Skills supply, e-health and preparedness

Leonid Yurkovskiy (SD)

Mr. Speaker! Today we have an important report that concerns several areas: skills supply, e-health, and preparedness. But without the skills, that is, the staff, the other parts become quite meaningless, so I begin there.

To give a picture: We are in a vicious spiral. Right now, the staff often experience that the workload is too high in relation to the salary, which leads to fewer people wanting to work in healthcare, which leads to the workload being too high in relation to the salary, which leads to fewer people wanting to work in healthcare, and so on. At the same time, many are qualifying for healthcare professions, which indicates that the problem lies in the system and not in the work itself.

We had the Agency for Health and Social Care Analysis visiting the committee today – very appropriate given this debate. I intended to make a few points there.

Sweden is unfortunately worse than average regarding stress and mental ill-health linked to work within, for example, primary care. We have few general practitioners in relation to the population – an increase of 80 percent would be needed. Socialstyrelsen's target value is 1,100 patients per doctor, and we are on average at approximately double that.

What is the situation in the country? The Swedish District Doctors Association made a compilation of which regions have a plan and how long it will take given the number of ST-doctors. On average, it will take approximately 50 years for the regions to reach the target value, but according to current forecasts, several regions will never reach it. For resource-rich, populous regions such as the Social Democrat-led Region Stockholm, it will take approximately 330 years to reach the target value according to current forecasts. One can state, Mr. Speaker, that it is not enough. The estimate also applies on the condition that no doctors choose to leave primary care in the future and that all choose to work full-time with primary care center work.

Good politics in the area will of course come from the Tidö agreement.

We have the National Health Competence Council's proposal for a national plan for the healthcare system's competence supply. Parts of it are being implemented now. There are many good proposals there, but they also presuppose that the regions can actually manage to implement the part that lies with them.

As an example, we are now strengthening the medical competence within municipal health and medical care. An amendment is being made to the Health and Medical Services Act which means that municipalities can now employ their own doctors. It is an example of something that is good.

We are also making economic investments. Socialstyrelsen is tasked this year with distributing approximately 1 billion kronor to municipalities and regions during 2026 to strengthen competence and improve the working environment.

What I am trying to get at in the part concerning competence supply, Mr. Speaker, and what I think the situation assessment makes very clear is that the regions are not coping with the assignment. Here we need a clearer state responsibility to solve the problem and break the vicious, negative spiral.

Mr. Speaker! A few words on digital infrastructure and e-health.

We unfortunately also have problems with information flows. It hinders coordination within healthcare, and it ultimately affects the patient.

This is also a regional issue: Despite good conditions given how digitalization has developed over the years, the healthcare providers have not succeeded in seizing the opportunities. The regions have simply not succeeded in managing the digitalization.

I can share a brief personal anecdote. There are thousands of examples of where it has fallen short, but this is a simple, patient-centered example.

I need to seek medical care. I call my health center. It is not possible to book an appointment online; one must call in. There is a number. The phone is busy. Do I even end up in a queue? Do they ask to call back? No, the call is just put on hold. I have to try again and hope that the phone is not busy then.

This is, therefore, the response one receives as a patient when one needs care – not when one is just going to call and ask some customer service question, but when one needs care. This is extremely serious, and it varies from region to region and health center to health center. We cannot have it this way. It is a problem – and, again, a regional issue.

As for the regions' procurement of medical record systems, we can hardly even speak of it. It is a terrible issue in itself and an enormous waste of tax money, which in theory leads to poor interoperability between the systems but has nevertheless resulted in the system in practice resting on a few actors. The entire system becomes dependent on foreign actors, foreign companies, and we lose enormous amounts of money that could easily have sufficed to establish our own system. I am talking about 20 million kronor per month for one region. You can forget about that: 20 million kronor per month for one region for these systems. Not everything in society is the market's role; that matter is crystal clear.

Good things are also being done in this area; I shall, of course, mention that.

National healthcare mediation is a classic SD issue. We are very pleased that it is being implemented.

Care providers shall be able to connect their medical record systems to the national infrastructure.

The eHealth Agency shall be given a clearer role.

Care providers shall be able to share health data with each other more easily.

All of this is very good, but there is more to be done.

A few words on preparedness, Mr. Speaker! Much is being done in this area, and here the parties are generally in agreement. But a concrete example where there have nevertheless been differing opinions among the parties is the issue of hospital closures.

Today, the regions are closing fully functioning hospitals and emergency rooms all over the country. In addition to the regular care being affected by this, the preparedness is also affected. If we now think about the preparedness perspective, we can learn from Ukraine, not least, about the importance of having many hospitals available.

Now the government is presenting a pilot for preparedness hospitals. The Sweden Democrats call it a strategic hospital. It doesn't matter what you call it; it is very good regardless. Sollefteå – a controversial case – is identified as a candidate in this pilot project. Now it remains to be seen whether the improperly governed Region Västernorrland will accept the extended hand. We shall see. But a tip and a message from the chamber is not to shut down hospitals if you safeguard the preparedness.

The Sweden Democrats are pushing at the regional level, since we are on that track anyway, that one should strengthen the health centers and the emergency rooms. Not least here in Region Stockholm, we have a concept with funding called Närakut+ – it perhaps can be an inspiration for others.

Otherwise, we stand behind the current policy in the area, Mr. Speaker. To summarize: We need state responsibility to strengthen the supply of skills. We need to establish a proper digital infrastructure, which we are now on our way to doing. And stopping the closure of functioning hospitals is absolutely crucial for the preparedness.

(Applause)

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Karin Rågsjö (V)

Mr. Speaker! In line with the member, I hope that what concerns Sollefteå is approved. That is well the question we are most in agreement on today.

I have a number of questions. The Healthcare Responsibility Committee, where I sat, developed a concept for how the state can take over certain issues. This concerns competence supply, pharmaceuticals, vaccinations, screening, forensic psychiatric care, and airborne ambulance care. There was a very good starting point to get this going. I must say that I really wonder where that investigation has ended up, because the only thing I hear from KD, who are responsible for the issue, and from the Sweden Democrats is that everything should be nationalized. There were plenty of good things about state governance in the investigation, but nothing has happened with this.

Now to a completely different question. We have today a competence situation in Sweden that is not at its peak. In the midst of this, during the years from 2022 to this year, very many laws have been introduced concerning the expulsion of people who work in healthcare. These are, therefore, competence expulsions.

I have met very many of these people. Some of them have had to stay because there has been media coverage about them. This is also about Sweden's reputation being tarnished by healthcare workers. Doctors and nurses who have come here over a period of ten years – many came during the large refugee wave – wonder if they should stay or if they should leave Sweden and go to Canada.

I wonder: What are you going to do about this? Even within research, Sweden's reputation is affected. Many researchers with a foreign background are wondering if they even want to stay here with the SD-dependent government that is now pushing forward. The goal seems to be, Mr. Speaker, that all immigrants should leave, and it should preferably happen as quickly as possible.

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Leonid Yurkovskiy (SD)

Mr. Speaker! Thank you, Member Rågsjö, for the relevant questions! First, I will address the proposals regarding state governance. We completely agree that these are good proposals, and we would like to see them implemented. The Sweden Democrats see this as the right path towards state ownership.

An example that has been highlighted regarding something being implemented and enforced is the possibility for municipalities to employ doctors now. Otherwise, I would like to refer that question to the relevant minister, who can account for what the work looks like at the department right now.

Regarding foreign workers, I want to remember that Karin Rågsjö was present at the meeting where the Ministry of Social Affairs informed the committee on the situation regarding labor immigration within healthcare. When it comes to the immigration concerning work permits within healthcare, it concerns approximately 2 percent. Furthermore, not everyone who comes here receives a livelihood.

One must remember that, for example, doctors and nurses reach the salary requirement that serves as the basis for why some are not allowed to stay. Now, the Swedish Migration Agency has provided a list of healthcare professions that are exempted, and healthcare assistants, nursing assistants, home care, and home nursing are exempted. Given this, I believe that the situation described by Karin Rågsjö is not real.

At the same time, persons who are not supposed to be in the country and who have received a "no" must not remain here. It is not enough to merely aspire to work in healthcare for this not to apply.

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Karin Rågsjö (V)

Mr. Speaker! The member says "aspire to" and mentions figures that do not hold up. I am using SKR's figures. If it is a bluff, then I do not know. The member may, in that case, take that discussion with SKR.

