Obligation to pay for dental care - new rules for certain foreigners

Christian Carlsson (KD)

Mr. Speaker! The time has come to address an injustice within Swedish dental care, namely the special rules that have applied to asylum seekers and persons who actually lack the right to stay in Sweden.

In March 2013, the then government submitted a bill to the Riksdag which aimed at making all county councils obliged to offer persons staying in Sweden without permission nearly free dental care. Adult asylum seekers but also foreigners staying in Sweden without permission now have the right to dental care that cannot be postponed. For an asylum seeker's treatment by a dentist at Folktandvården or by a dentist belonging to a healthcare provider that the region has an agreement with, a fee of only 50 kronor is charged today.

The previous government wanted well, but it has not been fair that persons who lack the right to stay in Sweden, who have not contributed to the welfare, have been able to receive dental care for a fifty-kronor bill while older Swedes have had to pay significantly more. It is also not reasonable to offer those types of welfare benefits for persons who are in Sweden illegally when we simultaneously need to pursue a restrictive migration policy and have a very limited immigration to Sweden moving forward in order to manage the integration and be able to strengthen our Swedish social cohesion.

In the bill being discussed in today's committee report, the government proposes new rules regarding dental care fees for certain foreigners and that the so-called "fifty-kronor note" is abolished. Our intention is that dental care for the affected groups shall primarily be financed by the individuals themselves, without the positive special rules in relation to Swedish citizens.

The proposition means that persons seeking international protection and foreigners held in detention by the Swedish Migration Agency, or who have received a decision on rejection or deportation but where the execution has been stayed, shall pay reasonable compensation to the Swedish Migration Agency for dental care that cannot be postponed if they have reached the age of 18 and have income or own assets.

For those staying in Sweden without the support of an official decision or regulation – this applies to persons who are evading deportation or expulsion – dental care shall no longer be subsidized. They may pay according to what the healthcare provider determines, but the obligation to pay shall therefore no longer be limited to the previously decided so-called "fifty-kronor" (femtiolappen).

Mr. Speaker! Today's report also contains another important proposal. Before January 1 of this year, Sweden's dentists needed to adapt their operations both to the reform on a strengthened higher education cost protection for dental care and to the reform on strengthened control over the dental care sector. The latter covers the licensing requirement for private dental care operations.

It has been shown that there are private actors who have not fully adopted the changes, despite efforts to inform them about the new legal requirements. The rule that applies now is that the activity that has been started before January 1, 2026, but has not been reported to the healthcare provider register, may not be conducted during the time the application is being reviewed.

We can also note that the processing time at Ivo has amounted to several months. That is not acceptable, and I know that Social Minister Jakob Forssmed is engaging in a dialogue with the authority regarding this.

That dentists unnecessarily have to cease their ongoing activities naturally has serious negative consequences for the healthcare providers and the patients. The government wants to do something about this.

The proposition therefore proposes that a private dental care provider that had commenced its operations before 1 January 2026 but had not reported this to Ivo shall be allowed to conduct the operations without a permit until the application has been finally reviewed, provided that an application is submitted before 1 January 2027. The legislative change is proposed to enter into force on 23 August 2026.

The Christian Democrats support the government's bill. We move for approval of the Social Affairs Committee's report.

Since this is the final debate for the Committee on Social Affairs during this parliamentary term, I, as the chair of the committee, would like to take the opportunity to thank the speakers, the Chamber Office, our own committee secretariat, and all colleagues in the Committee on Social Affairs for this period. It has been a privilege to lead the committee's work. I appreciate that we have had a constructive spirit and a pleasant collaborative climate despite political differences.

Given that several members are leaving and are not standing for re-election, I would like to particularly thank them for their contributions in the Riksdag. I would also like to wish them the best of luck with whatever they undertake in the future.

