Health care, medical care and social care

Christian Carlsson (KD)

Mr. Speaker! It is brightening in the Swedish economy, and it is therefore also soon brightening for ordinary people in Sweden. The government has taken responsibility in an economically tough time so that we have been able to fight inflation, and the Christian Democrats have therefore, together with their coalition partners, been able to present a budget for jobs and growth.

The historical upgrading of the defense and the justice system continues so that we prepare ourselves to be able to defend our country and fight crime with full force. We continue to strengthen healthcare and pave the way for better elderly care. At the same time, taxes are lowered, which means that ordinary people who work and all the country's pensioners will soon be able to keep more of their salary or pension. This gives individuals greater freedom and ordinary families increased security, which means that more people can once again feel hope and faith in the future.

The tax cuts, together with the right investments in infrastructure, research, and education, create the conditions for more entrepreneurship and growth. Thus, we strengthen Sweden and also lay the foundation for both prosperity and the financing of the welfare system.

When it comes to welfare specifically, the recent years have been economically tough for the regions and healthcare. The government has had to inject temporary extra funds, large economic amounts, to enable the regions to meet their pension costs as a result of inflation. At the same time, we are halfway through the mandate period in full swing with realizing our reform agenda for and reorganization of Swedish healthcare, so that more people who are ill can receive care in time and so that we can offer people a more equal healthcare.

Sweden's doctors, nurses and other staff perform fantastic efforts in their encounters with patients every day. But they have to work very hard. Healthcare is still characterized by too long waiting times, and we do not have equal access to care for people in different parts of the country.

This is what we Christian Democrats and the government want to resolve. We Christian Democrats want to leave today's healthcare model with 21 self-governing regions and instead let the state take over responsibility for and governance of Swedish healthcare. We also want to improve the conditions for the staff so that we can manage the competence supply, increase the number of care beds, and in this way ensure that more people receive the care they need when they need it.

Mr. Speaker! This is what the Christian Democrats asked for a mandate for in the 2022 election, and all reforms in the Tidö Agreement in the area of health and medical care have now been initiated. I am thinking of the investigation on letting the state take over the responsibility for Swedish healthcare, which can pave the way for equal care. I am thinking of the establishment of a national healthcare brokerage to make healthcare capacity visible and be able to offer care faster, which in combination with a tightened healthcare guarantee and a transition to a stronger primary care will create the conditions for more people to be able to receive care in time. I am also thinking of the development of a common digital infrastructure for the entire care chain, which will improve the working situation for doctors and nurses and at the same time lead to more efficiency and better quality in care.

In this year's budget, we allocate a total of 18 billion kronor to health and medical care. Regarding the temporary sector grant for the regions, the government continues to support the regions with 2 billion after the tough years that have been. But we also set a very clear focus forward at the same time. We allocate 7.5 billion in 2025 to increase care capacity and shorten waiting times.

The Christian Democrats have long championed the issue of increasing the number of healthcare beds. At first, we were relatively alone in this. Now, more are joining the journey. The National Board of Health and Welfare's recommendation is that the regions need to increase healthcare capacity by 2,300 beds in the short term. Thanks to the national competence supply plan that this government has taken the initiative for, steps are now also being taken in the right direction in the regions, and it is important that this happens.

Psychiatry is an area where we are now specifically concentrating efforts to shorten the waiting times. Mental ill-health is unfortunately increasing and has become a major societal problem, not just a problem for the individual. It is increasing among young people. It can range from everything from low mood to depression and serious eating disorders. We all know that the care queues to BUP tripled during the Social Democrats' time in power, and they are still far too long. Fewer than half of those waiting within BUP receive a first visit within the care guarantee's 30 days. Furthermore, the number of patient meetings in child and adolescent psychiatry is way too low. The despair is great among the families who do not receive the help they need in time.

We Christian Democrats and the government see these families. We are therefore establishing a budget of one billion SEK over the next three years to increase accessibility and shorten the queues to child and adolescent psychiatry. We are allocating 400 million SEK to suicide prevention and half a billion to strengthen the work of primary care and first-line care so that it can also, in practice, become the entry point for those who need help with mental ill-health.

Together with national development teams that can improve the regions' operations, as well as the national strategy for mental health, we can seriously create the conditions for shorter waiting times for all young people who are suffering and are currently waiting to be admitted to BUP or adult psychiatry.

Improving accessibility and shortening waiting times within Swedish health and medical care is and will continue to be one of the most important issues for the Christian Democrats and this government.

Let me also say something in conclusion about our work to prevent and combat crime. Sweden shall become safer again. The Government is therefore working for more police, sharper tools and stricter penalties. We already see the effect of this work in that more and more crimes are being solved.

The social services' crime prevention work is now being strengthened simultaneously through the new Social Services Act, increased staffing, and school social teams. We are expanding the parental support programs and home visits so that more children can grow up in safe and loving homes that are capable of setting boundaries.

To make Sweden safe, a policy for strong and secure families is needed. It is strong and secure families with time for the children, the right values, and hope for the future that lay the foundation for a secure society. The government's initiatives to prevent and combat crime therefore mean that we also have reason to feel hope for a safer Sweden.

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

(Applause)

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

Karin Rågsjö (V)

Mr. Speaker! The newspaper Sjukhusläkaren has requested and reviewed all Lex Maria cases that were received by the Health and Social Welfare Inspection in 2023. During a systematic review, all deaths, 237 in total, were sorted out. Among these, they identified the deaths where the chief physician or analysis leader mentioned lack of hospital beds, lack of resources, staff shortages, or high workload as a contributing cause. In the review, they found that 100 people died because of that.

In what way will your budget prevent those types of very tragic events, Christian Carlsson? I thought that a trimmed budget would increase the risks. You are making a tax cut of 34 billion. For someone who earns 70,000 kronor a month, it becomes a tax cut of 11,000 per year, or if one earns 200,000 kronor a month, as the Prime Minister does for example, it becomes a full 52,000 kronor in reduced tax per year. Does the care become better from the reduced taxes?

You are still showing the way in some way for how you want to work. It is not health and care that can cash in from your budget. It is rather that the shortage of care beds, shortage of resources, shortage of staff and high workload will continue with the budget you have presented.

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

Christian Carlsson (KD)

Mr. Speaker! In Sjukhusläkaren, one puts the finger on the problems that I describe that the government intends to address. One puts the finger on the need for precisely increased care capacity and more staffed care places.

Several different measures are needed. The first and foremost problem is that we need more people to seek out the veterinary profession and more who want to stay. Therefore, we have developed a national plan for the skills supply where the need for personnel is mapped, but also how the regions can work to get more to want to seek out and stay within the profession.

It is not primarily about a lack of beds, but it is about the fact that there needs to be trained staff in the operations. We have a particular focus in our budget on that the conditions for the staff should be improved, so that there are more employees and so that we get more care beds so that the queues can be shortened.

We are directing funds to exactly this, in order to avoid such a serious situation with overcrowding and risk of mistreatment as witnessed in Sjukhusläkaren and which Karin Rågsjö so meritably highlights.

It is 7.5 billion in targeted funds that we are allocating for this. It is an increase of 2.5 billion compared to the previous budget. We have presented a budget with the intention of obtaining more care beds and increased care capacity, so that more people can receive the right care and care in a timely manner.

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

Karin Rågsjö (V)

Mr. Speaker! Everyone knows that the shortage of healthcare beds is not about beds, but about staff. According to the signals I am receiving from Vårdförbundet, Sveriges läkarförbund, and Kommunal, they are not cheering for this budget either. Something completely different is needed to lift the entire healthcare system. One cannot just say: Now the state will soon take care of everything, and then it will become so wonderful.

We see incredible things happening in healthcare. It is appalling. What has been looked at concerns 2023. One will also look at how it has been during 2024. Will the figures change then? Will fewer people have died? Will we have more care beds, that is to say, staff? Will the staff have better conditions to work? Will they perhaps even have shorter working hours? In your dreams! Or will there be a resource shortage again, a staff shortage again and a very high workload? It is clear that everyone is worried about that.

Everyone who has been to an emergency department or to a hospital at all understands that the staff do everything to manage the situation there. The government is adding 2 billion extra. One can do a simple calculation: 2 billion for 21 regions - not much.

I believe that you have presented your budget to benefit the absolutely richest in Sweden, Christian Carlsson. The tax cuts have an extreme direction. It is not Olle Karlsson who works at the warehouse at Ikea who gets money, but it is completely different people who can receive a fairly round sum from the government.

I do not think it is okay, at the same time as we have a healthcare system that is on its knees, a school system that is on its knees, and a welfare state that is cracking. Preventive work is not just sharp tools in the handbag, it is also to have a dignified school, a good preschool, decent housing, and everything else that a society should be able to have for its inhabitants.

(Applause)

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

Christian Carlsson (KD)

Mr. Speaker! I note that when the Left Party acted as a supporting party for Social Democratic governments in the recent past, there was no national plan for the supply of skills. They didn't even have a grasp of what the skill requirements in Sweden looked like. No wonder there is a shortage of healthcare personnel when no one knows how many people should be trained and the regions cannot even answer how many employees they have within certain occupational categories.

This is what we are trying to sort out now. It sounds like we are leaving the door open when we say that we are now preparing a national plan for the skills supply. But that job was not done. Therefore, we are doing it now and producing such a plan.

And with this, we create the conditions from the state's side for the regions to work actively with the issue. We have developed proposals for how the workplace can be made more attractive so that more can be recruited.

One might think that the money – 7.5 billion – to increase healthcare capacity, ensure that we get more healthcare beds and shorten waiting times is too little. But it is a pity that Vänsterpartiet directs its criticism at precisely those targeted measures to cut healthcare queues. With a lack of governance, and if one loses focus on those issues, nothing more will happen. We have seen that before, when the regions have managed this entirely on their own. It has not been sufficient.

Yes, we are lowering the tax. I am proud that we are lowering the tax. And we are lowering the tax for everyone. If you add up our budgets, you can see that we are lowering it most for those who have the least. But everyone who goes to work – regardless of whether you earn a lot or a little, or if you have earned your money previously and are now a pensioner – now gets more financial room with our budget. You get more in your wallet. It increases people's freedom, and it increases people's security. It is a policy that is right to pursue.

(Applause)

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

Christofer Bergenblock (C)

Mr. Speaker! I would like to thank Member Christian Carlsson for the speech.

I think it is good that the government parties say that they want to continue to strengthen health and medical care both financially and organizationally. On the other hand, I perhaps do not see that reflected as well in the content of the policy that the government parties put forward.

I begin with the organizational issue. There, we hear the Christian Democrats repeatedly praise a nationalization of Swedish healthcare. It is very easy to hide behind that. One appoints an inquiry, which will be finished just in time for us to reach the next election, and then one can say that one intends to carry out a nationalization.

Everyone actually knows that it will not benefit anyone. Above all, it will not benefit the people in Sweden who are furthest out in the periphery. A centralized power has never been in favor of those who live in Sweden's rural areas and sparsely populated areas. But the confidence that the Christian Democrats have that if everything is governed by a general director in Stockholm, it will sort itself out, is astonishing.

What is needed is an incentive for the regions to work with a strengthened health and medical care. Certain things need more national governance; we are in complete agreement on that. But to throw Swedish healthcare into the largest reorganization ever and move 500,000 people from regional employment to state employment will only result in chaos.

Can the member explain in what way Swedish healthcare will benefit from this gigantic reorganization?

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

Christian Carlsson (KD)

Mr. Speaker! The Christian Democrats want the state to take greater responsibility for health and medical care. Already with the government basis we have now and the policy we are pursuing, we ensure that the state takes a greater responsibility for care. National healthcare coordination is one such example. We develop the national plans for increased care capacity and more care beds. It is a way for us to step in and say: Here, the regions need to act in a different way than they have done.

The reason why we need to move towards state control is that we do not have equal care in Sweden today. The differences in the country are too great for us to be able to maintain the current order.

Christofer Bergenblock seems to know more than I do about the details of what such a state responsibility should look like. He speaks of moving all employments and so on. What I am looking for is that the state shall have the full responsibility for the financing, the target vision, the follow-up, and the quality requirements. We want significantly fewer regions than today. It is very difficult to manage 21 self-governing regions. 6 executing regions are needed, but they shall be profession-led. We trust that the profession knows better than the regional politicians. We want to give more power to the employees within healthcare and less to the regional politicians.

We have several examples of why this is needed. We come from a model that was established in the 1800s, and as healthcare has developed, more and more turn to the state and say that they need more money, that they need help with medicines and that they cannot manage it all. These are some examples of why the state needs to have the full responsibility.

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

Christofer Bergenblock (C)

Mr. Speaker! There are, of course, parts that benefit from stronger national governance. It could be about pharmaceuticals, vaccination, and air transport. But to have a functioning healthcare system in the whole country, a proximity to the citizens and the patients is also fundamentally needed. That is what is destroyed through a total state takeover of healthcare.

Sometimes the government confuses the resources for healthcare with the organization of healthcare. We also heard in Christian Carlsson's speech that the government continues to strengthen healthcare financially. I am not sure that either staff or patients fully recognize themselves in the description.

At the mid-year point this year, there were 3,000 warnings within Swedish health and medical care. And regarding the care queues, the party leader Ebba Busch, whom the member is surely well acquainted with, said in 2022 that people were forced to wait in queues illegally long considering the care guarantee. In August 2022, it concerned 85,000 people. Today, more than 89,000 have waited longer than the 90 days, despite the change of government.