I can give a few examples of teenage deportations, where those to be deported are studying to be, for example, doctors. The healthcare assistant Nagam came to Sweden as a twelve-year-old together with her mother, and she is to be deported from Sweden. She is a qualified nursing assistant and is to be sent out. We have the medical student Naval from Örebro who has had to pause her education to instead work and show that she is self-sufficient in order to receive a continued residence permit in Sweden. That is what these cases look like.

One might think it is truly great that young people with great ambitions are to leave Sweden because you in Sverigedemokraterna have held the steering wheel while the other Tidö parties have sat in the back and just come along for the ride.

Mr. Speaker! In these discussions, there are many issues, and Stockholm always comes up. This is about the campaign being driven against the Stockholm region from the right, from Timbro and from companies that have allied themselves with the healthcare capital, if I may put it that way – now I am starting to sound like a real Marxist, Mr. Speaker!

If you look at the figures, you can see that healthcare has expanded enormously in Stockholm. They have had significantly better development than in, for example, Skåne; that must be said. There, they have had completely catastrophic figures. For example, the average waiting time during 2025 for a visit to specialist care was 62 days in Stockholm and 93 in Skåne. The waiting time for surgery within specialist healthcare was 80 days in Stockholm and 148 days in Skåne.

It is Skåne that is – excuse me, Mr. Speaker – on the cutting edge, not Stockholm.

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Leonid Yurkovskiy (SD)

Mr. Speaker! Thank you, the member, for the follow-up questions!

We begin with what concerned Stockholm. I have myself sat in the regional council in Stockholm. Regardless of all the problems we see now, I can attest that we were not unconditionally supportive of the policy that was pursued previously. Above all, we were enormously critical of the sell-offs of hospital properties that were made and of some privatizations linked to it. There, therefore, there need not be any differences of opinion.

However, the comparison with Skåne is interesting. Stockholm was previously governed by the Moderates and is now governed by the Social Democrats. We see in Stockholm that the queues are increasing, while we see that Skåne has been among the best at making use of the state subsidies. That means that the healthcare queues are now decreasing after a previously very bad situation with red rule. There are some differences there, but I urge everyone to look at the situation over time.

However, it should not matter who governs in which region – that is the point. There should be equally good care everywhere, and I am surprised that the Left Party, of all parties, cannot agree with us and the Christian Democrats on that issue.

I have a brief comment on the migration issue and the deportations during the last 50 seconds of my speaking time. I will not deny that the examples Karin Rågsjö raised are problematic and unfortunate. However, context was needed regarding how it has become as it has. This is a result of a dysfunctional system. People who have come here on other grounds are now not allowed to stay because they have found new grounds. That is what is happening.

What can be sent is that the jobs shall go to people who are already in Sweden, as far as that we can agree. We already have an unemployment, and we must solve it.

A quick point of clarification is also that the union's contract secretaries themselves say that no labor immigration was needed. That can also be discussed.

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Christofer Bergenblock (C)

Mr. Speaker! Thank you, Member Leonid Yurkovskiy, for the speech!

The Speaker raised the major staffing problems within Swedish health and medical care. If this is a challenge today, it will of course be an even greater challenge in the future. Meeting the goal of 1,100 patients per doctor will be very difficult and take a long time. It is also a problem to manage the staffing regarding nurses and nursing assistants in Swedish care.

This problem is furthermore accentuated when we go out into Sweden's countryside and rural areas – when we leave the metropolitan areas, the university towns and the larger cities and come to our smaller towns, our smaller localities and our pure countryside. Centerpartiet has provided both money and proposals regarding how the problem can be addressed in different ways and with different methods.

In the autumn budget, we included in the reform that we somewhat sloppily call rural doctors 2 billion SEK to be able to hire new doctors in primary care. In practice, it means that one should be able to have small doctor-led units that cover areas where the health centers do not reach. We allocated 1 billion to get ST services out in all parts of the country, because we see that they are very unevenly distributed today. We have also presented proposals that we shall investigate economic incentives to get people to move to where the jobs are. It could involve relocation grants or the cancellation of student debts.

However, I constantly miss the Sweden Democrats' view and problem-solving when it comes to how we are to manage the staffing of the Swedish health and medical care in our rural areas. What is the Sweden Democrats' answer to that question?

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Leonid Yurkovskiy (SD)

Mr. Speaker! I thank the member for the questions.

The government also allocates money specifically for care in rural areas, so it is not unique to the Centerpartiet, I want to say first. It is, therefore, done in a budget that the Sverigedemokraterna are involved in developing and supporting.

What I note is that all the proposals that Christofer Bergenblock highlights, and which are obviously partially interesting, clearly concern state support and state interventions. They simply point towards a greater state responsibility. If one still sees the need for state responsibility, I wonder why one does not want to go all the way. In addition to what is being done from the government's side – I can, moreover, mention labor policy in general, i.e., not just the policy in the area of the Committee on Social Affairs – I wonder why one does not want to take the step fully and let the state truly support the countryside with the help of the resources that the state has and that the regions clearly do not have or are not willing to use.

That is the primary difference here: Our proposal is that the countryside should be strengthened, but we do not see how that is to be done with the current system of regions. One can also simply say that more money for a system that does not work rarely leads to anything better.

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Christofer Bergenblock (C)

Mr. Speaker! The Centre Party would like to see the state take greater responsibility in certain areas of Swedish health and medical care.

The Care Responsibility Committee submitted its final report just under a year ago, and the Center Party fully supports the conclusions in that report. This includes, among other things, the conclusion to set aside the idea of nationalizing Swedish healthcare – that is, to throw it into a gigantic reorganization for ten years ahead.

The parts that the committee highlighted, for example a greater national responsibility for the supply of skills and a greater national responsibility for airborne transport, vaccines, medicines and screening, we also fully stand behind from the Center Party's side. We see, in fact, that a national responsibility is needed in certain areas to achieve equal healthcare in the country.

When it comes to the distribution of resources, we in the Swedish Riksdag have every opportunity to ensure that resources are distributed in a way so that they also remain in our more sparsely populated parts of the country. To a large extent, Sweden's growth consists of what comes from our rural areas – from the forests that grow in Norrland and in all of inland Sweden, from the ore that is mined up in northern Sweden, and from the energy that comes from large hydroelectric power plants – and we in the Centerpartiet want more of the money to remain there to provide for healthcare, elderly care, and welfare in our rural areas. I have, however, not seen any proposals regarding this from the Sverigedemokraterna side.

We also want to reform the state system for the redistribution of money between the municipalities in Sweden. Today, we are shifting money between the metropolitan regions. More should be shifted out to our sparse and rural areas, but I have not seen the Sweden Democrats stand behind that either.

So, what is the Sweden Democrats' answer to how we should level the inequalities – more than nationalizing the entire Swedish healthcare system?

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Leonid Yurkovskiy (SD)

Mr. Speaker! I thank the members for the follow-up questions.

In what Christofer Bergenblock says, he almost downplays the result of a nationalization, that is, what a nationalization would mean for Swedish healthcare. But everything the member speaks about points towards increased state control.

What is being proposed from the Centerpartiet side is that all these resources should be placed on increased state responsibility – or at least increased state funding – but that the result is then to be compromised by variations in the quality of the regional politicians and the regional organizations. That is the difference between Centerpartiet and Sverigedemokraterna in this case: Much of what the member says appeals to me, but I do not understand why one wants to have this source of error in the form of regions.

I am actually glad that many concrete proposals are coming, Mr. Speaker, because unfortunately, one often hears that we should not nationalize – that we should not ensure that there is truly equal care across the entire country and that resources reach their destination. Instead, we should take the region Knäckebrohult – that is a fictitious region – as an example, because there they have worked with some new coordination system and some new leadership structure that has streamlined healthcare by 5 percent over ten years. Then the regions should be inspired by one another.

I am glad that we have moved away from this somewhat in the debate and are actually talking about concrete, large-scale proposals where the state is the foundation. But as this exchange of remarks shows, there are still differences between the parties.

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Dzenan Cisija (S)

Mr. Speaker! This debate concerns competence supply, e-health, and preparedness in Swedish health and medical care.

The public wants to know if Sweden can guarantee its inhabitants care based on need, both in peacetime and in war and crisis.

Healthcare is not just a system of buildings and budget items, healthcare is people. It is the nurse who works double shifts so that a ward does not close, it is the doctor who tries to piece together a care chain when medical records do not align, and it is the ambulance personnel who rush out – sometimes to situations where the threat is as tangible as the illness. And when an ambulance paramedic is killed in the line of duty, it is not just a failure of the work environment; it is a societal failure.