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

Karin Rågsjö (V)

Madam Speaker! As a farewell present from me, who is about to leave, the member receives a small question. It is quite modest. It reads: Why do you never listen to referral bodies in any context when propositions are reviewed by them? Why do you not include them and do something with it? It feels like it is mostly something obligatory when the government pushes through its propositions.

In this case, the Swedish Migration Agency has strongly advised against implementing the proposal. They point out that the regulatory framework is problematic and insufficiently designed. This is the authority that is supposed to rule and take care of the entire issue.

I therefore think it is remarkable that the government proceeds with a proposal when the authority that is to handle central parts of the system points out serious deficiencies. It must still be a Swedish record in tone-deafness, Madam Speaker.

There are also other referral bodies besides the Swedish Migration Agency that have been very critical: Sveriges Kommuner och Regioner, Socialstyrelsen, Svenska Röda Korset and Lagrådet, who do not usually applaud your proposals very highly.

It is emphasized here that the concept encompasses more than acute dental care and refers to situations where even moderate delay can entail serious consequences for the patient.

The Swedish Red Cross has also advised against a change to the current order. The organization has agreed with the investigator's assessment that the proposal risks leading to poorer oral health.

This is a proposal that Member of Parliament Christian Carlsson calls fair. What do you think?

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

Christian Carlsson (KD)

Madam Speaker! The Government and its coalition partners, of course, carefully read through the referral responses that are submitted before the preparation of bills. But one does not actually need to agree with the referral bodies.

I assess the Swedish Migration Agency's conditions to fulfill the assignment as good because other transfers are made when money is received. This should absolutely be manageable by the Swedish Migration Agency.

SKR is a politically governed organization and is currently governed by the red-green parties. That perhaps says something about their response.

The Council on Legislation does not take a position on political content. They look at how well they believe it fits with how the legislation is structured.

We stand for the fact that we think it has been unfair. If one is an illegal immigrant in Sweden, one receives cheaper dental care than Sweden's elderly. I do not understand that there are red-green parties that can defend this.

I understand that the Alliance government had good intentions when they introduced this, but I also understand all the elderly people who have been upset by this when they themselves have to turn the coins over. They do not understand why those who have worked their whole lives and contributed to the welfare have to pay more for dental care than people who are not even allowed to be here.

We stand for removing this – every single time!

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

Karin Rågsjö (V)

Madam Speaker! I was more interested in how you are once again ignoring referral bodies. Member Christian Carlsson says that "one thinks." Unfortunately, this has been consistent over four years. There has been a great deal of thinking and very little of research, evidence, and listening to referral bodies.

When the authority that is to implement the proposal strongly advises against it, it must still send a signal to the government. One cannot simply say "It will probably be fine." It is very strange.

The Council on Legislation never enters into political debates but looks at the whole from the perspective of the possibility. Once again, the government has disregarded what the Council on Legislation writes.

Socialstyrelsen is not exactly a minor authority. They too have expressed their views on this. And one can also have many opinions about the Swedish Red Cross.

There is a tendency, Madam Speaker, and it is the one I return to. For four years, the SD-dependent government has not been very interested in listening to the referral bodies.

Christian Carlsson calls this a fairer reform. It is once again signal information. It always sounds as if the member or the entire government base for the SD-dependent government wants to see hordes of people running through Stockholm with flags in support of your proposals. That is not actually the case.

The most interesting thing is how you have ignored referral bodies in such a blatant way for four years.

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

Christian Carlsson (KD)

Madam Speaker! Once again, I want to state that we are not ignoring the referral bodies. But it is in the same way as with research. There are researchers who come to different conclusions. One cannot blindly read only one research report and think that the research says one thing and that one then does as it says. I do not hope that Vänsterpartiet is a slave to the referral bodies so that if one adds up all the referral responses, one gets Vänsterpartiet's political opinion.

It is, after all, the case that there are people in these agencies who make an assessment, and they happen to make a different assessment than our government. It is our government that has been given the mandate to govern the country, and it does so.