How can the government consider that it is providing the resources needed for Swedish healthcare when the queues are de facto becoming longer instead of shorter? How can one hide behind the idea that we will at some point in the future nationalize healthcare and in that way solve all the problems we see here and now? That is not taking responsibility. The member is very welcome to explain to me, Mr. Speaker, how one intends to take responsibility with the resources provided when the healthcare queues de facto increase.

(Applause)

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

Christian Carlsson (KD)

Mr. Speaker! The care queues, that is, the number of people waiting to have their first visit or to receive surgery or another measure, are not higher in September 2024 than they were in September 2022. That being said, the care queues are still far too long. It is to address that which we are undertaking a long series of measures.

National healthcare coordination is a way to be able to utilize the full capacity in all of Sweden's healthcare and to be able to see where there is available capacity where you can get your care if you cannot get it in your home region. Furthermore, we are tightening the healthcare guarantee so that it means something and to, at a significantly earlier stage, give you the power to be able to turn to another healthcare provider or region when you do not get the help you are entitled to.

Furthermore, we have the entire transition to close care. It doesn't matter which healthcare system you look at: If you have a strong primary care and strong health centers as the hub of the healthcare organization, you get a more efficient care chain.

We are in complete agreement in the chamber that power should be moved to primary care so that it gains a more central significance. But the failure of the entire transition points out that the regions are not doing their job well enough. Over the last four years, we have from this chamber pushed out 16 billion to the regions so that they should accelerate the transition, but we have no mandate to tell them what they should do. We must agree on what they should do. Have they spent money on a transition to close care? No, one can almost not see that the budgeting for primary care has increased at all. It is 16 billion down the drain. The state must step in and take full responsibility and take the mandate.

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! "It is brightening on the horizon." That is how the Prime Minister began his government statement here in the chamber at the beginning of this parliamentary session, and in a similar fashion, Member Christian Carlsson began his budget speech. It stung then, and it still stings today, a day on which we have received reports that the country's GDP is decreasing by 0.4 percent compared to the previous month.

For me as a Social Democrat, it is obvious that we should have a strong welfare system that functions in the entire country, a healthcare system that is secure for all patients, and an elderly care that is there for us when we get older, which provides security and in which both the elderly and the staff are treated with respect. Therefore, we have submitted proposals to provide resources to the welfare and that they increase in line with price increases so that neither the staff nor the patients have to pay for higher prices. We have also submitted proposals on how to clean up the market chaos and ensure that the healthcare companies put the patients first.

Now it is the midpoint of the parliamentary term. The midpoint can be used to evaluate the policy. In the election campaign, Ulf Kristersson lined up a number of issues based on which one should evaluate a government. One of these sounded like this: Is Sweden now stronger as a country, or are we more vulnerable?

Half of the parliamentary term has passed, and my question to Member of Parliament Christian Carlsson is clearly: Is Sweden stronger now as a country, or are we more vulnerable?

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

Christian Carlsson (KD)

Mr. Speaker! It is probably clear to most who are listening to the debate that Sweden is currently in the process of arming itself stronger. We see this in area after area. We have an economic policy that aims for entrepreneurship and growth, which makes Sweden stronger, which strengthens our competitiveness and which contributes to more resources for the welfare. We see it in the historical upgrade of the military defense and the justice system, but also by the fact that we are paving the way for a much stronger and better healthcare organization.

There is much to point out, but the investigation that Fredrik Lundh Sammeli himself is involved in – regarding whether the state should be held fully or partially responsible for Swedish health and medical care – is important in this context. Sweden needs a healthcare system for which we, from the state, have the full mandate to expand the care capacity. We must have a supply readiness within health and medical care and a care capacity that can withstand crisis and, ultimately, war. For that, firmer governance is required.

We also need a more efficient healthcare organization. The state must be able to step in and help the regions in the work.

We are, therefore, making progress. But two years into the parliamentary term, the deliveries are not finished, and we are not finished with our work. However, for every point in the Tidö Agreement concerning health and medical care, we have work underway. We naturally look forward to receiving delivery on this.

I hope that the Social Democrats want to be part of paving the way for a stronger Swedish health and medical care through the work to ensure that the state can step in and take a greater responsibility for healthcare.

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! We live in a restless time. That is simply something we must accept. I am incredibly pleased that we, in this chamber in this situation, can make important decisions in broad agreement to strengthen, not least, the defense capability in our country.

What worries me is that the government is not delivering a budget that meets the healthcare crisis we have, but a budget that risks deepening that healthcare crisis further. That is not what Swedish healthcare needs. That is not what the patients waiting in queues or in an overcrowded health center need. That is not what we need to build Sweden stronger. The capability of the defense also depends on us having a functioning health and medical care that can take care of the population and take care of people in crisis or war.

The Prime Minister's promise to present a budget that would ensure no more people are laid off within healthcare was, at best, a thumb-sucking. I have chosen to report the Prime Minister to the KU so that the Committee on the Constitution can examine which underlying documents and calculations formed the basis for this claim, which then did not amount to much.

My question to Member Carlsson is whether he considers Sweden to become stronger or more vulnerable by us having thousands fewer employees in Swedish healthcare during 2025 compared to 2024.

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

Christian Carlsson (KD)

Mr. Speaker! The Government presents a budget that takes responsibility for Swedish health and medical care. This year, we chose to provide 9 billion to the regions specifically so that they could manage the situation with high inflation and rising pension costs. We provided those funds with the clear proviso that we expected them to be used to protect healthcare workers from being laid off.

If one looks at how it looked before we allocated those funds and how it has become since then, one can observe that it is only 5 out of 21 regions that have notices, and it is not certain that all of them will be carried out either. Several regions also state that these are reorganizations that they would have needed to do for reasons other than the economic situation.

One must say that we have taken responsibility for this. When the pension costs are not as extensive for the coming years, it is naturally nothing strange that the temporary funds that were intended for one year, which SKR knew they were, disappear.

When it comes to strengthening Swedish healthcare, it is that we are injecting 2.5 billion, so that we now have 7.5 billion, for example, to increase the number of care beds and shorten waiting times. When the Social Democrats now inject more than the bourgeois government, the difference constitutes only 4 per mille of the total healthcare budget, I calculated. I hardly believe that it is the difference between a healthcare crisis and not. The Social Democrats must understand that it is the structural problems that are serious for Swedish healthcare, not primarily a lack of money.

(Applause)

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

Ulrika Westerlund (MP)

Mr. Speaker! Yesterday, a requested memorandum from the Ministry of Health and Social Affairs finally arrived regarding the updated high-cost protection for pharmaceuticals. It was requested because since the government's budget bill, it has been clear that cuts are to be made in the high-cost protection. It has just not been clear how.

A rumor has been circulating that the so-called first step, that is, the lower limit for when the high-cost protection first kicks in, is to be raised from 1,425 to 2,000 kronor. This has not been possible to fully confirm until yesterday, when the memorandum arrived and it turned out that the rumor was true.

It also turned out that the cost ceiling for the high-cost protection for pharmaceuticals is increased from 2,900 to 3,800 kronor based on the 2025 price base amount. This means that the fees for the individual can increase by at most 900 kronor during a twelve-month period.

This has met with protests. Over the weekend, SKPF Pensionärerna, Funktionsrätt Sverige, Reumatikerförbundet, and Astma- och allergiförbundet wrote in Svenska Dagbladet that this is a deterioration that will affect very many people, especially the elderly, the chronically ill, and persons with disabilities. "The proposal is a threat to our health. It is well-documented that 40-60 percent of all patients with chronic illness do not take their medications as the doctor prescribed, either deliberately or unconsciously. One possible cause is poor finances, according to Läkemedelsverket."

SKPF Pensionärerna have also conducted their own survey which shows that even now, far too many are forced to refrain from picking up their medications because they cannot afford them. Such an increase in the high-cost protection will therefore increase inequality in health.

I wonder what the trade-offs have been regarding exactly this. Is it reasonable that the chronically ill and the elderly should pay more for their medicines?

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

Christian Carlsson (KD)

Mr. Speaker! To begin with, one must step back a bit and see why this is coming now. Actually, it is a fantastic development we are seeing in the pharmaceutical field. Thanks to vibrant pharmaceutical companies and research, we have access today to medicines and treatments that we previously did not have. People can continue to live thanks to the great progress we are making in this area, which they would not have been able to do otherwise.

These fantastic advances, which we want to be able to take part in, have however also caused prices to increase enormously. With precision medicines and the latest pharmaceuticals, there has been an avalanche-like increase in drug costs.

What this is about is simply to review the ceiling for the high-cost protection. The high-cost protection is important so that people can turn to healthcare and access the medicines they need. But it is about how it should be designed.

This proposal arrived just recently. It is to be sent out for consultation, and then we will listen to views and see what we should land on for a final proposal. For me, it is important that one then tries to ensure that it is primarily those who need medicines often who are protected, for example chronic patients, as the member speaks about. If one needs medicines a bit less often, one can bear a higher cost. I think that is the right basic principle and the right attitude in this situation, where we simply need to find another future financing of medicines.

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

Ulrika Westerlund (MP)

Mr. Speaker! I thank you for the answer. The research progress is great. We are in complete agreement on that. It is also very good that people are listening to opinions. I believe that quite a few such opinions will come to the government regarding exactly this. It appears from the budget bill that these deteriorations are only the beginning. It is expected to save an additional over 2 billion annually in 2026 and 2027. Exactly how it will happen is not yet fully known.

In the autumn, I asked RUT, the Riksdag's investigation service, to take a closer look at how this deterioration could affect different groups. This was done on the premise that the first step would be raised to 2,000 SEK, which has now become a reality. RUT stated that such a change is estimated to mean reduced costs for the high-cost protection, that is, increased costs for the patients, particularly among the elderly.

In the group 75 years and older, the cost of the high-cost protection is highest. In this group, the high-cost protection is calculated to decrease by barely 140 kronor on average per person if the increase takes effect at the half-year mark. Divided into income groups, persons belonging to the two tenths of the population who have the second lowest and the third lowest income are calculated to be most affected by the change. These are conclusions from RUT that are completely in line with what the debaters present in the article from the weekend that I mentioned earlier.

This will make it worse for some of the groups that the government and the Sweden Democrats say they protect most of all, that is to say, for example, the elderly. I therefore agree with these organizations. It is not right to shift the responsibility for inflation and increased costs for pharmaceutical research onto persons with chronic illness or disabilities.

The debaters write that it should be obvious for the government to prioritize the population's health higher. Sweden should be able to proudly finance a development that provides equal opportunities for more people to live active and long lives.

Those who have the worst finances, often as a result of illness or age, should not pay the price when the government wants to save. It is fantastic with the improved results in pharmaceutical research which have given the opportunity for many to now live much longer and healthier lives as a result of it.

My question concerns the prioritization. Why should the money be taken from just these groups?

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

Christian Carlsson (KD)

Mr. Speaker! The costs for pharmaceutical benefits have increased sharply in recent years. They have increased by 10 billion just in the last eight years. It is an increase of almost 40 percent just between 2018 and 2024. We are injecting 6 billion to meet the strong cost development.

How we are to finance the medicines of the future is a common challenge for both the bourgeois and the red-green parties. The red-green governments have not tackled this issue previously, but we have a need to do so now.

We need to find a long-term sustainable financing where effective medicines can be made available. It is probably the case that individuals, regions, and the state will simply need to pay more in order to be able to finance this in the future.

It is not only important that it is cheap. It is also important that one has access to the best medicines when one is ill so that one can receive the care and treatment that one needs.

That is why we are not only working on ensuring that TLV is tasked with reviewing how to try to dampen the costs for pharmaceuticals. We are also ensuring that we now roll out an agenda so that we can have precision medicine and precision health evenly distributed in the country.

When it comes to how the medicines are to be financed, there is now a proposal. I hope that both the red-greens and others are prepared to be part of the discussions. Both the Socialdemokraterna and Centern have stood behind our budget prioritization here. It is a matter of us together finding a proposal that ensures that those who have the greatest need are those who are affected the least and that we who visit healthcare less often pay a little more.

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! I want to begin by making a connection to what was said in the exchange here before. We Social Democrats think it is a bad proposal. I reacted very strongly when I heard the Minister for Health sit in the Saturday interview and give the impression that this is a broad agreement.

There is no proposal that we have had the opportunity to review. There is no basis that we have taken a position on. On the other hand, the pharmaceutical area is an area that is increasing very much in cost.

It is fascinating that the government and the Sweden Democrats do not seem to have considered other alternatives than to shift the costs onto the most vulnerable patients. We will return to that debate.

The budget that we are now debating should be the answer to two major societal crises, at least if we had had a government that saw reality as it is and that took responsibility and made its budget priorities based on this.

The societal challenges are, of course, many. The Social Affairs Committee's area is enormous. It covers safety for people at all stages of life. It is about the expectant parents and their safety linked to childbirth. It is about the interventions in the lives of children and young people when life is tough and parental responsibility fails.

It is about the youth who tries to end their life and about the person in the middle of life who receives their cancer diagnosis. It is about the right to assistive devices and the right medicines and about everyone who carries a chronic illness.

It is about creating faith for the future when the darkness is at its darkest, about everyday life at the health center and about the care at the elderly care home, to name a few.

It is fundamentally about welfare for all of us and security throughout life, which should be equal and good regardless of who you are and where you live. It is about the society being there and being strong when we get old or get sick.

Mr. Speaker! In all areas and in everything in this policy area, there are two things that stand out more clearly than anything else. I am, of course, thinking of the national healthcare crisis and the accelerating gang crime where children kill children.

