Healthcare, medical care and social care

Christian Carlsson (KD)

Madam Speaker! Sweden is in a tough economic situation. Many families and companies are struggling against a background of high inflation and rising interest rates. Sweden has major problems with growth. We will see a recession this year and next year. The tough economic situation is also felt within the welfare sector. There is hope for a recovery in 2025, but until then, the direction of economic policy is fixed.

The government is lowering taxes for everyone who works and for the country's pensioners through a job tax credit with an emphasis on low- and middle-income earners, and we are extending the increased housing allowance to support ordinary people who are struggling. At the same time, we are making historical investments in defense and the justice system and to safeguard the welfare.

It is the right priorities if we, as Christian Democrats, put healthcare and security first. Therefore, I would like to move for approval of the committee's proposal in the report today.

People should be able to trust that healthcare is there and functions when someone in the family becomes ill. But unfortunately, there are far too many who have had to wait far too long for care or treatment. This is how it has been for a long time now.

The governing politicians have not for many years succeeded in tackling the problems or implementing the structural reforms that Swedish healthcare needs. It has affected very many patients. The Christian Democrats and the government are now restructuring the policy so that those who are ill can receive care in time and so that we can create more equal care for people throughout the country.

In the budget for 2024, the government adds 10 billion kronor in general government grants to support municipalities and regions due to the large cost increases. We also provide 3 billion in a sector grant to healthcare to give the regions and healthcare workers a better opportunity to provide good care, and we invest 3 billion in targeted government grants to healthcare, school, and care.

We are therefore strengthening welfare by an additional 16 billion kronor in total. This strengthens the conditions for welfare in these tough times. The government simultaneously continues its investments to shorten healthcare queues and increase the number of healthcare places with 5 billion kronor in 2024 and 6.5 billion kronor in 2025.

Together with investments in the continued expansion of primary care, reforms such as a national healthcare brokerage and a review of the healthcare guarantee so that care is provided to a greater extent based on need, the intention is that this will be able to lead to both more staffed healthcare places and that more people receive care in a timely manner.

Some other highlights in the budget are that we manage to double the investment to strengthen cancer care. We allocate 1 billion kronor per year 2024-2026 to update the national cancer strategy so that Swedish cancer care continues to be at the absolute forefront.

It is time that we ensure that a national common digital infrastructure for healthcare can be introduced with common standards so that the patient's health data and records become accessible throughout the entire care chain for all care regardless of the primary provider.

Something that, on the other hand, concerns me, Madam Speaker, is that mental illness is increasing. It is increasing not least among young people, and at the same time, the queues to child and adolescent psychiatry are still far too long.

We invested 1.6 billion in 2023 to cut the queues and strengthen primary care specifically to be able to meet this need. Next year, we will inject even more so that all the girls and boys who today are just being bounced around in the system can actually get help.

Alongside this, the government is also working on a national strategy for mental health which will be able to lead to further concentration of efforts in the area.

It is, however, not only the young who need support. The elderly also need it. That is why it is very good that the government continues to show care for Sweden's elderly by investing to break the elderly's involuntary loneliness.

That the elderly should be treated with respect is not just a slogan or a political goal. For us Christian Democrats and also Sweden as a country, it is a fundamental value.

In line with the fact that the proportion of elderly over 80 years of age is increasing by 50 percent between 2020-2030, more and more of us will be in need of care. That is why it was an important announcement when the government announced that the Elderly Care Initiative is now being extended for three years.

I am aware that these 1.7 billion do not solve all problems when it comes to the supply of skills within elderly care. But it has been a successful initiative that means care staff can educate themselves during paid working hours. The fact that the initiative is now being extended creates better conditions for a safe and dignified elderly care.

Madam Speaker! Let me, in my opening statement, conclude by saying something about the insecurity in Sweden. In order to make Sweden safe, I believe we need to be clear to ourselves that the insecurity is, to some extent, due to a crisis of values.

The significance of safe families and parental responsibility has long been downplayed in our society. Order and discipline and the importance of compliance with rules have by some been presented as something almost old-fashioned or at least far too restrictive.

Instead of emphasizing personal responsibility and our responsibility as citizens to take control of our lives, that we should behave properly and do what we can for society, more and more people have come to refer to society's responsibility to give us what we need. More and more people are instead asking the question of what society can do for them.

This is a dangerous development, especially in combination with the fact that we have received an increasingly segregated Sweden. In today's Sweden, we have parallel societies of exclusion where far too many parents have never gone to work and far too many children have always failed in school.

Overall, it has led to a lack of faith in the future and a diminished sense of responsibility for one another in society. Unfortunately, this means that more people today are prepared to break the law and subject other people to crime. It is precisely this that has made Sweden unsafe.

That development can be reversed. Safety can be reclaimed. The government is now working for more police officers, sharper tools in the fight against crime, and stricter penalties.

In this budget, we are strengthening the security and operations of the State Institution Board, Sis, and also the social services' crime prevention work with a new Social Services Act, increased staffing, and school social teams.

But just as important is that we strengthen the support for families. We are expanding the parental support programs and home visits so that more parents can receive guidance and so that more children will grow up in safe and loving homes.

It is strong families with good values and hope for the future that seriously lay the foundation for a secure society. For that reason, there is actually also reason to feel hope for a safer Sweden.

(Applause)

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

Karin Rågsjö (V)

Madam Speaker and members of the House! I intend to start in the preventive sector - social services. Eight out of ten social service managers have difficulty recruiting social secretaries, if we are to speak about working preventively. Half of the social service managers state that they have difficulty providing the interventions that the individual is entitled to.

You call this a historic investment in social services. It is actually money to prepare a new Social Services Act, and it is only 200 million.

You describe that you are making a targeted investment in crime prevention work with 80 million kronor for preventive measures against gang crime next year. In reality, it is – one sees that when looking at the budget – a cut from 250 million that has been allocated in previous years.

It almost sounds as if you have had "Baghdad Bob" as a role model when you have made all types of statements. The resources for social services are heavily minimized, and I really wonder what will become of the preventive work. Where are the preventive measures? The school is also running at a deficit with the budget you have.

I am extremely worried that we are entering a period where people will feel relatively abandoned. This specifically concerns the social workers, who are supposed to do a job that reaches exactly those young people who need help and support.

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

Christian Carlsson (KD)

Madam Speaker! What we see is the establishment of a billion-kronor investment to be able to strengthen the staffing within the social services as we transition the social services' mandate towards working more on the preventive side with the crime-fighting and crime-preventing.

I believe that it is an important shift we see now, because if we are to succeed in making Sweden safe, the entire society needs to be involved in preventing and combating crime. I would say that the most important crime prevention work we do in social services, but also within, for example, BVC, are all the home visits. It is about the parenting support programs. It is precisely the safe families and the safe start in life that are so important also for the continuation of the child's life. One must feel a basic security and attribute a value to oneself so that one also attributes a value to others. It is largely there that society has gone wrong, I would say.

We naturally need a completely different type of competence within the social services as well when we are to meet the challenges of our time. We are prepared to review the social worker education to strengthen competence regarding crime prevention, but I also see completely different threats to society today. We have, for example, a major problem with radicalization, and there the social services must get much better tools to meet the narrative that they themselves are exposed to when Islamist extremists threaten the social services and cause fewer people to want to work there.

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

Karin Rågsjö (V)

Madam Speaker! If the social services had received resources in 2022 and now one could have been more proactive towards the radicalized groups that the member highlights. The families could also have been addressed in a completely different way, by being on-site. Social services do not have the possibility for that today; I can only say that.

Now I will move on to the next question, which concerns healthcare. KD usually calls itself the healthcare party. That is very high-flown. There is a deficit of 24 million kronor in the regions next year. You also usually speak about state governance. In that case, I think it becomes a bit strange when the state abandons the regions. What are you going to say to Västra Götaland when, for example, 2,000 employees are to be removed at Sahlgrenska University Hospital? What are you going to say to them? And what are you going to say to Sörmland, a fairly small region that has a budgetary imbalance of 1.7 billion due to inflation? How are they supposed to fix this - are they going to lay off the 700 people who have been given notice? This concerns, for example, 400 healthcare workers.

I am very worried about healthcare, quite simply. Will the cancer queues decrease with the budget you are presenting? One can wonder about that. Will the queues to BUP decrease with this record-low budget in these times?

Sure, it is inflation. And then the state, just as during the pandemic, must provide support, direct the money, ensure that healthcare is delivered and ensure that people get the care they are supposed to have. I promise, unfortunately, that we will be standing here next year and seeing increased healthcare queues and increased queues for BUP due to resource shortages in the regions. It is not the regions' fault that it has become like this, even though the member will surely answer in the next turn that it is so.

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

Christian Carlsson (KD)

Madam Speaker! In the budget for 2024, the government is adding 10 billion kronor in general government grants to support municipalities and regions. We are also injecting 3 billion in a sector grant to healthcare to give them better conditions to manage their operations. In total, we are strengthening welfare with an extra 16 billion kronor. The government's investment in welfare is the largest investment in the budget; it constitutes 40 percent of our total reform space.

It is true that SKR counts on these deficits. But with the government's budget, we cover more than half of the deficit. State grants account for approximately 30 percent of the municipal sector's total income. But the state is now, therefore, stepping in and taking greater responsibility and covering more than half of the sector's deficit. That is taking responsibility.

The state cannot compensate for all cost increases for households, companies, or the municipal sector. Everyone must help each other and do what they can. The regions' results have been record-high for the last three years, and their financial position has been strengthened. Now it is a matter of using central reserve funds, to streamline and prioritize, or to declare a state of emergency and temporarily operate with a deficit.

There are different conditions in the different regions. But the state and the regions must take responsibility for managing this tough economic situation, and the state is taking more than its share of the responsibility.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! Member Carlsson says in his speech that the government safeguards the welfare. That is, however, a truth with modifications.

The reality is that the healthcare sector receives a reduced total appropriation. The government prioritizes other things than welfare, and municipalities and regions are hit hard by the increased cost pressure and inflation. This year, the total appropriation for public health and healthcare is reduced by 15 billion. At the same time, SKR has pointed out that the situation we are in as a nation entails a deficit and a need of 24 billion.

My questions to Member of Parliament Carlsson are: Why is the government creating this healthcare crisis, and why are the needs that healthcare has in this situation not being met? The price of not taking responsibility will be very high for the individual patients, who do not receive the care and treatment they need, and for the staff, who will be driven to their knees.

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

Christian Carlsson (KD)

Madam Speaker! I believe very few would agree that the government that has governed the country for a year has created the welfare crisis we find ourselves in, when we know that the Social Democrats have governed during the last two terms. We also know that what is primarily driving the tough economic situation now is inflation. It is inflation that is the big problem for the regions.

Just as I answered Member Rågsjö, the government is doing its part to take responsibility for the economic situation. The largest investment in the government's budget goes towards strengthening welfare - 40 percent of our reform space. The government takes absolute responsibility for the situation. Then it is the regions that are responsible for healthcare. It is clear that they also must take responsibility for ensuring their finances balance.

When it comes to the billions that the Social Democrats consider should be provided, the question is when they intend for them to be in place. What we have seen is that the Social Democrats have placed an unfunded budget on the Riksdag's table, despite being the Riksdag's largest opposition party. Here, I would like to know a bit more about how Fredrik Lundh Sammeli intends to proceed, regarding the billions that it is claimed could be added to welfare if the Social Democrats' budget alternative wins approval.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! This is the second budget that the sitting government is presenting. Last year, they underfunded the budget and did not meet the needs of the municipalities and regions. This time, they are far from meeting the needs that healthcare has.

I believe that Member of Parliament Christian Carlsson and I can share the view that staff are healthcare's most important resource. But in this situation, the staff will have to work very hard. They are becoming fewer and getting worse working conditions, and with that, healthcare also becomes worse.

In his speech and in the exchange with Vänsterpartiet, Christian Carlsson highlights the issue of efficiencies. How does the member believe that efficiencies are the answer to the healthcare crisis that the government has created?

