Medicines and dental care

Christian Lindefjärd (SD)

Madam Speaker! I would like to begin by moving to approve the committee's proposal for a decision.

On January 1st this year, our major dental care reform, tiotandvården, came into effect. It is a reform that the Sweden Democrats and the Tidö government have developed together.

The reform means that you, who are 67 years or older and need to repair or treat your teeth, only pay 10 percent of the reference price. The reference price has been established by the industry together with TLV. For treatments that are not covered, the ordinary high-cost protection applies. All dentists who are affiliated with Försäkringskassan are obliged to accept these patients.

I am proud that we are implementing this reform. We are talking about a group of people who have worked hard their entire lives. Many have low pensions and sometimes poor oral health. Now they get a real opportunity to prioritize their dental care. Far too many have lived with worry, pain, and shame. Poor dental health can lead to loneliness and mental ill-health. No one should have to ask themselves: Can I afford to eat next month, or should I go to the dentist? Now more people can afford to go to the dentist.

Let me take an example. Kent, 67 years old, a pensioner from Vendelsö, has been waiting for this reform. When he recently needed to have a root canal, he paid 410 kronor instead of 4,100 kronor. It is an enormous difference – money that can now go towards other things in life, perhaps towards the veteran Saab or an annual pass to AIK Hockey.

Madam Speaker! Criticism has been voiced against the reform, including from the dental profession. It is argued that the reference prices are too low. But then one must also ask: Why has the industry not contributed to a greater extent with better and more comprehensive data to TLV to ensure correct price levels for various treatments?

Dental care prices have increased sharply in recent years. Venture capital companies have bought up clinics, and the market is moving towards ever larger chains. When competition decreases, prices risk being pushed up. A common complaint from patients is that they do not know what the treatment will cost. They receive unclear information, and the final bill becomes significantly higher than expected. Here, the information must become better. More people need to be aware of Tandpriskollen and compare prices. Is it too expensive – change dentists! Consumer power must be strengthened.

Madam Speaker! Another major challenge is the skills shortage within dental care. In the metropolitan regions, the situation is relatively stable, but outside of these – especially in rural areas – it is difficult to recruit staff in both the private and public sectors. The shortage of dental hygienists is particularly serious. They perform preventive work that is necessary for good oral health in the long term.

It is positive that the number of admitted students to the dental training programs is being increased and that over-admissions are being made so that more people can be trained, but education is not enough – we must also ensure that the staff work where the needs are greatest. In other countries, they work with writing off parts of student loans for those who serve in rural areas for a number of years. One can also reserve certain training places for local applicants to strengthen the regional competence supply. These are measures we should consider.

Madam Speaker! In Sweden, we should be proud of the citizens' good oral health. It is built on long-term and successful work within children's dental care with summons and regular check-ups. It is also a responsibility for guardians to ensure that children and young people attend their booked visits. Here, the private dental care also needs to take greater responsibility and contribute to alleviating the pressure so that the entire responsibility does not fall on Folktandvården.

Dentists need varied work tasks. It is important for them to want to stay in the profession. Working only with, for example, children limits experience, while a broader patient group provides greater competence and development opportunities.

With dental care, we take a big step forward. This is a reform that needs to be expanded to larger parts of the population in the long run. We strengthen the security for the elderly, improve accessibility, and show that dental health is a part of general welfare and that teeth are a part of the body.

Madam Speaker! Developments within the pharmaceutical industry are moving at a rapid pace. Only a few years ago, few could have imagined that we would have effective medicines against obesity, which change the lives of many people. The question is what comes next. What breakthroughs will we see in five or ten years?

Sweden is a leading life science nation. We must continue to be that. Research and pharmaceutical production are crucial for our competitiveness, for jobs, and for our GDP. But it is also about security. The pandemic and the unrest in the world show how vulnerable we are when production is located far away. Therefore, it is a very important announcement that the state is now securing antibiotic production in Sweden by purchasing a factory in Strängnäs. In these times of uncertainty, we must be able to guarantee the availability of life-saving medicines.

Madam Speaker! Today, thousands of people in Sweden live with rare diagnoses. They are dependent on orphan drugs and treatments that often already exist but do not always reach the patients in time. Here, we are lagging behind several of our neighboring countries. The problem is not a lack of innovation. The problem is the system. On one side, we have TLV, and on the other side, the regions and the NT Council. When two actors are to make decisions, long processes arise. Sometimes, introductions are slowed down with reference to costs.

We must dare to see the whole. Is it cheapest for a person to be on sick leave, for Försäkringskassan to pay, or for the municipality to have increased costs for assistance? It is the same tax money, but different accounts. When people receive the right treatment in time, it is not just a cost. It is an investment in quality of life, work ability, and the economy of society.

It should not matter where in Sweden one lives. Care should be equal. The Care Responsibility Committee has proposed that the state should take greater responsibility for pharmaceuticals. It is a step in the right direction, but we are not there yet. The silo thinking must come to an end.

Madam Speaker! Another area that requires our attention is clinical trials. For several years, they have decreased in Sweden. Pleasantly enough, we now see a cautious increase, but we need to do more. With better coordination, simplified regulations, and clearer responsibilities, we can strengthen Sweden's position. This gives patients early access to new treatments and strengthens us as an innovation nation. This is also an economic issue. A strong research sector creates growth and confidence in the future.

Madam Speaker! This autumn, we in the Social Affairs Committee visited Scotland to study their Pharmacy First model. Instead of first booking a doctor's appointment, then receiving a prescription, and subsequently picking up the medicine, the patient can go directly to the pharmacy. There, a pharmacist makes an assessment and provides the correct treatment and advice. This frees up doctor's time for those with more complex needs.

We have highly educated pharmacists. We have pharmacies with generous opening hours. We have the competence. There is a broad consensus that this is a wise reform, but it is still being slowed down by certain actors. It would benefit patients, relieve the healthcare system, and strengthen efficiency.

Madam Speaker! During the year, the high-cost protection was increased. It was a difficult but necessary decision to safeguard the system's long-term sustainability. Since 2012, the state's pharmaceutical costs have increased by 55 percent. Patients' costs have increased by 21 percent during the same period. That development is not sustainable. At the same time, it is important to remember that the sickest, who quickly reach the free card level, are not affected once they have reached the ceiling. For them, the high-cost protection remains at 7,117 kronor. Many hit the ceiling already at the first withdrawal. It is solidarity in practice. Those with the greatest need receive the most support.

In conclusion: A healthy and well-functioning population is the foundation for a strong society. Therefore, we must continue to develop the pharmaceutical policy with both heart and a holistic perspective.

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

Mikael Dahlqvist (S)

Madam Speaker! Thank you very much, Member, for the speech! Much of what the Member said from the rostrum, I can sign off on. What makes me a bit thoughtful or surprised is why the Sweden Democrats are not pushing through what they believe in. You do, after all, belong to the government base.

Now to some things I would like to ask the members about. The Social Democrats also stand behind the dental care reform. It is good. But on the other hand, I do not understand why one should give with one hand and take with the other. In order to implement this reform, the government, with SD's support, removed free dental care for young people.