Sweden's health and medical care is in crisis. The year has been filled with examples of warnings, layoffs, and austerity measures. The Government and the Sweden Democrats are making Sweden poorer, and bear the responsibility for the healthcare crisis they have created by prioritizing large tax cuts for the wealthiest over necessary investments in healthcare.

We in the opposition have truly tried to shed light on the serious healthcare crisis, but it is clear that the Tidö government is dodging the consequences for both the sick and the employees. For me, it is clear that the government is not taking this situation seriously.

The healthcare crisis we are seeing now is a result of two years of state budgets where the care has simply received too little money. The queues are increasing, accessibility is worsening, and the staff have to run faster to try to make it suffice.

All over the country, we see serious consequences of the healthcare crisis. The layoffs have been many, and the reserves are depleted. In the moderately-led Östergötland alone, one will face 2025 with nearly 1,000 fewer employees compared to this year.

The government still does not seem to realize the gravity of the situation. If they did, they would not enter 2025 with 7 billion less in sector grants to healthcare. This is happening at the same time as health centers are closing, service is deteriorating, patient fees are being raised, and new fees are being introduced, among other things, within dental care and ambulance care.

The truly sad thing, Mr. Speaker, is that this healthcare crisis could have been avoided. Already in the autumn of 2022, we Social Democrats pointed out and warned about the consequences of the SD government choosing to prioritize tax cuts for high-income earners over state grants to municipalities and regions before 2023.

Before 2024, it was the same thing. We Social Democrats doubled the money for healthcare. Instead, the government urged healthcare to become more efficient and used the reform space for tax cuts. The pattern is clear and recurring. Welfare is being eroded, and the richest get tax cuts.

This is not taking responsibility for Sweden. This is not the leadership we need in times like these. That underfunding healthcare for three years in a row is now having the consequences we warned about. It results in fewer employees, worse service, and higher fees. It is a bad policy both here and now, and when it comes to building preparedness and capacity in the restless times we live in.

Mr. Speaker! The second major societal crisis that the government is not clearly enough addressing is the accelerating gang crime in our country, which is becoming increasingly brutal. The government's economic policy has placed Sweden's municipalities in an impossible position. The resources that are allocated do not meet the cost developments but instead force cuts.

It becomes particularly clear when it comes to the costs for the placement of children. These placement costs are now increasing very sharply all over the country. The increased costs risk pushing out other important interventions to break the recruitment of young people.

When Ulf Kristersson says that the deadly violence is like Sweden's second pandemic, it becomes clear that these are just words that are not met by action. Bottom line, the government does not prioritize the work against gang crime. Bottom line, they still prioritize tax cuts for the country's high-income earners.

We Social Democrats have shown in our budget alternatives that it is possible to prioritize differently. In this year's budget alone, we allocate a total of 15 billion kronor more to municipalities and regions. These are primarily unearmarked funds that municipalities and regions can use as they wish. To break the recruitment of new members and stop gang violence here and now, we also propose an investment of 1.5 billion per year for targeted interventions for young people in crime or on the path into crime.

When a young person ends up on a downward spiral, it is important that we, with all available means and gathered resources, are there to turn the development around. These are investments that could have made a real difference here and now - not later.

Mr. Speaker! It is the midpoint of the parliamentary term. I summarize the situation as one where there is much to be desired. Sweden is emerging from the cost crisis poorer than we should have had to. Unemployment is at its highest in a decade, and Sweden's growth is among the lowest in Europe. Gang violence is creeping down in age, and the government and the Sverigedemokraterna have driven forward an acute healthcare crisis in the entire country.

In this year's budget bill, the government cuts healthcare, allows the new recruitment to the gangs to continue, and refuses to support all those who struggle to make ends meet. When the Swedish people want measures to tackle the problems they face in their everyday lives, the government chooses to borrow money to lower taxes for those who earn the most.

Sweden can do better than this. Unfortunately, a majority in a first step of the budget process has given the budget policy a different direction than the Social Democrats desired. This means that we abstain from taking a position regarding the allocation of appropriations within expenditure area 9 but move for approval of reservations 1 and 2.

We prioritize reinforcements for healthcare and measures to strengthen Sweden's growth. We are moving forward with powerful measures to stop the violence here and now and break the new recruitment to criminal gangs. At the same time, we support all the families with children and retirees who have been hit hard by the cost crisis.

(Applause)

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

Leonid Yurkovskiy (SD)

Mr. Speaker! That an opposition party such as the Social Democrats has views on the government's priorities is not surprising to me. I have no opinion on that in substance.

However, I have noticed that during several debates, it has been implied that it is the government and the Sweden Democrats who have now caused a healthcare crisis. During last year's committee report debate, the Sweden Democrats' group leader Linda Lindberg posed a very relevant question to the Social Democrats and to the member. The question was about what was the reason that the healthcare queues increased during eight years of Social Democratic rule. Why did the healthcare crisis get worse during eight years of Social Democratic rule?

Of course, this debate is about the future and about the decisions we make now. But the Social Democrats have, on several occasions, spoken about how it was the government and the Sweden Democrats who have created a healthcare crisis over these two years, and therefore I want to clarify the matter.

It is one thing to claim that the government is prioritizing incorrectly; that is something one can think as an opposition party. But it is a completely different thing to say that the government has caused the healthcare crisis. Therefore, I want to repeat the question to the member: Why did the healthcare queues increase during eight years of Social Democratic rule?

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! Swedish healthcare has for a long time faced great challenges. The suit for healthcare is too tight, and there are many things we would need to do to streamline and improve Swedish healthcare. This includes, in particular, focusing on the supply of competence, which is perhaps the absolute greatest challenge for the welfare system.

But it is also clear that we have been in a very tough economic situation over the last two years. It has affected everyone - private individuals but also the state as a whole and not least municipalities and regions. That the government and Sverigedemokraterna did not more clearly meet the development we could see ahead for 2023 has created a national healthcare crisis, which the government and Sverigedemokraterna need to take responsibility for.

It is no secret that regions across the country, regardless of who governed them, pointed out that they are on their knees. This is a cost crisis that we are unable to manage, they said. To then not meet this in the budget for 2023, nor for 2024, and actually not even prioritize it for 2025 - that is not taking responsibility in this situation.

So no, healthcare was not perfect on all points when we governed. But the government and Sverigedemokraterna have not taken the responsibility that needs to be taken in this situation with a cost crisis in our society.

(Applause)

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

Leonid Yurkovskiy (SD)

Mr. Speaker! I thank the member for the answer, and I am pleased that we seem to be quite in agreement on much of the description of the problem.

Now I have once again heard the Social Democrats' objection to the government's budget, but I note that I still have not received any answer to the questions. This is not only the second time I am asking the question, but it will be the second year in a row that the Sverigedemokraterna ask it - precisely because of what the Socialdemokraterna say about it being us who should have created the crisis.

Do you mean to say that there was no crisis during the Social Democrats' time? I have statistics from SKR's waiting list database, and it is clear that the waiting times increased year by year. Every year under the Social Democrats' rule, it was a bad situation, and it only got worse.

I therefore want to ask the question again. I want to make another attempt and give the member another chance to get this right. Why did the healthcare queues increase during eight years of Social Democratic rule if it is now only a matter of such simple political priorities as it sounds when one listens to the member?

Mr. Speaker! I can state that the healthcare crisis was already a fact under the previous red-green government. We take on the responsibility to solve the crisis, but we do not take the responsibility for having created it. That is for the other parties to do.

(Applause)

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! It is no secret that Swedish healthcare has for a long time struggled with queues, that it is not efficient enough and that we have not had the capacity that healthcare needs.

In a previous exchange, we could observe that the healthcare queues continue to increase even during these two years, with a new government. The issue surrounding healthcare queues is something we will likely have to grapple with for a long time. But beyond that, the national healthcare crisis has meant that we have ended up in a situation where care is suspended, where staff are laid off, where staff quit, where positions are not refilled, and where staff are dismissed. Healthcare becomes even less equipped to meet the patient at the health center, at the hospital, and in all that we mean healthcare should become better at.

What I consider deeply serious is precisely that our ability here and now is far too poor in relation to the time we live in. We would need to have much more focus on how we increase capacity and strengthen preparedness. We are too close to the red lines. Therefore, this would need to be the focus: How can we improve healthcare to shorten the queues but also to increase preparedness and thereby our common security?

With the policy that the Sweden Democrats and the government are pursuing, I can only state that we are moving further and further away from succeeding in shortening the queues or building security in Swedish healthcare.

(Applause)

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

Johan Hultberg (M)

Mr. Speaker! I think it was almost telling when Fredrik Lundh Sammeli now tried to walk away and sit down, because it is obvious that the Social Democrats are actually trying to flee their responsibility.

Lundh Sammeli is trying to make it seem as if we have a national healthcare crisis. But the fact is rather that we have a regional healthcare crisis. The Moderate-led government takes responsibility for Sweden. We have successfully managed to fight inflation, which is the major problem that is pressing the regions financially. Thanks to the fact that we moved from 10 percent inflation when we won the election after a Social Democratic failure, we have now fought inflation and won that battle. Only the regions' pension costs are decreasing by 25 billion next year thanks to that. We are providing the regions with better conditions.

The fact is simply that it is the regions that bear responsibility for health and medical care. It is the regions that are the providers of Swedish health and medical care. We give them better conditions to take their responsibility through national reforms, by providing funds, and by working with strategic issues such as competence supply and digital infrastructure. But the regions must deliver.

I can take a speaking example, the region we find ourselves in right now, Region Stockholm. One could speak about Region Stockholm and the art of succeeding in worsening a region in 390 days. Here we now see how diversity is dismantled, how freedom of choice decreases, the healthcare queues increase, the buses become fewer, the tax becomes higher and the economy worsens.

Every year with moderate rule in Region Stockholm, we had a financial surplus. Now there is a large deficit and the queues are increasing. The Social Democrats need to take responsibility for their regional failures instead of shifting all responsibility to the state. It almost sounds like Lundh Sammeli, as if the Christian Democrats have won and healthcare has become state-run. But the fact remains: the regions bear responsibility for healthcare. We create better conditions, but it is time for the Social Democrats to take responsibility for what is delivered in the regions.

(Applause)

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! God forbid that the Christian Democrats win the issue of nationalization of healthcare.

Neither I nor other Social Democrats are in the least afraid of taking responsibility. It is a regional responsibility to drive and lead the health and medical care forward. But it is also a national responsibility to be helpful and join forces. The prioritization that the government has made during the past two years and is making in this budget is once again classic Moderate politics on the theme that tax cuts are the solution to everything. The past years, but also the budget that is now before us, cannot be interpreted in any other way than that you actually do not care about the cost crisis that has hit the regions and which leads to warnings and layoffs, increased patient fees, increased regional taxes, worsened accessibility, and worsened working conditions for the staff. Otherwise, one would prioritize the national policy differently.

It is not that the money does not exist. The government and the Sweden Democrats say that they think welfare is important, but they have not met with regions and municipalities in the enormous challenge that they have to grapple with.

When it comes to Region Stockholm, I can only state that the table was not set when the new government took over. It is a showcase of market failures to clear up. I believe it is incredibly important to have the strength to continue doing that, but also to transition to a more good and close care.

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

Johan Hultberg (M)

Mr. Speaker! I do not know if it is at Bommersvik or where it is that the Social Democrats learn to be so shameless, because I actually think Fredrik Lundh Sammeli is that in his descriptions.

We heard attacks from the rostrum regarding the issue of pharmaceuticals, that it will result in a higher cost for the individual patient for medicines, when the Social Democrats do not add a single krona more than the government in their budget. Stop trying to deceive the voters, and take responsibility for your historical failures! The healthcare queues more than doubled before the pandemic when the Social Democrats were in charge and held a position in government.

An intensive effort is currently underway on the government's side to shorten the healthcare queues, and I am the first to say that we need to do very much more, because I am not satisfied. Therefore, I am pleased that the Tidö parties in the updated Tidö Agreement launched this week that the queues will become a prioritized issue moving forward. But it also requires that the regions take their responsibility. Therefore, I am pleased that we have performance-based funds in our budget – funds that the Socialdemokrater unfortunately want to reduce and Vänstern want to remove entirely – because there needs to be requirements on the regions so that they do not just receive more money but also deliver better results.

According to SKR's own economic reports, productivity within Swedish health and medical care has decreased by 23 or 24 percent between 1995 and 2022, I want to remember that it was. It is completely unsustainable. We must get more care for the money. But with the Social Democrats in regional boards in Region Stockholm, Region Västerbotten, or wherever it is in Sweden, it becomes less care for the money, longer queues, and less money in the wallets of the taxpayers, who get increased taxes.

It requires regional accountability and that the conditions we create from a national level are taken advantage of.

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! When it comes to the cost of pharmaceuticals, we know that it is something that is increasing. Christian Carlsson explained that it has increased over a longer period. One can state that in a very short time, the cost for the high-cost protection has gone from 37 to 41 billion.

I am completely convinced that the framework that the budget entails, a saving of 500 million, can be achieved in more ways than by going in and worsening the high-cost protection for the individual. It will be interesting going forward to receive the account from the government of what it is that they have reviewed to see if there are alternatives to that saving and the model that they now choose to roll out. I believe that it will hit hard for those who really need the high-cost protection the most. Therefore, we are clear that there must be other models to choose from than that path.