We Social Democrats understand the reality, and we see a healthcare crisis. When it comes to the supply of competence, we see that the staff shortage is a real problem that only grows larger with the government's poor welfare policy. We see that the attractiveness of the profession has fallen and that many employees experience a growing sense of inadequacy and moral stress. It is not sustainable for either the staff, the patients, or the economy of the society.

The government wants to educate more people in the industry, but it is not enough. We must also give healthcare workers better working conditions, strengthen the healthcare's leadership, and secure long-term sustainability. When the healthcare system is forced to plan for cuts, layoffs, and closed healthcare departments due to short-term targeted one-off grants, the government cannot simultaneously say that it takes responsibility for competence.

The National Healthcare Competence Council has presented its proposals, and we Social Democrats want the national plan for competence supply to be implemented and built on continuing education, career paths, and strengthened leadership. We also want to quality-assure the validation of foreign licenses so that we safeguard patient safety. At the same time, we want to stop the crazy politics that drive competence deportations. Sweden cannot afford to deport trained healthcare personnel when the needs are growing.

Mr. Speaker! eHealth is an enabler. Digitalization can make healthcare more equitable, more accessible, and more secure. For this, we need a national digital infrastructure that functions throughout the entire care chain and in the entire country. We Social Democrats want to see a time-bound roadmap from the government that holds together governance, standards, timeline, and investments. At the same time, we must strengthen 1177, which already has the residents' trust. We want to develop 1177 as first-line digital care in the public sector.

A few regions have audited digital care and billing. It has been shown that a large proportion of the audited care contacts lack a basis for reimbursement because many contacts in practice have concerned referrals or simpler advice.

Tax money should go to healthcare. We need order now. The online doctor system must be organized, linked to the health centers, and be a complement to them. We also want the marketing of online doctors to be characterized by moderation.

E-health is about control and patient safety. Today, regions lack a clear legal basis to request and review private providers' patient records. We want regions to have the control tools they need to detect welfare crime.

Mr. Speaker! Preparedness is about healthcare facilities, competence, stocks, medicines, electricity, and IT resilience. We Social Democrats want to improve preparedness for war and crisis. We see the need for preparedness hospitals, especially in strategically important locations such as Gotland and in northern Sweden.

We want the state to ensure that strategic stocks of medicine and healthcare supplies are built up. We also want Apoteket AB to be tasked with establishing national pharmacies with a clear preparedness mandate across all of Sweden. That is how you build resilience in the entire country, not just where the market happens to be profitable.

Mr. Speaker! Competence supply, e-health, and preparedness are interconnected. We Social Democrats want the Swedish healthcare system to put the human being first, both as a patient and as healthcare personnel. We also want all residents to receive care based on need, both in peacetime, in war, and in crisis.

I conclude by, on behalf of the Social Democrats, moving for approval of reservation 4.

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Leonid Yurkovskiy (SD)

Mr. Speaker! I thank the member for his speech. There is, of course, much in it that we agree with, and I believe that applies to all parties in the committee.

I would like to ask a question about staffing. It is somewhat linked to the healthcare queues; these two things go hand in hand.

We have seen – and see – the Social Democrats' policy at the regional level. We also saw the Social Democrats' policy during their eight years in government before this government took office. Why was the situation bad then? Why did the healthcare queues double then? And what has changed in the Social Democrats' policy today compared to how it was then so that a different result is achieved?

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Dzenan Cisija (S)

Mr. Speaker! Thank you, Leonid Yurkovskiy, for the question!

It is obviously about resources, which today's government, which has the Sverigedemokraterna as its largest support, has not provided.

Competence supply is about having the right people in the right place. Today, we have a broad staff shortage. We have declining attractiveness and increasing workload. The staff also experience moral stress and a feeling of inadequacy. This could be called a competence crisis. It is not just about educational places, which the government is pushing for, but also about the work environment, employment conditions – wages etc. – leadership and long-term perspective. This is lacking because the resources are insufficient, and that is due, among other things, to the Sweden Democrats.

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Leonid Yurkovskiy (SD)

Mr. Speaker! I thank the member very much for the answer. I naturally agree with what he said in the parts concerning the working environment and the like.

The Chairman mentioned that it is about resources. Was it not about resources when the Social Democrats were in power? It should reasonably have been, but then perhaps other rules of the game – or forces of nature – applied.

Much of what the member mentioned points to a greater state responsibility. Long-term perspective is one such thing. We, of course, stand behind that, but given the description of the problems and the package of solutions, the question to the Social Democrats is: Why are the Social Democrats not for state ownership? That is what I wonder.

This cannot be applied to all parties that are against it, but for the Social Democrats' part, and based on how the party describes the problem, the most reasonable conclusion should be state ownership. We still do not land there. The only explanation I can see is that the pressure from within – from the very many regional politicians – is too great. I do not know if the member can confirm or deny that theory, but I see this as a clearly plausible explanation. No other such explanation exists.

In light of everything the member has said, my question is why one is still opposed to state ownership.

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Dzenan Cisija (S)

Mr. Speaker! I must say that in our shadow budget, we have added double resources to healthcare when it comes to general state grants. That is where there is a difference between the Sweden Democrats and the Social Democrats.

We want, in connection with skills supply, to retain those who are already there through investments in the work environment, continuing education and leadership.

Leonid Yurkovskiy asked a question regarding nationalization. An investigation has been conducted, and I think it is clear which path should be chosen. I want to assert that a nationalization does not create any new healthcare beds. Staff management and preparedness, on the other hand, will do so.

We Social Democrats want instead that the National Health Competence Council's national plan for competence supply, with the 25 proposals that have been submitted, should be implemented. We do not support the government's competence demonstrations, which the media have highlighted recently.

We want to quality-assure the validation of foreign identification documents and counter welfare crimes.

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Crister Carlsson (M)

Mr. Speaker! We are now debating the Committee on Social Affairs' report 22 Competence Supply, Health and Preparedness. I move for approval of the committee's proposal for a decision and move for the rejection of the motions.

This report is quite diverse and covers several very large and completely different areas. Therefore, I will try to concentrate on skills supply and preparedness.

Mr. Speaker! Over the last decades, we have been able to see that it has become increasingly difficult to provide skills for operations; it is extra clear during holiday periods. In the Tidö Agreement, we have agreed that there is a need for some national governance within this area. This primarily concerns a national mapping of supply and demand and taking responsibility for creating conditions for skills supply across the entire country. This does not, however, deprive the regions of the responsibility to ensure long-term skills supply within their own area.

Let me go back to the 80s and 90s – yes, I am older – when we had many more departments and, according to my experience, it was difficult to get a job and permanent employment because of the dense staffing. Today, the question of staff shortages is significant, even though we perhaps have a quarter as many care departments and hospital beds to be staffed because medicines and day surgery have taken over much.

So what has happened? In the 80s and 90s, very high grades were required to get into the healthcare track, according to the old system over 4.0. The best on the healthcare track went to the nursing education, and it was also a requirement to first be a practical nurse. One studied for two years first and then two more years. In between, one often had a fairly long work experience, at least some years, which was recommended. Now, in large part, everyone gets into the health and care program, and one does not need to be a practical nurse to get into the nursing program. Even for this program, the admission points are alarmingly low today.

Previously, the teaching in the nursing education was concentrated on anatomy, physiology, pathology, pharmacology and practice. In today's education, great emphasis is placed on research, and the aforementioned areas have been sidelined, which I personally think is unfortunate as the nursing profession is both practical and theoretical.

So what has happened? Personally, I believe it is due to the shift in the 90s when everyone was to become nurses. That caused nursing assistants and healthcare assistants to largely disappear, which diluted the nurse's role.

I am convinced that the nurses and nursing assistants of the past were better equipped for the reality of that time than today's nurses and nursing assistants are for today's reality. That is my observation.

I am convinced that we see here part of the reason for today's skills shortage, because skills supply is not just about filling positions but also about retaining knowledgeable, experienced staff so that they become the backbone of healthcare. Further reasons why staff choose to leave the profession can be a sense of hopelessness regarding the mission and that the staff feels they are not seen and heard. There is a long distance between the management level, and I want to assert that there are more managers than leaders. There is a certain difference in that.

A simple way to create participation is to involve the staff in the work with schedules, work methods, and development projects. There are places where they do not have healthcare developers but instead let the staff on-site be healthcare developers.

Mr. Speaker! I believe everyone in here agrees that we must solve the long-term supply of skills for Swedish healthcare. It is not worthy of a welfare state like Sweden that we cannot deliver the healthcare that citizens need. Therefore, we need to optimize the healthcare we have today and let the hospitals work based on the conditions that prevail at each respective location.