Then I still can't help but laugh a little in the benches when I hear Christian Carlsson speak warmly about Äldreomsorgslyftet. It is incredibly pleasing that we now have a government that continues with that part. If one looks at the logic the government has had over time, one sees however that it has many times been about closing down or cutting back and then injecting a little bit and calling it a major new reform or initiative.

When it comes to Äldreomsorgslyftet, I can only state that it would have been much better if the government had never issued the notice that it was to be phased out and concluded without the possibility of taking the reform further from the very beginning. It has created enormous uncertainty, and we have lost momentum in the work. But I welcome that the government in the budget now finally has included a clear statement.

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

Christian Carlsson (KD)

Madam Speaker! Member Lundh Sammeli argues that the government's investment in welfare is far from meeting the need. We are, therefore, covering half of the estimated deficit. The truth is that even the Social Democrats' budget alternative is far from meeting the entire need that welfare has, if we look at the deficit that is now estimated. The difference is that the government has presented a funded budget that has a majority in the Swedish Riksdag, while the Social Democrats claim they can provide an extra 10 billion to welfare. They are to introduce a bank tax at the turn of the year to finance it.

Everyone knows, however, that this cannot be implemented then. Absolutely, in a few years, one can certainly introduce a bank tax that will make the Swedish people poorer because you will only be shifting that cost onto the households. But next year, there is no possibility of introducing any bank tax. Thus, the Social Democrats have placed an unfunded budget proposal on the Riksdag's table. It might suffice to wave it around to be able to claim that the opposition wants to invest more in welfare, but it is not taking responsibility for the country. It is not an effective and feasible policy. Therefore, it is also not credible.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! Sweden's health and medical care is in crisis. In recent weeks, region after region has presented austerity packages, and it is clear that the consequences will be significant.

In several places in the country, health centers have been closed and service has deteriorated. In Sörmland, 700 employees have been laid off. In Östergötland, a hiring freeze is now in effect with the aim of reducing the workforce by 600 positions. At Sahlgrenska Hospital in Gothenburg, 2,000 people are to be let go. At the same time, patient fees have been raised across the country and new fees have been introduced in areas including dental care and ambulance care. Despite measures, the regions show weak results, and many are borrowing large sums ahead of 2024.

The truly sad thing, Madam Speaker, is that this healthcare crisis could have been avoided. Already a year ago, we in the opposition warned of the consequences of the SD government choosing, before 2023, that is in last year's budget, to prioritize tax cuts for high-income earners over state grants to municipalities and regions. Our warnings were dismissed at the time. Instead, the government urged the healthcare system to streamline.

Streamline - I don't know how many times I have met employees within healthcare who loathe this word, not because they dislike changes that make their work easier, more efficient, or faster, but because they know that the word streamline is a code word. The word does not mean that the employer is investing in labor-saving measures. The word streamline always means increased control, layoffs, and higher workload within healthcare.

In that way, we entered 2023. The regions first had to use their savings but then began to plan for cuts. As the spring progressed, however, it became clear that these cuts would be large, so large that they would come to affect the operations. The regions then turned to the government and the state for an announcement: Will we at least receive compensation for the expenditure increases in 2024?

With the state budget we are debating today, the message came: No, there will be no compensation. Instead, the Government urges the healthcare sector to increase efficiency.

This is not taking responsibility for Sweden.

That underfunding healthcare for two consecutive years now has exactly the consequences we have warned about - fewer employees, poorer service, higher fees, and larger debts in the regions. When the government prioritizes tax cuts for those with the highest salary incomes and refuses to tax the banks, the state's support for health and medical care simply does not suffice to retain current staff and capacity.

We Social Democrats have during the previous parliamentary term and in the budgets for 2023 and 2024 shown that it is possible to prioritize differently. In 2023, we allocated twice as much to the municipal and regional sectors as the government, and this year we are allocating twice as much to healthcare. These are funds that, if they had been added, would have significantly relieved the regions' struggling economies and meant that cuts could have been avoided.

In the budget, this is seen primarily under expenditure area 25 but also under expenditure area 9. Here, we Social Democrats allocate 1,040 million more than the government for a permanent initiative for healthcare personnel as well as an increased appropriation to Ivo.

Madam Speaker! The economic priorities that the government has expressed in the budgets for 2023 and 2024 follow from their Tidö Agreement. This agreement was concluded early in the autumn of 2022 based primarily on Sweden Democrat priorities.

Since the regions' finances have primarily deteriorated after the Tidö Agreement was concluded, there were hopes in some places that the announced update of the agreement would bring relief. Even though Moderater and Kristdemokrater believe that efficiencies are the way forward, perhaps Sverigedemokrater would see that healthcare needs more resources.

On Friday, the news unfortunately arrived. In a debate article, the Tidö parties presented their new point. Everyone who had hoped for resources was, however, greatly disappointed, as the healthcare news in the updated agreement was – a review of the healthcare guarantee.

Do not misunderstand me, Madam Speaker. There may be good reasons to review the design of the healthcare guarantee. The National Audit Office has recently evaluated the old one, and it has its flaws and shortcomings. But in this crisis, this appears completely out of touch with reality.

We thus have a healthcare system on its knees, with closed health centers and laid-off employees, and the Tidö parties' answer is to review the healthcare guarantee. So, you are not taking responsibility for Swedish health and medical care. So, you are not taking responsibility for Sweden.

Madam Speaker! Since a majority in the first step of the budget process has given the budget policy a different direction than the one we desire, we abstain from taking a position regarding the allocation of appropriations within expenditure area 9 and refer to our special statement in accordance with the routine we have here in the chamber.

(Applause)

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

Linda Lindberg (SD)

Madam Speaker! I thank the member from the Social Democrats for a very interesting speech. The Social Democrats talk about taking responsibility. Really, member Fredrik Lundh Sammeli – what have the Social Democrats done with Sweden as a country during all those years that you have sat in government? It is exactly as you write in your reservation: "Sweden is in a historically uncertain time. Innocents are losing their lives in gangs' wars over money and drugs, and the security policy situation in our surrounding world remains serious. At the same time, the new economic reality has hit Swedish households with full force. The Government and the Sweden Democrats have failed to take control of the economic crisis, the security threat, and the insecurity in our country."

I can say in all honesty to the member that it is not the Sweden Democrats who have caused the insecurity that we see spreading throughout the entire society in Sweden today.

I want to ask a question to Fredrik Lundh Sammeli. Admittedly, funds have been allocated, among other things to limit the healthcare queues, but the healthcare queues have grown during all your years in power. Why do we not have shorter healthcare queues today? It can surely not be this government's and the Sverigedemokraternas fault that we have long healthcare queues. Are the Socialdemokraterna truly satisfied with your years in power? When will you, just as you did with migration, admit that you have failed completely?

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

Fredrik Lundh Sammeli (S)

Madam Speaker! I thank Member Lindberg for the questions.

I am proud of the years of government we have had in Sweden. We have built a strong society. We have built it on community, solidarity, human rights and sound values.

It is quite clear that healthcare has challenges and has had them for a long time. We need to improve the conditions for the staff. It is a very central issue. And over the recent years, we have added billions in welfare to strengthen the conditions for municipalities and regions. A very large part of the staff's conditions is a question of resources to have enough employees and a work environment that is sufficient and bearable, which makes it possible to work full-time and not leave the profession. Healthcare queues are not primarily a question of a lack of premises or equipment, but about a shortage of staff.

We have done important work that must continue. That is why we clearly, in the budget options last year and now ahead of next year, add money to precisely staffing investments. We believe that permanent investments are needed. We need a larger investment for healthcare so that they can do a good job.

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

Linda Lindberg (SD)

Madam Speaker! It is a fact that the Social Democrats have wallowed around in the Government Offices and in the government for far too many years. Some new ways of thinking and a new way of working need to be introduced.

It is also a fact that the entire responsibility, the result, and the solution is not just to throw out more money. There are many other parts, for example agency mandates and other things, which also mean that one can solve the problems in healthcare and the challenges that exist.

The competence supply and the staff shortage is not something that has fallen from the sky over the past year, but it has been a problem for a very long time. The generational shift, that we will get a large cohort of elderly people, is something that has been signaled by the profession for many years. Yet here we stand today, after the Socialdemokraternas eight years in power, with major challenges within elderly care and a competence supply that is deficient. We have shortages within many licensed professions within healthcare. We have long healthcare queues. We have a healthcare guarantee that does not work. The only answer from the Socialdemokraternas is that we must inject more money.

Sweden is one of the countries in the Nordic region and Europe that spends the most money on healthcare, and we receive the least amount of care. Then one must think in a different way, Fredrik Lundh Sammeli, and not just pour out more money and believe that it is the answer and that the voters will think it is a good solution.

I ask again: When will the Social Democrats admit, just as you did with migration, that you have also failed with the Swedish health and medical care?

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

Fredrik Lundh Sammeli (S)

Madam Speaker! The healthcare crisis is Kristersson's healthcare crisis. But it is equally Åkesson's healthcare crisis.

I think Member Linda Lindberg illustrates it well. We will not be able to efficiency our way out of this crisis when the regions are on their knees and alarm reports follow alarm reports across the country, because the money is not enough. The cost crisis that we all are affected by as people in this situation with war in Ukraine and a very restless world hits enormously hard, not least against the regions.

The important thing here is to see that we need to continue to create long-term conditions for the regions in order to be able to ensure good health and medical care. We need to invest in the staff, because that is the important part. But then we have a government that delivers less money and where SD's signaling of evil in some areas has become government policy.

I can probably agree with much of Member Lindberg's enumeration of the societal challenges, but we definitely do not have the same answers. Less money for welfare will mean worse welfare. Reporting laws and other inventions from this government will make the conditions for the staff much worse, and that will not be the focus that we need moving forward.

(Applause)

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

Johan Hultberg (M)

Madam Speaker! There is a saying that goes "empty barrels make the most noise." That was what I was thinking of when I listened to Member Lundh Sammeli. It was a high tone and harsh criticism of the sitting government, but I did not hear a word about any reforms from the Social Democrats' side and about how we can cut the queues in health care or how we can make the social services better equipped for its important preventive work - nothing about how.

The only answer the Social Democrats have is "more resources". That answer is based on a castle in the air, as my colleague from the Christian Democrats pointed out. The Social Democrats base their financing on an idea that it will be possible to introduce a bank tax from January 1st that brings in 10 billion. It is not serious, Madam Speaker.

What Member Lundh Sammeli did in his speech was to mock that we in the Tidö parties think it is very concerning that we have a poorly functioning healthcare guarantee in Sweden, a healthcare guarantee that actually has not been followed since it was introduced. It is a healthcare guarantee that is statutory and which is supposed to give the individual patient care according to established time limits but which is not complied with.

Then we think it is reasonable to review how we can strengthen the patient's position while we, in a government position, now create conditions to shorten the queues. We are making targeted efforts to provide the regions with extra funds if they succeed in shortening their queues. We are addressing the basic problem of insufficient staffing.

What is the Social Democrats' answer? That is my simple question to Member of Parliament Lundh Sammeli.

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

Fredrik Lundh Sammeli (S)

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

"Empty vessels make the most noise, or the loudest," Member of Parliament Hultberg began. I can only state that this government neither provides resources nor has particularly many proposals so far to meet the challenges we have. I look forward to discussing those proposals and being able to both join in on good policy and oppose bad policy.

As I said in my speech, there are reasons to review the healthcare guarantee. But I expect something more from a government in the midst of a national healthcare crisis. If the point that can be delivered is a review of the healthcare guarantee, the coming year will be extremely tough for healthcare workers and for all those patients who do not receive the healthcare they need.

I believe it is important to discuss how we create an attractive profession. Therefore, we have submitted proposals on how we should work with the skills supply over time. I am completely convinced that it is not only pension issues and defense issues that need preparation in politics. I believe that a skills preparation is part of being able to work long-term with these issues in politics.

It is also the case that these targeted efforts are something we have had over time in politics. Now that it is being evaluated, the criticism will be that targeted efforts to shorten queues for regions that do not have the prerequisites to do so do not create any shortened queues. I hope that we are able to steer that policy away from the performance-based.