When it comes to queues, we mean that performance-based queue billions in this situation are completely wrong to implement. Therefore, we choose to take the 2 billion that the government allocates as queue billions and put them on a staffing investment and additionally add another 1 billion. 3 billion for staffing investments is much better than 2 billion in performance-based support to shorten the queues.

I can only state that I, in any case, find it difficult to see how one can say with any credibility that Swedish healthcare is better equipped to shorten the queues today than it was two years ago.

(Applause)

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

Leonid Yurkovskiy (SD)

Mr. Speaker! I begin by moving to approve the committee's proposal for a decision in report SoU1, which concerns expenditure area 9 Health care, medical care and social care.

It is an honor to participate in such an important debate, as the issues we are discussing actually concern life and death. It is also very rewarding to do this work with committee colleagues from all parties who genuinely care about their fellow citizens.

I also want to take the opportunity to remind that we in Sweden, regardless of party, are quite in agreement on the basic principles for healthcare and care policy. There are large countries where that kind of access to healthcare and welfare is not at all as self-evident. If one listens to how it has sounded from the red-green opposition, one could almost believe that Sweden is heading in such a direction. That is not the case.

The most obvious thing that needs to be stated is that we are now increasing the appropriations for this expenditure area by 10 billion kronor from last year's report. Then we have added funds in the supplementary budget as needed, and that can also happen next year if necessary.

We will, of course, discuss the details, but there is no question of any so-called cut. The purpose of the policy area is that those who need care shall receive it, receive it in time, and receive it with as good quality as possible. What do we do with this budget to take further steps in that direction? Well, to begin with, it is 7.5 billion to shorten the care queues. It is another multi-million investment, 250 million kronor, to finally get a national healthcare brokerage in place, which the Sverigedemokraterna have pushed for a long time, to make the care capacity accessible. It is about 1 billion kronor for measures for better cancer care.

Mr. Speaker! The most frequently recurring objection from the red-green opposition is not about the investments in substance, but rather that the government is simultaneously lowering taxes. This is generally a positive announcement for households. The opposition argues that the regions should instead be given more money.

Sweden spends more money on healthcare and has a higher density of doctors than the EU average, while at the same time we have significantly longer healthcare queues. We are therefore getting less care for the money. At the regional level, where the responsibility for healthcare actually lies, the Sweden Democrats is a party that prioritizes core activities. But let me then bring up some examples of when that is not the case, often when it is the red-green parties that are in power.

In Region Stockholm alone, language interpretation costs amount to approximately 160 million kronor. Then we have what is called the care need index, CNI, where in practice resources are focused based on identity rather than care needs. According to that model, approximately 400 million kronor are paid out solely based on the variable foreign-born in Region Stockholm. It is clear that one cannot withdraw all the money, but there clearly must be better models.

The cost of care for illegal immigrants also amounts to many millions, hundreds of millions, every year. Circumcision rituals on children, that is, non-medical circumcision of small boys, are also a multi-million cost - believe it or not.

Then we have Islamist study associations, men's art in the subway, Norrlandsoperan, the Concert Hall, wind power bought and sold for millions in losses, participation in Almedalsveckan for hundreds of thousands of kronor, hbtqi-diploma, gender equality integration, yes, why not a cloned spruce for almost 8 million kronor.

Mr. Speaker! Why do I bring this up? It is to demonstrate that the situation within Swedish healthcare cannot be solved by injecting more of the state's money into the regions. It requires both reprioritizations and structural changes, which we, of course, also work for at all parliamentary levels.

What I just mentioned can be regarded as a waste of welfare, which is quite serious. But I also want to mention direct welfare crime because healthcare and care is a new risk area for organized crime. Unserious and criminal actors are an ever-increasing challenge, according to several authorities, unfortunately. Information has emerged that HVB homes can be linked to crime and criminal actors. One sees clear signs of similar developments within dental care, aesthetic treatments, and even health centers.

Besides lost resources, this means that patients and users are subjected to inadequate and sometimes directly harmful care. In addition to all the agency mandates that the government gives in the area, we also add 9 million kronor to intensify the work against welfare crime. These are funds that go to the Health and Medical Care Responsibility Board. The same applies for 2026 and 2027. That is good.

Mr. Speaker! I want to mention a few more things that are good. The government is increasing the state grant to the organizations for people with disabilities by 20 million kronor annually. That is good. The government also proposes that the hourly rate for the assistance allowance be increased by 3 percent for 2025. That will be approximately 390 million kronor in costs for the assistance allowance. That is also good. Furthermore, there is 400 million kronor for suicide prevention work. That is extra important, and it is also good. Then there are approximately 1.6 billion kronor for equal healthcare, women's health, and maternity care. In total, the investments amount to approximately 18 billion kronor for 2025. This is good.

This is fundamentally good welfare policy. Would some things look different if the Sweden Democrats were allowed to present an entirely separate budget? Of course! That is the case for all parties. It is natural. But this budget adds up, and it has the support of the Swedish people through the Riksdag. The same cannot be said for the red-green base.

Mr. Speaker! I was met with some raised eyebrows when I requested only six minutes for my speech, but I still consider that the Sweden Democrats' position is presented and that the budget investments are accounted for, not least when the previous speaker has been taken into account. I will stop there and look forward to the upcoming exchanges of remarks.

(Applause)

In this speech, Jonas Andersson (SD) agreed.

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

Karin Rågsjö (V)

Mr. Speaker! I would like to thank the member for the informative speech.

As usual when the Sweden Democrats speak, regardless of whether it is about snow removal or ambulance flights, everything is ultimately the fault of the immigrants.

I have a small future prediction for Sverigedemokraterna and MP Leonid Yurkovskiy. Even in the current situation, there is a great shortage of staff within several welfare professions. According to the Socialstyrelsen's latest assessment of supply and demand for licensed personnel in health and medical care, all regions reported a shortage of midwives, specialist doctors, and nurses. One can say that it is a problem.

What does your future outlook look like here? All immigrants should preferably leave, according to the policy you pursue and push for. According to Statistics Sweden, SCB, every fourth employee within health and social care is born abroad. That must be a big problem for you. Among the doctors, the proportion is even larger - 34 percent. A full 40 percent of the healthcare assistants and 26 percent of the nursing assistants come from other countries, that is to say, are foreign-born. Of Sweden's population, foreign-born make up 19 percent, but a significantly larger proportion is thus working within healthcare.

It is clear that the Sweden Democrats and also the Moderates, the Liberals and KD throughout the Tidö cooperation are sending signals that as many immigrants as possible should leave, and of course, that creates ripples. Does one want to live in a country where the entire politics is about that I, as an immigrant, should leave from here and am not valuable? Who will work in healthcare?

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

Leonid Yurkovskiy (SD)

Mr. Speaker! I thank the Left Party for the intervention.

The first thing one must do is, of course, distinguish between immigration and immigration. When the Sweden Democrats have criticized the completely failed immigration policy, which also lies at the basis of why the welfare state is so burdened right now and why we see the problems, we do, of course, not mean highly specialized doctors who save lives in Sweden.

At the same time, we now have a common line that prioritizes jobs. It will guaranteed help more people into work, even in healthcare. At the same time, we are adding 7.5 billion to increase healthcare capacity. All of this together must nevertheless be a good contributing force to increase the strength of the healthcare capacity.

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

Karin Rågsjö (V)

Mr. Speaker! I believe the member does not quite see what is happening in Sweden. Your entire policy in the Tidö agreement focuses on immigration. Most of the proposals are about that. In the proposals concerning law and order, immigration is highlighted as a problem. The member highlights interpreters in health and medical care. People who do not speak perfect Swedish should not have an interpreter. My God, what a waste! At the same time, you are slashing health and medical care through the regions. You have not invested enough so that the things that need to be done can be done. What does the staff see today of your policy?

I think it will be strange for all the healthcare workers with a foreign background who hear the member. The member distinguishes between human and human. Your entire policy is based on that. I am astonished.

Another question that I might have time to get to quickly concerns your view on raising the prices for medicine for all persons who need it. It should be your voter groups, that is to say, the poor. But it seems that you have abandoned those voter groups. Prices are going up for food, rents are going up and now the price of medicine is going to go up. One does not get a chance to manage. You support that.

How is it that you, who consider yourselves a party for those with the worst circumstances in society, poor finances and so on - you have put forward your messages - agree to that type of proposal? The medicine will become more expensive for all those who are multi-morbid, for the pensioners and so on. It is an interesting question.

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

Leonid Yurkovskiy (SD)

Mr. Speaker! Thank you, the member, for further questions and input!

To make a distinction between people and people – no, I make a distinction between immigration policy and immigration policy and also between different goals with this policy.

There are several problems with immigration. I am not highlighting this primarily to talk about immigrated healthcare personnel, but we are talking, as I mentioned, about hundreds of millions just for one region when it comes to illegal immigration and the care of these people. These are people who are not even supposed to be in the country. It is clear that this is a problem when it comes to healthcare.

Another problem is that healthcare and especially elderly care have been used as a kind of integration project. That is also a huge problem. We cannot let this continue just because certain problems arise regarding staffing—which, hopefully and judging by everything, are short-term. This problem must be handled in some way—language deficiencies and so on.

When it comes to the increase in pharmaceutical costs, Vänsterpartiet is likely also very aware that it is market forces that govern this. For once, I can almost agree with Vänsterpartiet that what the market forces achieve is not only positive in the end. The, as was said earlier, avalanche-like increase in pharmaceutical costs is, of course, nothing that the government has decided on. Costs have increased by approximately 30 percent over the last five years, and the forecast is that they will increase by an additional 30 percent over the next five years.

It is obviously quite unrealistic that this increase would not affect the patient at all. But one can see that the state continues to take a large responsibility. We are adding money, and in the grand scheme of things, the state will now pay even more to ensure that people receive medicines.

With this said, one can also observe that this price increase is also due to the fact that the medicines are becoming better and more specialized. It is clear that we want the medicines of the future and not those of yesterday, and this comes with a price tag.

(Applause)

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! During the election campaign, Jimmie Åkesson promised that dental care would be included in the high-cost protection if the Sverigedemokraterna came to power. Two years later, the Sverigedemokraterna are in and are abolishing the free dental care for young people between 19 and 23 years old, and furthermore, they are halving the dental care support for all young people between 24 and 29. Before the election, more were to receive better dental care. After the election, it is suddenly fewer.

With Åkesson's broken promise also comes a dental health that will to an even greater extent be governed by the wallet. It is a policy that strikes directly against the dental health of approximately 400,000 Swedes. How could the promise that everyone would receive better dental care lead to Jimmie-prices for the young?

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

Leonid Yurkovskiy (SD)

Mr. Speaker! Thank you very much, member, for the very interesting question - even though it has been discussed for quite a long time already. I can only state that everything is going according to plan. We will see the Jimmie prices first when this is finished.

The Sweden Democrats have been clear throughout that such a reform should be introduced broadly but also gradually. We are currently prioritizing those with the worst oral health so that they receive the dental care they need and deserve. Even though the elderly are now prioritized in connection with the strengthened high-cost protection, the reform shall be scalable and designed in such a way that it is possible to also include the rest of the population further ahead.

To mitigate the effect of the proposed changes, there are changes for the age group 20-23. But at the same time, they receive a double dental care subsidy, 600 kronor per year instead of 300. So it is not as bad as it looks.

What must be taken away from this is that resources, especially personnel resources, are limited. In order for us to truly ensure that those with the worst oral health receive the care they need, the staff must be available.

We see that there are very many missed appointments among those with the best oral health. The profession itself thinks this is good, even though one might actually be avoiding the simplest patients. It is thus both very frequent visits despite good oral health and many missed appointments. There is, therefore, a kind of incentive structure built in here.

In summary, the answer is that we shall reach the Jimmie awards and the goal that the Sverigedemokraterna have promised. This, however, needs to be done step by step, and now we take the first step.

(Applause)

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

Fredrik Lundh Sammeli (S)

Mr. Speaker! Should I interpret this as the Sweden Democrats doing as the Liberals do and saying one thing before the election and doing something else after the election? That is not how it has sounded.

I can state that time and again I hear Sverigedemokrater defend this deterioration for young people between 19 and 29 by saying that dental care is being improved for pensioners. That is not true. The budget we have on the table and are debating today implies a one-sided deterioration for young people when it comes to dental care. Deteriorations will occur now, while any improvements are pushed back to at least 2026.

This is a budget that worsens things for young people, who have to pay for tax cuts for the richest. No matter how much one tries to portray this as a reform for pensioners, the truth is that this budget contains zero kronor in that area. There will be no improvements for pensioners in 2025.

Then it is obvious that teeth should be seen for what they are: a part of the body. As a Social Democrat, I welcome all parties that want to contribute to a high-cost protection within dental care. We need to head in that direction and build that reform.

But it is not the proposal that the Sweden Democrats campaigned on that we see now. It is not that we are now seeing improvements for pensioners, but what lies on the Riksdag's table and that we have to take a stand on today is less money for dental care for younger people – the deterioration whose implementation you have already contributed to.

I just want to ask the member if you can ensure funds for the regions when they now need to take responsibility for the transitional provision that the government and the Sweden Democrats have decided on.

(Applause)

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

Leonid Yurkovskiy (SD)

Mr. Speaker! I can begin by stating that I do not have the Tidö negotiations in this chamber, so the answer as to what and when will come will, of course, have to wait.

I can state that we are at least in agreement on the ambition here, which is pleasing. It is a good prerequisite for getting things done.