Another major reason for the lack of competence is that Swedish healthcare is in the process of administering itself to death. Staff describe over-documentation while at the same time the systems cannot be used optimally. When it comes to the quality registers that are kept today, licensed staff spend several hours retrieving data from the medical record systems. This should be able to be automated.

Mr. Speaker! We face a new reality in the world. After decades of relaxation, we have a war in Europe and also conflicts in the Middle East that we do not know how they will develop. That we have a lack of preparedness within Swedish health and medical care became clear during the pandemic. After having been zero and nothing, the work with the preparedness has now begun. In 2022, 2.7 billion was allocated to civil preparedness; in 2028, 19.4 billion shall be allocated. The establishment of a ministerial post for civil defense has been important in this situation. Work is now being done intensively between the departments to map out what needs exist, and the work to build up stocks has begun.

It is obviously easy to be wise in hindsight and think that we should not have dismantled the stocks we had. But now we have the chance to create a modern stockholding with materials that can be used during major events, whether it concerns war, pandemics or other disasters.

The acute hospitals that exist today are needed, and we need to ensure that they can maintain their competence to be able to function fully both in daily operations and in the event of war, pandemic, and major disasters. In addition to securing medical material, it must be ensured that all types of transports to and from the hospitals can be managed, which means that helicopter landing sites and decontamination reception centers for contaminated patients must be reviewed.

Mr. Speaker! We also need to be able to handle everyday problems such as the washing of blankets and clothes locally. We need to increase the amount of reusable material in the operations and ensure that cleaning and sterilization can be carried out continuously and locally. Using disposable materials works perfectly well in normal cases. But during major events, the transport capacity will not be sufficient, and then there is an imminent risk that we will not be able to manage the influx of patients due to a shortage of materials.

(Applause)

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Christofer Bergenblock (C)

Mr. Speaker! I thank Member Crister Carlsson for the presentation.

The Chairman of the Committee raises the issue of competence supply in Swedish health and medical care. Let me therefore tell you a little about what the competence looks like today. We are completely dependent on immigrant labor in Swedish health and medical care. A third of our nursing assistants come from another country, half of our healthcare assistants are born abroad and a third of our doctors are born abroad, as is a third of our biomedical analysts. Furthermore, half of our dentists are born abroad. Without these, Swedish health and medical care would collapse.

At the same time, the government is conducting a deportation policy of divine grace. We see how young people who have completed upper secondary school and begun their education to become nurses are being thrown out of the country. We see how competence withdrawals hit nursing assistants and healthcare assistants in Swedish health and medical care. We see how the image of Sweden has been damaged internationally, which makes researchers and highly qualified personnel hesitate to work in Sweden because there is a risk that their teenage children will be deported. The policy that the government and the Moderaterna are conducting is harmful to Sweden. We need more people working in Swedish health and medical care, not fewer.

In what way does the government's deportation policy help Swedish health and medical care?

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

Crister Carlsson (M)

Mr. Speaker! The Prime Minister has said that healthcare and care personnel shall be protected and therefore are not covered by the increased wage requirement.

I completely agree that we need people of foreign origin in Swedish health and social care. I have seen that myself. At the nursing home where my mother lived, there were many with an immigrant background, and they deserve a gold star as they did a great job. We were previously involved in this regarding language requirements, and I really want to emphasize that there must be such a requirement.

The leadership says that we need more people working in healthcare. Yes, we perhaps need more people working with their hands on the patients. I want to assert that there are enough nurses in our society, but they are not where they should be: with their hands on the patients.

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Christofer Bergenblock (C)

Mr. Speaker! I believe that there are many in Swedish health and medical care, both nurses, doctors and nursing assistants, who see that there is a shortage of staff today. There is a shortage of hands.

It does not mean that we should not work with using digital aids and medical technology and work in smarter ways. It is clear that we shall do that, but we will also need more staff moving forward to fulfill the mission.

Mr. Speaker! We had a presentation today in the Committee on Health and Welfare from the Agency for Health and Care Analysis, where it turned out that precisely this—that one does not have enough time for the patients—is one of the things that our doctors in primary care experience as the greatest workplace environment problem. We definitely need to work to get more in there.

The Chairman of the Committee reads an article where the Prime Minister says that exceptions will now be made from the wage floor that the government has introduced and which will be raised to 33,390 kronor from and including June 1.

That means that the government is now going to introduce additional bureaucracy and administration in the Swedish authorities. Instead, the government could simply say that wages in Sweden are set by the parties via collective agreements and that the only reasonable wage level one should demand, regardless of whether one comes from Sweden or from abroad, is a wage in accordance with collective agreements.

I find it very difficult to understand how a Moderate-led government can think it is sensible for the government to sit and decide on wage floors in the Swedish labor market, but so be it.

It is, however, still very unclear which groups will be included in the exemption and, above all, what salary requirement will be imposed on those who have exemptions. What does the member know about that?

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Crister Carlsson (M)

Mr. Speaker! I have no insight into that work at all.

I still want to say that we cannot bring in labor from abroad when we have such high unemployment as we do in Sweden – around 8–9 percent. We must, of course, take care of the unemployed and try to get them into work and not bring in foreign labor and let our own unemployed remain in unemployment.

The chairman speaks about the need for more employees. I still want to point out and emphasize that we have very many who are attending our nursing and assistant nursing programs. There is a supply need, and we also need to bring them into healthcare in a way that makes them feel secure when they start working. I believe that a large part of the competence shortage we have today is about this.

I agree, as I have said, partly that immigrants do a very good job; I would like to emphasize that. The language requirement, however, is A and O in order to function in healthcare.

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Karin Rågsjö (V)

Mr. Speaker! We heard a lot here.

First and foremost, I want to say to Member Crister Carlsson that today we have an extremely competent cadre of nurses who are doing a fantastic job. We have a completely different healthcare system than when the Member and I were somewhat younger; it is a much more qualified healthcare.

What is putting pressure on the healthcare staff are the extreme differences between what they are expected to do and what they can do with their resources.

It is clear that one wonders when one sees that Arbetsmiljöverket, in its supervision of the hospitals during 2022–2024, concluded that within healthcare, 73 percent were required to take measures. In that case, they have landed completely wrong. It is also about an incredibly problematic situation within primary care, where 69 percent needed to take measures. These are large-scale investigations. Then also came Försäkringskassan's investigation of healthcare personnel, which showed that very many are on the verge of burnout.

That was exactly what we heard this morning when talking about primary care doctors; many of them are also close to exhaustion. They cannot handle the situation they should be able to handle if they had slightly better opportunities to hire more. But that is not how it looks today.

If we are to do something about healthcare, we should ensure that the healthcare workers feel a bit better, and then they must also have more colleagues to work together with. It would be interesting to hear Member Crister Carlsson's view on this. Do we need to hire more in a situation where we also have a completely different demography than 20 years ago, with more elderly people, for example? How are we going to manage this?

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Crister Carlsson (M)

Mr. Speaker! I shall also take a brief look back, but not so far back in time.

It is about the time when I served as a regional councillor. At that time, within our budget framework, we had the opportunity to reduce the working hours for nurses. We raised the wages for nurses, and we reduced the working hours for nursing assistants. We introduced something called "patient-proximate service," which is intended to ensure that staff with slightly shorter education fill in on cabinets and drawers and other such slightly more basic jobs.

We also introduced a manager program. The manager plays an incredibly important role for the working environment in the departments. I want to assert that a good manager beats an increased salary when it comes to creating well-being in the department.

If we get through what we have also done in other regions, I believe that people will be made to want to enter healthcare and work with the patients. I also believe that we must have staff who work with administration who are not healthcare staff. The healthcare staff must work with the patients and have their hands on the patients. It should be rewarded, which was what we did during the last parliamentary term.

Those who received shorter working hours and higher wages were those who worked 24/7 and had their hands on the patients. There, I believe we have at least part of the solution.

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Karin Rågsjö (V)

Mr. Speaker! That sounds absolutely wonderful, Member Crister Carlsson! Reduced working hours sounds like the worst left-wing propaganda – great!

It is also something that, for example, Vårdförbundet demands. I would like to see that the issue is taken seriously, because I actually do not believe that we will be able to hire people who are able to work 100 percent. Very many today work 60 percent in order to cope, which also affects their pensions. Reduced working hours is absolutely a way forward; I must say that. It was interesting to hear from the member's side.