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

Johan Hultberg (M)

Madam Speaker! The Tidö Agreement has been updated with additional points that we want to implement in a government position. The Tidö Agreement is already from the beginning a very extensive catalog of reforms for how we shall step by step attempt to make this country better.

There are large cracks in our healthcare system. We have a poorly functioning healthcare system in many respects. This we need to rectify. We have, Madam Speaker, a long series of reforms concerning addressing the fundamental problems within Swedish health and medical care, for example with the supply of competence. There, we are developing a national competence supply plan.

Speaking of efficiencies, Madam Speaker, I see an opportunity to streamline the healthcare's poor IT infrastructure. There, we are now taking a collective approach to create a national digital infrastructure.

It is an important task for the state to work with the basic strategic issues and the conditions for the regions. But ultimately, it is each region, which is self-governing as of now, that is responsible for delivering good health and medical care to its inhabitants.

Member of Parliament Lundh Sammeli said in his speech, or if it was in the previous exchange of remarks, that healthcare needs a larger suit. Then one must actually ensure that the state's suit grows and that the resources, viewed as a whole in the economy of society, grow as well.

Had unemployment developed as the EU average, we would have had 40 billion more per year into the state treasury. But the Social Democrats failed with their goal of the EU's lowest unemployment. Instead, we got the fourth highest. If we are to be able to put on the suit, Madam Speaker, it is important that we are able to conduct a good economic policy that ensures more people get into work and self-sufficiency and that the economy grows.

Unfortunately, the Social Democrats are once again prioritizing the benefit line over the work line, and it is a threat to the welfare.

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Fredrik Lundh Sammeli (S)

Madam Speaker! The Tidö Agreement is a catalog of reforms, says Member Hultberg. Yes, definitely, there are many reforms in there. But which reforms meet actual societal problems? There are very many reforms that create new societal problems, and we will address that in many debates ahead.

Working with the IT infrastructure is very good. I think that we have not come far enough there. We in the committee have been to Estonia to look at what more we can do and what we can learn from others. Digitalization is very important, and in that regard, the entire entry of AI into healthcare is incredibly important to follow. How can one take advantage of that power and resource?

It is the same with the supply of skills, but we are soon leaving a year where the government chose to prioritize tax cuts. It sometimes sounds in the debate as if the Social Democrats always have other money. But we are leaving a year where the government, which Hultberg supports and which provided a basis for, spent 13 billion on tax cuts for the absolutely best paid instead of meeting the needs of municipalities and regions. That policy continues now.

One can always discuss and say that we need to get more people into work. Yes, definitely! That is why it is completely baroque to cut back on labor market policy, as this government is doing. It is not just about saying that this, this, and this we think is important. It is also about having a policy that supports it, and that is where this government deserves all the criticism because one hand does not know what the other hand is doing. One is happy to say one thing, and then one pursues something completely different that will be counterproductive. That is what we are critical of.

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Linda Lindberg (SD)

Madam Speaker! We are now debating expenditure area 9. I move for approval of the proposal in the committee report and the government's proposal for the 2024 appropriation for expenditure area 9, which amounts to 110.3 billion kronor.

In the state budget as a whole, we are making major investments in welfare. Of the reform space we have, we are investing approximately 40 percent in welfare. It is a historical sum in that context, but as we have touched upon earlier, the state cannot fully compensate for all inflation. We are in a tough situation, that must be acknowledged, and everyone must help each other.

We are well aware of how things look in the country's regions, believe me! We know that there are regions that are forced into savings. But politics is about priorities, and here we see that it is important to monitor and focus on the core activities.

I am, however, very humble, Madam Speaker, before the challenges that exist in the regions, where many of my colleagues sit and work and struggle to make the budget balance. It is, in many ways, the pension costs that are causing problems for the regions.

Madam Speaker! As a member of the Riksdag and with the mandate we have, I am, despite tough times and despite that it is overdue, nevertheless positive about the Swedish health and medical care. We have a high tempo, and we have a majority in the Riksdag for the reforms that we have agreed upon.

I can also say that there is a high tempo at the Ministry of Health and Social Affairs, and with four ministers, it will be a significantly faster delivery than previous governments have managed. It is clear that health and medical care is a prioritized area for the coalition parties. In the Tidö Agreement, there are large and important parts that are necessary, and it is a pity that this work has not been started earlier. It is good that the people have now given us their trust, and we take this trust with the utmost seriousness.

We see, among other things, that it is important to conduct a review of a full or partial state ownership of the care. I mean that this can be a success for Sweden. We must, from a national level, be able to manage the care more effectively and with increased responsibility. Not least during the pandemic, this was important, and it was clear that it was lacking.

We also need to achieve equitable care throughout the country. This is furthermore one of the requirements we have in the goal for the area. The goal for health and medical care policy is that the population shall be offered a needs-based and efficient health and medical care of good quality. Such care shall be equitable, equal, and accessible. This goal was adopted in 2015.

Today, we are not at an equal healthcare. It cannot be that your care is to be determined based on where in Sweden you live. You should be able to expect good care, effective medicines with few side effects, as well as aids with good function regardless of where in the country you live, Madam Speaker. Today, priorities are made within each region, and if you have the misfortune of becoming ill in a region that does not prioritize exactly what you need, for example, diabetes care, you do not get the latest aids or medicines, which you would have received if you lived in another region that considers this an interesting, important, and prioritized area.

To increase equality and access to care in our country, we are now working, among other things, with the digital national healthcare brokerage, which is another important part. This is a proposal that the Sverigedemokraterna have championed for many years. We initially had a different name for it, and we have taken inspiration from the Danish system.

The system is based on all healthcare providers, both public and private, registering their available healthcare capacity. Based on the register, healthcare providers, but also individual patients, can then choose to have care performed at another location if the waiting time is shorter there. In this way, we shorten the queues, and we help each other across regional boundaries. In fact, no one benefits from waiting in a healthcare queue. It is a strain on health, but it is also a strain on the economy.

We simply need to increase cooperation between the regions, but also between the public and the private, in order to shorten the healthcare queues. There is a will and a capacity that is not being utilized today. This is a waste, I would like to assert.

The previous government strongly opposed private healthcare providers and pushed to ensure they did not get the space they could take. This was not responsible when it comes to such important issues as making healthcare more accessible. The most important thing for us is not who does it, but that it is done.

When we talk about tax crowns, it is the case that every tax crown needs to be protected in order to generate the greatest possible benefit for the citizens. It is a fact that welfare crime is a societal problem. This is something that previous governments did not dare to speak about or address.

Both the state administration and the municipal sector need to work in a purposeful manner to counteract such crime. The State Office, in its analysis of corruption in municipalities and regions, has among other things submitted proposals for state interventions and recommendations to municipalities and regions on how they can improve their work against corruption. Welfare crime appears as a new risk area where corruption can be part of a larger problem, with actors who deliberately want to profit from the welfare system. We need to address this, and it is extremely provoking that this has been allowed to escalate without anyone daring to tackle it.

Now we are acting, with a payment authority and with measures to curb crime against the welfare state. It is those who are in need of, for example, LSS who should receive support in the form of tax funds - not robbers and bandits, Madam Speaker.

Politics is, as has been said, a matter of prioritizing, and I mean that the Sweden Democrats and the government have a clear order of priority that differs significantly from the one that the Social Democratic-led government had. We do everything we can to avoid ending up in a bad situation.

Back to how we shorten the healthcare queues. In addition to the healthcare brokerage, which is not quite in place yet, we are allocating 5 billion to the regions to shorten the queues. These will, so to speak, be performance-based funds.

The healthcare queues must be shortened. Since the healthcare guarantee was introduced, it has practically never been met. The goal of the healthcare guarantee is to increase accessibility to planned care as well as to eliminate queues and waiting times. Many regions and healthcare providers do not meet the healthcare guarantee's timeframe. This is an additional problem.

In the new Tidö Agreement, we have now, as the speaker before me has said, included the healthcare guarantee as a priority point where we four parties agree that something must be done. We want to see a new and strengthened healthcare guarantee which means that children and young people should not have to wait more than 30 days. This is perfectly reasonable.

I will also finally touch upon the skills supply, because somewhere this is the very focus when it comes to solving all the problems that we in this chamber today agree exist – we must succeed with the skills supply.

We have a fantastic profession out in the country, with many skilled and committed people who work hard every day. But they are far too few. They need to receive support, and they need to be more numerous to be able to cope. The shortage of staff leads to a poor working environment and staff turnover. We need to work at all levels for a good environment so that staff stay or return to healthcare. I believe that this is the greatest challenge we face, Madam Speaker.

The staff is the healthcare system's absolute most important resource. To increase the availability of staff with the right competence, a better working environment and better conditions for development in the work are required - so that more people will want to and have the strength to work in healthcare. We must become better at recruiting and retaining healthcare staff.

Many also cannot manage to work full-time. We should ensure that more can and want to work full-time. Such a success would solve a certain part of the skills shortage.

But then we must also ensure that there is room for physical and mental recovery during the workday. Today, the work environment is often heavy, with many sick patients. This is partly because people are generally sicker by the time they reach inpatient care, and partly because more people with milder care needs are managed and treated in outpatient care. We must ensure that a little more breathing room in the schedule can be offered so that the staff can manage to work full-time and remain at their workplace for longer.

It is not always the salary that is the most important, but it is about a bearable work week, about good collegial cohesion and about having a certain influence over the day and one's schedule. When we are reached with reports that staff are resigning in order to be able to take their vacation, something is really wrong, Madam Speaker. This is not something that this government has been able to influence previously, but now we are doing everything we can.

We are now, among other things, conducting a review of the skills supply in Sweden. We are looking at a national mapping of the need for healthcare personnel now and in the future. This is to be reported in May. We are therefore doing many things in parallel with the investments that are visible in the budget.

We are also investigating language requirements within elderly care. This is part of the work that has been highlighted by, among others, the Health and Social Care Inspectorate and the Corona Commission. It is also a way to strengthen the work environment - that as colleagues, one can speak with each other and feel that one understands the work tasks to be performed. Not least, it is a security for the elderly, and also for loved ones, to understand and be able to make oneself understood.

I would have liked to talk a bit about dental care, but I feel that I have dragged on a bit. With respect for the late hour, I therefore choose to conclude here.

(Applause)

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

Fredrik Lundh Sammeli (S)

Madam Speaker! It would have been good to have as much time in the exchange of replies, as there was much to comment on.

I have noted that MP Lindberg has embarked on a healthcare tour, and it is good to visit reality. I believe we share the view that healthcare queues need to be shortened and accessibility increased.

Then it is interesting to ask in what way Member Lindberg means that the policy pursued for two years, with two budgets during this mandate period, is what Swedish healthcare needs. Is Member Lindberg satisfied with the outcome, and do the Sverigedemokraterna not have more power behind their words when it comes to welfare?

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

Linda Lindberg (SD)

Madam Speaker! Fredrik Lundh Sammeli asks me if I am satisfied with the work we have done so far, if I understand his question correctly. Yes, I am very satisfied with the work that the Ministry of Health and Social Affairs is doing. There is a very high pace at the ministry, and we have produced in principle all the underlying documents in the first round before the major reforms and initiatives that we are making within the Swedish health and medical care. Among other things, we are looking at the care queues, the healthcare guarantee, and the national healthcare brokerage, which I believe is a way to stitch together the different regions and the private healthcare providers so that we can shorten the queues. I believe that it is a good instrument and a very good way to work.

We need to increase the digitalization of the infrastructure in healthcare, which has been neglected. Previous governments have not managed to achieve a better order there. It is quite cumbersome within Swedish health and medical care, not least when it comes to documentation and so on.

It is also a fact that it is a very heavy burden for those who work in healthcare. Here we must ensure that there is breathing room in the schedule and time for physical and mental recovery so that they can manage to work full-time. Today, unfortunately, many do not do so. Had we succeeded in achieving this, we would have gained increased capacity in the Swedish health and medical care. This would in turn mean that we could open more departments and get more available care beds, which would also shorten the care queues because we would be able to deliver more care.

I am quite convinced that we are on the completely right track. As I mentioned in the previous exchange, Member of Parliament Lundh Sammeli, it is not always the only solution to throw in more money. During your time in government, we have seen that it is not the solution to the problems. If one gets more resources, they often find them in other projects. It is not always the whole solution.