There was free dental care up to 23 years of age previously, and now the limit has been lowered to 19 years. At the same time, the double dental care subsidy up to 27 years was removed, if I remember correctly. This creates thresholds for this group to receive dental care, perhaps especially when one is a poor student or at the beginning of their working life. My question is how the Sverigedemokraterna justify the introduction of such a reform while you are pitting two groups against each other. Why were you not more generous and prioritized keeping the youth instead of making tax cuts for high-income earners?

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

Christian Lindefjärd (SD)

Madam Speaker! Thank you for the question, Mikael Dahlqvist!

I can start by saying this: Have you not listened to the dental care industry, that is, both the private dentists and the public dental care? Many young people do not go to the dentist for their scheduled visits. That is one thing. They have no need for care. Sure, you can always find a person who has drunk energy drinks their whole life and hasn't brushed their teeth. But young people have good dental health. They only go to the dentist for regular check-ups.

The group you are talking about, the elderly, have a great need for dental care. We are moving resources to that group. I do not think we are pitting groups against each other. It is you who are doing that. With your proposal, the groups with the greatest needs will not get appointments. They will have to sit and wait for youths who are to go first. If a youth today has made regular visits, gone when they were called, and cared for and brushed their teeth twice a day, they should not have a need for care. If they have a need for, for example, braces and discover it when they are 15 years old, they join the queue.

Someone who has not gone to the dentist and starts going there only when they are 20 years old might get a shock. But I see no problem with this. I think you are pitting groups against each other. The group that has the greatest need will have to wait the longest for dental care.

I have myself heard from people in the dental industry that the ten-dentistry [tiotandvården] has become a success. Many elderly people have been waiting for this to happen. What you are doing is truly pitting groups against each other.

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

ANDRE VICE TALMANNEN

I just want to remind you to use names or the word member and not to say "you".

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

Mikael Dahlqvist (S)

Madam Speaker! Thank you very much, Member, for the answer!

Politics is about will. Politics is about prioritizing. The Tidö parties have been clear during the mandate period that they prioritize that people who have a lot should get more.

We stand behind this dental care reform. The member must not misunderstand my message. We stand behind the fact that the costs for dental care must be lower. But the Sweden Democrats have chosen to give tax cuts to people who earn over 66,000 kronor a month and who do not need that money. It is about the money bag. One could have given that money to children and young people.

Then I agree with the member that they may not as a group generally be prioritized. But in this group, there are many who have very poor dental status, partly due to a growing problem with energy drinks – there is more and more warning about consequences in the form of caries. I believe the member is also fully aware of this.

It is actually this that is my point of attack when it comes to the Sweden Democrats: I simply think that the priorities are strange.

In your speech, you also mentioned the increase of the high-cost protection for pharmaceuticals. Yes, it is clear that if one has chosen other priorities for groups who perhaps do not need them, one must increase it for those who are poor. It is particularly noteworthy that one made this increase of the high-cost protection just now, when people are on their knees due to the interest rate shock, inflation shock, and rent shock.

For me, this proves that it is an active choice – perhaps not the choice that we Social Democrats would have made. Actually, my question remains: Could you have made a different prioritization with the benefit of hindsight?

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

Christian Lindefjärd (SD)

Madam Speaker and Member Mikael Dahlqvist! I do not believe we would have made any other prioritization. We have made a good prioritization. We have taken the step towards dental care with this.

We raised the high-cost protection. Personally, I would have thought that one should index it a bit more every year. That would have been better. It is necessary, because the costs for medicines have increased. It is not possible to have a system where it just rolls on. Ultimately, we will not be able to afford it; we must hold onto the money.

You whine about the tax cuts for the rich. The problem is that the tax cuts are for everyone, the entire Swedish people. With your tax increases, you can promise these things, dental care for youth and all that. At the same time, you will raise the tax for everyone, so it becomes a zero-sum game in the end.

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

Karin Rågsjö (V)

Mr. Speaker! I have a few questions based on the rather diverse topics we are dealing with today.

As mentioned earlier, you chose to change the high-cost protection. It was a rather hard blow to very many people in Sweden. In the referral responses, very many said that this will not turn out well – it was almost everyone, from Cancerfonden to Apoteksföreningen.

In politics, one can prioritize. When it comes to the tax cuts, the member of parliament points out that it concerns 25 billion during these three years. It concerns the income taxes and has primarily been targeted at those who have it the absolute best; that can be seen in any table. That money would have been needed within the welfare system and perhaps to protect those in Sweden who live and have lived under an extreme economic pressure when it comes to prices, rents, and most things. We also have a fairly high unemployment.

A question to the member is, Mr. Speaker: How did you think? How this can be good for distribution policy at all is a mystery to me, Mr. Speaker.

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

Christian Lindefjärd (SD)

Mr. Speaker! Thank you very much, Member Rågsjö, for your questions and your reply!

As I said: For the group that has the greatest need of the high-cost protection, the 20 percent who hit the ceiling, we did not touch the ceiling. That is what I mean. For the group that has the greatest need, we are not talking about any huge increase.

I agree that there can be groups that earn very much money. But we still must have a system that keeps up. It cannot go haywire in both directions with so much money.

Then I can think that we perhaps would need to index the high-cost protection a bit more every year so that we can avoid this sharp increase. If we see that prices according to KPI go up, we must increase a bit more. It is a solution.

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

Karin Rågsjö (V)

Mr. Speaker! I thank you for the answer.

I move on to the next question: the dental care reform, which is partially good. What is bad is that one is to pay for one's own examinations and so on, but we will let that go.

The National Board of Health and Welfare has looked a bit into this. It concerns the socioeconomic differences in dental health. They have done it very well, I think. The differences are largest among those born in the 60s, 70s, and 80s and smallest among those born in the 40s and 50s, says the National Board of Health and Welfare. Then one can wonder if it perhaps would have been better to invest long-term in a dental care reform for the entire population. I think that must be the goal. In roughly the same way that the teeth should be included for everyone, just like the whole body.

At the same time, the free dental care for children and young people was removed. You made it so that more young people have to pay themselves, quite simply. In hindsight, people have looked at what happens to these young people. There is also a huge unemployment among young people. These are people with student loans and so on. It is 66 percent fewer in the age group who have gone to the dentist because it becomes too expensive for them. They might prioritize buying books for their studies instead, or paying their rent.

Today, people live in extremely pressured situations, in different ways. This also applies to young people. Not all young people have parents who can cough up a few thousand for an examination. This group was worth protecting, we think. What do the members think?

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

Christian Lindefjärd (SD)

Mr. Speaker! Thank you, Member Rågsjö, for further questions!

I actually think that one has a personal responsibility if one has become that old. You receive a general dental care subsidy. You can save it for two years. The examination might cost a thousand kronor. Then you can actually go to the dentist. It is also required that you behave – brush your teeth twice a day and follow the recommendations.

It is actually about personal responsibility. I think that those who have passed 20 years old are adults and must take responsibility for their lives. You cannot pamper people their whole lives. These young people have a responsibility. I learned early on that you just have to take responsibility. You can book an appointment and go to a dentist. If it were to become terribly expensive, it is also possible to get an installment plan.

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

Christofer Bergenblock (C)

Mr. Speaker! Thank you, Member Christian Lindefjärd, for the speech!