It is exactly as the previous speaker who discussed with MP Crister Carlsson pointed out when it comes to the fact that very many healthcare workers are being deported. It is happening rapidly. Even though the government, through the Prime Minister, says that things will indeed happen and that the government will stop this, nothing is happening. People are being deported, and there are 600 people on the list.

It is not just about this, but it is also about the mental climate that prevails within the healthcare system. I am thinking, for example, of researchers. There was a very good article in Svenska Dagbladet yesterday where the situation for many researchers in Sweden is described. Do they want to stay in the climate we have created in Sweden? Suddenly, Sweden is a country where immigrants are not at the top, if I may put it that way, but are seen as something that does not belong to society.

We are on a very dangerous journey. I think we have to say it like this: Okay, we are going to need more immigrants and people who come here and work! One cannot say that one should ensure that the 9 percent who are unemployed shall enter and work within health and medical care, without one also having to train staff.

Today, educated personnel are being deported. This also applies to young people who are in the medical program and so on; they are being deported because they have reached the age of 19 or 20. It is a catastrophe for Swedish healthcare.

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Crister Carlsson (M)

Mr. Speaker! I did not perceive any concrete question from Member Rågsjö, but I will try to answer what I believe she meant.

No, it was not left-wing politics we pursued there. It was pure moderate politics.

Regarding deportations of younger people, so-called teenage deportations, we are raising the age to 21 years. There are also reasons why someone is deported. I cannot go into specific cases, but there are probably reasons why the deportations occur. It is the Swedish Migration Agency that handles this, and I cannot, as said, interfere in any details regarding how and why.

(Applause)

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Karin Rågsjö (V)

Mr. Speaker! Do you remember the thunderous applause for the healthcare workers during the pandemic? I do. They stand in sharp contrast to the results from the Work Environment Authority's national inspection of acute hospitals and primary care. These leave no doubt: Swedish healthcare has a structural work environment problem that is now so serious that it affects both the quality of care and the health of the healthcare staff.

During the years 2022–2024, the Swedish Work Environment Authority inspected workplaces within healthcare. 73 percent were issued requirements for measures. In the care departments of acute hospitals, the deficiencies were even greater: 80 percent did not meet the requirements of the Work Environment Act. In primary care, the figure landed at 69 percent. The most pervasive deficiency concerns unhealthy workload and the imbalance between demands and resources that has long characterized healthcare. It is about the bloodletting that has occurred for decades within public care, and it is about the healthcare staff.

There is a shortage of healthcare beds across the country, including in intensive care, which can largely be attributed to a shortage of staff and a work environment that in many cases is completely unsustainable. Stronger national governance and resource allocation are required, exactly what the Healthcare Responsibility Committee concluded.

It seems especially ungrateful to work in the Skåne region, where Tidögänget rules. There, the waiting time for specialist care is 93 days, to be compared with Stockholm which has 62 days – despite the fact that Skåne has half as large a population as Stockholm. Perhaps that is something to reflect on in the southern part of Sweden.

Higher wages, more employees, and better working hours, for example in the form of reduced working hours, are required. It is required that the state takes greater responsibility for education for all healthcare professions. Equal national economic management within healthcare is required. A long-term national economic plan for basic education, further education, and continuing education for healthcare personnel is required, and specialist training for healthcare personnel must be regulated by law. It cannot be a free-for-all; here, we want to regulate.

Staff within healthcare must also see that the investments being made are long-term, not just short-term. If the general state grants had been value-secured, that is, indexed with price and population, the regions would have had 10 billion more today, and they would have needed it. This is what Vänstern wants to do.

Now we move quickly to journal systems. Regardless of the political color of the region, errors often occur. The problems with regions that are to introduce new journal systems within health and medical care have been a recurring theme in recent years. These failures lead to large costs for the regions but hardly to it becoming better for the patients.

Vänsterpartiet thinks it would have been very good if we, just in this area, had had some kind of national thinking so that one could find a coherent and functioning national journal system that could facilitate mobility within healthcare for both patients and employees.

AI, Mr. Speaker, is fantastic – but do we have a grip on it?

Several attempts and studies are currently being conducted at Sankt Görans Hospital in Stockholm to develop the diagnostics of breast cancer. A study from 2023 showed that samples that previously took 15–30 minutes for a human to analyze can be analyzed in 3–4 minutes with AI. The attempts conducted at Sankt Görans Hospital have resulted in the queues for mammography being gone. The follow-up of the attempts also shows more identified cancer cases and fewer false positive cases.

This type of efficiency frees up working time for doctors and other healthcare personnel and should, of course, be spread across the country. It is an incredibly important development, and we must ensure that things continue to happen in this area. It will also strengthen various assessments made within healthcare.

But there are also great risks with AI when it comes to privacy protection, and the question is who should bear the responsibility when something goes wrong. We are very dependent on the USA in Sweden, and it would be very good if Sweden owned these functions. Just like that, we could stand there without this part from the USA. We want the government to come back with proposals to develop national and state-owned AI models for screening.

Mr. Speaker! Cash is king. When the healthcare market expands, various right-wing politicians often sit and watch tax money roll away to the companies. There is no denying that. Do we get equal healthcare because of that? Well, welfare resources must be directed according to the principle of need, where the greatest need comes first.

For the online doctor companies and other private healthcare providers, the healthiest patients who require the least intervention are the most profitable. It is them they are after – the low-hanging fruit.

Region Stockholm has tried to reduce the costs for online doctors, but it has turned out to be very difficult. The online doctors are very skilled at finding loopholes in the legislation. Many have moved their operations to Region Sörmland, where the reimbursement level is higher, which leads to higher costs for the public in other regions – very clever! During the period January–October 2024 alone, Region Stockholm paid more than 300 million kronor to the online doctors. These are enormous sums that just keep rolling on.

The online doctors are paid per contact, and there is no cost ceiling. This creates incentives to entice patients to get in touch again and again for ailments that do not actually require care.

If you ride the subway in Stockholm, you can also see that various online doctor companies are courting customers in the subway. Imagine if a health center in Stockholm were to court its customers in that way! We have also seen online doctors who manipulate fees and who, without asking, transfer patients from their permanent health center to their own operations. This is real; it is not something I am making up.

The agency Vård- och omsorgsanalys has looked at digital care and shown that approximately 25 percent of online doctor contacts are new care that would not be provided anywhere else. Even Konkurrensverket has questioned the reasonableness of online doctors distorting competition.

In order to close the loopholes for the online doctor companies, the Patient Act must be changed. The Act states that patients themselves are completely free to choose their healthcare provider, which is good, and that also includes the online doctors. But here we must also look at the consequences. We want to change the Patient Act to stop the online doctors' operations in their current form and find new forms. Therefore, I move for approval of reservation number 25.

Swedish health and medical care is in a critical situation. At the same time as the demands on care are increasing, we still have a major shortage of competence. In the midst of this, a number of laws have been enacted that mean very many healthcare workers can now potentially be deported, which we have spoken about previously. Sweden's reputation as an open society is being tarnished.

In ten years, 4,000 doctors and 2,000 nurses have come to Sweden from other parts of the world. They are very worried, and so are all the teenagers facing deportation decisions. Do it again and do it right! We are waiting impatiently for the government's proposal regarding what is intended to be done to fill these gaps.

The death, suffering, starvation, and the humanitarian catastrophe in Gaza as a result of Israel's relentless war following the massacre on October 7, 2023, cannot be described. Thousands of children have been killed, injured, and traumatized. The healthcare system in Gaza has been completely shattered.

14 European countries have received patients from Gaza, but the Swedish government says no. Vänsterpartiet believes that we must receive patients just as these 14 other countries have done, for example, Italy and Spain. It is extremely important. We must safeguard the right that should exist for the children, for example, who are severely injured and still are not receiving help with prosthetics and so on.

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Crister Carlsson (M)

Mr. Speaker! I must react to the Left Party's eternal complaining about private healthcare providers. The Left Party simply does not trust private individuals' initiative, including in healthcare. One believes that politicians and the state can do better.

I can tell a short anecdote. In 2018, we took over in Region Dalarna. At BUP, they received barely one patient per day per licensed staff member. The region was fourth from the bottom in Sweden regarding availability at BUP. When we stepped down in 2022, we were among the top four.

Doesn't Member Rågsjö think that the private child and adolescent psychiatry has done a good job and that it is the quality of the care, not who runs it, that is most important?

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Karin Rågsjö (V)

Mr. Speaker! I thank Member Crister Carlsson for the question.