My question to Fredrik Lundh Sammeli remains: Are the Social Democrats satisfied with their efforts within Swedish healthcare, or should one, along with the migration, admit that one has failed?

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

Fredrik Lundh Sammeli (S)

Madam Speaker! The routine regarding the rebuttals is that this time it is I who am asking the questions and Linda Lindberg who is giving the answers. In our previous exchange of rebuttals, it was vice versa.

Member of the Board Lindberg gave her speech and pointed to this with performance-based grants. She highlighted it as something very powerful and important. But in the situation we are in today - where the regions are on their knees and region after region is downsizing and laying off staff - performance-based grants will be perceived as a direct mockery. This is not what the regions need.

People have different conditions for providing the care that is needed. In this case, money is needed. Without money for health and medical care, the effects will be enormous. The staff will get worse working conditions. More will leave the profession or reduce their hours because they cannot cope. It is anything but what we need. And the patients will get worse accessibility.

I am sorry, but you have not provided the text of the speech to be translated. Please provide the Swedish text from the Riksdag, and I will translate it for you.

The second reflection I have concerns Lindberg highlighting the language requirements in elderly care. I agree with that. I think it is very good. Work is ongoing, and it is good that you take it further. But Linda Lindberg is welcome to elaborate on how we shall ensure that we take care of all the staff who are currently in the operation. And what responsibility should employers have to make it possible for staff to learn languages if there are deficiencies there?

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

Linda Lindberg (SD)

Madam Speaker! You must understand that I am still very curious as to when we will hear the admission from the Social Democrats that they have failed with the Swedish healthcare system. But I suppose I will have to press Fredrik Lundh Sammeli a bit more on that in some other exchange of remarks.

The performance-based grants should be there to shorten the queues and increase healthcare capacity. When applying for a grant, one must submit proposals on what one intends to do. It could be that one wants to hire more staff or let more people work full-time. In that sense, it is a way to promote the supply of competence. There are different ways to view a performance-based grant and how one organizes the application procedure itself.

When it comes to the language requirements within elderly care, it is quite right that the Riksdag made an announcement to the government that this should be implemented. Otherwise, the Social Democratic-led government would not have done it. It was, in fact, an announcement from the Riksdag to appoint an inquiry to review the language requirements and to introduce language requirements within elderly care. The previous government made a light version of it, which we have now corrected, so that it is in accordance with what the committee meant from the beginning. This can be pointed out.

To still strengthen the staff who are present and who do not have sufficiently good language skills, we believe that one must ensure that the staff are given the opportunity to learn the Swedish language. Then, one is given a certain amount of time to do this. Those who subsequently do not master the language perhaps should have another task within elderly care and not have such close contact with the elderly.

From the Sverigedemokraterna side, we put the elderly in the foreground. The elderly should be able to make themselves understood, be able to understand what is said in the room and understand the care they receive. That is the most important thing. But obviously, we shall ensure to take advantage of the competence that exists and offer language skills, so that people are given a fair chance to work within elderly care.

(THIRD DEPUTY SPEAKER: I remind the chamber of the rules of procedure: that everyone speaks through the Speaker and does not use "you" and "you".)

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

Karin Rågsjö (V)

Madam Speaker! The member highlighted the staff as the gold within healthcare. We truly agree with that. But then I wonder a bit cautiously how the incredible deficits - 24 billion in the regions - will contribute to the staff's conditions to get what they need. It is about recovery and that they should not have to stress themselves to death and so on. That is one of my questions.

I also wonder what the regions are supposed to do. They are facing huge problems. For example, Sahlgrenska University Hospital is to cut 2,000 positions. Region Sörmland is to cut 700, of which 500 are within healthcare. This is, therefore, something that affects the employees, and it will affect the patients.

Another question concerns primary care. We all agree that it should be boosted. Primary care should grow and have a main task. But now we can see in various reports that it is not going so well. There is a resource shortage, and there is not enough staff.

An additional question is: If there is a new pandemic - God forbid, we really don't want that! - how will elderly care cope then? Are there enough nursing assistants? You in SD spoke so warmly about exactly elderly care during the pandemic. Now we see that elderly care still has the same problems that the Corona Commission described in its reports. Is this something the member has reflected on?

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

Linda Lindberg (SD)

Madam Speaker! The recurring point in all of Member Rågsjö's questions is the lack of staff. We must address this. We know that there is a large proportion of educated and licensed staff and also others who could fill a major role in Swedish health and medical care but who have chosen to leave the profession and have other assignments and jobs. This is proof that we have failed for a long time. This is not something that has occurred during the last year, but it is a problem that has existed for a long time.

We have not succeeded in getting in enough authorized personnel within health and medical care. It is a problem. But that personnel has not disappeared here and now.

I do not shirk the responsibility, but we are currently doing many things to map out exactly what we need. It is about where we see the competence shortage as strongest, how we can direct funds in the best way, how we can get more hands into welfare, and how we can strengthen the elderly care and make it more attractive to work there. But I do not believe it is just a matter of throwing in more money.

I understand that SKR, for example, highlights that a certain number of billions are needed. It is clear that one must be allowed to have requests, and it is clear that we must try to accommodate the requests that exist. That is what it is about. But we also need to prioritize, and I do not believe that the solution always solely concerns money. We need to ensure that it is a work environment that is bearable. Then we need to have breathing room in the schedules. It needs to be so that one can have a certain responsibility and influence over one's schedules.

I know that Member Rågsjö and I are very much in agreement on these parts. But it is a challenge to make it work, and I believe it needs to take a little longer. I really hope that we do not have a pandemic around the corner.

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

Karin Rågsjö (V)

Madam Speaker! With the deficit that exists in the regions - two years on the run, if I may put it that way - it is going to be extremely hard for the staff. During all the visits we have made, they say it is a resource shortage. It becomes a staff shortage. And the staff will not just flock directly to, for example, Sahlgrenska University Hospital, which is going to cut back, or to the other regions. It is a healthcare crisis we are facing. And I am very worried about it. I am worried that the cancer queues will increase, that the queues to BUP will increase, and so on. We were already in a half-risky situation earlier, Madam Speaker.

I quickly move on to some other questions I have. They concern the social services, which is also an industry in crisis, to say the least. This can be seen when eight out of ten social managers have difficulty recruiting social secretaries. Half of the social managers state that they have difficulty providing the interventions that the individual needs and is entitled to.

You in the Tidö parties have had very many press conferences about what you are going to do in vulnerable areas and so on. Then one wonders anxiously what will happen with the social services, for example. How is it possible to work preventatively with a social service that is largely already on its knees and which has enormous problems? There are no preventative measures in the places where they would be needed. You would have needed to make a massive effort directly.

The years are passing. It is two lost years for the social services. I cannot see that the new recruitment will decrease with the work that is ongoing regarding the Tidö parties - I must say that. I am very skeptical about this.

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

Linda Lindberg (SD)

Madam Speaker! The social services area is also one of our priority issues. We are working very well with those parts. I suspect that the Minister for Social Services will participate in the debate a bit later to make it even clearer.

I do not quite know what member Rågsjö is actually requesting. It is quite clear in the budget that we are investing funds here. We are investing, among other things, 100 million on interventions for child and youth health. There are many other parts that we are doing. We are looking at the new Social Services Act - there shall be more preventive interventions. We have several other proposals in the pipeline, from other budget areas. There we also allocate financial funds but also other parts to work preventively.

I think it is quite clear. I think it is a very high pace, Madam Speaker, at the Ministry of Social Affairs even in these areas. I think it is a bit unfair to point out that nothing is happening and that it is two lost years. I would like to assert that we have at least eight lost years within healthcare and within social services in this country. Then one actually succeeded in accomplishing nothing, in principle. There has been much that has lain in the filing cabinet at the ministry in this area, especially when it comes to social services.

Action is now being taken here. We are addressing the parts that exist and working effectively, not least with the State Institutions Board, which has also been neglected for an incredibly long time. We are now taking large steps to resolve the problems that exist there.

Yes, I can accept a certain amount of criticism, but it is not the case that this has fallen from the sky over the past year. I think we have had a high tempo. I think we have many good proposals and many good things that are coming in.

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

Martina Johansson (C)

Madam Speaker! I pressed the reply button while listening to Member Lindberg's speech. She mentioned that there is a shortage of staff and that we have a skills shortage in many areas. I completely agree with the Member on that. That is why there are investments in several budgets to strengthen competence.

But what made me press the button was the following: This means that we need to recruit more employees in elderly care and health and medical care and also social services, for that matter. But I don't quite understand how that can work when the Sweden Democrats, together with the government, have made decisions to force labor migrants who today work in these operations to leave their jobs. It affects especially the northern parts of the country, where very many are forced to leave their jobs. There are no replacements.

How can we have quality and enough employees if we do not even allow those who are there today to continue to do a good job and contribute to tax revenues and welfare?

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

Linda Lindberg (SD)

Madam Speaker! We are actively working to ensure that we can address the skills shortage. I have explained this in my speech. It can also be followed in the budget.

It is a major task that is underway. It has perhaps existed to some extent even previously, but it has not been able to have any effect. We need to ensure that those who are in healthcare today choose to stay. And we need to attract new employees, but it is very difficult to be an attractive employer as things look today. It becomes a small spinoff, Madam Speaker. And it becomes a bit difficult to succeed in attracting employees when we are simultaneously very clear about how difficult and heavy it is to work within Swedish health and medical care today.

The question of labor immigration is actually a question that lies within another area, so I think I do not need to go into it particularly much. But at the same time, it is important that we ensure that we do this. Previously, it has been open for low-wage workers in Sweden. It is perhaps a group that we have not always needed. We have our own unemployed who could instead be given job opportunities.

Since it is always the case when one sets a limit that it hits certain people whom one perhaps did not intend it to hit. But I still think it is a reasonable limit. It is also about ensuring that we get people here who are licensed, for example within healthcare, who could contribute to us obtaining a higher level of competence within the Swedish health and medical care.

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

Martina Johansson (C)

Madam Speaker! It is clear that it is a major task to strengthen competence and increase the number of employees. We need good employers and more. I cannot disagree with the member. It is clear that there are jobs that need to be done and that we can do this in different ways. But I still find it very difficult to understand that while one says that we need more employees, one also says that others should leave their jobs.

The government enters and sets a wage cap. Then we are dealing with completely different issues concerning the parties in the labor market that do not fall within this committee's area of responsibility. That we agree on. But this affects health and medical care. Then one should from the Social Affairs Committee be much clearer and say: These groups it should not be about. I do not know if it is different groups of labor we should focus on. I do not know if I misunderstood the member or not.

But employers can do other things to make employees want to work there. One can have more flexible operations. Health centers can look different depending on where in the country they are located or depending on what the need is.

I still feel that I haven't quite received an answer to the question. How can one say that we need more employees and at the same time - in the same party and in the same government - say that certain employees are not allowed to stay and work?

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

Linda Lindberg (SD)

Madam Speaker! I thought I was quite clear in my answer to Member Johansson just a moment ago.

I think it is good that one is clear about having a regulatory framework regarding what applies and that it applies to everyone. Previous governments have been very good at precisely special solutions, where there are rules that apply to some people but not for others. I am of the opinion that it is important to have some form of principle of fairness. Either we have a limit or we do not have a limit. I think that is important to stick to, and I think one has landed completely correctly in the balancing act that has been made in just that question.

One of the very greatest difficulties within the Swedish health and medical care is, once again, that we have problems getting staff to the health and medical care. It is the absolute biggest and most important challenge that we have today, and we must work on it at both the municipal, regional, and national level.

We are now doing several things. We are looking at where the competence shortage is greatest, how we can open up to make it more attractive to work in healthcare, and how we can strengthen those who already work there. It is about how one can get career advancement and how one can get greater opportunities for research.

There are actually very many parts there, but as I have said, I believe it is incredibly important.