I noted in particular that the member emphasized how important it is that we have equal healthcare throughout the country. But I can simultaneously state that during this parliamentary term, no work has been done to reach that goal.

Today, there are great differences in both dental care and healthcare depending on where in the country you live. We can see that in rural areas, one-fifth have a permanent doctor contact. Nationally, it is one-third. We can see that twice as many die from treatable conditions in rural areas compared to in urban areas. And we can see that dental status differs significantly depending on whether you live in a rural area or in a city, where among 79-year-olds, it is 75 percent who have more than 20 teeth remaining in their mouth. Among residents in our sparsely populated areas, it is only 56 percent. It is an enormous difference.

This is about what policy one pursues to achieve equal healthcare across the entire country. There, I lack proposals and changes from the Tidö parties, because it has not become better during the mandate period. It is not least about the access to dental clinics and health centers to obtain this equal healthcare.

My question is therefore: Why have the Sweden Democrats not done anything to close these gaps during the mandate period that has been?

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

Christian Lindefjärd (SD)

Mr. Speaker! Thank you, Member Christofer Bergenblock, for the questions and the statement!

The positive thing is that the municipal type supplement for dental care will be introduced in the coming weeks. A government proposition will be submitted. If you live in Varberg and are over 67, you will receive an extra 10 percent, and if you live in a rural area in Sorsele, you will receive 20 percent. This is coming now, and it is an incentive so that people in rural areas will receive extra dental help. The member should agree that this is good.

It doesn't matter either if one wants to travel from the rural areas to Stockholm for dental check-ups or repairs. If one is just 67-plus, the dentist will receive the municipal type supplement anyway.

This will be introduced in the coming weeks. It is something on the way.

As I said, perhaps one also needs to change the training programs a bit and create targeted places. It is, for example, a problem that during the last year only a single person from the whole of Östergötland got into the dental training. It is a deficiency for Östergötland. Many would like to move back to their home location.

We may have to have a targeted intake, so that a place is targeted so that a person from a specific area can be able to get in.

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

Christofer Bergenblock (C)

Mr. Speaker! It is very good that the municipality type supplement is finally coming. It is sad that it could not be included in the reform from the start, even though it was such an important part to provide better conditions for our sparsely populated areas and rural regions – regardless of what type of municipality one now belongs to. The vast majority of municipalities in Sweden will now, if this is implemented, be able to receive a share of the municipality type supplement.

It provides better conditions for dental care to conduct its operations. But the most important prerequisite for dental care, healthcare, and welfare in general is the availability of staff all around the country. No work has been done by the government to increase that availability.

From the Center Party's side, we want, for example, regarding dental care to introduce a basic service year that can also be located in our sparsely populated and rural areas, so that people get the opportunity to establish themselves there. We also want to review the possibility of establishing relocation grants for those who want to move out to the welfare services in our rural areas, and we also want to look at the question of writing off student debts.

At the same time, the government and the Sweden Democrats are pursuing a policy concerning return migration grants. They are spending 2.5 billion kronor to get people to leave Sweden. These are people who are needed in health and social care. We have now seen a number of publicized examples where individuals have been forced away from Sweden despite already having permanent jobs within health and social care. This is a sad development, naturally.

But why have the Sweden Democrats not done more to get people to move there where the welfare needs them, throughout our sparsely populated areas and rural regions in Sweden?

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

Christian Lindefjärd (SD)

Mr. Speaker! Thank you, Member Bergenblock, for further questions!

The municipal type supplement is intended to benefit the dental care industry in rural areas. The member himself agrees that it is very good. Everyone will benefit from it – even I, who live outside Stockholm, will receive an extra 10 percent when I get older.

This is something we do, but we cannot do everything. We do a lot, and I know that there are things in the works. But things will also be able to happen further ahead. It is just a matter of us getting four more years.

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

Mikael Dahlqvist (S)

Mr. Speaker! Today we are debating, as mentioned, pharmaceuticals and dental health. I will begin with pharmaceuticals.

Medicines are not a common consumer good. They are vital for patients, especially for those with chronic diseases, for children and the elderly, and above all for people with rare diagnoses. They are a prerequisite for health, function, and in many cases, survival. For that very reason, medicine policy requires long-term thinking, clear governance, and a consistent perspective on equality. But today, unfortunately, we see the opposite.

Mr. Speaker! There are reasons to review the general prescription right. When the regulatory framework is abused by certain prescribers, both patient safety and trust in the system are at risk. Therefore, we Social Democrats have insisted in our budget motion that this should be reviewed.

The government refers to an ongoing investigation. The directives are, however, not written, and the timeline is uncertain. This issue is so important, we believe, that faster measures need to be taken.

The same applies to the national pharmaceutical strategy for 2024–2026. It is good: The level of ambition is high, and there are clear goals and so on. But it is very difficult to see any concrete effects. Patients still face shortages of medicines. There is a lack of availability. There are large regional differences and slow introduction of new medicines.

Mr. Speaker! Since 2022, the government has in stages tasked the Dental and Pharmaceutical Benefits Agency, TLV, with investigating access to medicines for rare diseases. But it has happened all the time on a clear condition: State costs must not increase. It is a political choice with consequences for the patients.

What is remarkable is that in opposition during the previous parliamentary term, one took the initiative for several motions, where it was demanded that this should be resolved expeditiously and that it should be sent with money. But now, in a government position and with the support of Sverigedemokraterna, one completely ignores the issue.

Sweden belongs to those countries in Europe where new medicines are introduced most slowly, or not at all, partly as a result of our systems and criteria for how one can be included in the benefit system. This is serious for patients with diagnoses. It means that they may not get access to medicines that exist at all or that it is delayed. It actually contradicts the principle of equal care.

Mr. Speaker! Medicine shortages and backorders have been a recurring problem for several years. It must be said honestly here that this is, in many respects, a global challenge. At the same time, I would also have wished for a greater commitment from the government when it comes to solving this difficult issue.

The Social Democrats believe that we need better national coordination and introduction of medicines and treatments. We Social Democrats already saw several years ago the need to reform both the decision-making levels and the criteria for approving new medicines within the subsidy system, as well as the need for long-term and sustainable financing.

Since so much time has passed, we now believe that a new pharmaceutical investigation is required. It is, however, important that one builds upon the investigation we developed in order to gain a comprehensive grasp and elaborated proposals.

Mr. Speaker! Instead, the Tidö parties have prioritized measures that weaken patients' financial protection. The increase of the high-cost protection from 2,900 to 3,800 kronor is a clear example. The decision was made despite clear signals that pharmacy staff regularly meet patients who refrain from picking up their prescription medications for cost reasons.

This is not an unforeseen consequence, but it is an outcome of a conscious decision.

Mr. Speaker! Even the pharmacy market shows the need for change. The deregulation from 2009 has led to increased commercialization and poorer access in parts of the country. We believe that patient benefit must carry more weight than market logic.

That is why we have a number of proposals, including increased powers for pharmacists, better conditions for remote pharmacies, and a clear distancing from cross-ownership between healthcare providers and pharmacies.

I will now move on to speaking about dental care. Good oral health is a central part of people's health and well-being. Poor oral health is not only stigmatizing; it can also lead to serious follow-up diseases. Despite the fact that oral health has generally improved, differences remain between different groups, and in dental care, the economic barriers are clearer than in other health and medical care.

