and the implementation started. But only now, in the spring of 2026, is the investigation being appointed.

If one had taken care of the issue of screening and equality in screening activities in Sweden, one could also have had a ready proposition on the table of the Riksdag and an initiated implementation there. But that has not happened. The same applies to the airborne transports, the competence supply, and the forensic psychiatric care. All of this has been postponed due to the agreement entered into with the Tidö Agreement, in which the Moderaterna were involved. How does the member view the fact that, from the Moderaterna's side, they have contributed to delaying reforms that are very important for Swedish health and medical care?

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Thomas Ragnarsson (M)

Madam Speaker! I thank Member Bergenblock for the question. But now we must nevertheless clear up certain matters here. To say that we could have submitted a proposition in the autumn of 2022 on the basis of what the Care Responsibility Committee concluded is a bit strange, as the Care Responsibility Committee's work had not even begun then. It was appointed as part of an investigation into whether we should have national healthcare.

I can agree that in the best of worlds – for here there are some areas where we actually agree – it would have been underway. But at the same time, we have actually had a bit of something else to look at and think about. I actually think that we have delivered at a quite high level in many areas until now – at the expense of something else, but that is the reality.

But I really hope for this first step, which was mentioned earlier, that a number of areas have been looked at. These are extremely important areas. Therefore, I think it is something that we should tackle when we have won the election – and we will know that in September.

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Christofer Bergenblock (C)

Madam Speaker! I think perhaps the member misunderstood me slightly if he perceived that a government bill should have been on the Riksdag's table in the autumn of 2022. No, however, we were aware already in the autumn of 2022 that the issue of pharmaceuticals, for example, needed to be investigated. There, a clearer national responsibility needed to be taken. It did not actually need to be analyzed within the framework of the Healthcare Responsibility Committee, but an inquiry could have been appointed with directives to look at the pharmaceutical situation already in the autumn of 2022. Then the inquiry could have been completed a year later. It could have been "referred for consultation" in the middle of the parliamentary term, and the government bill could perhaps have been on the Riksdag's table already a year ago. But that is not how it has become.

Let me dwell on another point that the member raised, namely this matter of a national healthcare brokerage. From the Center Party, we have a different proposal. We do not mean that we should have a large bureaucratic model for a national healthcare brokerage where the regions are to sit and report: "Now we have an available slot for a hip surgery at the hospital in Halmstad in three months." Instead, a greater responsibility should be given directly to the patients by making information available on 1177 regarding what the healthcare queues look like and the quality of the care. And as a patient, one should have the right to choose already from day one, when one has received a referral.

The healthcare mediation that the Moderaterna and the government are talking about is, in practice, after the healthcare guarantee has expired. How is it that the government and the Moderaterna do not want to give the patients this opportunity and this responsibility, which one actually has when one gets to choose the health center all by oneself from day one?

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Thomas Ragnarsson (M)

Madam Speaker! I misunderstood Member Bergenblock's question initially, and I probably said it incorrectly. I did not mean proposition. This part about us having started to initiate an investigation in the autumn of 2022 was known. But at the same time, it has scattered quite a bit when it comes to the pharmaceutical issue. It is an incredibly complex issue. I still think it was good that it was taken up as part of the Care Responsibility Committee. The six points that are in the Care Responsibility Committee are backed by all parties, and I think that is a strength when it comes to doing future work.

The Member of Parliament, who supported a government for a period of eight years, could have raised the issue of pharmaceuticals if he had considered that this should be implemented. The Member of Parliament could have raised it during the final year of the mandate period.

Then it concerned care mediation. It should not become a large and heavy colossus. I do not think so either. That is the big problem within Swedish health and medical care today. We have administered the Swedish health and medical care into pieces. Sometimes we as politicians also become the system's defenders: Yes, we must have this. This is how it has always been.

I hope that this can become a fairly smooth organization that actually benefits the patient. If one were to put it on 1177, there would still be someone who has to put it in. In that case, it is still an administrative burden.

I believe the advantage of this system is that we still get some order and structure. Otherwise, it could be like this: Some people are extremely driven and will almost seek care before they have had problems. They have a little pain in the hip and think that it probably needs to be replaced, and so on.

I believe that we need this period, as the Care Responsibility Committee proposed, that we stick to the waiting time.

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Karin Rågsjö (V)

Madam Speaker! There is much I can agree with Thomas Ragnarsson on. This concerns, for example, the Care Responsibility Committee. There we are in complete agreement.