But with respect for the fact that the Social Democrats do not have the opportunity to answer here and now, I still wonder how it is intended that this should be implemented all at once. From our side, it is clear that it is required to do this step-by-step for it to work, not least when it comes to the burden on the staff, who must manage all the patients. So it is the simple answer: One does this step-by-step so that it can work. I think this is a very clear answer to the Social Democrats.

One thing that can be added regarding specifically the young people is that free dental care for this age group is something relatively new. It has worked very well even before, without this. We also still see that they have the best oral health; they do not have the great need that the older group has. Therefore, one must reprioritize, we believe.

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

Christofer Bergenblock (C)

Mr. Speaker! The member highlights the costs of language interpretation in Swedish health and medical care. This is, after the now virtually scrapped referral law, one of the issues in the Tidö Agreement that has been most criticized by all healthcare personnel in Sweden. Outcries have occurred from doctors, nurses, and nursing assistants, who have said that this is an issue that will lead to deteriorated patient safety and a deteriorated work environment.

One can, of course, if one thinks it is the right way to go, ignore patient safety and say that the portal paragraph in the Health and Medical Services Act is not something one takes responsibility for or cares about.

But the question is whether this is the Sweden Democrats' entry point into the issue of the cost for interpretation services. The Sweden Democrats have, in principle, in all Swedish regions, put forward proposals that in one way or another aim to introduce an interpretation service fee. They have gone the furthest in Region Blekinge, where a decision has actually been made on it, but the decision was reviewed by the Administrative Court in Växjö this autumn and rejected because it conflicts with the Health and Medical Services Act. Now, the question was not examined in to what extent it conflicts with the portal paragraph regarding the right to equal care for all, but it was simply stated that one does not have the right to charge that form of fees today.

My question to the member is: Based on the extremely strong protests that have been against this, what consequences do the Sweden Democrats and the member assess that the introduction of an interpretation service fee will have for patient safety and for the staff's working environment?

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

Leonid Yurkovskiy (SD)

Mr. Speaker! Thank you, member, for the question! That the healthcare's already limited resources are being pressured by the fact that people cannot learn Swedish year after year is a huge problem. Had it been about small amounts of money, one could of course have overlooked it, but we are talking about hundreds of millions every year in just one region. It is not sustainable.

The Sweden Democrats argue that this must be solvable. We are open to using AI tools or similar, which are only getting better and better and safer and safer when it comes to translation, but we are also open to the option that one has to pay for it oneself. This should, of course, not affect patient safety. When one receives care and is met by the healthcare system as a patient, it must be of full quality. But one must be prepared to pay an extra fee for an extra service.

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

Christofer Bergenblock (C)

Mr. Speaker! It is striking to hear that this is not supposed to affect patient safety when it is precisely this that all healthcare staff are highlighting will happen. If one starts to charge a fee for an interpreter within healthcare, it will automatically lead to some people choosing not to hire an interpreter because it entails a cost for them. They will begin to bring children and relatives into meetings with healthcare staff because they cannot afford to spend extra money on an interpreter service cost. This is what is being highlighted from the staff's side.

What has been and still is a major problem within healthcare is precisely child and relative interpretation. This is completely ignored in the idea that the Sverigedemokraterna have regarding the removal of this fee.

What is truly frightening is that the paragraph in the Health and Medical Services Act concerning everyone's right to equal care is being completely ignored. In the end, it will mean that not everyone will be granted the right to equal care.

If there are problems in the language between the healthcare provider, the doctor, and the patient, there is a high risk that this in turn leads to mistreatment, incorrect medication, or misjudgments, which in itself can entail greater costs. This has been seen in Denmark, where they have tested this since 2018: The costs have not become smaller at all, but have instead increased. We are talking about some per mille of the Swedish healthcare costs, which total somewhere around 650 billion kronor.

My final question to the member is: Is the member prepared to amend the portal paragraph of the Health and Medical Services Act to achieve this purpose and remove people's right to equal care?

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

Leonid Yurkovskiy (SD)

Mr. Speaker! Today we are debating the budget. I will not go into any potential legislative changes.

What I want to state is that Sweden has a very generous system regardless of what background people have. That one can be expected to pay a certain fee for a very expensive extra service if it cannot be resolved with other smooth technological solutions, video calls etcetera, we think is of course reasonable, not least because the healthcare system is so heavily burdened.

The regions have a burdened economy, in some of them as a result of misprioritizations. Then this must be an opportunity for the regions to save, quite simply. It is both a matter of justice and a matter of common sense when living in Sweden that one is expected to speak the Swedish language, especially after many years in the country.

(Applause)

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

Karin Rågsjö (V)

Mr. Speaker! What is a ball at the palace anyway? I wonder that on a day like today, December 10, when the Nobel festivities are underway while we sit here in solidarity in the chamber instead of being at the party. The Minister might have been there.

Mr. Speaker! We are going to talk about where the money goes. In that case, it is relevant to ask what we get for the money. What do the tax dollars go towards?

I thought I would give a small overview of events from reality. Just between January and October 2024, Region Stockholm paid more than 300 million kronor to app doctors in various companies that have agreements with Sörmland. Every time someone from Stockholm or other regions uses these apps, we in the region have to pay. The online doctors are, in fact, paid per contact. There is, so to speak, no cost ceiling. Hey, look at what it's going!

The Agency for Health and Care Analysis has conducted a review of digital care, which is very good – digital care is good – which showed that approximately 25 percent of online doctor contacts concern new care that otherwise would not be provided anywhere else. It also shows that digital healthcare visits are primarily made by children, younger and young adults, urban residents, people who do not have any chronic illness, and people with relatively good socioeconomic conditions – i.e., those who need the care the least.

You on the right always say that one must be efficient within healthcare. Surely removing the online doctors' ability to milk the regions for money must be efficient?

Mr. Speaker! The online doctor companies and other private providers prioritize the healthiest patients, who require the least intervention but provide high compensation because they are the most profitable. This means that public healthcare has to take responsibility for people with very large healthcare needs to a greater extent, which is resource-intensive and affects public healthcare.

The expansion of private actors within healthcare has made profit opportunities governing how healthcare resources are distributed, instead of letting needs govern. Vänsterpartiet believes that the Swedish health and medical care needs to return to being governed with a starting point in healthcare needs. The neoliberal dogmas must be replaced. The Health and Medical Care Act's portal paragraph on care based on need needs to become a reality.

Take back the care, and start by regulating the market! We have clear evidence today, also from my own region, that it can be patient-dangerous to let profit interests rule.

Mr. Speaker! Long-term conditions are required to build up and provide good health and care. The newspaper Sjukhusläkaren has requested and reviewed Lex Maria cases received by the Inspectorate for Health and Care, Ivo, during 2023. It concerns 237 deaths. They identified deaths where the chief physician or analysis leader mentioned lack of care beds, lack of resources, staff shortages, or high workload as a contributing cause to the death. 100 deaths are considered to be due to such factors.

Will the SD-dependent government's budget, where it invests in tax cuts for high earners, reduce the risk of deaths due to precisely resource shortages, staff shortages, and high workload?

The SD-dependent government proposes no increase of the general state grant for next year. Healthcare is the part of the welfare that has been hit hardest by the government's cuts in recent years. In order to be able to direct the state support to healthcare, where the needs are greatest, Vänsterpartiet proposes a reinforcement of the sector grant to health and medical care with an additional 5 billion kronor, in addition to the 2 billion the government provides. We also propose a recovery support, and it concerns general state grants to welfare of 20 billion - 10 billion of them shall go to healthcare.

This is not just about this year. Healthcare has been subjected to various savings and cuts since 2011. One must also say that all parties are somewhat responsible for this. But now we must step in with more resources. We are entering with 6 billion more than the government during 2025 for public health and healthcare. It must be felt on the ground. It must be felt by the staff and, of course, by the patients.

In a situation where those working in schools, healthcare, and elderly care see the needs growing daily, the government and Sverigedemokraterna deliver a budget of cuts, not because the money is lacking but because one actively chooses to do so. In this situation, a tax cut is also proposed that is record-breaking, 34 billion, with a historical distortion in favor of high-income earners. The theme becomes in some way: for moderates, by moderates. And you other parties are going along with this.

15 of 21 regions now reported, in 2024, that they had a shortage of staff regarding half or more of the regulated professions, including specialist nurses and doctors with specialist competence. It is a huge red flag. Securing the state grants is therefore one of our most important structural reforms at the current moment. We believe that the state should guarantee that no staff within the welfare sector are laid off. Increasing resources to enable the retention of staff is super important.

We want to introduce a resource distribution model and that an indexing of the state grants should be investigated, so that they can follow both population and price developments. That would be quite relevant.

What do we say no to – for we also say no, of course? We say no to the government's proposal for performance-based interventions, billions of kronor to shorten healthcare queues. Then you might think that we are just sitting and thinking in the chamber, but we are not doing that. We have listened to the Health and Social Care Analysis and the Swedish National Audit Office and read their reports. The Swedish National Audit Office states that the investment has not had any clear, long-lasting effect on waiting times. The billions of kronor do not shorten healthcare queues, do not raise the quality of care, and cannot be reconciled with the goal of equitable care.

This was enough for us to pull those funds, quite simply.

Primary care is suffering. Generally speaking, primary care is the part of the care chain that is in greatest need of upgrading in the country's regions. The concept of close care is unfortunately quite hollow now. We all wanted to invest in primary care through a reform. At that time, all parties were in agreement. 1,100 patients per doctor sounds great, but it is not going that well.

If primary care is to be the base of the care chain, a number of changes are required, Mr. Speaker. One cannot stand and say that money means nothing, as the Minister for Finance said in his famous statement.

Primary care must be upgraded, and accessibility must be improved in various ways. The work environment needs to be improved and working hours shortened across the entire healthcare system. It is priority one for us.

Care costs more in rural areas. Therefore, common resources must be distributed in a good way. People in rural municipalities have poorer health than the average, while residents in wealthy municipalities around major cities, like myself, have better health. Therefore, we allocate 1 billion to exactly this in the form of a general government grant.

Everyone is talking about psychiatry. There are different levels to this, i.e., where one has the entry point to psychiatry. Psychiatry is one of the most neglected areas of healthcare. The focus is often on short-term treatments, and access to care is very uneven between the regions. Those who have money go to a private therapist. If you have a temporary psychosis, a depression, or something that is bothering you, you might be offered three sessions in the region's operations.

Our starting point is that preventive and early interventions need to be combined with adequate care that is accessible and equal across the entire country. Therefore, one must also have the possibility of psychological treatment. This must increase. It is not enough with just medication.

The proposal means that individually tailored psychological treatment shall be offered within primary care through referral, but the final clause is that only non-profit actors shall be able to be covered by the proposal.

We are therefore putting in extra money and reinforcing this in 2025, 2026, and 2027. The Government and SD have already set an amount, so to speak. We do not say no to that, of course, but we are putting in 700 million more than the Government during these years.

At its core, it is about equating mental health care with somatic care and about reinforcing everyone's right to good treatment. In a welfare society, mental support should not be a class issue.

Everyone should be able to afford to have good teeth, not just those who can pay for expensive treatments. Since the dental care market was deregulated, prices have increased. Everyone can see that. The costs are very high, and many choose not to go to the dentist. Teeth then become a class marker.

We want to introduce a real high-cost protection within dental care, similar to the one that exists in healthcare. It should then not only apply to those aged 67 and over, but for the population at large. That way, those who are worst off are not disadvantaged.

To this, we propose 4,876 million kronor for a number of years. It may sound extremely expensive, but then one can remember the tax cuts and wonder: Does the population need decent dental health? Or do those who earn 200,000 kronor a month need a little extra bonus and a little extra gold trim on their very glamorous lives? No.

I am almost finished, Mr. Speaker.

Everyone should be able to afford medicine when they get sick. It should be obvious. But now this is being threatened by the government and the Sverigedemokraterna. What one pays for oneself will be increased by around 900 kronor in rounds.

Already today we see how people with ordinary jobs are forced to refrain from picking up their prescribed medicines. Many live on the margins, even people who work. It concerns single parents, nursing assistants and shop employees. They find it difficult to prioritize their health when they have to make every penny count.

34 billion in tax cuts for the richest and increased fees for pharmaceuticals does not feel okay.

The Left always has its class glasses on. TBE vaccine is expensive. We want it in the high-cost protection for adults, and we want it free for children. Who gets TBE is today a class issue.

It is also high time for a vaccination program for the elderly.

We can create equal health without class markers. Politics is about making choices. But you Moderates, Sweden Democrats, Liberals, and Christian Democrats choose to do it in a different way, to invest in the richest. Our budget is aimed at equality, not at ensuring that those who have it the absolute best get it even better.

I move for the approval of reservations 1 and 2.

(Applause)

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

Johan Hultberg (M)

Mr. Speaker! It is lovely to listen to Member Rågsjö. She is a spirited debater who always makes one crack a smile. At the same time, the policy that Member Rågsjö advocates is not particularly funny. Perhaps it is a bad joke, for this policy would have entailed radical challenges for the Swedish welfare system.

The policy that MP Rågsjö and the Left Party are pursuing has, thank goodness, never been fully tested in Sweden. But we could take a plane and travel to France to study the effect of such an economic policy. We see now in France how the costs for interest in the state budget are higher than the defense appropriations are. That is how it goes when one borrows and when one does not pursue a responsible economic policy. It is unfortunately, Mr. Speaker, precisely this that the Left Party wants to do in Sweden.

Thanks to the fact that we have a responsible government that has succeeded in fighting inflation - it has gone from 10 percent down to below 2 percent - things are brightening on the horizon. It looks better for the regions even though the situation is still strained.