We have over the recent years worked for the elderly to be at home for as long as possible and that they should be treated in primary care, which I think is very good. But this also means that one gets patients with an increasingly heavy care need within inpatient care, which also means that the staff has a heavy workload. And if one is not given space for recovery, whether physically or mentally, it is clear that it is difficult to manage working full-time. Here I believe we have one of the breaking points, Madam Speaker.

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

Karin Rågsjö (V)

Madam Speaker! Now comes a quote with a swear word; I am very sorry for that.

"What the hell do I get for the money?" said the right-wing business boss. Do we get pool cleaning, rut-Christmas cleaning in Lomma and on Solsidan, I ask you in this Sweden Democrat-dependent government. Or will it be a welfare that can be relied upon?

Now, the situation is that the welfare state is on a starvation diet, even though we are a wealthy state. In the budget for 2024, the government and Sverigedemokraterna added 10 billion kronor in the form of general government grants. One has to be happy with the little. It was far from enough even when the budget was laid. Then came further forecasts showing that there was an even larger deficit, and if no further measures are taken, the municipal sector will run with a deficit of 31 billion kronor. These are quite well-calculated figures. 24 billion will land on the regions. This is about inflation and pensions, among other things.

Vänsterpartiet demanded that extra money be added to the welfare system in the form of an extra supplementary budget. The government and Sverigedemokraterna voted against this. You give the thumbs up instead, we believe, for a broken healthcare system, elderly people who receive poorer care, and a social service that cannot work preventatively.

In Örebro län, they are cutting 600 positions. In Skellefteå, they are stopping their primary care initiative. In Östergötland, personnel costs are to be reduced by 600 million kronor, and in Sörmland, there will be 700 fewer people in the region. There are examples from all regions. Sahlgrenska University Hospital in Gothenburg, a flagship hospital, is cutting 2,000 positions.

This is a steel bath.

Your answer has been that it is the regions' fault. They have done something wrong. Use the money that is in the coffers! But it is not really possible to do that. During the last parliamentary term, you completely sawed off the previous government.

I am thinking of all the initiatives that were made, for example, during the pandemic. There, you stood up for the state to take a greater responsibility. Now we are not in a pandemic situation, which we are grateful for, but in an inflation situation. Then the state should also take a greater responsibility for the regions. That is our view.

What will become of this? Will it mean missed cancer treatments and closed clinics? What will happen with social services? It is quite serious out in the regions and municipalities, and I think this is very ignorant politics from the state, from the Moderaterna, Sverigedemokraterna, Liberalerna and Kristdemokraterna.

In addition to acute supplements to municipalities and regions, we have also proposed an indexing that would mean solving the financing of welfare in the long term by having welfare automatically receive more money as the population increases and Sweden's population becomes increasingly older.

We have a Christian Democratic healthcare minister who often and gladly speaks about the state needing to take a greater national responsibility for healthcare. But when the crisis comes, what happens then? Then it was just empty words.

Those who defend the government's and the Sweden Democrats' policy argue that the regions must blame themselves and that it is not the state's mission to save healthcare. One might be able to increase efficiency, for example.

But it is enough, as said, to rewind the tape three years and see what happened during the pandemic when we actually managed to hold up the healthcare system with the help of state resources. I am also thinking of what the Corona Commission wrote about the elderly in everything they produced. Nothing of that has you followed up on, as far as I can see. Elderly care has continued the problems that the Corona Commission highlighted.

Politics is about prioritizing, it is usually said, and you have put other things in focus. You are putting more money into increased rut and rot deductions and into tax cuts. One makes their choice and hopes that it will work out in some way.

Vänsterpartiet will always stand on the side of the patients and the healthcare staff. During the pandemic, we all saw how valuable healthcare is. The applause just rattled. We want to see a healthcare system that can be preventive, that can save lives and that makes a difference, not a healthcare system where hard-pressed staff are forced to run themselves into exhaustion.

What do we do then? You will, of course, say that we have printing presses in the basement. That is usually a given line. Johan Hultberg is already nodding. He has already written this down. But I have answers to that, Johan.

Vänsterpartiet has invested 20 billion more than the government in general state grants to municipalities and regions just to maintain the staffing density in welfare. We have an increased appropriation for the recovery bonus to promote a sustainable working life within health and medical care. We propose that this appropriation be increased by 350 million kronor for 2024. You remove it, as far as I can see.

We also want to initiate a high-cost protection for dental care. It is time for that reform, and we are allocating 4.7 billion to it. We allocate 500 million more for medicines that are becoming more expensive. You know that; we talk about it often. We have 700 million more for psychiatry, a total of 2.9 billion.

When it comes to TBE vaccines that are super expensive, we introduce a high-cost protection for adults and make it free of charge for children. We allocate 500 million to make new and rarely occurring medicines available and 1 billion for care in rural areas - all funded.

Then we move on to the social services. Increased inequality and a deeply rooted class society create social vulnerability in Sweden. It has always done so, in all generations.

Social services employees perform work at an individual level far beyond their boundaries. We see increased inequalities in schools and difficult economic conditions for very many families. School is the single most important preventive measure, and we know that you, who have zealously defended the market school, now stand there with a school that is extremely segregated, which affects students where the school is the straw and the way forward. The school needs a completely different weight, together with social services.

Eight out of ten social welfare directors have difficulty recruiting social secretaries. Over half of the social welfare directors state that they have difficulty providing the interventions that the individual needs and is entitled to.

In order for children and young people to be able to receive support early, the social services' employees must work hands-on together with the preschool and the school. But that does not exist today. What the government calls a historic investment in social services is actually money to prepare a new Social Services Act. They are only allocating 200 million kronor to it.

The government also describes it as making a targeted investment in crime prevention work with 80 million kronor for preventive measures. In reality, this is a cut from the 250 million that was allocated to this in previous years. As I said before, it is almost as if Bagdad-Bob has been the role model for your very many press conferences - a string of press conferences with so little money!

What is our proposal to the social services? Yes, 1 billion kronor directed towards the social services' work with children and young people in risk groups, 270 million for preventive measures against gang crime and 350 million kronor to strengthen the social services' work with men's violence against women - and the increased state grants, that is, 20 billion more than what the government gives.

A folkhem is not recreated by bloodletting of healthcare, care, and social services. Instead, an ice-cold society is created, far removed from solidarity and consideration for one another, and for a society with a focus on all citizens. Shame on the parties that downplay the possibilities of the welfare system!

I naturally stand behind the Left Party's budget proposal in our special statement.

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

Johan Hultberg (M)

Madam Speaker! It is always a pleasure to listen to Member Rågsjö. She adds color to the debates, Madam Speaker. I naturally could not help but request a reply when I received the direct invitation from Member Rågsjö regarding the fact that we are in an inflationary situation. Exactly! We are in an inflationary situation.

The Swedish economy and welfare are challenged by inflation. In that situation, it is incredibly important that one pursues a responsible economic policy that does not contribute to inflation rising further but instead contributes to inflation falling. It is that which now particularly challenges the regions. It is that which causes pension costs to rise, personnel costs to rise, and the costs for medicines, consumables, rents, in short everything, to increase.

In that situation, Vänsterpartiet fuels inflation. Borrowing is increased by 175 billion. It is a threat to welfare because it means that resources will be fewer in the long term. We cannot just look at the resources for welfare over one year, but we must have a sustainable policy over time.

Madam Speaker! As a small piece of consumer information, I would like to tell those who are following the debate this late evening that in this expenditure area, Vänsterpartiet actually cuts resources for healthcare by 6.4 billion. That corresponds to approximately the turnover of region Blekinge. It should nevertheless be said, given the incredibly high tone that Vänsterpartiet has.

It is true that the government has had many press conferences. A battery of reforms is coming to give the social services better tools, to make important investments in foster homes, and to strengthen the quality of the welfare.

How are the healthcare queues going to become shorter, Member of Parliament Rågsjö, when you remove the entire appropriation that goes towards increasing the number of healthcare beds and shortening the queues?

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

Karin Rågsjö (V)

Madam Speaker! For all the targeted grants you have sent out to the regions, there is a foundation missing to stand on. You enter with 10 billion in targeted state grants, when up to 24 billion is missing. If one then sends out the grants, the targeted measures, it means that there are not as many who can work with them. That is what the healthcare system and the regions have said. They do not want that type of targeted measures, but they need state grants so that they can build the healthcare from the ground up.

Staff in healthcare and social services are saying everywhere that it is a crisis. It is clear that if you are going to lay off 2,000 people at the university hospital in Gothenburg, Sahlgrenska, I call that a crisis. It is not an efficiency measure, and this will hit those living in Västra Götaland hard.

Let us look at Sörmland, this small region. There, they are going to cut 500 people in healthcare. Why are they doing that? Do they have too much money? Is there too much staff? It will hit incredibly hard.

You have thought that one should dig a little into one's own cash box. Yes, that can be done if one is going to have a fantastic economy the following year. Then one can invest with the surpluses that exist. But I hardly believe, Member Hultberg, that honey will flow over the country in the next budget that you will present for 2025. You will make the same types of targeted interventions for those who have it best in this country, just as you have done now. It is right-wing politics - and now also with the Sverigedemokraterna.

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

Johan Hultberg (M)

Madam Speaker! The Left Party and the Moderates are worlds apart. The Left Party is the party with gold-plated trousers, who can always spend more money. The Moderates are a bit dull and boring. We are responsible, and we think it is important to take responsibility not just for the year but also for coming years, for coming generations. We shall not burden coming generations for investments that we want to make today. Therefore, we pursue a responsible economic policy that brings down inflation - it is falling now - which means that the regions will be in a better position ahead.

I still think it is important to point out the fact that welfare is the area that we particularly prioritize in the budget. We cover a very large proportion of the deficit that the regions have struggled with. We are making an increase of 10 billion in general government grants. An extra 3 billion is a targeted government grant to precisely the regions, which are particularly hard pressed.

It is nevertheless important to remember that the regions have also had record-high surpluses over the last three years. The summary of accounts from last year shows that they set aside almost 15 billion in the result equalization reserves. It is a matter of the regions also being able to prioritize, to do their homework.

As a resident of Västra Götaland, Madam Speaker, I am also incredibly critical of the red rule in Västra Götaland, which is unable to make priorities. There, Vänsterpartiet has pushed for that it is more important to lower the fares in public transport than to prioritize cancer care. Such a priority the Moderaterna will never make.

I did not receive an answer to my question from Vänsterpartiet. How are the healthcare queues going to become shorter when you remove the entire initiative that goes towards increasing the number of healthcare beds and shortening the healthcare queues?

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

Karin Rågsjö (V)

Madam Speaker! I have explained that without a foundation to stand on for the regions with a significantly higher state grant, those targeted measures will not have any effect. To get momentum in healthcare, personnel within healthcare are needed, but it is they who are now being laid off.

Now one wonders anxiously about the own responsibility. It is not that one can use the deficits in that way, as the Moderaterna, for example, say. It should be a one-time thing, there must be conditions to replenish the following year, and so on. But then it does not look so cheerful. Who will do it? Not many.

You have raised the issue of equalization reserves. But they look completely different in all the regions, and it is not possible to work in that way.

What is needed is a reasonable economy for the country's regions and for the entire social service. Now they are quite obviously on their knees. You have pushed very hard for rut, rot, and tax cuts. I do not know if it is gray politics; rather, it is hanging out a bit with the luxury-lovers, as the right usually does. You hang out with the luxury-lovers, and the ordinary people are left to stand in the care queues that exist. You wish them good luck or perhaps refer them to some obscure private company.

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

Johan Hultberg (M)

Madam Speaker! Let me liken Sweden to a fine old house that has a proud history but whose maintenance has unfortunately been neglected, a house where small errors and deficiencies were not repaired in time and therefore have grown large and serious, a house that had a safe, stable and secure electricity and heating system but where the house's previous owner let the safe and stable boiler be thrown out and furthermore meddled with the electrical system. Now it is uncertain whether the system will hold up if it becomes a severely cold winter. But despite all its errors and deficiencies, the house is fundamentally both fantastic and loved. It is a house with enormous potential, but the renovation need is great and complex.

Madam Speaker! I am, of course, speaking about Sweden after eight years of red-green rule. When the Moderaterna and the Tidö parties won the election last year, it was because the voters were tired of mismanagement. The voters were tired of a government that turned a blind eye to Sweden's large and serious problems. The voters wanted a fresh start and a government with the ability to get things done.