This is unacceptable. Dental care is unequal today. We Social Democrats stand behind the ambition in the dental care reform. Strengthening the protection for those with large and long-term dental needs is fundamentally the right way to go, but the reform must not be built by simultaneously worsening it for other groups.

The government and the Sweden Democrats have chosen to finance the reform through savings that hit young people. Free dental care up to 23 years of age has been removed, and the double dental care support has been removed. We oppose this. The result risks being higher thresholds to dental care just at an age when one is economically sensitive, especially if one is a student or is without work.

Mr. Speaker! Already in 2021, the Social Democrats presented a dental care investigation to generally lower the economic thresholds to dental care. Our direction is firm: We want to see a step-by-step developed high-cost protection, starting with the elderly, and specific investments for young people. We also do not want dental care for those exposed to violence to cost more than a standard doctor's visit.

We believe that the government gives with one hand and takes with the other. We Social Democrats want to see, instead, a coherent reform for equitable dental care throughout the country and throughout life.

Mr. Speaker! I move for approval of reservation 18, which concerns high-cost protection in dental care, and reservation 7 regarding issues of state responsibility for pharmaceuticals.

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

Noria Manouchi (M)

Mr. Speaker! I would like to start by telling you about a campaign I was on last week. It was certainly very cold outside, but at the end of the campaign, an elderly gentleman came forward who made it all worth the effort.

He had been to the City Library and printed out an A4 sheet describing the dental care reform that we have now implemented. He pointed at the paper and explained what opportunities this has now created for him to receive dental care, and he just wanted to say thank you for this. Before he left, he smiled a big smile, with some gaps in his mouth, and said: Now I'm going to become even more handsome! Then he walked away.

We laughed but simultaneously realized the seriousness of what politics means out in reality and what an enormous difference this type of reform can make in people's lives. To this man and to other pensioners, I just want to say: Thank you yourselves – thank you for having built up one of the world's absolute best countries to live in!

Mr. Speaker! Swedish health and medical care does not suffer from a lack of ideas. It suffers, however, from fragmentation, silos, and a patchwork of systems that do not hang together. Therefore, the Moderate-led government has focused on long-term reforms that strengthen the system at its core.

A central part of this is the construction of a national digital infrastructure for health and medical care. Health data shall be accessible throughout the entire care chain, in municipal care, in regional care, and in dental care, regardless of the primary provider. This is important for patient safety, for continuity of care, and so that the care's resources can be used more efficiently.

It is not just about efficiency, but it is also about quality. When data can be followed over time and between levels of care, entirely new opportunities for follow-up, research, and innovation are created. We will be able to follow the long-term effects of treatments in a better way, both medically and economically, and thus be able to make wiser decisions for the future.

Mr. Speaker! Swedish pharmaceutical policy faces new challenges. The international market is changing rapidly, and the availability of medicines is affected by geopolitics, trade policy, and global value chains. At the same time, the need for innovation, clinical trials, and precision medicine is increasing.

The government has therefore tasked TLV with analyzing the pricing system in light of the new global situation. It is partly about securing access to cost-effective medicines but also about ensuring that Sweden continues to be an attractive launch country. This will be crucial for the patients, for healthcare, and for research.

At the same time, we are strengthening Sweden's position within clinical trials through the establishment of Swetrial, a national partnership intended to strengthen Sweden's role within clinical trials and life science, and through mandates to the Medical Products Agency and the Ethical Review Authority to streamline the permit processes.

Our goal is clear: more clinical trials in Sweden, shorter lead times and better cooperation between authorities, regions, academia and the business sector.

The government has also updated the national pharmaceutical strategy and strengthened the agencies' mandates through the regulatory letters. The E-health Authority is investigating a national structure for pharmaceutical agreements, which will reduce the administration for the regions and create a more equal handling across the entire country.

Mr. Speaker! Approximately 500,000 Swedes suffer from a rare health condition. It takes an average of seven years to receive a diagnosis, and even if one has received a diagnosis, there are many who do not receive treatment or medication in this country.

That is why the National Board of Health and Welfare has been tasked with developing a proposal for a national strategy for rare health conditions. At the same time, TLV was tasked with analyzing the conditions and proposing tools to strengthen access to medicines for rare health conditions. My hope is that this will improve the lives of many of the 500,000 Swedes who are affected. It is about time.

Another important reform will be the introduction of a pharmaceutical assortment. It will strengthen the role of pharmacies and pharmacists. The assortment will make it possible for pharmacies to provide certain medicines and products with a clear connection to pharmaceutical competence and advice for the patient. This will relieve other parts of the healthcare system and at the same time increase accessibility for patients and increase efficiency. In this way, we will be able to better utilize the collective competence of the healthcare chain.

Mr. Speaker! Sweden shall become a country where patients get faster access to new and effective medicines. Sweden shall be a competitive country, where research and clinical trials take place on-site instead of on the other side of the world and where the professionals' competence is fully utilized in a way that strengthens both patient safety and accessibility.

This is the direction that the government has established. This is how we build a modern, robust and long-term sustainable pharmaceutical system.

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

Mikael Dahlqvist (S)

Mr. Speaker! Thank you very much for the speech, member!

I agree in large parts with what was said in the speech regarding goals and visions. The problem with the current government with the support of the Sverigedemokraterna is, however, precisely that it is only beautiful words and goals. One is very determined and implements sharp politics when it comes to tax cuts for the wealthy. In this area, one investigates itself to death, Mr. Speaker.

As early as 2022, the government parties began commissioning TLV to investigate how to ensure that people with rare diagnoses or diseases get access to new, innovative medicine. There were already a number of investigation reports. What happened to them? Instead, new investigations are being ordered.

The second issue is that when we were in government – we are talking about the time five, six, or seven years ago – we were constantly told by the Tidögänget in opposition that we were too slow and too hesitant. You produced committee initiatives on committee initiatives within this area.

Now almost the entire mandate period has passed, member of Parliament, and nothing is happening. Now you are painting a new picture of visions and ideas. The credibility is not particularly great, I think.

My specific question to the member is: Why have you not previously implemented a policy that ensures access to medicines? There are concrete proposals. There is a picture of what the problems are due to. And above all: Why have you not financed the cost?

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

Noria Manouchi (M)

Mr. Speaker! I thank Member Dahlqvist for the question but also for the account of the Social Democrats' own government failure.

The member mentions that the Social Democrats had governed the country for eight years before Ulf Kristersson became Prime Minister, and that is correct. They had eight years, and yet they failed to manage to carry out anything of what the member mentions.

Investigations were commissioned, the member argues. Yes, they were commissioned, but the results were not good enough. This is a pattern we have seen overall in the political field. Even in, for example, the education field – I previously represented the Moderaterna in the Education Committee – it was clear that investigation after investigation could not be turned into policy because they were too poor.

This government does not act in the same way, but rather the opposite. We have tasked Socialstyrelsen not to investigate an issue, but to produce a concrete proposal for a national strategy. Sweden is one of the few countries in the EU that lacks a national strategy. Despite the Socialdemokraterans being in government for eight years, they failed to get one in place. We will have it in place before this mandate period is over.