But let us look again at Region Stockholm, which Karin Rågsjö highlighted. It is her home region, and Rågsjö never misses a chance to highlight Region Stockholm. Vänsterpartiet sits there and governs, and what has happened? Well, one has reduced the freedom of choice. The healthcare queues have skyrocketed. One has closed urgent care centers. There have been 200 fewer healthcare beds. Primary care's share of the total healthcare budget is the lowest in modern times.

This is the consequence when Vänsterpartiet is involved in governing. Member Rågsjö needs to answer this: How can the queues become shorter when she slaughters the appropriation to the regions to shorten the queues and for an irresponsible economic policy?

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

Karin Rågsjö (V)

Mr. Speaker! The wolf is coming soon, it sounds like.

What we are looking at is how we can put together today's troubles in Sweden - today's challenges, as everyone says, but which are problems. It is about the railway, it is about the transition and who should pay for it. It is about the bits and pieces that are vital for this country, and then we consider that one must use loan financing.

We have argued that today's surplus target for financial savings should be replaced with a deficit of minus 1 percent over a business cycle and over the next eight-year period. In our budget, we therefore propose that new infrastructure and housing investments be financed by loans.

The quality increase in municipal and regional welfare, together with improved insurance systems for households, we must of course finance in a completely different way. And do you know what happens then? With our proposal, Sweden would still have one of the lowest national debts in the EU at the end of the business cycle in 2032. That is how it is. This is not make-believe politics.

I am extremely concerned. I see no light on the horizon. I see quite a lot of darkness. If we do not fix the railway, if we do not succeed in building more housing and everything else that people need, then I believe it will become pitch black. Then we will need headlamps to make our way forward.

When it comes to Stockholm, we are trying to reverse the development with the free choice of care. It may sound great with free choice of care, but one can also look at what has happened with the freedom of establishment. One can look at the gynecological clinic located in the basement of S:t Görans sjukhus, which has huge problems with its care. One can look at vaccination centers that carry the samples in a handbag. One can look at a lot!

If we are to have free choice of care, we must also regulate them and know what is happening, right? It has cost so much for Stockholm to have a certain level of oversight on this. Talk about bureaucracy!

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

Johan Hultberg (M)

Mr. Speaker! It honors Member Rågsjö that she clearly demonstrates what the Vänsterpartiet stands for. It is precisely that I tried to describe – a deeply irresponsible economic policy based on the assumption that debts do not come with a cost.

That is exactly the example France shows: It is costly to borrow. It comes with a bitter aftertaste. It is truly, Member Rågsjö, like peeing in your pants - excuse the comparison. It will not get better tomorrow if one borrows to try to solve today's problems.

If we are to manage the welfare state, we must pursue a responsible economic policy. We must ensure that it pays more to work and that more people move from benefit dependency to work, and we must ensure that we get more care for the money.

But, if we look back at Region Stockholm, we see that where Vänsterpartiet is involved in governing, the results are worse. That is, today 45 percent more patients have to wait more than 90 days for surgery than when Moderaterna were in power. They say they are to have control over the care choices, but they are slaughtering them. You are removing the freedom of choice and letting patients stand in queue because you are so ideologically driven to remove everything that private health and medical care is called.

I understand that Milton Friedman may not be an economist that Member Rågsjö has read much of. But he is right in that there are no free lunches. Debts must be paid, and with the Left Party's policy, it is tomorrow's generations who will have to pay for the investments that one says one wants to make today.

I believe that is completely the wrong way to go, Mr. Speaker. When we know that the demographic development is such that there will be more and more elderly and fewer people to support more and more, then we really need to make sure to hold onto the money and pursue a responsible economic policy.

We would get an incredibly serious situation in Sweden. We would become pure France with the Left Party's policy!

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

Karin Rågsjö (V)

Mr. Speaker! Pure France - yes, one can wonder.

It is not only Vänsterpartiet that is saying this. It is also very many within the business sector who wonder what this government is doing. Who is going to pay for all the nuclear power plants? Who is going to pay for the railway? Who is going to build?

Good God! There is darkness over the country with the government that exists, with the support of SD whipping from the backseat! I am very concerned, I must say.

If we do nothing, the welfare state will shrink when we have to pay for the nuclear power plants. We will have to pay for the railway and everything else. Who will have to pay, do you think? The elderly in elderly care and the sick! That is what I believe.

We must find other reasonable ways forward. We have calculated this. We have very good economists in our office. It will not be sad. We are not going to pull any money out of the cellar, but one can do very good things by agreeing that one has minus 1 percent over the business cycle. Now, we and Miljöpartiet were quite alone on that, but we will return to the issue.

Why has it become like this with the free choice of care in Stockholm? It was a total freedom of establishment. I will say that it is even very many Moderates in the region who are backing down and saying that we cannot have it this way. It has cost unreasonably much to have completely free choice of care, and it has also led to a very dull development for some patients.

Do the members know what? The new majority, including Vänsterpartiet, is very popular! Do the members know why? Yes, because we have also reduced working hours, and that benefits healthcare overall!

(Applause)

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

Johan Hultberg (M)

Mr. Speaker! We now have to debate the part of the state budget concerning health and medical care and social care. In this part, the Moderate-led government makes important investments to shorten care queues, increase care capacity, improve care, and strengthen social services through, among other things, more early and preventive measures.

Before I delve deeper into expenditure area 9, I would however like to zoom out and place the expenditure area in a larger context.

Thanks to a responsible economic policy, Sweden has won over inflation. This means that we can now invest to build Sweden stronger and more competitive. This means that we can now lower taxes on both work and pension as well as savings. This means that the finances of the municipalities and regions are strengthened dramatically.

Yes, the economic situation is constantly challenging. Sweden's problems are both many and large, but, Mr. Speaker, it is brightening on the horizon.

Eight years of red-green mismanagement made Sweden both more dangerous and poorer. When the voters in the 2022 election gave the Social Democratic government their marching orders, inflation was over 10 percent, a liter of diesel cost 28 kronor, and deadly gun violence had tripled in ten years.

Now Sweden has received an absolutely necessary new start. Through the Tidö cooperation, Sweden has received an action-oriented government that, based on an extensive reform agenda, is tackling the serious problems that Sweden has, not least in the area that this debate focuses on.

Let me begin with health and medical care. The picture of Swedish healthcare is complex. Swedish healthcare is well-educated and committed staff, good medical results and low preventable mortality. Swedish healthcare is also long care queues and an all too weak position for the individual patient.

The conclusion of this should be self-evident. Sweden needs more moderate politics, especially to improve accessibility.

The government is now doing a lot to cut the healthcare queues and increase healthcare capacity. Not least, the government is working to improve the basic conditions for the regions. This is being done concretely, among other things, by taking greater responsibility for strategic issues such as skills supply and the digitalization of healthcare, but also by supporting the regions financially. Next year, 2 billion will be added in a special sector grant to healthcare. In the budget, large performance-based resources are also added, totaling a full 7.5 billion next year.

Mr. Speaker! It is important to demand that the regions perform. If accessibility is to be improved and queues shortened, yes, then the regions must take their responsibility. Here we see how regional leadership plays a major role. It makes a difference whether it is the right-wing or the left-wing in Swedish politics that governs at both national as well as regional and municipal levels.

Between 2021 and 2024, between eight and nine out of ten patients in Region Halland received care within the care guarantee's limits. It is a region that has always been governed by conservative parties. In Region Västerbotten, which has always been governed by S-led majorities, only three to six out of ten patients during the same period received care in time. The regional leadership matters.

Mr. Speaker! Other initiatives in the budget within health and medical care that I, as a Moderate, particularly want to highlight concern cancer care, women's health and diseases, and psychiatry, and in particular child and adolescent psychiatry.

We Moderates have for many years pushed on the issue that Sweden needs an updated cancer strategy, and now it is happening. The investigation into an updated strategy has just landed on the Minister for Health and Social Affairs' desk. An updated strategy is an important tool for developing cancer care. We can and we shall become better at preventing cancer and at diagnosing and initiating treatment early. We can and we shall also become better at providing rehabilitation and aftercare, and we shall ensure that the transition from pediatric cancer care to adult care does not become as brutal as it is today.

In the budget for next year, the annual investment in cancer care and childhood cancer care is doubled. A total of 1 billion kronor is allocated annually during the coming years to strengthen cancer care.

The government invests a total of 1.6 billion annually to make healthcare more equal and to improve women's health. This is incredibly important, because although Sweden is one of the world's most equal countries, Swedish healthcare is not equal today. For example, there are unjustified differences between men and women in both access to care and in quality of care.

Before I shortly switch to talking about care and social services, I want to highlight the major investments and some of the many measures that the government is now taking to reduce mental ill-health. In the budget, a three-part investment is made totaling 1.3 billion kronor. Firstly, an investment is made in first-line care for mental ill-health. Secondly, the suicide prevention work is strengthened. Thirdly, a special investment is made to increase accessibility to BUP. A national strategy for mental health will also be coming soon.

Mental and physical health are connected. Therefore, the government's initiatives to increase children's and young people's physical activity are also significant. Through the leisure card, more children and young people will have the opportunity to participate in sports and other association life. Movement and community prevent ill health.

Preventing social problems is an important task for the social services. It is a task and a responsibility that will become even clearer next year. That is because the new Social Services Act will come into effect. In connection with the new law, the government is making a special competence and staffing initiative that amounts to a total of 8 billion kronor until 2028. Furthermore, the municipalities will receive new resources to scale up the social services' crime prevention work. Until 2028, the government is investing 1.7 billion on this.

Madam Speaker! The Government is also making several targeted investments to ramp up the work with preventive and early interventions. Specifically, this includes investments in family counseling and in school social teams.

Preventive measures are not always sufficient, however. To remedy the shortage of places within the State Institution Board and to strengthen the care chain and the quality of care, the government continues to increase the resources to Sis. An additional nearly 700 million will be added next year, while during 2025 and 2026 the government will subsidize the municipalities' placements within social child and youth care.

Before I go in for landing, I also want to mention the government's initiatives for strengthened knowledge management in elderly care, a care contact in special housing, and increased support for relatives. I am also pleased that the important civil society is strengthened in the government's budget, among other things through an increased state grant to the organizations for people with disabilities. Speaking of disabilities, the assistance allowance will be increased next year by 3 percent or approximately 400 million kronor.

Madam Speaker! The budget contains both goals and means. In the budget, the government presents the direction for the policy and the goals from which the policy shall originate and which shall guide the state's work forward. I am pleased that the budget for next year also contains an updated goal for the ANDTS policy, i.e., the policy regarding alcohol, narcotics, doping, tobacco, and gambling. It is something we Moderates have pushed for a long time.

In conclusion and to summarize, I state, Madam Speaker, that the Moderate-led government and the Tidö parties are keeping the state's finances in order, strengthening the households' economy, and in addition making major investments in health and medical care and social services. We four parties in the Tidö cooperation take collective responsibility. Step by step, we are getting Sweden in order. The opposition parties, on the other hand, are deeply divided on practically everything. It is truly a red-green mess. For me, it is clear which side in politics is capable of governing a country.

Madam Speaker! I vote in favor of the committee's proposal.

(Applause)

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

Karin Rågsjö (V)

Madam Speaker! Thank you, Johan Hultberg, for describing the world order so well!

I have some tips on the way from Vänsterpartiet regarding the leisure card, which we actually support. However, I think you should investigate what is happening with this. We can see that Försäkringskassan has been given the responsibility of distributing the card in some way, and it seems to be a bit of a mess when it comes to that. A tip to the parties is therefore to look into it so that the leisure card does not become a flop, because the leisure card is perhaps well-intentioned.

Member of Parliament Hultberg mentions a number of areas that we absolutely cannot say no to. Cancer care is excellent and likewise all these small flagship projects sailing around. 1.4 billion and 1.3 billion are mentioned, but if there is no foundation to stand on, it becomes a bit strange. If one holds various press conferences about these investments and at the same time does not step in and provide sufficient reinforcement, for example with state grants, it becomes like building a house without a foundation. Does the member of parliament understand what I mean, or am I being too vague this late in the afternoon?

I mean that it becomes a lot of fluff. One can have very many press conferences on an assembly line, but it becomes very shallow. The thing is, there must be staff out in the regions and at different clinics who can work with these issues in a good way. When we notice that is not the case, it becomes a clash between your well-intentioned shots and reality. When it comes to all the targeted state grants that very many have used over the years, it becomes a lot of projects and not so much workshop.

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

Johan Hultberg (M)

Madam Speaker! The basis is that we have a Health and Medical Services Act and a Local Government Act that describe who is responsible for what. The legislation is quite clear regarding the fact that it is the regions that bear the primary responsibility for Swedish health and medical services. The regions have their own taxing rights to finance the care, and the regions are responsible for providing Swedish health and medical services.

We at the state, national, and legislative level have a responsibility - I believe - to create the best possible conditions for the regions to take their responsibility. Therefore, I think it is good, right, and correct that the government prioritizes a number of important strategic issues for Swedish health and medical care.

The first and most important is, naturally, the supply of skills. That is why the Moderat-led government is taking greater responsibility specifically for this with a national skills supply plan, which Member of Parliament Carlsson touched upon earlier. We are also making special investments to address the shortage of certain key groups within healthcare and to ensure that we can train tomorrow's employees.

Then the regions must take responsibility for being attractive employers and ensure that good care is delivered.