We Moderates are determined to get Sweden in order. But the renovation of our country is both extensive and difficult. The work will take time, because we are going to do it properly. We will not just putty over and paint over what is damaged. We will break up and replace what is rotten, water-damaged, and moldy. We will rewire the electrical system so that it becomes safe and stable again.

Madam Speaker! The fact that the Swedish economy, like the world economy, finds itself in a difficult situation with high inflation and a recession makes the renovation work even more challenging. In this situation, it is necessary to think long-term and carefully prioritize what is particularly important. It is a matter of making it more profitable to work and improving the business climate so that the economy grows and more people get into work and self-sufficiency. Only in this way can the costly work of getting Sweden in order be financed, and only in this way can we afford not only to fix what is broken but also to make urgent new investments.

Madam Speaker! Let me focus on those parts of the Swedish construction that we specifically work with in the Committee on Social Affairs and which we are now debating under expenditure area 9.

Fundamentally, Swedish healthcare, like Sweden as a whole, is absolutely fantastic. We have good medical results, among the best in the world. Every day, healthcare workers make absolutely outstanding efforts to cure, alleviate, and comfort. This is important to emphasize and highlight, while at the same time we must not turn a blind eye to the fact that we also have problems and shortcomings, not least in the form of lack of accessibility and far too great differences. We see geographical differences in care and health. We also see large differences between different groups as well as between men and women. It is unacceptable and something that requires political answers. I therefore want to talk about some of the answers from the Moderaterna and the Tidö parties.

We are making special investments and reforms to improve women's health. We are investing in maternal health care and maternity care. The Government has also given several important assignments to strengthen girls' and women's health, including one on measures for equitable health and medical care with a focus on endometriosis, menopausal issues, migraine, pain conditions, and other commonly occurring diseases and conditions that only or particularly affect women.

Another of the answers from me and the Moderaterna to reduce inequalities is to strengthen state governance. Now, we Moderaterna do not believe it is so simple that geographical differences in healthcare would suddenly disappear if we had a different organization or a different principal for healthcare, but it is a question that we will now carefully turn over and over in the so-called Vårdansvarskommittén.

Whether there is a changed principalship or not – it is clear that state governance needs to increase to ensure better compliance with both current legislation and national healthcare programs and guidelines, not least to secure an equitable implementation of new treatments. Whether one gets access to that new medicine shall be governed and decided by healthcare needs, not in a postcode lottery. One way for the state to govern is, of course, through economic resources.

Cancer care has long been a priority area for the Moderaterna. I am pleased that the government is now doubling the investment in cancer care. Work has also been initiated to establish an updated national cancer strategy. As a Moderate, I believe in performance-based reimbursements, and the budget also contains such. The purpose is to shorten the care queues and increase the number of care beds. We will also now investigate a strengthened care guarantee. No one should have to die in a care queue.

What is also required at the national and state level is increased accountability for overarching and strategic issues. Such increased accountability is also taken by the Moderate-led government. The work to create a national digital infrastructure has begun, as has the work to develop a national skills supply plan.

Speaking of skills supply, I am proud that the government is now investing 1.7 billion per year during 2024, 2025 and 2026 to continue with the initiated skills initiative for staff within elderly care. It is a significant and in-demand initiative to raise the competence and thereby the quality within care. At the same time, we are investigating how language requirements for staff within elderly care can be introduced for the purpose of increasing safety and improving patient safety.

Madam Speaker! What the government also takes is a very great responsibility to support municipalities and regions financially in these difficult times. During the next year, we are adding 10 billion in increased general government grants. Additionally, we are adding a further 3 billion in a special sector grant to healthcare because we see that the economic situation is particularly concerning for the regions. Furthermore, we are adding 3 billion in targeted government grants. In total, it is a full 16 billion.

Now we have heard the opposition's representatives criticize the government for not investing enough. But the red-green opposition does not stand for any responsible or even credible policy. The financing of its initiatives consists of castles in the air and borrowed money. To significantly increase borrowing is, as I said earlier, Madam Speaker, a direct threat to welfare. With a red-green policy, there would be fewer jobs and higher inflation. This means, in the long term, reduced resources for healthcare, elderly care, and social services.

Madam Speaker! The work of renovating Sweden must be long-term and persistent. That is how the Moderates and the Tidö parties take on the great task that it entails to get Sweden in order. Step by step, reform by reform, we repair and fix. Step by step, reform by reform, we rebuild and renovate.

What we particularly prioritize is to work with early and preventive measures. Therefore, we are investing in strengthening primary care. Therefore, we are investing in the establishment of a leisure card in order to give children and young people increased access to sports, culture, outdoor life, and other association life. Therefore, we have established a delegation for crime prevention measures within the area of social services. Therefore, we are also investing in school social teams, while simultaneously removing confidentiality barriers so that children and young people who risk being drawn into crime can be identified early and receive interventions from school, social services, and police in cooperation.

A huge reform process is underway within the social area with a particular focus on children and young people. I am now talking about reforms that are vital to give vulnerable children a safe and good upbringing. I am talking about reforms to give the social services completely new tools and a clear preventive mandate, this including through a new Social Services Act.

With a clearer preventive mandate for the social services, increased resources from the state also follow. In total, we are investing 8 billion over five years to improve staffing within the social services and ensure a good implementation of the new law. Another important investment is being made in parenting support. 400 million we are investing to give parents better conditions to take their parental responsibility. Parental responsibility shall be tightened and clarified. Failure to take parental responsibility must have consequences.

Madam Speaker! Sweden now has a specific Minister for Social Services. It is a clear expression that Sweden has received a government that truly prioritizes social work, which sees and understands that we need to mobilize the collective strength of society to stop the criminal gangs' new recruitment and which moves from words to action when it comes to ensuring that the best interests of the child always weigh heaviest.

Madam Speaker! With that, I move for the approval of the committee's proposal. We say yes to the government's budget for better and more accessible healthcare, yes to investments in elderly care of good quality, and yes to a strengthened social service with better conditions to provide early and preventive interventions.

(Applause)

In this speech, Crister Carlsson, Marie-Louise Hänel Sandström, Malin Höglund, Thomas Ragnarsson and Jesper Skalberg Karlsson (all M) agreed.

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

Martina Johansson (C)

Madam Speaker! I took the floor following Johan Hultberg's speech after having read the following in the government's budget: "Furthermore, the government sees a great need to invest in good care, strengthened safety, security and capacity within the State's Institutional Board. Against this background, the government has announced an inquiry that shall review Sis's mandate and organization."

I agree with the member that a great deal of work is required to get the State Board of Institutions to function and provide a good quality for our children and young people who need that type of care.

An article today from Sveriges Radio shows and reflects that staff are having difficulty maintaining security at one of our institutions. I become very concerned when I read the article. It is children and young people who need care and school in order to return to an inclusive society.

Against the background of the government's budget and the article, I wonder what the Moderates and the government will do to resolve the situation that has arisen. I had intended to pose the question to the Minister for Social Services. But she could not be present in the debate.

What will the Moderates and the government do already now during the Christmas and New Year holidays, but also in a three-month perspective, in a one-year perspective, and in a three-year perspective, so that we get our healthcare and care of our important children and young people in order?

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

Johan Hultberg (M)

Madam Speaker! I and Member Johansson truly share the commitment to the socially vulnerable children. Some of them are within the walls of SiS. Some of them are gang criminals. We want the responsibility for them to be transferred from SiS to Kriminalvården. Today's reporting in the media shows how important it is.

The system is not equipped to handle these grossly criminal individuals with an enormous amount of violence that strikes fear into the employees. That is what the media's reporting showed today. Achieving that reform, which is hopefully in place by 2026, will be an important step.

We are also working in parallel to give Sis better conditions to maintain security by having completely different powers. This applies, for example, to restricting access to telephones or the internet so that persons on the inside convicted of serious crimes cannot continue to communicate with gang criminals on the other side of the wall and in that way get in drugs, direct criminal activities, or plan escape attempts.

We are also making a historically large investment in Sis. It is an activity that has been neglected and underfunded for decades. One has premises that are not at all suitable for the mission that is to be performed. One does not have enough staff with the right competence and much more.

Madam Speaker! I am therefore genuinely concerned when I take note of the Center Party's budget motion where you cut and allocate 323 million less to Sis. This means that the conditions to meet the problems and challenges that the member just so well described become much, much smaller.

Madam Speaker! The question perhaps in some sense goes back to the member himself.

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

Martina Johansson (C)

Madam Speaker! When it comes to transferring the responsibility from Sis to Kriminalvården, I believe we can reach an agreement when it concerns children and young people who are convicted of crimes. I believe that Kriminalvården can handle that type of behavior in a different way than what Statens institutionsstyrelse can do today. It has to do with the breadth of mandates that Sis has.

We are quite in agreement on that. It just feels a bit like the solution in the situation that we find ourselves in today, and which we have now read about in the media today, is not what happens in 2026. It is not the answer, but we need to do something now.

I agree with the member that we could have done things much earlier. There is actually no conflict in what history says. The question is only: How quickly can we deliver to improve what is today?

The government is sometimes very good at delivering incredibly fast things. They push things through. We will have a discussion after the turn of the year that does not belong to this committee's mandate. There, they want to push through rapid legislation in almost a shorter time than we did during the pandemic.

Then one can act, but not when it concerns the safety and right to care of children and young people. In those cases, one postpones it instead of acting today so that children and young people feel well even during the Christmas and New Year holidays at the institution in question.

We have heard today that money is not always what makes one do the right things. We must have competence, and so on. We are not cutting back generally on Sis. It is more about the administration around it.

We are also strengthening social services in many respects so that children and young people do not end up there. It is about methods and investigations much earlier, already when the children are small.

Again: What measures does the government have to manage the situation now during Christmas and New Year, and in the coming months and year?

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

Johan Hultberg (M)

Madam Speaker! SIS as an institution has been very poorly managed. I truly wish I could stand here in the chamber and say that the problems will be gone after the New Year's holiday. It would not be serious to say that.

The problems are large, deep and many. We are trying to work with a range of measures that are both here and now and acute, but also with long-term measures.

Here and now, it is in many ways increasing the economic resources that is what is important. Therefore, it is naturally a matter of concern, Madam Speaker, that the Center Party proposes a total of 323 million less for the institution next year.

It means that there would be fewer opportunities for Sis to work with security assessments and how placements should be made. It is about investing in the security systems, being able to work with the competence development of existing staff, and perhaps raising wages slightly to attract the key competencies that are so important for increasing the competence and quality in healthcare.

It is important. I am glad that Member Johansson is able to see what is so important when it comes to Sis. It concerns the fact that we have the grossly criminal who need tough measures and to be moved to Kriminalvården.

But we also have, for example, the young girls with self-harming behavior who need completely different interventions and who have not committed any crimes whatsoever. They need care, attention, and love.

It may be that the Ministry of Social Affairs cannot give them. But we can give the institution Sis better conditions to deliver its important mission.

Here and now we do it through increased resources and by giving them better tools. In the long term, we shall review the entire Sis organization simultaneously while we carry out all the reforms to prevent children from having to be placed at all.

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

Karin Rågsjö (V)

Madam Speaker! I also intend to stick to the social issues. I intend to speak about what can be done preventatively before young people end up at Sis, because by then it has gone very far. All investigations indicate that the prognosis is not at its peak when they leave Sis.

You have spoken very much about preventive measures. But unfortunately, I do not think that much has happened. There is no direct action in this issue in this budget, nor in the year before. One must probably try to do something completely different.

When I traveled around and visited the social services, it was obvious that in Gothenburg, Stockholm, Malmö, Landskrona and other municipalities, people were very concerned about their resources. It is difficult to work preventatively. That is also what the social services directors say, and they say that it is difficult, for example, to recruit and retain social secretaries.

You have made what you call a historic investment in social services. I think that is a bit misleading even from a Moderate perspective. You call money to prepare a social services law a historic investment in social services, but you are only allocating 200 million kronor in 2024. It sounds a bit meager.