At the same time, I want to remind that we have also tasked TLV to propose concrete tools to secure access to medicines for rare health conditions.

During these three years, I would like to assert, this government has achieved significantly more in this area than the Social Democrats did during the eight years they wasted.

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Mikael Dahlqvist (S)

Mr. Speaker! Thank you for your answer, member!

Now we are talking about the government period we are in. But your criticism was incredibly clear during the last mandate period. These problems did not appear eight years ago, we must honestly admit. They appeared four or five years ago. What did the Social Democratic government do then? Well, it appointed a huge pharmaceutical inquiry to review the entire structure of drug subsidies and different decision levels. Where is the inquiry's report? Yes, it is surely lying around as junk in some cabinet. Instead, the government is considering appointing a new inquiry.

It becomes a bit of a rhetorical question here. The member says that we just investigated and investigated and that they were poor investigations, but most of the investigations that we produced at the end, you have actually implemented reforms on. Just take the protected professional title for nursing assistants. That was a Social Democratic investigation. In the legal field, almost all your reforms during the first three years came from the Social Democrats. Here, one probably has to examine a bit what is true and what is not true.

The fact remains, however: One of the fundamental problems in achieving the goals and visions that we completely agree on regarding medicines for rare diagnoses, and above all regarding getting more medicines to Sweden in a faster way, is spelled money. I do not see a single letter of money in the government's documents.

It has rather been the opposite: In every investigation assignment that TLV has received from the government, it has stated that it must not cost more. TLV has every time responded that it is not possible to carry this out if more money is not provided, among other things to resolve expensive pharmaceutical costs.

My question remains: Where is the sharp policy in this area?

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

Noria Manouchi (M)

Mr. Speaker! I must agree with the member on two things.

It is true that the Tidö parties directed sharp criticism at the Social Democratic government during the eight years that a national strategy for rare health conditions was not in place. We directed sharp criticism, and quite honestly, you deserved it, Mikael Dahlqvist. Many European countries are now on their fourth, fifth, or sixth version of this national strategy. We are the government that will now ensure that Sweden gets its first national strategy in this area in place. In that, the member is correct. We directed criticism, and now that we are in power, we act.

The second point where I want to give the member the right is that many inquiries in the justice area came from the Social Democratic government. That is correct. When you lacked your own majority, this chamber took a majority decision to force your government to proceed with a good deal of these proposals, and you were then forced to appoint inquiries. That is correct. You sat in government but lacked a majority in this chamber, and we forced you to appoint these inquiries in the justice policy area. Then we could carry out the policy that we started in this chamber, followed in government position, and finished in this chamber.

In both of these respects, the member is correct.

In summary, I can say this: It means in other words that the Social Democrats are good at talking and that the Moderates are good at doing.

(Applause)

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Karin Rågsjö (V)

Mr. Speaker! I have a few questions for the member.

We are today totally dependent on the USA, India, and China to get medicines, or parts of the production, to Sweden. The USA has already choked off some medicines to Europe and Sweden. This is directly life-threatening. My first question to the member is how we are to work on the conditions for Europe – and this must happen very quickly – to bring more of the production back to Europe and Sweden. We must have the possibility to produce life-saving medicines if a crisis occurs. We cannot rely on the USA in that respect, unfortunately.

My second question concerns the clinical trials. I think clinical trials are very good. We have talked about this for a long time. The problem has been that the staff have not been able to conduct clinical trials to any significant extent, simply because there has been a lack of staff. How have you solved that?

The clinical trials taking place within healthcare have been difficult to carry out. The pharmaceutical companies have spoken about this for a long time, and it has been due to a shortage of staff.

My third question concerns the Healthcare Responsibility Committee. There were a number of points concerning the state's conditions for working with pharmaceuticals in different ways. That question was to be investigated. The investigation was submitted in June 2025. The Healthcare Responsibility Committee has conducted a good investigation, and there is much to take in.

What has happened with the investigation?

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Noria Manouchi (M)

Mr. Speaker! Member Rågsjö raises important issues. I share the member's concern regarding the international situation we find ourselves in when it comes to pharmaceuticals, supply chains, and preparedness. It is worrying that it is not possible to rely on the USA in this situation.

That is why it has been so important for TLV to analyze the pricing system in light of the new global situation. We obviously need to look significantly more at what we can do in relation to European cooperation to go further in ensuring the production of life-saving medicines, not least in terms of antibiotics.

When it comes to clinical trials, the government is doing quite a lot in the area. My hope is that this will increase the attractiveness of wanting to conduct clinical trials in Sweden and attract both the business sector and actors in the field.

Through the establishment of Swetrial, this national partnership, I hope that we will increase the attractiveness. This also applies through the enormous investment we made in the research proposition of 600 million on life science. It will make a difference in the conditions.

Our goal is to have more clinical trials in Sweden. One of the most common opinions we encounter is that the processes are too long. That is why, for example, the Medical Products Agency and the Ethical Review Authority have been tasked with streamlining the licensing processes.

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

Karin Rågsjö (V)

Mr. Speaker! The problem we face regarding pharmaceuticals, USA, India and China, the entire production chain, is that Sweden becomes vulnerable as a country. Even the EU becomes vulnerable.

It feels like this has been urgent for a long time, but now it is extra important to work quickly. We must be able to manufacture certain medicines ourselves. Vänsterpartiet raised a motion already during the pandemic about how we can introduce the conditions to manufacture, for example, antibiotics, antiviral medicines, and cancer medicines – medicines that cannot be delayed. We must look further into this.

Then it was the question of clinical trials. I have had many contacts with different companies in the pharmaceutical industry and healthcare. The problem is not that the trials are not attractive, but the problem is that there has not been staff on site to conduct these trials. The prerequisites have not existed. When the staff are running because they are in such a hurry with the practical work and when there are too few of them in the departments, there has not been much time left for clinical trials. It is a problem.

Then we come to the Care Responsibility Committee. It was a good committee. Eight parties were in complete agreement on which issues should be driven forward and handled nationally. We were not in agreement on state care, but rather on the issues. I have not heard a sound from the SD-dependent government about what has happened with the large packages, and that is a bit tragic.

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Noria Manouchi (M)

Mr. Speaker! It is a priority for the government to strengthen Swedish resilience in the healthcare systems and to increase our preparedness. This shall be achieved partly through expanded European cooperation and partly through higher domestic production. I believe that the member and I agree that the work needs to be accelerated and that the work becomes more and more highly topical with every headline we read about the international situation.

Being completely dependent on countries far away that we cannot trust in terms of life-saving medicines is not reasonable. I am fully convinced that the work the government is now carrying out with several assignments to agencies and other actors to ensure that Sweden becomes a more attractive country for clinical trials, for research, and for innovation will strengthen our country in this very difficult time.

(Applause)

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

Karin Rågsjö (V)

Mr. Speaker! Our dependence on the USA, India, and China is total. It is life-threatening for the supply of pharmaceuticals in Sweden. Europe must bring more of the production of pharmaceuticals home, and Sweden must be able to manufacture life-saving medicines itself if the crisis comes. That is the overarching question.