This responsibility must be taken by the regions, while the state can take important initiatives to reduce the regional differences and to address in different ways the problems that we in this chamber are, after all, quite in agreement on, for example that we have too large differences across the country and that we have great challenges. In that case, I think it is good that we, for example, use tools such as the national cancer strategy to raise the quality throughout the country, to concentrate resources within certain areas and so on.

We are therefore taking responsibility, but fundamentally it is the regions that have the responsibility.

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

Karin Rågsjö (V)

Madam Speaker! In the crisis that has nonetheless occurred within healthcare, it becomes more difficult, so to speak, to harbor this type of direction of the projects, if I may put it that way, which you are directing out. If there is no ground to stand on, it becomes very shaky.

What I hear from the staff is that there has been a healthcare crisis. That is how it is perceived. What is extremely important for the patients is that there is staff and competence on site and that the staff do not have too much to do and are running around too much, as is the case now. I mean that the state still has a basic responsibility that you did not take during the great crisis that it was and which you have not balanced out now either. Then it becomes a completely clear problem to accommodate staff.

I think your weak point is that you have not stepped in and sufficiently backed up the regions during this crisis - it is, of course, about the state grants - which would have been needed for the regions to be able to receive new money and do other things, for example the cancer strategy, which is super important.

In order to be able to take care of targeted measures, a good base was needed. We have seen that over the years. I would wish that instead one worked much more with state grants and actually did not make these types of investments that are considerably smaller and which become projects. One is to work with them for four years together with SKR. You close a deal, and then you are to work with these issues. It is always difficult to evaluate.

I would have liked to see considerably higher state grants, if I'm being honest.

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

Johan Hultberg (M)

Madam Speaker! Who does not want higher state grants? Naturally, everyone does - every single municipal politician, every single regional politician, and every single Member of Parliament would have wished that the state grants could be many times larger. But that is based on having an economy that grows - that you have growth, that you have a work ethic that ensures more people get jobs, and that you set requirements that people should make themselves employable and move from benefits to self-sufficiency.

This laborious work of re-establishing the work line has been initiated by the Moderate-led government. We strengthen the drivers for work, we ensure that targeted educational efforts are made so that people become employable, and we ensure that we take responsibility for the state's finances so that we can actually support the regions in times of crisis. If one does not have order in the state's finances, the state cannot participate in supporting the regions when it is tough. Now the state has been able to do so, thanks to the fact that we have not listened to Member Rågsjö, that we have not pursued Left Party economic policy, and that we have not borrowed for operations.

Inflation was over 10 percent when we took office. It is now defeated. That means the regions get 25 billion just in reduced pension costs during the next year. It is brightening, as they say, on the horizon. These are tough times. We are also making continued investments to support regions with a targeted sector grant. But then it is also a matter of regional politicians regionally having to take responsibility for how they use these funds.

I think it is striking that as soon as the red-greens come into power in the regions, the economy deteriorates and the healthcare queues become longer. We see it in Dalarna. We see it in Region Stockholm. We see it in my own home region, Västra Götaland. Leadership matters. We have responsible leadership nationally. I wish we had responsible regional leadership in more Swedish regions.

(Applause)

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

Ulrika Westerlund (MP)

Madam Speaker! I intended to interject on a rather small budget item that concerns both Johan Hultberg and me, and it concerns HIV prevention. The government has chosen to lower the appropriations for HIV prevention. So far, perhaps the most noticed measure has been that they have chosen to completely cut the appropriation to Unaids in the aid budget. But the government has also scaled back national HIV prevention. The appropriation is lowered next year by 23 million to then be scaled down by an additional 6 million until 2027. With these reductions, the appropriation is down to 2004 levels, which is a halving in today's monetary value. There are, of course, many organizations working with HIV prevention that have protested, for example RFSU, RFSL, Hiv-Sverige, Noaks Ark, and Posithiva Gruppen. They write in a debate article that HIV still exists, as we all know, and that it affects many people's lives. Certain groups, those who are often called key populations in the international work against HIV, for example men who have sex with men, migrants, trans people, people who receive compensation for sex, and people who use drugs intravenously, run an increased risk of contracting HIV. In Sweden, that is indeed the case.

Some of these groups also often face greater obstacles when it comes to accessing care and information. Here, the knowledge, experience, networks, and efforts of non-profit organizations are absolutely crucial. That Swedish HIV prevention targeted at certain groups, for example men who have sex with men, has functioned as well as it does is largely thanks to the work from civil society. And that was the case from the start. From the beginning, it was almost only civil society that carried out interventions, before the state stepped in during the 1980s and began to help. Many are still dependent on the organizations' support to get information about safer sex and access to free condoms and HIV testing. When these non-profit organizations are weakened, a large part of the competence and experience that is crucial for meeting the needs is lost.

How have the thoughts gone here, I wonder, of course. Why is this appropriation being cut with this small amount of money? These are small sums in the state budget, but they are sums that are large and important for those who are affected.

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

Johan Hultberg (M)

Madam Speaker! I am pleased that Member Westerlund highlights this important area. We have come a long way in Sweden, among the countries that have come the furthest in combating HIV. We should be proud of that.

I am also pleased that my government has begun work on reviewing the infectious disease legislation and the duty of information that we always have in the legislation, even though Member Westerlund, just as I know, that one who is well-treated for their HIV does not transmit it. It is something that I believe is worth saying in this debate, because I am quite sure that there are many who follow and listen to the debate who do not know this. Here we have, therefore, an outdated legislation that the government is now reviewing. I think that is good and very welcome. And I know that Member Westerlund also thinks so.

I am also proud and happy that the grant for HIV prevention was doubled thanks to the fact that we, in the then opposition during the previous mandate period, succeeded in getting our budget through. Thanks to the Moderaterna and other conservative parties, there has therefore been more money for this work.

But I understand that there is now a concern that the appropriations will decrease moving forward. I assume that the government will take into account the views that are now being put forward and that they will review what the levels should be moving forward, not least in connection with the new national HIV strategy, which implies increased ambitions, not least in the work to try to combat stigma. Naturally, we must ensure that the economic resources required for this work are available. Now I can only state that there will be a somewhat reduced budget for this purpose moving forward. Then we will have to see in the next budget what the appropriations will look like.

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

Ulrika Westerlund (MP)

Madam Speaker! I thank you for the answer. It sounds hopeful. I hope that some small adjustment will take place.

It is also, of course, very positive with the new HIV strategy and the review of the Communicable Diseases Act. It is many of us who have pushed for this for a very long time.

I have received reports from some civil society organizations that they contacted Jakob Forssmed's staff at the Ministry of Health and Social Affairs when they saw this reduction. They were then informed that this reduction was intentional. It occurred because Sweden, according to certain measurements, has reached the so-called 95-95-95 target, meaning that at least 95 percent of those living with HIV know their diagnosis, that 95 percent of them have antiretroviral treatment, and that 95 percent of those treated have well-functioning treatment with suppressed virus levels.

It has led to fewer people contracting HIV in Sweden today than before and that PrEP is available for risk groups, and all these three things were, according to information, included in the assessment of whether the grants should be reduced. It feels a bit cynical and unfortunate; it is as if one is rewarded for their successful work, which has occurred in an interplay between authorities and civil society since HIV came to Sweden, by having the conditions worsened. They are worsened because one has succeeded.

According to this organization, it was also stated that they plan to give the Public Health Agency a larger mandate to conduct HIV prevention. Such work will, however, also continue to be dependent on a strong civil society that can complement and support the agency's work. As I mentioned earlier: Those who have the opportunity to reach the most affected are often the organizations that work for rights and health for them. Here we have been extremely strong in Sweden, and some civil society organizations have been stronger than others.

We also need to work together to ensure that we reach all relevant groups, and I do not believe that is possible without a grant to civil society. Furthermore, the grant for HIV prevention also affects STI prevention broadly because one often informs about several things simultaneously. This applies in particular to RFSU, which is out at schools, festivals, and so on.

My question therefore concerns again this fact that the prevention has been successful and that it is unfortunate that the carpet is being pulled out a bit from under the organizations that have made it possible.

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

Johan Hultberg (M)

Madam Speaker! It is always the case in budget work that there are more good causes to spend money on than there are available budget funds. It is always tough and hard prioritizations. I understand that Member Westerlund - and also many others, for that matter - questions just this prioritization. I can, however, state that the framework for the direction of public health policy is the same and that it is a matter of a redistribution within that framework.

I cannot comment yet on how the appropriations will develop moving forward, but we will, of course, listen to the various civil organizations that are involved in the work. As a Moderate, I am the first to emphasize how incredibly important the role of civil society is. Society is larger and stronger than the state, it is agreed, and it is important that we continue to support civil society's efforts to take the work even further. This applies in particular to the fight against the stigma that unfortunately continues to be very large and widespread and which causes people living with HIV in Sweden to exhibit a significantly poorer quality of life than many others.

For me and for the Moderates, therefore, the work of the pandemic remains an important issue, and we will have to return to the budget question. I do, however, think that the new strategy and the review of the Communicable Diseases Act and the duty to inform are clear evidence that these continue to be very important issues for the Moderates and the government.

(Applause)

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

Christofer Bergenblock (C)

Madam Speaker! I thank Member Johan Hultberg for the speech and for the exchanges that have taken place.

In a previous exchange where the member participated, I perceived that he meant that the regions have a very large and far-reaching responsibility for the activities they carry out. I fully share that view. At the same time, the member just now highlighted that we need to reduce the regional differences, because we can see that today there are unreasonable differences in healthcare in Sweden's different regions, and that it is a challenge.

The challenge consists largely in the fact that there are different conditions in the regions, not least depending on how much countryside and sparsely populated area one has. We can see that there are health differences between, on one hand, pure rural and sparsely populated regions and, on the other hand, urban regions in the form of both public health, survival in treatable diseases, and dental status, which, for example, has emerged from the state dental care investigation.

That is why the Center Party has added 1 billion kronor more than the government and distributed the money with a different distribution key, which favors smaller regions with somewhat fewer resources. We have previously heard the Christian Democrats say that the solution to everything is nationalization. That is not how I have perceived the Moderates, Madam Speaker, but I would very much like to hear how the Moderates intend to address the inequalities that exist today between Sweden's regions.

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

Johan Hultberg (M)

Madam Speaker! Yes, it is indeed the ten-thousand-kronor question in the Swedish healthcare debate, and I believe we shall all be humble enough to say that no one has the answer fully.

It is challenging. We see that we have large regional differences. I do not believe the solution is as simple as all differences disappearing overnight if one simply changed the primary responsibility. If we zoom in on individual regions, we can also see that there are large differences within regions – between different clinics at different hospitals, between different municipalities, and even between different neighborhoods. It is, therefore, a complex issue.

An important explanation for the regional differences is, however, the supply of skills – that some regions and some parts of our country have more difficulty than others in attracting and retaining well-educated healthcare personnel. Therefore, I think it is important that the state tries to take a greater responsibility for the supply of skills, and as I mentioned, the national skills supply plan is one step in that, as are the budget investments we are making.

There is also an ongoing work that I have the privilege of participating in within the Care Responsibility Committee, where I nevertheless perceive that all eight parties in the Swedish Riksdag see that there is probably a point in the state taking a greater responsibility. It does not necessarily have to be about the state being the principal for everything, but the state needs to steer to a greater extent within certain areas - and perhaps be clearer and stronger within certain areas.

At the same time, I believe there is a point to the state sometimes taking a step back. In my conversations with regional politicians, it often becomes apparent that they feel they are hit by a hailstorm of steering signals from the state. I believe we would sometimes benefit from actually clarifying the state's steering and working more with quality follow-up and ensuring that patients receive the care that is mandated by law in Sweden.

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

Christofer Bergenblock (C)

Madam Speaker! I thank Johan Hultberg for the arguments.

I believe we share much of the picture regarding the problems concerning equality. It naturally concerns both the access to staff, i.e., the competence supply, and the regulatory framework and bureaucracy that place obstacles in the way, above all for solutions in rural areas, where it is difficult to find flexibility in the current legislation. It naturally also concerns the financing and the distribution of resources.

Of these parts, it is the budget we are discussing today, and there it is clear that the distribution of resources is one of the components. When it comes to the extra funds that we in Centerpartiet have, as stated, added, we therefore use a different distribution key. To raise an example in this debate, it would mean that Region Gotland went from 13 million to 63 million in state grants. Furthermore, we add 200 million kronor to Region Gotland in another budget item, in the form of an island grant.

Region Gotland has been raised quite a bit in the discussion. Meetings have been requested with the government and with the Minister for Health and Social Affairs. It is a clear example of a region that has very specific challenges linked to both being an island and having an extensive rural area. I would still like to hear a reasoning on how the Moderaterna think about the challenge Region Gotland and the other more sparsely populated regions have when it comes to solving the healthcare challenges.

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

Johan Hultberg (M)

Madam Speaker! For me and the Moderates, it is quite obvious that the state needs to take greater responsibility for Swedish health and medical care. From the national level, we need to step forward in a number of areas and take greater responsibility to create better conditions, not least for smaller regions.

I particularly want to highlight the work on skills supply and the work on the digital infrastructure, which are truly fundamental if we are to be able to reduce administration and ensure that we utilize health data in such a way that Swedish health and medical care can become better at not only treating disease but also preventing future ill health and identifying patients at an early stage - before they have developed type 2 diabetes or cardiovascular disease. These are two areas where the state needs to take greater responsibility.

The state naturally also has an important responsibility to equalize the economic conditions between municipalities and regions. A proposal for a changed equalization system, which has been worked out in broad political agreement, has just been submitted. We will have to see how this proposal is taken forward.