I am not against private healthcare providers. I myself go to a health center owned by a cooperative of doctors. It works perfectly. That is not what we are looking for. We are looking for the loopholes, let's say for the online doctors. Online doctors have appeared quickly, and they have seen that they can earn a lot of money by catching quite healthy people in their systems.

I do not think it is okay for online doctors to regularly stand and solicit customers in the subway. I do not think it is okay that they, on their sites, refer patients to their clinics from the clinics they already have. It happens daily. I do not think it is okay that private online doctors profit from the regions by deceiving them. That is exactly what has happened in Stockholm. I do not think it is okay.

There will absolutely be private initiatives. No one in the Left Party is against that, but they must not trick the regions out of money. It is not a good thing – absolutely not.

It has certainly worked very well in Dalarna with your initiative, but there are also other examples of precisely those who work with diagnoses of young people. They have capitalized on people's despair over not receiving help from the regions. We have seen that, and they have also had to shut down their operations.

"Private" can be anything. It can be Sankt Görans, which has this fantastic AI project running. But it can also be those who cheat the state and the regions out of money. So we cannot have that.

There is a healthcare law that says sickest first. That system does not run the online doctors.

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Crister Carlsson (M)

Mr. Speaker! Member Karin Rågsjö must be different from the Left Party members in our region, because they were very much against private care. If it was private care, it was: No, thanks!

I agree that there are many good private health centers that do a great job. Many of them are initiatives that have been taken by the staff in the region. They have started their own health centers that function well. Of course, we must not have cheating and trickery in healthcare.

I move on to another issue. The regions went 8 billion plus over last year. From the left, there is a lot of talk about the government having to fix the shortages in healthcare. Sure, there are some shortages in healthcare, but isn't it the regions' responsibility to rectify the shortages? Is it only the government that must do it? How much responsibility should we place on the regions?

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Karin Rågsjö (V)

Mr. Speaker! There were a lot of questions.

We are against profits in welfare in the way it functions now – for example for private actors. It is common knowledge.

We also see an enormous spread of fraud, even at health centers, vaccination centers and so on. It is not okay. They are simply laundering money. So, we don't want that, do we?

Let me go back to the regions. Before the happy 7–8 billion rolled in, they were 24 billion down. For various reasons, it has been a catastrophic economic development in Sweden. During the period when the state grants were not increased to meet the large needs that existed in the regions, people had to be laid off. That was the situation. It was 24 billion down, and now 8 billion plus – they are therefore still in the minus.

One thing we might be able to agree on in Sweden is to index the state grants so that the state grants follow the development, as for example wages do. We do not accept wage negotiations where someone says that you do not get a higher salary this year without going with the 2 percent you have received previously.

There is much that can be done. The regions are struggling in different ways, but I have explained that the state must take a clearer responsibility for the economic management, index the grants, and invest more in welfare than in lowering taxes for the absolutely wealthiest.

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Dan Hovskär (KD)

Mr. Speaker! I would like to begin by expressing my support for the committee's proposal.

We are therefore debating today the Social Affairs Committee's report on skills supply, e-health, and preparedness. These are three important areas that fundamentally are about one and the same thing, namely the ability to provide people with secure care when they need it.

For the Christian Democrats, the starting point is clear. Care shall be based on the human being, not on the system. But today we see a system that all too often is insufficient, and we see healthcare staff leaving the profession due to a pressured work environment. We see patients facing long queues, even though we see that the trend for healthcare queues has turned. Healthcare queues have decreased by 28 percent with our policy, but there may be a skills shortage that risks deepening as the population ages. This is not an isolated challenge, but it is one of the great welfare issues of our time.

Mr. Speaker! The Tidö parties and the government are now taking important steps to strengthen the supply of skills in health and medical care. In the budget for 2026, funds are allocated for better governance, more training places, and strengthened skills across the entire country. We see investments in women's health, cancer care, and psychiatry, and not least to shorten the queues to child and adolescent psychiatry.

But it is not just about money, it is also about using competence in the right way. Far too many doctors and nurses testify that they are not allowed to work with what they are trained for. Administration, inefficient IT systems, and lack of organization take time away from the patients. Here we need a cultural change. We must ensure that the right competence is used for the right task, that healthcare staff are relieved, and that the digital tools actually facilitate, rather than hinder. This is crucial for more people to want to stay in healthcare.

Mr. Speaker! Another important step is the work on a national plan for skills supply. It is necessary. Today, educational places, internship places and specialist services are unevenly distributed across the country. This leads to unequal care and a shortage of staff where it is needed most.

We Christian Democrats believe that stronger national coordination is required here. More places for work-based education are needed. Better planning of specialist services is needed. We also need to create conditions so that more people want to work in and stay in healthcare, not least in rural areas.

Madam Speaker! We Christian Democrats want to highlight a particularly important part: municipal health and medical care. That is where more and more elderly and multi-morbid people receive their care. Yet, the municipalities have long lacked sufficient tools to ensure that there is medical competence.

Therefore, it is welcome that the Christian Democrats and the government are now moving forward with a proposal to make it possible for the municipalities to employ doctors. It is a crucial reform. It is about creating continuity, it is about increasing security, and it is about moving care closer to the patient. The elderly person living in a special housing facility should not have to face a system where the doctor is far away. The doctor should be there where the elderly person is.

Madam Speaker! Health and access to data is another key issue in this report. When used correctly, digitalization can contribute to better quality, shorter waiting times, and more equitable care. But if used incorrectly, it risks creating more administration and frustration.

The development of e-health must stem from the organization's needs and from the patient's best interests. We need better health data, strong privacy protection, and systems that actually support the healthcare professions in their work.

Madam Speaker! Finally, I want to say something about preparedness. The pandemic showed us that a strong healthcare system is also a matter of national security. We must have the right competence, the right staffing, and the right organization – not just in everyday life but also in a crisis. It requires long-term thinking, coordination, and clear responsibility.

The security situation in our global environment is serious. Step by step, we are now preparing Sweden's total defense and preparedness. Healthcare is no exception. Therefore, it is positive that the government yesterday decided to carry out a pilot project for preparedness hospitals, so that there will be a capacity to provide care for a large number of injured people. Especially hospitals facing decommissioning, for example Sollefteå hospital, shall be considered in the selection of hospitals.

This project gives Region Västernorrland a new opportunity. The regions are the primary authorities for health and medical care in Sweden. To participate in a pilot project for preparedness hospitals is an offer from the state, which, for example, Region Västernorrland can take a position on.

The ability to maintain healthcare under difficult conditions is crucial for both the population's security and Sweden's defense capability.

Madam Speaker! In summary: Sweden has fantastic employees in healthcare. But they need more and better conditions. They need a reasonable working environment. They need the opportunity to develop in their profession. And they need a system that works and that does not work against them.

The government's work regarding skills supply, health and care, and preparedness are important steps in the right direction. But the work must continue, with a clear focus on that which must always be at the center: the human being.

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Karin Rågsjö (V)

Madam Speaker! When it comes to Sollefteå, I think it sounds very good. Vänsterpartiet has been there several times in different constellations. It is a good initiative.

One should start a bit positively, but now something else is coming. I am thinking about this matter of 28 percent shorter healthcare queues. We looked at that a bit, because we thought they were interesting figures. I think it is fantastic if the healthcare queues decrease; that is not it. But when you calculated your 28 percent, Dan Hovskär, you had excluded the nine regions that had changed their various systems. But we looked at them too. That is, it was possible to do so. And no matter how you measure it, you end up with completely different figures.

One lands at 13 percent if one measures from October 2022 to January 2026. One lands at 8.4 percent if one looks at January 2023 to January 2026 and so on. At most, one reaches 14.8 percent. But we did not reach 28 percent.

The Christian Democrats are responsible for healthcare. That is your responsibility. Therefore, I wonder how it can be so wrong. It sounded very credible, but we have really plowed through the figures – not I personally, but others who are good at it – and see that a reduction of 28 percent does not hold.

So, one of my questions to the member is: What were you thinking there at the press conference? It sounds great with 28 percent, but it is not 28 percent.

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Dan Hovskär (KD)

Madam Speaker! Thank you for the questions, Karin Rågsjö!

It is true that there has not been the same opportunity regarding all regions, because some have changed their systems. It has made the whole thing more difficult.

According to our figures, which Socialstyrelsen and no one else has compiled, we see that the healthcare queues have decreased by 28 percent from October 2022 to January 2026. One has attempted to look at the figures that are comparable. When the investigation was conducted, it was not possible to include the figures from the other regions, as they were not comparable. It is in that way we have seen that the development has changed and that a trend break has nevertheless occurred.