It is good that we are restrictive today when it comes to antibiotic prescriptions. It protects against resistance. But there are other medicines that society has lost its grip on. Of course, it is good with medicines that alleviate anxiety and worry as well as keep depression in check. But Socialstyrelsen's statistics for 2023 show that 1.2 million patients collected antidepressants during 2023. That is, therefore, 11 percent of the population. The largest increase has been among children and young people.

We want to appoint a review of how the follow-up of medication within psychiatry can be improved and patient safety increased. The responsibility falls on politics to provide the best possible conditions to receive help and care.

We want the government to review how the medication of depression has developed over a ten-year period, whether the medication has contributed to better mental health in the population. For adults, the prescription of antidepressant drugs takes place primarily within primary care. The availability of other treatment therapies within primary care is not at its peak. It can therefore not be ruled out that primary care, which consequently accounts for 60–70 percent of new prescriptions of antidepressant drugs, has very extensive prescription, partly because there are no conversation therapists on site.

The prescription of psychopharmaceuticals, in particular anxiolytics and antidepressants to children and young people, has increased significantly in Sweden. It is particularly problematic because research cannot in any way show how it has helped or not helped.

It is a serious situation when minors are given so much medication in such a blatant manner. We believe that the government needs to immediately conduct a review of prescriptions to children and young people and ensure that pharmacological treatments do not occur due to a lack of resources within child and adolescent psychiatry or other considerations.

We want the government to examine these issues and also look at how the mental diagnoses have developed over time in connection with medication. I move for approval of reservation 9.

There is a section in the Care Responsibility Committee's final proposal stating that the state's responsibility for pharmaceuticals should increase significantly. This shall be investigated. There is good material in the Care Responsibility Committee's investigation. Today, there is a lack of functioning cost models for expensive and specially designed pharmaceuticals and long-term treatments aimed at small patient groups. Consequently, people with severe and serious illnesses risk being left without treatment when they are not considered sufficiently cost-effective. It is very important that these issues result in equitable and good healthcare.

We want the government, while awaiting the review of the investigation from the Care Responsibility Committee, to investigate the conditions for the state to provide special support to the regions for the treatment methods and medicines that are extra costly.

On July 1, 2025, the high-cost protection in the pharmaceutical area was changed so that patients now pay a higher co-payment. It was another slap in the face – it is perhaps uncertain if I may express it that way, Mr. Speaker – from the SD-dependent government towards those who are financially struggling. The increase met significant criticism from a long line of referral bodies. It was also made simultaneously with the large tax cuts for quite a few very wealthy people. We voted against the proposal in the Riksdag and believe that the increase should be withdrawn. In our budget motion for 2025/26, we allocated resources to this.

Teeth are a part of the body, and dental care should eventually be included in healthcare. Everyone, not just those under 67 years of age who can afford expensive treatments, should be able to afford to have good teeth. Since the dental care market was deregulated, prices have risen sharply. It is, of course, a class issue.

We stand behind the dental care. It is not the problem. One must also have a plan forward. We have conducted a review of how much that type of dental care reform would cost and will stand behind it.

At the same time, I must say again that the Socialstyrelsen statistics from 2024 show that the socioeconomic differences regarding dental health are largest among those born in the 80s, 70s, and 60s and lowest among those born in the 40s and 50s. It is therefore Socialstyrelsen that says it and not me who is standing there spreading myths. That is good to know.

Someone here in the chamber said that one should not spoil the young too much. It was a fantastic expression: that we spoil the young too much. We spoil them with 24 percent unemployment. We spoil the young by not being able to offer them decent rental apartments when they cannot afford anything else. Do we spoil the young? Can that be possible? It was nicely expressed. I am going to use it in all my social media immediately.

I think that one should protect people. Not all young people today have parents who can cough up money for, for example, dental visits. That should be kept in mind. I do not think that we spoil the young people in Sweden today.

It is hardly likely that many young people are watching this debate. It is rather the older ones who are doing so. I think that instead we should consider what happens when young people cannot go to the dentist, because the age limit for the state dental care subsidy has been raised.

In that age group, there were 66 percent fewer who went to the dentist. One can wonder why they did not do so. Did they use the damn money to go and buy beer instead? What happened along the way? I believe those young people simply are quite short on money. I cannot see that we have specifically curbed young people in Sweden.

We want a real high-cost protection within dental care, a robust system that can be achieved through a number of investments over a number of years. We think that it should be included in the universal welfare model.

We also want a good distribution effect. In that case, dentists and dental care staff are needed. We have written about that in other motions. A good start would be not to deport dentists or their families.

We really want to see a high-cost protection within dental care, which we address in reservation 19.

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Dan Hovskär (KD)

Mr. Speaker! I would like to begin by expressing my approval of the committee's proposal in the report.

Medicines and medical devices are an obvious and integrated part of healthcare and care. When people become ill, the care must be close, accessible, and secure. It must be quick to obtain a medical assessment. Can I manage it with the help of self-care, or do I need the interventions of primary care or inpatient care?

When self-care is the right way forward, pharmacies are a crucial part of the care chain. They provide approved medicines and medical technology products and contribute pharmaceutical expertise that strengthens patient safety. For us Christian Democrats, the whole is central. Every link in the chain must function.

Mr. Speaker! Today we see increasingly frequent shortage situations for medicines, both in Sweden and globally. This creates concern for patients and major challenges for healthcare. Therefore, the government is working purposefully to strengthen the medicine preparedness, reduce vulnerability, and mitigate the consequences when shortages do occur.

The Christian Democrats' view is clear: A secure pharmaceutical supply, well-functioning pharmacies and the pharmacists' role in the care chain are crucial to being able to offer need-based care on equal terms throughout the country. The Government has therefore developed a national pharmaceutical strategy for 2024–2026. The strategy focuses on access to medicines, better pharmaceutical treatment and improved coordination within healthcare, as well as on strengthening clinical trials and pharmaceutical development in Sweden.

Mr. Speaker! The Christian Democrats and the government are investing powerfully in research, innovation, and life science. During the parliamentary term, we have developed a historically large research and innovation bill. We are strengthening precision medicine with 80 million kronor to Genomic Medicine Sweden and investing over 100 million kronor annually in an equitable implementation of precision health throughout the country.

We are funding a national innovation cluster for advanced therapies, ATMP, with approximately 80 million kronor to strengthen expertise, clinical trials, and the commercialization of new advanced treatments.

Furthermore, the government allocates 60 million kronor annually to the new national partnership Swetrial to strengthen clinical trials in Sweden.

In order to shorten lead times and reduce unnecessary bureaucracy, the Medical Products Agency and the Ethical Review Authority have been given a joint mandate to streamline and cooperate regarding licensing processes in close dialogue with regional biobank centers. An investigation into constitutional obstacles for clinical trials is also ongoing.

Mr. Speaker! Access to medicines must also work for patients with rare diagnoses. Therefore, TLV has been tasked with strengthening access to medicines for rare health conditions. The Government is also working closely with the regions through the agreement on state contributions to medicine costs. A joint working group has been formed there to ensure both access to new effective medicines and long-term sustainable pricing. This is good for the patients.

We are strengthening the national coordination for pharmaceutical agreements and cost reductions. A national structure reduces administration, creates more equitable working methods, and makes it possible for patients across the entire country to simultaneously gain access to new treatments.