I do not know if I can deliver any individual solutions for Region Gotland in this debate, Madam Speaker. I do believe, however, that it is important that the state takes greater responsibility within these central areas and also gives the regions the opportunity to shorten their queues, for example through the performance-based compensations we deliver and by pursuing a responsible economic policy that ensures less money is spent as a result of inflation driving up costs. More money can therefore be invested in health and medical care.

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

Christofer Bergenblock (C)

Madam Speaker! The Committee on Health and Welfare has a responsibility that extends across many areas: health and medical care, disability policy, elderly care, ANDT issues, and social services. Today we are debating the budget for the coming years within this area. I can only state that the challenges are many and that sufficient initiatives are not being taken by the sitting government to address these.

Swedish healthcare is in many ways world-class, not least regarding treatment results. Being affected by a severe illness in Sweden is still an advantage compared to being affected by the same thing in many other countries. However, there are problems in Swedish healthcare, and to a large extent, it is about a lack of equality. Not least in Sweden's rural areas, there is a lack of access to both primary care and specialist care, and that affects the outcome. As was mentioned just now, one can, for example, see that the health figures are higher in rural areas than in more densely populated areas. One can also see that the mortality regarding treatable diseases is higher.

The work for good and close care therefore needs to be strengthened, and extra resources need to be placed where they are needed most. For that reason, the Center Party allocates more than 1 billion kronor more than the government directly into healthcare. We do this, however, with a different distribution key, in order to benefit the smaller regions.

The extra money will help the regions meet their commitments regarding the healthcare guarantee. Unfortunately, however, we continue to see long queues and waiting times for many operations. We also see that the queues differ significantly from region to region. Recently, it has been noted that the queue for breast reconstruction after cancer is up to four years in Region Skåne but only two to three months in Västra Götaland. Despite this, not all patients in Skåne are aware of the possibility of turning to Sahlgrenska for a faster operation.

That is why the Center Party wants to develop a national comparison service with waiting times, accessibility, and quality that the patient themselves can access in order to make an active choice. As a patient, one should already from day one have the right to choose where one wants to have their operation performed, regardless of whether it is with a region or with a private healthcare provider.

We do not believe at all in the Tidö parties' idea of reporting everything to a state healthcare intermediary in Stockholm. Bureaucratic colossi have never been the Center Party's guiding principle. Instead, it has been people's power over their own lives and their own situations.

Madam Speaker! This year marks 30 years since the Act on Support and Service for Some Persons with Disabilities, LSS, entered into force. This has been highlighted by the disability movement in connection with a number of events during the past year. The celebration has, however, had a somewhat bitter aftertaste because the development over the last 10-15 years has gone in the wrong direction. The Act has been eroded through stricter assessments and an increasingly clear juridification.

The number of people with personal assistance has decreased by 8 ½ percent since 2015, and despite new legislation on strengthened rights to assistance from last year, there has only been a marginal increase. On the contrary, we have seen that children have been seriously disadvantaged due to the new legislation, as the standardized parental deduction that was introduced led to more children losing their assistance. While waiting for the legislation to be reviewed, the Centerpartiet has therefore allocated an extra 100 million kronor in the budget to completely reset the parental deduction.

It is not only within the assistance that the development is going in the wrong direction, but it also concerns the right to accompaniment. The number of persons with the right to accompaniment has decreased by 72 percent since 2010 because these persons are no longer judged to belong to person group 3 within LSS. This is not due to them having regained their sight, but rather because a new practice has been established. This is such a serious deterioration that the Riksdag has issued a notice to the government to initiate an investigation into new legislation as soon as possible.

The calculation of the assistance allowance was also an issue where the majority in the Riksdag could agree to put pressure on the government to take measures. Following this announcement, it is pleasing that a model for future calculations is now to be investigated. The Center Party has long asserted that an indexed calculation that takes into account the cost development in society needs to take place.

Madam Speaker! Care for the elderly is another area that I want to highlight in the debate. The Centre Party believes that even as an elderly person, one should be able to live an active life and be able to age with the assurance that society is there and takes its responsibility when one needs support and help.

Access to social activities and community is something we place special emphasis on. Unlike the government, however, we believe that civil society has a very important role to fill in that work. We believe that pension organizations, study associations, and churches are important actors in creating activities and contributing to community.

That is why it is with astonishment that we have followed the government parties' slaughter of the appropriations to the study associations by a total of 500 million kronor. Instead, they add 100 million annually so that municipalities and regions shall take over responsibility from civil society. The consequence of the change will likely be fewer gatherings and cultural activities for our elderly.

Centerpartiet also sees that there is a very great need for more housing for the elderly. For that reason, we are adding 850 million kronor over a period of three years in stimulus grants for the construction of new secure housing. By enabling secure housing for Sweden's elderly, one contributes to a functioning housing chain as well as to reduced loneliness and insecurity. We therefore want to see an elderly housing guarantee for the right to secure housing for those who are 85 years of age or older.

Madam Speaker! In conclusion, I would like to say something about the work on the ANDT issues and the work for children and young people.

Alcohol consumption among young people has never been at such low levels, but on the other hand, snus use continues to increase. In that situation, lowering the tax on snus, as the government is doing, is a very strange measure. These funds could also have been used for something significantly better.

The biggest problem right now is however neither smoking nor snus, but it is nitrous oxide. Daily, new alarm reports arrive about how nitrous oxide is distributed and sold directly to young people, furthermore flavored with, for example, strawberry. The possibility to stop nitrous oxide is already prepared in a government investigation that was placed on the government's table in March, and now we are waiting for a legislative proposal to come.

In other matters, the government has shown that it is possible to proceed with fast-tracks regarding legislation, but in the issue of nitrous oxide, they have not done so. We from Centerpartiet are prepared to contribute to a fast-track.

In recent years, we have also been able to see more and more children and young people falling into the clutches of criminal gangs. We therefore see a great need to also strengthen the preventive work. We believe this is best done through well-functioning preschools and schools, a very present social service and a strong civil society, but naturally also with more police.

We see a great need for urgent reinforcements within social services and therefore add 350 million kronor here and now to be able to increase the efforts for children and young people.

Madam Speaker! Challenges are, as has been said, not lacking within the Social Affairs Committee's area. But in far too many parts, the government today is doing too little too slowly. An increase in ambition is needed within healthcare, within disability policy, within elderly care, and within social services. We in the Center Party want to contribute to that increase in ambition.

Lastly, I want to say that I support the Center Party's budget proposal in its entirety and the specific statement contained in the report.

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

Christian Carlsson (KD)

Madam Speaker! The elderly should be treated with respect, and Sweden's elderly deserve dignified care. It is an important issue for the Christian Democrats, and therefore we are pushing for several of the reforms and initiatives that the government is undertaking in the area.

We have an initiative to strengthen knowledge management aimed at better quality for the elderly in care. We are also planning for permanent care contacts at residential facilities and, not least, strengthened support for relatives. So many family members carry an enormous burden and deserve society's appreciation for what they do for their elderly.

We are also making an investment that is missing in the Center Party's budget alternative, and that is the investment to counteract loneliness among the elderly. Why is it the lonely elderly who are left out in the Center Party's budget?

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

Christofer Bergenblock (C)

Madam Speaker! I thank Member Christian Carlsson for the question, which I am very happy to answer.

It is not that the Center Party is investing less in countering the loneliness of the elderly. The Center Party is investing more than the government on those issues, but we do it in a different way.

I know that the Christian Democrats want to nationalize the entire healthcare system and have enormous confidence in the state and what it can achieve. In the Centre Party, we have an incredibly strong confidence in civil society and what it can achieve.

The government adds 100 million kronor to its budget to provide grants to municipalities and regions to carry out measures to counter loneliness among the elderly. The Center Party adds the 500 million that the government has removed from study associations to be able to carry out measures aimed not least at the elderly and in that way create community and counter loneliness.

In addition to just those parts aimed at civil society as a support to make interventions and continue with the interventions it already makes because we have that trust, we also put money into stimulating the construction of safe housing. Over three years, we are allocating 850 million kronor to stimulus measures to get more safe housing, and safe housing has the ability to gather the residents in a community. There are requirements that there are common areas, and there are requirements that there is staff for part of the time that the safe housing is open. It creates opportunities for interaction, community, coexistence, and activities between the residents.

The truth, Member of Parliament Christian Carlsson, is therefore that the Center Party allocates more to counteracting the loneliness of the elderly than the government does.

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

Christian Carlsson (KD)

Madam Speaker! It is a small amount in context, but the money we allocated for the municipalities but also civil society to be able to counteract loneliness among the elderly has had a great effect. They have a great effect for the individual elderly, and they have had the effect that more people want to participate and contribute.

It is naturally not the case that all the contributions that the Center Party gives to folkbildningen will go towards countering the loneliness of the elderly. I think that when it concerns such small amounts as it does here, the Center Party can well let both the support to the municipalities and the support to civil society remain in order to counter the loneliness of the elderly.

It is very good that the Center Party is pushing for an elderly housing guarantee so that the elderly can move into housing on the day they need it. But one should not have to move into housing because one feels lonely. We must also have other measures to seek out the involuntarily lonely elderly.

It feels particularly urgent, naturally, in these times, in Advent. We are heading towards Christmas. We know that when the holidays come, when we gather to celebrate our common holidays, the loneliness often feels the greatest. My message from now on is therefore this: Think about the lonely elderly! Do not skimp on them!

With that, I would like to take the opportunity to wish the member, the Chamber Office, and my colleagues in the committee a Merry Christmas.

(Applause)

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Christofer Bergenblock (C)

Madam Speaker! Thank you, Christian Carlsson, for the contribution!

I perceive it a bit as an invitation to budget negotiations. There, I and the Center Party are definitely prepared to extend a hand. If the Christian Democrats are prepared to back down and contribute to us restoring the 500 lost millions to the student unions, we will probably be able to contribute to providing a little more money to municipalities and regions in that way to strengthen operations aimed at the elderly. But I am not sure that the member is actually prepared to go that way. Perhaps he also does not have the mandate to negotiate the budget from the rostrum in the chamber of the Swedish Riksdag.

However, I can state that the net result of our various initiatives is to the advantage of the Center Party. That is to say that we are allocating more money. The half million that we allocate to study associations is not directed solely to the elderly, but we have been able to see that those who have been hardest hit by the cuts within the study association activities are the elderly, people with disabilities, and those living in rural areas. There, these funds will come to good use and can contribute very much, not least to counteracting the loneliness of the elderly.

Since then, it is the case that we have a housing problem today, and by enabling the right to secure housing, more will be able to move into such a community. It does not solve all problems, but it is an important part of the solution. We need both activities and good housing for our elderly.

I would like to conclude by thanking you for the Christmas greeting and also wish the chairman of the Committee on Social Affairs a Merry Christmas.

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

Lina Nordquist (L)

Madam Speaker! It is a very great relief that it is no longer more and more people who are standing in the healthcare queue. But we must nevertheless state that it is still far too many. People in Sweden still wait for too long for care, and then the care is also always unequal for different groups in society and also in different parts of the country. It is naturally primarily the regions' responsibility. They manage our country's healthcare. But the state must take greater responsibility than before when it comes to strategies and frameworks and to look far ahead.

We must support the regions' work in providing care in a timely manner, regardless of postal address and who the patient is, whether one is a child when struck by a disease and then becomes an adult, or if one is struck by a disease and needs care from different instances. One must not get lost in the care.

The security policy developments around Sweden and Sweden's membership in Nato place greater demands on the state taking strategic responsibility for the healthcare system's preparedness and healthcare capacity in crisis and war. But of course, the opportunities to withstand difficult times will increase significantly if we become better at managing everyday life. We have not done that so far.

The state's main task is to create strategy and structure, but the state also needs to provide money for the reforms that are implemented. To be honest, I do not think people care one bit about who decides and who pays. We just want it to work when life falls apart. It is very pleasing that the state next year contributes 7.5 billion to get through important reforms and steps on the way toward better care, regardless of whether it is everyday life or a crisis.

The state also provides an additional 6 billion so that people can receive effective medicines, regardless of what they are affected by. It could be a common or an uncommon disease. Sweden shall be a leading country when it comes to good care and good medicinal treatment, including precision medicine. Precision medicine will revolutionize healthcare and, above all, people's lives; I am convinced of that.

Regarding health and medical care, it is very pleasant that the first stage of a dental care reform is now finally being initiated, first for people who are 67 years of age or older, on January 1 next year.

Madam Speaker! The list becomes long even outside of healthcare when it comes to the changes that are needed. In the field of disabilities, for example, greater participation is required both through support to the Agency for Participation and through support to disability organizations. This can, for example, involve interpreting services and service dogs. On that, billions of kronor are spent, and it is needed. But the largest sum goes to the absolutely crucial personal assistance, where the standard amount increases by 3 percent to a total of 27 billion. Thank you, Minister, for the fight for this! It plays a major role.

I could stand here for a long time and account for how things look, but you know just as well as I do that elderly people need nursing assistants with sufficient knowledge and that children need good support and plenty of leisure time. The Minister will surely later in the debate account for the billions that go to the most vulnerable children - those children who must not become our country's most broken people when they become adults. They must also have opportunities and a future. It is absolutely crucial.

I vote in favor of the government's and the committee's proposals in these areas. These are significant changes, Madam Speaker, which in turn are parts of large reforms for every person's security, future, and opportunities. They will make a difference for how people have it in our country.

(Applause)

(cont.)

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