Preventive measures need to be stepped up in Sweden. Everyone talks about preventive measures, but it seems that quite few understand what preventive measures actually are. It is not cameras on lamp posts that is the preventive work, but it is hands-on in school, social services, preschool, and so on.

My question is: When will the major investment that you have prepared for two years arrive?

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

Johan Hultberg (M)

Madam Speaker! Member Rågsjö spoke earlier about the many press conferences that the government has held. Unfortunately, it does not seem that Member Rågsjö has listened so carefully to the content of the press conferences. If she had done so, she would have known about all the initiatives we are making, both when it comes to economic resource reinforcements and—which perhaps is at least as important—when it comes to creating better tools. It is about better tools for social services, schools, and the police to work preventatively.

A completely fundamental problem today is that we have a secrecy legislation that sets up obstacles for school, social services, and the police to work together, to exchange information, and to identify early those children and young people who hopefully have not even been drawn into gang crime but who are in the risk zone.

It is there and then - and this is what Member Rågsjö and I agree on - that we have the greatest and best chance to stop the young people from being recruited. It is then that we can make early preventive interventions that ensure that this person does not need more extensive interventions later in life. It is such interventions that ensure the person does not commit serious crimes and does not end up in an institution or in prison.

Madam Speaker! Having a new Social Services Act in place is somewhat of the foundation for the work that needs to be done in the coming years to create more preventive work and a stronger social service with a preventive perspective. The proposal will hopefully land on the Riksdag's table shortly.

But already now, the government has announced that we are providing resources not only to say that the social services must work more preventatively, but also to provide them with resources and tools. Next year, as mentioned, it is only a few hundred million, but then it is scaled up year by year. In total, it is 8 billion that we are investing in this area. That, Madam Speaker, is a historic investment.

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

Karin Rågsjö (V)

Madam Speaker! 8 billion - when will they arrive? One wonders anxiously. Tell me which table those 8 billion will appear in!

I actually see your numerous press conferences. I have also noted that the Sverigedemokraterna are always present. They are, after all, your prerequisite for having a government at all. You describe there that you are making a targeted investment in crime prevention work - which one needs to do - with 80 million kronor for preventive measures against gang crime until next year. But this is in fact a cut from the 250 million you had previously. We find that a bit strange.

Completely different types of measures are needed to reach children and young people who are suffering. Measures are needed in preschool and in school. A leisure activity is needed that is not a youth center but that involves activities and so on. Those are the preventive measures, and what I see is that there will not be much of that next year either.

Now it is really urgent to stop the new recruitment. With a school that also has financial problems – the school has also been hit by inflation and lack of state subsidies – I am very worried that the development will continue. How is one to break the new recruitment of children and young people? That is the absolute most important thing. There, one must have completely different resources than the government has now.

But that sounds absolutely fantastic with these 8 billion! It almost sounds like something the Vänsterpartiet would have put in the budget. I must keep an eye on that, because I am very curious about just this. It is with great interest, Johan Hultberg, that we now note that 8 billion will soon be coming for preventive measures. It will be a world sensation!

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

Johan Hultberg (M)

Madam Speaker! I can recommend the budget as a evening's leisure for Member Rågsjö, because it is described in it. Over five years, we invest 8 billion to ensure that there are good conditions to increase staffing within the social services and ensure a good implementation of the new Social Services Act.

I am very proud that the appropriation called 4:7 was already doubled last year from just over 500 million to over 1.3 billion. Now it is being scaled up so that in 2025 it is close to 3 billion and in 2026 close to 4 billion.

It is naturally an important message to the social services that we see and understand that they have a tough situation. When we increase the expectations and demands on the social services from this chamber, from the Riksdag and the government, we also provide resource reinforcements so that the social services can shoulder this responsibility.

Parallel to this work, Madam Speaker, we are making many other initiatives that are about working preventatively. It begins, just as Member Rågsjö pointed out, in school. We ensure that the knowledge school is re-established. We ensure that homework help is provided and that students who fall behind receive interventions. A full-fledged school is the best vaccine against crime and, for that matter, all other social problems as well. School is completely central.

In the expenditure area we are debating, we are also making important investments in parenting support. It is absolutely crucial that parents take their responsibility. It is difficult to be a parent, and in that case, it is important that society can be there and provide support. We do that with 400 billion in parenting support, while simultaneously investigating how we can ensure there are consequences if a parent does not accept the help and does not do what is required so that their child does not get caught in the clutches of gang criminals.

(Applause)

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

Fredrik Lundh Sammeli (S)

Madam Speaker! Sweden is in an acute crisis with the escalating gang violence, which is creating great fear and anxiety among people. At the same time, the gangs are taking tax money directly from our health and medical care system.

Recent revelations of how even criminal actors seek out the health and medical care sector to make money demonstrate the need to not let Swedish health and medical care develop into an uncontrolled healthcare market.

In our budget alternative, we have allocated more money to Ivo. It is a central actor that has taken on an increasingly important role in Swedish health and medical care in the work to ensure that both regions and, above all, private providers follow current laws and regulations.

I have two questions for Member Hultberg. For the first: Are the Moderaterna prepared to take the measures required so that criminals cannot run health centers? For the second: Is Member Hultberg prepared to act so that Ivo receives the resources and tools they need?

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

Johan Hultberg (M)

Madam Speaker! Yes, absolutely. It is an incredibly large and serious problem that MP Lundh Sammeli raises. I can state that the previous government, unfortunately, also did not see this problem coming. They did not carry out all the necessary reforms that would have needed to be started much earlier so that we would not find ourselves in the serious situation we have right now.

On many occasions, requests have come from Ivo, the Swedish Economic Crime Authority, and a long line of other law enforcement agencies to the government regarding requirements for secrecy relaxations. Requirements have been made for completely different tools and instruments to be able to work preventatively and earlier identify over-utilization and fraud, and to be able to tighten supervision. I and the Moderaterna, and I dare to actually also say the government, are absolutely prepared to turn over every stone to address the enormous problem that welfare crime is.

Madam Speaker! The reason why it is such an incredibly serious problem actually has two roots. For the first, it steals resources from the welfare system. It is money that should go to people in need of assistance. It is money that should go to health and medical care. For the second, these funds feed a very serious crime that strikes fear into our society, which creates insecurity and takes people's lives. That is why it is so important that we address the problem.

This government has already done a lot. It is about getting several important initiatives in place, which were raised earlier, for example a payment authority to ensure that we can stop the subsidy fraud. There needs to be better supervision. We have strengthened Ivo with resources and given them more tools, and more are coming that need to be investigated. I also do not rule out further resource reinforcements.

We are in complete agreement that this crime shall be crushed.

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

Fredrik Lundh Sammeli (S)

Madam Speaker! Thank you, Member Hultberg, for that announcement! I expect that it means that the government is prepared to take more powerful measures than to appoint an inquiry to map out how municipalities and regions work with the issue.

Regional Sweden, Municipal Sweden, and our authorities are clear: changed legislation was needed. Fortunately, such proposals are already on the Social Affairs Committee's table. We Social Democrats have submitted five concrete proposals for measures there that we now need to take. I look forward to that support.

I am also pleased that the government is moving forward with a payment authority. It is a task that we initiated, and it is good that it is being implemented. But I also look forward to the government taking the measures needed so that we will have completed proposals over the coming years so that both this and future governments can continue to be powerful in this area.

I had been looking forward to a debate with the Minister for Social Services, who was scheduled for the evening but is not here. I will nevertheless take the opportunity to pose my question to Johan Hultberg. In the member's statement, he very clearly highlights the need to work on crime prevention and to break the new recruitment. Why then is the government cutting the funding for crime prevention work, which is directed at the municipalities that have vulnerable areas?

One moves from the reform that has applied for the last three years with a quarter of a billion annually to ending up at 80 million. At the same time, it is said that this is something powerful. It is too little money, and it is a deterioration compared to the conditions these municipalities previously had to work from.

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

Johan Hultberg (M)

Madam Speaker! I am also sorry that the Minister for Social Services unfortunately had a conflict when today's debate ran over time and she was not able to be here. I know how much she would have liked to inform Member Lundh Sammeli about all the reforms that are now being made in the area and the extensive work that is ongoing, not least with creating more crime-preventive work across authority and department boundaries.

I can state that the social allocation within expenditure area 9 has been almost vanishingly small in previous years. Already in the first year, we doubled the investments for the development of social work, which provides the social services with completely different resource additions. Over the next five years, as mentioned, we are allocating 8 billion to realize the ambition increase in the new Social Services Act.

Parallel to that, we are making other incredibly important investments in crime prevention work in the form of parenting support and in the form of investments in school social teams, which shall be targeted at precisely those schools and areas where the needs are greatest. We are making an investment in social reinforcement teams – or social intervention units, as we have also called them – which also, again, shall be targeted specifically at the areas where the needs are greatest.

The state needs to take increased responsibility to support the social services in all 290 municipalities in Sweden, but especially in those municipalities and those areas where exclusion is greatest and where gang crime has spread and taken its strongest grip.

(Applause)

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

Martina Johansson (C)

Madam Speaker! Expenditure area 9 is a large area that spans many different parts. We have heard that in tonight's debate. It concerns healthcare, it concerns medical care, it concerns social care and it concerns social services.

Care and nursing shall be accessible, it shall be offered to everyone, it shall have high quality and it shall have self-determination - if the Center Party is allowed to decide.

We have a healthcare system that we should be fundamentally proud of. It is a good healthcare system that reaches the vast majority. But of course, it can always be better. The foundation of healthcare is primary care, and for it to be able to function and be good across the entire country, it also needs to look different in different parts of the country. It needs to be able to be that kind of traditional health center that most of us think of, with many different competencies on site. But it must also be allowed to be operated by an individual doctor together with a nurse, for example, if that is what is needed in that specific part of the country.

Madam Speaker! The vast majority of elderly people in our society live in their regular residence their entire lives - some with the help of home services and home healthcare, others completely without any interventions. Some of our elderly, however, need support in some form of housing, a senior housing facility or a special housing facility. But what we see is that not everyone has that intervention met as they do not have a sufficiently large need. For that reason, the Center Party sees that we need to have an intermediate step with a secure housing facility, and we want to introduce a senior housing guarantee for those who are 85-plus.

Madam Speaker! Patient safety and the working environment are important. It is important for the patient, and it is important for the staff. This is one of the reasons why the Center Party says no to healthcare personnel being required to report people in care who are undocumented. This is also something that has met resistance from nursing assistants, nurses, doctors, and many others. There is a fear that people will refrain from seeking necessary care.

For the same reasons, we also say no to the proposal that one should pay for an interpreter. The risk to patient safety and the work environment is great if the patient and healthcare staff cannot understand each other.

We have previously been into the unreasonable decision that the government has also made regarding wage demands for labor migrants. It hits hard against healthcare and elderly care, especially in northern Sweden where employees are forced to leave their employment without any replacements. It results in poorer care, poorer quality, and a poorer working environment. It also becomes worse for those who need the healthcare and care.

The work of these people should actually be appreciated. They contribute to healthcare, to welfare, and to our tax revenues, and they are an asset to Sweden.

I am changing the subject a bit and moving on to talk about LSS and personal assistance. A lot has happened since 1994. Back then, it was a radical freedom reform that the Swedish Riksdag decided on. Today, it has become a bit more controversial, and the rights are not as self-evident.

That is why the Centre Party supports state ownership when it comes to the assistance, and I know that more parties here in the chamber support that.

But I wonder: Where is the bill? I wonder why I do not hear the Tidö parties talking about this, which was among other things a driving factor when the Kristdemokraterna pushed this during the last parliamentary term. We need it to ensure the quality. We also need to increase the assistance allowance so that those who are to perform this job also receive a compensation for providing good care and support to those who are in need of assistance.

But we may perhaps need to consider how we carry out this calculation. The calculation was quite low in 2023 and 2024 in relation to the costs. I do not have the answer to exactly how this calculation should be made, but we have in any case allocated funds to be able to increase the compensation.

Madam Speaker! The social services are also part of expenditure area 9. For me, this is very much about children's right to be heard and to be involved.