A coherent national digital infrastructure for healthcare and pharmaceuticals is also a crucial issue for the future. Structured and secure healthcare data enables better follow-up, faster implementation of new treatments, and increased use of real-world data, to the benefit of both patients and research.

Mr. Speaker! I now want to move on to dental care. The Christian Democrats and the government have, through the Tidö agreement, implemented one of the most significant dental care reforms in many years. This year, an enhanced high-cost protection was introduced which in practice makes dental care more similar to healthcare. The government allocates 3.4 billion kronor per year and is now strengthening the reform with an additional 379 million kronor to meet increased reference prices.

What does this mean in practice? Yes, that people who are 67 years and older get a significantly reduced cost for necessary dental care. The state covers 90 percent of the cost, while the patient pays 10 percent of the reference price. A treatment with a reference price of 2,000 kronor will therefore cost the elderly person only 200 kronor. This makes a difference. This applies to treatments linked to illness, pain, broken teeth, as well as rehabilitation and habilitation. For other treatments, the current high-cost protection continues to apply.

Mr. Speaker! This is a reform that improves oral health – and thus general health – for thousands of elderly people. Good oral health is not a luxury but a part of the quality of life. In many cases, oral health is completely crucial for nutrition, social interaction, and health in general. No elderly person should have to forgo dental care because their wallet is thin.

The objective of the reinforced high-cost protection is that more people should be able to go to dental care based on need and not based on ability to pay. For the Christian Democrats, it is clear that the elderly with the greatest need should be prioritized. This is, as we see it, a first step in a reform with several stages. The ambition is that this will, in the long run, cover all adults.

Mr. Speaker! With this, we take clear responsibility for both the pharmaceutical supply and dental care, with human dignity, security, and equality at the center.

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Christofer Bergenblock (C)

Mr. Speaker! Let me first move to approve the Centerpartiet's reservation 8 under point 3 regarding state responsibility for pharmaceuticals.

The development of vaccines and medicines was one of the decisive factors for the population explosion that occurred during the 20th century. Vaccines against smallpox, measles, and tuberculosis have saved millions of lives worldwide. When penicillin arrived, a paradigm shift occurred in the true sense of the word for human survival in pneumonia and bacterial infections. Antiviral drugs have transformed HIV from a deadly epidemic into a chronic but manageable condition. Development is moving forward at a breakneck pace. During the 2000s, the emergence of new therapies and new medicines has been breathtaking, with biological drugs, gene therapy, and precision medicines.

But at the same time as development moves forward, there is a counter-movement that distrusts medicines and vaccines. We see it on the other side of the Atlantic, but we also see it here in the Swedish Riksdag. Even in our parliament, there are politicians who believe that both climate change and vaccines are parts of a global conspiracy and who are prepared to sacrifice both the planet's and people's survival in their fact-resistant contempt for science. Let us collectively counteract these forces!

Mr. Speaker! Since the state pharmacy monopoly was deregulated in Sweden in 2009, the availability of pharmacies and medicines has increased significantly in society. We have gone from around 900 to 1,400 pharmacies. In many places, the pharmacies have the same opening hours as the grocery stores. Parts of the pharmacy assortment are actually found in the grocery stores today.

At the same time, accessibility is not as good in all parts of the country. As usual, it is worse in our rural and sparsely populated areas. In barely half of our municipalities, there are no more pharmacies now than before the deregulation. About fifty pharmacies receive rural area grants, and there is reason to review that grant again in order to strengthen the possibility of pharmacies throughout the country.

Other changes also need to be made. Among those we want to see from the Center Party's side is the introduction of the concept of remote pharmacist. One of the major difficulties in our rural areas is indeed the access to pharmacists, and it does not become easier when the Tidö parties push out people who are needed in our welfare. If the pharmacist meets the customer digitally and does not need to be present at the physical pharmacy, the possibility of conducting pharmacy operations across the entire country increases.

But there are more development opportunities for our pharmacies. What is needed is a shift in the view of the pharmacies and an insight that they can actually constitute a much more central part of the entire health and medical care system. Therefore, from the Center Party's side, we want to use the pharmacies much more strategically than is the case today in order to relieve the healthcare system and utilize the competence that the pharmacies possess.

We want to enable pharmacists to extend prescriptions for certain medicines, so that as a customer, one is not forced to seek urgent healthcare if new medicines need to be collected but the prescription has expired. We also want to introduce a pharmaceutical assortment, so that certain medicines can be dispensed directly by a pharmacist after consultation.

We also want to look at the possibility for pharmacies to function as a complement to primary care for certain care-related services, especially in rural and remote areas. This could, for example, involve monitoring or vaccination. Much of this has already been implemented in the United Kingdom under the name Pharmacy First. Sweden is not the first in this area, but there is no reason for us to be last. This is also an important part of our preparedness.

Mr. Speaker! The Centre Party also wants to see greater national responsibility for the entire pharmaceutical management in Sweden. Today, costs are shared between the state and the regions depending on whether it concerns prescription medicines or clinic medicines. We also have two separate organizations for medicine introduction: TLV and the NT Council. There is reason to review this system and look at the possibility of a unified national responsibility for the medicine issue, which was proposed by the Healthcare Responsibility Committee. The previous Minister for Health intended to appoint a new medicine inquiry in the autumn of 2025. Now it is almost spring 2026, and no one seems to know what the Minister for Social Affairs, who has taken over the responsibility, actually thinks on the matter.

Another area where changes are needed concerns the access to medicines for rare diseases, so-called orphan drugs. It concerns a patient group with double vulnerability. On the one hand, very few are affected by the specific diseases, which makes those affected very lonely; on the other hand, it is difficult to gain access to effective therapies – both because they are difficult for pharmaceutical companies to produce and because it is difficult to get them through TLV's needle's eye.

The Commission for Innovative Orphan Drugs has produced a summary that clearly shows how access has developed since TLV's new payment model was introduced in January 2025. TLV has so far approved two products and rejected three. The NT Council has approved one and rejected one, and half of the products are still awaiting a decision. This is in line with previous analyses that point to long lead times and difficult-to-assess criteria.

Sweden already ranks low in a European comparison, with an availability of only 19 of 66 European-approved orphan drugs. The government's low prioritization to solve this issue is not reasonable.

In summary, access to medicines is a matter of equality. Which medicines are prescribed should not depend on which region one lives in or which doctor one has. The possibility of picking up medicines should not be dependent on whether one lives in the countryside or in our metropolitan areas.

Access to specialized medicines should not depend on whether one lives in Sweden or in Germany. Everyone should have the right to accessible and equal care, regardless of who they are and where they live.

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Lina Nordquist (L)

Mr. Speaker! I would first like to say a few words about liberal bourgeois pharmaceutical policy.

The government has allocated billions annually in addition to what was previously needed for people's medicines. The medicines are becoming increasingly better, Mr. Speaker. But naturally, this also costs money and must do so.

Efforts are also being made now so that even more medicines will be available to patients in the future. We are working for more clinical trials and for more revolutionary treatments for severe diseases and rare conditions.

Furthermore, the government is introducing a pharmaceutical range. Medicines shall be able to be moved from prescription-only with requirements for doctor visits and prescriptions to instead become over-the-counter with pharmaceutical advice. The pharmacists' competence is utilized and, at the same time, healthcare is relieved.