During the previous parliamentary period, when Vänsterpartiet and Socialdemokraterna were in power, we saw that the queues doubled. Here we still see a break in the trend. The queues are decreasing. What we have looked at, in the regions where it was possible to compare the figures, concerns operations and the first contact for specialist healthcare. That is the answer as to why the figures look the way they do.

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Karin Rågsjö (V)

Madam Speaker! The regions that you excluded, Dan Hovskär, we included. It was actually possible to do so if one went in and looked at SKR's page. They were Blekinge, Dalarna, Gävleborg, Halland, Norrbotten, Sörmland, Västerbotten, Västernorrland and Örebro. Some of them have very good results. Others do not have such good results.

It is clear that one can fix the figures if one removes nine regions. Now, I won't be like that; you probably thought correctly.

It is clear that there is a huge difference if one first says 28 percent, and then it lands on 14 percent because these regions were not included. I think it is a bit sad. It was, so to speak, a bit of a damper on the joy for my part.

Then we see a shortage of labor now within both healthcare and elderly care. At the same time, there is a long list of people who are to be kicked out depending on things that have to do with the legislative changes that you have whipped through together with the rest of Tidögänget, which hit very hard. We face demographic challenges, large pension retirements, and increased healthcare needs.

This makes me wonder. To deport educated staff and young people undergoing education, for example, people who are studying to become doctors or nurses, is that really such a smart idea in these times? Or is it just about you wanting to appease the Sweden Democrats' entire idea of throwing out as many immigrants as possible?

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Dan Hovskär (KD)

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

We can start with the statistics. It is possible to compare apples and pears. The statistics we have compiled, however, attempt to compare the same things directly, but it has not been possible to do this with all regions, as some have changed systems. There are no relevant figures that can be entered into the system.

The National Board of Health and Welfare has produced figures showing that the queues have decreased by 28 percent. That is what we must base our assumptions on. We see that there is a trend break. There is a positive development compared to when the Social Democrats and the Left Party were in power.

We are implementing measures that have an effect, and people can see that the care queues are actually decreasing. That is what I am proud of.

Then, in the best of worlds, one would have compared all figures, but it must be relevant and it must be comparable figures.

It is true that many who work in our healthcare have a foreign background. There are very many who have a foreign background there. The vast majority of them have Swedish citizenship and are not affected at all by these various reforms. But for those who are still affected, an exception will now be made. It concerns nursing assistants and other healthcare personnel. That is to say, it should not be necessary for more to be deported among those who meet the requirements.

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Christofer Bergenblock (C)

Madam Speaker! First, I would like to move for approval of reservation 2 under point 1, regarding the supply of skills. The supply of skills is the single most important issue that Swedish health and medical care has to grapple with. Yet, we are sitting with a government that has made the deportation of welfare personnel its hallmark.

This is happening at a time when we see that the need for healthcare staff will increase for a long time to come. This is happening at a time when we see that our countryside has extra difficulty recruiting staff. This is happening at a time when all competence is truly needed. It is both unreasonable and unacceptable!

From the Center Party's side, we have long pointed out that competence supply and the dimensioning of educational places is one of the areas where increased national governance is needed. This is also one of the proposals that was highlighted in the Care Responsibility Committee's final report nearly a year ago.

The National Healthcare Competence Council has also, in its proposal for a national plan for competence supply, raised 25 different proposals for measures, several of which rest with the government to address. From this plan, which arrived over a year ago, almost nothing has happened so far. And all proposals from the Healthcare Responsibility Committee are still on the government's desk waiting for better times. It is obvious that the Tidö parties have not taken the issue of competence supply as seriously as it deserves.

Madam Speaker! The most important and simplest thing to ensure future skills supply is, of course, to take advantage of the personnel we have today. It is not sufficient, as the government does, to conduct a deportation policy that in the short term contributes to direct skills losses in our operations and in the long term creates fear and uncertainty, which causes even more to risk disappearing.

Sweden is today completely dependent on foreign-born labor. Every second healthcare assistant, every third nursing assistant, every fifth nurse, every third doctor and every second dentist is born abroad. In just the last ten years, 39,000 people have come to Sweden who now work within Swedish health and medical care. We need them all.

That the government has focused on deporting healthcare workers has created further anxiety in a sector where the focus should instead be on addressing the existing deficiencies in the working environment. From the Center Party's side, we see instead a need to create a better and safer working environment that ensures the staff feel satisfied and want to stay within healthcare and elderly care.

We know that leadership is absolutely crucial for well-being in the workplace. Therefore, we want to create a national leadership program for managers within healthcare. In this way, we can create a common and knowledge-based foundation for managers wherever they are in the country. When one looks at what young employees value when they choose an employer, good leadership is among the highest-ranked issues.

Madam Speaker! We also see that the conditions for development in the workplace are absolutely crucial for well-being. Therefore, we want to create more career paths, including through more specialist-trained nursing assistants. But we also mean that all healthcare personnel should have the right to continuous further education during their employment. At the speed at which healthcare is developing today, with new research findings, new therapies, and new medical technology equipment, it is absolutely necessary that the staff can also develop their competence within the framework of their employment.

In addition to the fact that we need to attract more young people to start working in healthcare, we see a need to take care of our senior employees so that they stay longer. Senior nursing assistants, nurses, and doctors across the country should have the opportunity to develop at work even after they have turned 60. Not least, it is important to take advantage of their experience and competence to mentor new employees and contribute with their experiences. We believe that a permanent initiative on senior labor in healthcare and elderly care should be established through an agreement between the government and SKR.

Madam Speaker! One of the problems within the skills supply is that it looks very different in different parts of the country. The difficulty of supplying skills is accelerated when we leave the university towns and the metropolitan areas. In smaller towns and in our rural areas, it is significantly harder to get staff than it is in the large cities. Therefore, we need stronger national governance of education and educational places.

Not least, the operationally-based training and the placement of various medical services are crucial for where one then chooses to settle or at least stay for a few years. Therefore, we also believe that it is important that VFU positions, AT positions, basic service positions, and ST positions are offered in all parts of the country and are distributed evenly between the regions.

This is an area where the government has done far from enough. That is why the Centerpartiet allocated almost 1 billion kronor more than the government for new ST services in the autumn to build up competence across the entire country.

Centerpartiet sees a need to reintroduce a basic service year within the dental education to facilitate for more dentists to find their way out to our small towns and rural areas.

Centerpartiet has also pointed out that Sweden, like Norway, needs to look at economic incentives to attract more people to take welfare jobs in our rural areas. This could, for example, be done through the cancellation of student debts or relocation grants.

Madam Speaker! Imagine if the 2.5 billion kronor that the Tidö parties allocated to get people to move from Sweden instead had been used to get people to move within Sweden to where the jobs are. Then the money could have done real good. Unfortunately, this action is symptomatic of a government that has largely forgotten Sweden's rural areas.

Madam Speaker! Sweden faces a major challenge in meeting the demand for skills in the future, not least in our rural areas. Therefore, it is required that we make use of the staff we have and stop the unjust deportations. They harm healthcare, they harm the work environment, and they harm the image of Sweden to no benefit whatsoever.

We simply cannot afford that kind of politics. Instead, we need a policy for all staff and all of Sweden where we take greater national responsibility for the supply of skills and make it attractive to work in all parts of our country.

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

Lina Nordquist (L)

Madam Speaker! Competence supply and preparedness are actually largely the same thing. If we in healthcare, social services, and our other safety net can hire skilled people and get them to stay, our country has a significantly better preparedness. This means that employees must be given very good working conditions, and in many places in Swedish healthcare, more colleagues who are satisfied are needed.

A region with healthcare education and specializations cannot only look to its own needs. The government is now developing target values for how many professionals each region needs to train so that healthcare in all of Sweden can function. Work is also underway to develop more regulated specializations for important healthcare professions.

Madam Speaker! Continuing education shall now become a self-evident right throughout one's professional life. It shall be an explicit employer responsibility to provide such continuing education and an obligation for every employee to undergo such education. I do not believe that anyone will be particularly opposed to it in healthcare. It is long-awaited and important, and finally, it is on its way.

The next step we Liberals want to take during the upcoming parliamentary term is to introduce national competence levels that ensure we take advantage of people's increasing competence and provide good wage development. In every professional group, a newly graduated person coming to their first workplace should know that the most experienced person at that workplace earns double what they do themselves and that they themselves can get there.