I would like to see the National Board of Health and Welfare receive a much clearer mandate to point out methods and training for those who work with children and young people, both when it concerns investigations of children and young people and within the confines of the family home. It also needs to be reviewed how risk and protection assessments for these children and young people should be made, regardless of whether it concerns a custody dispute, a child growing up in a family where a risk is seen that the parents fail in their care, or a child with disabilities that create a risk for continued development. We have also allocated funds for this in our budget.

Since the Chamber has previously made decisions on frameworks that do not correspond with the Centre Party's frameworks, we abstain from taking a position and thus have no reservation. I refer instead to our special statement.

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

Christian Carlsson (KD)

Madam Speaker! Secure families are the most important factor for children and young people to get a good start in life. But all too often there are deficiencies in the family. Very many children grow up in broken families, and it often ends with the children needing to be taken into care and growing up in the society's care. In some cases, it leads to a placement in HVB-homes and in other cases it can end at Sis.

The Speaker and I agree that the support for children in social care needs to be strengthened. The Government is now carrying out important work to increase recruitment of, for example, foster homes to avoid institutional placement. But the very best would be if the children had never ended up in the situation where they needed to be taken into care. An important link in our work to ensure that happens is the parenting support.

That is why I was surprised when I read in the Center Party's budget proposal that they want to cut 36 million in one fell swoop by completely phasing out the Agency for Family Rights and Parenting Support. In what way does that ensure that more children grow up in safe and loving homes?

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

Martina Johansson (C)

Madam Speaker! I thank Christian Carlsson for the question.

MFoF - the abbreviation is faster to say than the full name of the agency - has been a spin-off from Socialstyrelsen since earlier. We see no reason to have double agencies that actually partially do double work and which do not quite suffice for the work they are supposed to do.

I hear testimonies and meet with employees within family law who do not receive the support in method development that their colleagues working with children and young people within social services receive, where they get the assignment from Socialstyrelsen. We also see how the authority has taken over part of what was within Socialstyrelsen, but the work has not been further developed.

Then, the parenting support in itself is important. It needs to be targeted towards different cultural backgrounds, because we need to understand parenting from different perspectives for it to work in practice.

We should not have more agencies in Sweden than we actually need. It results in incredibly large overhead costs that we could instead use to develop methods, support employees, and create training so that interventions can occur as soon as the children are small, so that they never end up in the society's care, as the member himself pointed out, but can live in their original families and grow up in safety.

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

Christian Carlsson (KD)

Madam Speaker! I can see that the Center Party is cutting back on the Agency for Family Rights and Parenting Support, but I cannot see that other agencies are being strengthened to take over the agency's mandate, hence the question.

I would like to talk a bit more about Sis, because many of the children who grow up in broken families end up there - far too many. It is the most vulnerable youths who end up there, together with heavily criminal youths.

The irregularities within the operations have been very serious and still are. We know that young girls have been subjected to sexual abuse by both staff and other inmates. No one has escaped the escapes during the spring and how explosions and escapes could have been planned because people have access to phones or electronic communication, such as computers, at the residences. We also know that drugs have been ordered and that one can have contact with pimps to sell sex at the residences with the help of mobile phones. The staff do not have the authority to search the rooms for weapons and drugs and cannot lock rooms and departments at night, even though some of Sweden's heaviest criminals are held in some of our Sis-homes.

I think it is very obvious that we need to ensure that we strengthen the staff's powers in order to increase safety. We need to give Sis better conditions to recruit good staff, and better premises are needed. We will review Sis's organization in an investigation that looks at Sis fundamentally, but then we must also be prepared to provide resources.

The Center Party, instead, carries out a saving of 323 million. In what way does that help our most vulnerable children and young people?

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

Martina Johansson (C)

Madam Speaker! It is about putting money where it makes a difference so that we do not have to take children into care. We are putting reinforcements into social services so that we can prevent children from ending up in the state's care. That is where we put the money. We have also chosen to strengthen the chains of justice so that we get better investigations and better handling of those who commit crimes - so that we make the right interventions at the right time.

We can agree that we need to take restrictive measures when it comes to electronic handling. However, it is a legislative issue and not a money issue.

For us, it is about investing money early so that we do not need to take more into care. I noted that the government at various times has spoken about the need to strengthen LVU and that prosecutors should have the right to take children into care, but then it is about taking more into care. We want instead to allocate resources so that they do not need to be taken into care. That is our point, because it is the safe family that is best for the child.

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

Lina Nordquist (L)

Madam Speaker! This will be quite quick to tell about, because the goals are not difficult. The difficult part is to do it in a long-term way without abruptness and without constant changes to where we are headed.

Madam Speaker! Actually, it is as simple as that it should not matter where we come from, where in the country we grow up or live, what we work with, or whether we have an even or odd number in our personal identity numbers. We should all be able to feel well and be able to live a good life. If we are struck by illness or injury, it should not matter which illness. We shall get what we need, and we should not have to wait when it is hardest in life – neither for support nor for care.

This sounds simple. Sweden is a wealthy country with many skilled people, so we can manage this. Nevertheless, we unfortunately have far too much further to go to reach that goal. There are completely unacceptable health disparities today, both geographically and socioeconomically and in many other ways. We need to close those gaps. Therefore, I move for approval of the committee's proposal.

I am also very pleased that we will vote on this budget and on this expenditure area, because strategic work is now being carried out for wiser governance of care and support in our country.

A crucial part is, of course, colleagues who enjoy their work, good work tools and infrastructure, less over-bureaucracy and more time for the meeting between people. A workplace should not be a panic room, Madam Speaker - not in healthcare, not in elderly care and not in social services. It also should not be a journey back in time to work there, but it may well be a journey of knowledge.

This budget provides strong support for children who suffer and for women who are subjected to violence. Reforms are being implemented with this government and this budget basis for measures against involuntary loneliness, for a rich life throughout life, and for a strong elderly care.

When it comes to healthcare, we have agreed that we shall develop healthcare in rural areas, industrial towns, and suburbs. Everyday care must become stable and long-term, both for patients and relatives and for employees at health centers and in hospitals – where the care beds must begin to suffice – and in home care, whether one has it in their pocket or in their living room.

We Liberals think it is incredibly pleasing that every patient will now finally be given the opportunity to have a fixed doctor contact through the primary care reform.

We are very pleased that one goes even a step further and also looks into whether this can be introduced in specialist care, where people have long-term contacts with a different specialist than the general specialist.

We are incredibly proud that every municipality shall have a medically responsible physician. So much care is performed under the municipalities' management and with them as the responsible parties. Yet, there is far too little medical competence surrounding the strategic decisions made there and the routines that determine people's lives there.

We still have a bit to go. There are completely unacceptable health disparities in our country today, regardless of how we divide ourselves as people, and that must not be. But I am very proud that we are a good way on our way with this budget and with this government.

(Applause)

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

Ulrika Westerlund (MP)

Madam Speaker and dear colleagues! In our committee, we have the privilege of working with important issues, healthcare and social services, which affect everyone. The strong commitment here tonight shows that many of us care. There is much to be done here.

Much of the ill health we see today can be prevented. How we design our society and work with the public health perspective in interventions at different levels is of great importance. How the state budget is allocated also has great importance, even though the primary responsibility for most interventions lies at the regional and municipal levels.

In this context, I also want to mention the ongoing investigation regarding the ownership of healthcare and that we do not currently consider a gigantic and resource-consuming reorganization to be what healthcare needs. We believe it is better to focus on the areas that are not working and direct the efforts there.

In our budget in expenditure area 9, we have made some investments that I particularly want to mention.

We are increasing the general state grants to municipalities and regions by 14 billion. It is an important prerequisite to be able to manage the operations at all and maintain a reasonable working environment for those who work there.

We are skeptical of the performance-based funds that the government has allocated regarding, among other things, care beds. We see it as a flawed way of thinking that leads away from the real problem, which is the staff's working environment, working conditions, and wages.

Care is facing major challenges. More colleagues are needed in both healthcare and municipal care and elderly care to create a good working environment for the staff with a calmer pace and increased attractiveness for the profession.

Money is of course never everything. But for the reform on good and close care, where primary care is the hub, to be implemented in a good way, investments are required, especially now in times of inflation and high interest rates. An overly limited supplement will lead to cuts in core activities across the country. We already see now how nurses are being laid off while the care queues are far too long. This cut-back policy will hit hardest those who are in a tough economic situation and who are in greatest need of welfare services, but in the long run, we will all be affected.

It is not only the cuts in the regions' operations that directly affect healthcare. Reductions in the municipalities also hit healthcare in the long run. Young people who receive poorer support in school, social services that do not manage to identify needs in time, school health services that do not have sufficient resources and so on – all of this risks leading to various forms of ill health that require resources further ahead.

Miljöpartiet wants to emphasize the importance of working preventatively to avoid ill health for everyone. Mental ill health is widespread in large parts of the population and should be given more attention, and for the elderly, it is of great importance to identify needs in a timely manner in order to be able to provide support and interventions that can reduce, for example, fall accidents, personal suffering, and resource-intensive interventions from the regions.

Healthcare costs are also not something that should be seen as constant. What we manage to prevent through various initiatives, we make up for through reduced healthcare costs later. In that context, I want to, of course, once again advocate for our proposal for a public health act.

Madam Speaker! Even though we advocate for general grants in the first instance, I still want to mention a targeted initiative that has fulfilled a very important function: the so-called recovery bonus. It has given staff groups the opportunity to test new ways and their own ideas to improve the work environment, including working time models. Many projects have been ongoing across the country.

It is sad, thinks Miljöpartiet, that the government is now concluding this initiative. The funds have been available for staff groups within both health and medical care and elderly care, and for us, the idea was that this initiative should continue.

Madam Speaker! I would like to specifically mention a few more areas.

The first thing is personal assistance. For the assistance to function in a good way, the working conditions for being a personal assistant need to be sufficiently good.

Many assistance companies are warning that the low increases of the assistance allowance are depleting their possibilities to recruit and retain assistants and to conduct serious work. The increases have been made at all too low levels, even though the government this year has increased the increase to 2.5 percent instead of last year's 1.5 percent. It lies below the collectively agreed wage increases.

The template level is about which wages one can offer, being able to value employees with long experience and competence when it is important, and providing guidance and training. If the space becomes increasingly narrower, there is a great risk that serious companies will be wiped out and that the less accountable ones remain. Therefore, the template level in itself is important for a well-functioning and serious sector.

Miljöpartiet therefore considers that the level should be increased by 5 percent during the next year. We also consider that the government should rather return with proposals for a long-term, stable and predictable model for the upward adjustment of the assistance allowance moving forward. Our proposed increase is intended as a first step on the way towards being able to close the gap that has arisen after a number of years with all too small upward adjustments at the end of the mandate period.

Madam Speaker! I want to mention a few more areas briefly here towards the end.

One is our initiative to increase the healthcare's role in the preventive work with children and young people in risk zones. Healthcare needs to have a larger role in the structured preventive work for children and young people who risk going astray. We want to enable a fast track to psychiatric investigation and care for children and young people in risk zones. During a crisis, there is often a greater receptivity to treatment, which can disappear if the child has to wait. This should be part of a tailored preventive work with children in risk zones, and a method for this needs to be developed.

Madam Speaker! Miljöpartiet also argues that persons who have been subjected to sexual assault should not have to pay for examination and care. There should be no risk at all that someone who cannot afford such a care contact avoids seeking it, and society needs to do everything to facilitate things for a victim of violence. Region Skåne has made a decision on the equivalent, and we believe that it should apply in the entire country. The state should contribute to the cost, which we estimate at 18 million annually.

In conclusion, Madam Speaker, we find ourselves in a time of great societal challenges. Climate change and a severe loss of biodiversity are shaking the fundamental conditions for safety, freedom, and economic development. If we do not succeed in reversing the trend, we will also see increased costs within healthcare and elderly care.

Miljöpartiet shows in our budget proposal that a different path than the government's is possible – a path that secures welfare and a sustainable society and accelerates the green transition. I naturally stand behind our special statement.

The deliberation was hereby concluded.

(A decision was to be taken on 13 December.)

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