First out in this is naloxone nasal spray, which literally saves lives in opioid overdoses but which has only been able to be prescribed by doctors and directly to persons at risk of overdose. It has not been able to be prescribed to any other people around these severely addicted people. Naloxone can now, after consultation, be given to firefighters, paramedics and relatives. It is an important first step. But many more steps need to be taken.

Mr. Speaker! For the Liberals, it is important that we do not stop at the pharmaceutical assortment but constantly ensure that we take advantage of the competence of pharmacists and pharmaceutical staff at our pharmacies. They can play a significantly larger role in the care chain.

What finally concerns medicines is that today almost 6 percent of all medicine packages are listed as restocks or shortages. The government is now working very hard to counter the medicine shortage. It affects sick people. It also creates an anxiety. Even if one receives their medicine, one cannot be quite sure of it every time.

We must have the medicines we need both in everyday life and in a crisis. It is an important preparedness issue. We want to increase the national responsibility, strengthen stockpiling, and secure the role of pharmacies and pharmacists, Mr. Speaker.

So moving on to dental care. Swedish dental care has dragged on for far too long with a systemic error that has subsidized healthy mouths more than those who have the greatest need. The oldest and sickest in our country have many times been forced to choose between sustainable finances and their health.

Those who have many years of tooth wear in combination with diseases and medications that cause dry mouth are hit harder than we others by problems with their oral health, Mr. Speaker. Poor dental health in turn most likely increases the risk for other serious problems such as cardiovascular disease and malnutrition. Now we are finally fixing the holes in Swedish dental care.

At the turn of the year, just a few weeks ago, a historic reform came into force in Sweden. Seniors now pay only 10 percent of the reference price for the repairs and root canals they need. The rest is covered by the collective fund. On average, seniors' costs are now estimated to be more than halved from more than 4,500 kronor to under 2,000 kronor in a year. This obviously means that more people will now be able to have a healthy mouth and thus many times a healthier body.

Mr. Speaker! It does not stop there. The Liberals and the government have also strengthened the special dental care subsidy for risk groups. We have given staff in elderly care better tools to help the most vulnerable with their oral health.

Finally, the principle of need and solidarity has been introduced into the Dental Care Act. This means that dental care now receives a clear statutory mandate to prioritize those patients who have the greatest need. Actually, it is incomprehensible that it has not been so all along.

Step by step, we are now ensuring that people can live their entire lives. No one should have to isolate themselves and suffer from bad teeth. Regarding pharmaceutical issues, no one should have to live on the wrong side of a county border and receive worse care than their neighbor. No one should happen to be struck by the wrong disease, and therefore there was no medicine when they arrived at the pharmacy. It is politics that I am very proud of.

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Nils Seye Larsen (MP)

Mr. Speaker! It has been a rather long day for some of us who started the day with a panel debate at 9 in the morning. I will make myself a bit shorter than I had intended and focus on the important parts.

I want to begin by highlighting what we have in our special statement together with the Social Democrats and the Left Party. It concerns the increase of the high-cost protection for pharmaceuticals. It is an issue that makes me very worried.

The increase of the high-cost protection for pharmaceuticals has had tough consequences for many social groups that have it hardest. It is often persons with disabilities or the elderly and those with chronic illnesses who are the hardest hit.

I have sometimes reflected on a certain trivialization that can be seen in comments on social media about that it is only about 90 kronor more per month. But in the total pot, it still becomes more money in an expensive everyday life for people who already have it incredibly tough.

What has been worrying for us and our fear is that it has consequences not only economically for very vulnerable groups but perhaps also health-wise, because people simply refrain from picking up their medicine because they cannot afford it.

Most recently, for example, in a survey conducted by Riksförbundet Sveriges Makalösa Föräldrar, which checked with its members who are single parents, 29 percent stated that they had refrained from picking up prescription medication for themselves due to their finances, which is an increase.

We consider it indecent for Sweden. It is sad that we have chosen to prioritize tax cuts over the possibility for people to afford good treatment.

The second thing I want to highlight, and where I move for approval of reservation 5, is an issue that has become even more urgent due to the geopolitical situation we find ourselves in. We could read this autumn about how suddenly Subutex was removed from the range.

Without us having everything exactly on the table – we received a presentation in the committee about it – we can assume that the new reforms under Donald Trump have had an impact, such as Most-Favored-Nation Drug Pricing.

This represents a major challenge for the availability of medicines in Europe now and in the future. This is a European challenge. We have seen how we have gone from, at the beginning of the 2000s, accounting for a fairly large part of pharmaceutical development in Europe to having reduced it significantly. A much larger proportion of new medicines are developed in the USA. With this type of policy, it risks having devastating consequences in the future for our access to medicines and the possibility of having a strong life science sector here, especially in Sweden.

This has made the situation that we have already seen as a challenge even more acute. The Swedish pharmaceutical system is not adapted for the rapid development that we have seen when it comes to medicines and new treatments. I am thinking primarily of precision medicines and the type of orphan drugs that can play a decisive role for small patient groups.

That is why we need to break free. Just as previous members have mentioned, there have been pharmaceutical investigations on site. There was a great expectation when the government tasked TLV with analyzing and proposing how we could strengthen the treatment of rare diseases and increase access to orphan drugs. But then the entire investigation was hampered by the fact that it could not cost more, which made it a disappointment when we saw the result.

Now the Care Responsibility Committee has said that a number of areas have been identified where the state needs to take greater responsibility. This concerns, among other things, pharmaceuticals. We are now waiting. We need to take action, and our strong urge to the government is that we must move forward. Clinical research is part of the whole, but we must do something about the fact that Sweden is at the bottom of Europe when it comes to access to orphan drugs.

There is one more thing I want to mention regarding pharmaceuticals. It concerns pharmaceuticals and the environment, for it is an area that has unfortunately stood still during this parliamentary term. Pharmaceuticals, all the way from manufacturing to our use of them and to them ending up in our watercourses, are a major environmental problem and a major challenge that we must manage.

We have long waited for TLV to come forward with proposals, for example concrete proposals on environmental classification or environmental premiums in the benefit system or other things that allow us to create incentives for more environmentally friendly pharmaceuticals. It is even the case that European pharmaceutical actors have been pushing and requesting that we take the lead in this issue and drive this in Europe, as it would provide a competitive advantage. But here it has stood completely still during this mandate period. This is something that we in Miljöpartiet, if there is a change of government, will definitely take action on.

I will shorten the debate a bit. We had a debate as recently as this autumn regarding dental care where I summarized a great deal of the Green Party's policy. I fully agree with what the member who spoke about the dental care investigation said. Actually, we should have proceeded with it to have broader proposals. It is then about gradually reaching a more comprehensive high-cost protection, that dental care should increasingly be covered by our existing high-cost protection. Tiotandvården is a step in the right direction, but it has many shortcomings and challenges. Our vision is, of course, that teeth are a part of the body and that we will gradually get to a point where more and more of dental care is included in the high-cost protection.

We also think it is very worrying that the age limit for when one is no longer entitled to free dental care was lowered, because good habits start early. This can have major consequences for the "curled" youth, if I may use that expression.

The deliberation was hereby concluded.

(A decision was to be taken on 17 February.)

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