I think like this: We would also have liked to see some form of healthcare commission, similar to the Defense Commission, where all parties, healthcare providers and so on sit down and look at the long-term conditions for Swedish healthcare. I think that would have been good. I experience that during the government's four years there have been somewhat messy interventions, I must say, and it never turns out well.

A question that we have not touched upon very much concerns the personnel situation, that is, how the healthcare staff are doing. One has seen, for example, in the Swedish Work Environment Authority's report and in the Social Insurance Agency's report, that it looks very bad, so to speak. It is about the staff being given a work environment that allows them to hold together and work a whole working life. I then ask Thomas Ragnarsson: Can a reduction in working hours for some who work shifts be something?

I will content myself with that question, and then I will proceed.

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Thomas Ragnarsson (M)

Madam Speaker! Thank you, Member Rågsjö, for the question! It was a very pleasing question. I feel that I know something about healthcare and the staffing situation. I have been a manager for twelve years.

I can state one thing. There is a good study where they have looked at why nurses choose to leave the profession. Many times one hears that it is about poor wages. But the most common answer is actually that it is about poor leadership. Close leadership is missing. And when close leadership is missing – regardless of whether it is in a hospital or in municipal home nursing or home care – you get problems. You do not see things as they arise in their infancy, but they have gone too far before they are detected. Then you get sick leave.

For the staff, it is probably also about the feeling of not being seen and heard. It lifts people up incredibly if just one's manager comes by every morning and says: Hello, Karin, so nice to see you! Or: I think you look a bit tired today. Has something happened?

It is the small things that make one feel appreciated and seen. I believe we must reclaim this.

It is actually a regional issue. I usually say – and I stand by it – that we have far too many managers and too few leaders. If we had leaders within healthcare and within municipal home care, we would not see the problems that we see today. I am actually completely convinced of that.

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Karin Rågsjö (V)

Madam Speaker! Many talk about needing shorter working hours. For those who work on-call, for example, it is very difficult to hold together a whole working life.

Now to something completely different. You have appointed an efficiency delegation – that sounds good – so that healthcare can become more efficient. There, one can seek money, and it increases the administration. This was a response to the regions' large savings in 2024, when staff were also laid off for the first time since 1990.

So, there was a lot of bureaucracy involved in applying for these funds. And when this efficiency delegation was appointed, they did not include healthcare staff who know the issue. Yes, they included a person who has worked in healthcare but as a manager. They included the head of Kry, and they did so precisely during the period when they had received demands for repayment from three regions. It was incorrect billing, police reports, and so on. I think it was a bit bold to include Kry.

Now it is shown further that Kry continues to work on being efficient by, for example, having a doctor, or several doctors, who take 100 calls per day. Then you also get cash for that. It sounds extremely unprofessional.

I ask the member: What are we going to do about this failure regarding the choice of care and the conditions for operating? It is about our tax money running away.

I do not want them to run off to a doctor who has 100 phone calls or opportunities to have very short visits during an entire day. It sounds totally unserious with 100. What does the member believe we should do about this?

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Thomas Ragnarsson (M)

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

I will start with the question about shorter working hours. It is very good, because we already have that. There is no healthcare personnel who work more than 35 hours a week if one has rotation duty. We already have a shorter working time.

The question is: Would it help to lower it to 30 hours? No, I don't think so, actually. Above all, it would create other problems. Every time we lower the working hours, we have to bring in more people. It is usually competence we are talking about that must be brought in. That means we get a competence deficit.

We must ensure that we take care of the staff we have. They should have reasonable working conditions. That is the foundation of all working life. But as for us lowering the working hours further, I don't even see that coming. There are no opportunities for that.

In healthcare, we have often been very worried about and had some difficulty talking about efficiency and productivity. There is a thought with the efficiency delegation that is very good. It is about daring to start talking about those issues within healthcare.

Why would it be ugly to talk about productivity and efficiency in healthcare? We are creating health. That is the finest thing one can do. I think that is absolutely excellent.

When it comes to LOV and that part, we do not stand behind people cheating. I am completely against that. We are perhaps the party that is strongest against cheating and crime when it comes to such parts.

We are above all very good at hunting them down, and that is what we are doing now. We will continue to do that. We do not create laws or build systems for criminal elements to exploit them.

(cont. § 9)

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