Madam Speaker! The Government is allocating 50 million kronor to help the regions strengthen the work environment and innovative ways of working. New legislation for good and close care provides better opportunities for primary care. It will truly strengthen the work environment there.

Work is also ongoing to strengthen the competence supply for occupational health care. This is significant for all workplaces in Sweden and definitely for healthcare.

Something that is incredibly significant is the introduction of a national digital infrastructure that supports people who work in healthcare rather than creating problems for them and consuming their time.

Madam Speaker! The Liberals want more people to be able to work on a small scale in Swedish healthcare during the coming years. We are convinced that it will make a big difference for the supply of skills.

Today, many health centers have so many listed that they are more or less populated like a medium-sized city. Of course, a health center must ensure that those who need to meet a dietitian, physiotherapist, or psychologist are able to do so. But it does not mean that it is reasonable for all professional groups to be employed at the same workplace.

Still, that is what many regions require today. The consequence is that there are very many employees in the same place and that they must work on a large scale. The one who wants to practice healthcare themselves must become a corporate person and probably leave the clinical everyday life behind.

It is a pity because we are losing wise people who could provide good care all around Sweden. It is a pity because we know that patients feel most at home in small-scale care.

It is a tragic irony that many regions set requirements for large-scale operations in order for patients to receive more care closer to home and for everyone to receive all the competencies that are needed. What ironically often happens is that smaller towns sometimes do not get any health center at all.

We want more professionals to be able to provide and give small-scale care and work at smaller clinics. We believe that it would make many stay in healthcare. It would provide more care in industrial towns, in suburbs, and in rural areas. This needs to be secured by the state, and the state needs to set the framework for Swedish healthcare. To that, we liberals believe that a strategic overall responsibility is required.

We also want to introduce a healthcare group, equivalent to the national pension group or the recurring defense preparation. It would reduce the volatility between parliamentary terms and give healthcare the long-term perspective that patients and employees truly need.

Madam Speaker! Experienced professionals are absolutely crucial for every improvement of our safety net. They are crucial for each other and for Sweden's patients. Therefore, shortage occupations must become dream jobs in Swedish healthcare.

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

Nils Seye Larsen (MP)

Madam Speaker! Initially, I want to say that we in Miljöpartiet naturally stand behind all our motions, but I particularly want to move for approval of reservation 3.

The Swedish health and medical care system faces major challenges today. It is about underfunding, staff shortages, high workload and a pressured work environment that risks wearing out the healthcare's invaluable employees. It also makes it harder for the healthcare to be able to meet the needs of the future, to be able to develop when it comes to quality and efficiency and to be able to manage the so important transition to a good and close care.

The personnel shortage within health and medical care is already today a major problem, and it will become an increasingly extensive problem within a near future. The situation is particularly difficult already now in Sweden's more sparsely populated regions. It is therefore obvious that significantly larger long-term investments in health and medical care are needed than what the government proposes. If we are to be able to strengthen care in the long term, we must also strengthen the conditions for those who work there. It is about being able to employ more, reducing the burden on the staff who already exist, improving the work environment, and creating time for recovery, development, and further education.

Madam Speaker! The work environment is a completely crucial issue for the supply of skills. A poor work environment risks wearing out the healthcare staff we have and also leads to people who have educated themselves in the healthcare profession largely leaving the profession or choosing other paths. Therefore, the working conditions must become long-term sustainable, and we must also proceed with the proposals on shorter working hours.

Shorter working hours, together with a good working environment and good working conditions, can in the long run strengthen the supply of skills in healthcare. It can make healthcare professions more attractive and contribute to more people wanting to work in healthcare, to being able to retain the staff who are already there today, and to reducing sickness rates in healthcare professions, which today are characterized by high workload and high sickness absence. Staff participation needs to increase, and real investments in a good and long-term sustainable working environment are needed.

The recovery bonus, which was introduced when we and the Social Democrats were in government, showed despite its limited scope that targeted investments in the work environment can yield very good results. Therefore, the Green Party wants the government to task Socialstyrelsen with investigating and returning with a proposal for a long-term investment for a good and sustainable work environment within health and care, where work models and technical or digital solutions to reduce the workload can be tested and evaluated in cooperation with regions, municipalities, healthcare staff, and research.

At the same time, a more unified and strategic effort is needed regarding skills supply, and here the National Healthcare Skills Council plays an important role. The Council presented in May 2024 – it is starting to be a while ago – a national plan with 25 proposals for measures. We believe it is important that the government proceeds with these proposals together with the regions. The regional healthcare skills councils also have an important function, as they can capture regional needs and specific challenges, develop working methods, and contribute to long-term planning regarding staffing and educational needs. Therefore, they also need better resources and better conditions to operate.

Madam Speaker! We need more educational places when it comes to veterinary professions and better opportunities for continuing education and specialist training.

In June, the investigation "Strengthened patient safety through the right competence – based on the needs of health care and dental care" was presented. It contains a number of concrete proposals to strengthen continuous continuing education regarding healthcare professions. These are good and important proposals, and it is therefore extremely urgent that the government promptly proceeds with these proposals.

Rural municipalities and sparsely populated regions face particularly great challenges when it comes to recruiting staff. The shortage affects many professional groups: general practitioners, district nurses, psychologists, physiotherapists – the list can be long. Demographic changes, a declining and aging population, and socioeconomic structures mean that certain regions and municipalities find themselves in a particularly difficult situation. We therefore believe that the government must take a specific strategic grip on the supply of competence across the entire country. In that work, there must be a clear focus on how competence can be secured in rural regions and municipalities.

Madam Speaker! We must also speak about the importance of migration for the healthcare sector's supply of competence.

Swedish health and medical care is already today dependent on people who are born in other countries. It is therefore very serious that the government pursues an extremely restrictive migration policy and simultaneously expels people who work in health and care professions around the country. This policy also puts a spoke in the wheels of the government's goal to attract highly qualified labor, as the restrictive migration policy, where the rules of the game are also constantly changing, has a direct deterrent effect.

When healthcare is already struggling to recruit, politics must facilitate – not complicate – for people with the right education and competence so that they can work in Sweden, or for young people who have grown up in their new homeland Sweden so that they can stay here and train within the healthcare profession.

Madam Speaker! Yesterday, we could read in a press release that the government is tasking Socialstyrelsen to carry out a pilot for readiness hospitals with the objective of strengthening the healthcare system's ability to handle a large number of injured. When selecting hospitals, Socialstyrelsen shall particularly consider those that are subject to decommissioning, for example, Sollefteå sjukhus. Socialstyrelsen shall reimburse the regions for costs linked to the pilot. This can include costs for maintaining capability in peacetime, which can be utilized during high readiness and war.

This is pleasing, and I can state that the government has taken inspiration from my motion on strengthened acute and emergency healthcare in northern Sweden.

Miljöpartiet has been very concerned and strongly opposed to the decision regarding the closure of Sollefteå hospital. A well-functioning emergency and preparedness hospital in Sollefteå is absolutely crucial given the expansion of the I 21 regiment and in order to ensure functioning emergency care in northwestern Västernorrland. Now we must do everything we can to stop the closure.

Madam Speaker! Digital care has great potential to strengthen accessibility and relieve other healthcare services. But today's order with private online doctor companies has also led to growing problems. Evaluations show that digital doctor visits are often made for milder ailments while costs are shifted to the regions through out-of-county provision, which is being utilized. Aggressive marketing has led to a situation where online doctors are used most by residents in Stockholm and other metropolitan areas, while they are used least where the distances are greatest. This market means that resources risk being diverted away from patients with greater needs. Thus, we depart from the principle of equitable care based on need.

Digital healthcare contacts are an established part of Swedish health and medical care, but development has proceeded faster than legislation and governance. Therefore, digital care needs to be better integrated into the regular care structure, with clear requirements for continuity and follow-up responsibility. Digital care should be a tool when it comes to demand management and equitable access to care. We must, therefore, deal with the dysfunctional market of online doctors that we have today.

In conclusion, I would like to mention a few words about the situation in Gaza and that Sweden has not yet received patients from there. After all, there are at least 14 countries in Europe that have done so. We are talking about an area where almost all necessary healthcare infrastructure is completely destroyed, and the situation is still catastrophic for the inhabitants. We therefore urge the government to do exactly what many other European countries have done: Receive patients from Gaza who are in desperate need of proper care!

(Applause)

In this speech, Jacob Risberg (MP) agreed.

The deliberation was hereby concluded.

(A decision was to be taken on 1 April.)

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