Regarding the Council on Legislation, they base their decisions on how we usually do things in Sweden. Much needs to be done differently in Sweden when it comes to legislation. Therefore, we are coming forward with new proposals that are groundbreaking and which involve real change. At times the Council on Legislation resists, but we move forward because it makes Sweden better.

(Applause)

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

Christofer Bergenblock (C)

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

I want to move on to the part concerning our private dental clinics and the conditions for them. We in Centerpartiet and the opposition are in complete agreement with the government parties regarding the need for licensing for dental care in order to address the problems that have existed at some practices and the welfare crime that has crept in there as well. At the same time, there was also a concern among many private practitioners regarding the licensing process that started on January 1, not least linked to the experiences from Ivo and their processing times regarding other activities within health and care.

Until May, Madam Speaker, Ivo had managed to issue an approved permit to a clinic. After that, additional permits, in the magnitude of 15 pieces, were added, and there are many applications that are lying and waiting. This was not entirely a novelty, because one knows how it has functioned – or has not functioned – at Ivo previously.

It is good that we now step in and say that the practice is given an extended period to report its activities to Ivo so that a permit review can be carried out later. But we also see that there are problems in this.

One of the problems is that there is an ambiguity for activities that have been conducted between March 2 and August 23, when the new law enters into force. How have the government parties intended for those activities to be handled in the upcoming permit review?

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

Christian Carlsson (KD)

Madam Speaker! Just as Member Bergenblock says, the background to why we have established this licensing requirement is that we unfortunately have extensive welfare crime infiltrating our operations and that there has been a need to introduce the licensing requirement to ensure that taxpayers' money goes to care and that criminals do not milk our welfare systems. But I also want to admit that we must, of course, be self-critical when we see that several different types of licenses that have been introduced are not implemented in the way that the policy intended.

That is why it is very good that our Minister for Social Affairs has had a close dialogue with Ivo. It is good that the government is acting and presenting this proposal. However, it is still the case that with the proposal currently before us, we will not be able to remedy all the problems that have been caused by Ivo's long processing times and the unclear and insufficient implementation that has occurred. If, for example, an application has already been submitted and a rejection has already been received, we cannot remedy that. It is only when this law enters into force that the new rules begin to apply.

This means that some actors end up in a bind. Whether there is anything that can be done to remedy this, one must of course continue to have a dialogue about it, but that is the situation right now. This represents a major step toward improving the situation for many of the private dentists.

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

Christofer Bergenblock (C)

Madam Speaker! I therefore understand that there is actually no proposal from the government on how to handle those who have conducted activities but have not submitted an application or a notification to Ivo.

But let us move from there to the opportunity that existed in this bill to also highlight other problems that have emerged during this time. One of the parts that has been criticized quite a bit is how Ivo carries out the reviews during the granting of permits, where they are extremely detailed in their requirements. This would have been an opportunity for the government to also clarify how detailed Ivo should be in order to complete the processing within reasonable timeframes.

I do not perceive that the government has made any clear position or pushed to make any clarification. Therefore, we from Centerpartiet have raised this as a notice to the government.

Another issue we have raised as an announcement is that there should also be transitional provisions for those who have run a business and, upon a change of ownership, are to hand it over to someone else. As it has been now, it has resulted in a period in between when the business cannot be operated. It could be a generational shift in a dental practice where a child is to take over the business from a parent who is retiring and has ended up in a situation where they cannot continue to operate the business because they are awaiting the decision from Ivo.

I also miss clearer demands from the government's side on Ivo to manage the processing times.

These are three important questions. Why have they not been included in this bill, when the opportunity existed?

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

Christian Carlsson (KD)

Madam Speaker! The Government views the major shortcomings regarding Ivo's processing times and the application of the permit requirement seriously. That is also why the Minister for Social Affairs during the spring has had an ongoing dialogue with the Director General at Ivo on precisely the importance of the new permit requirement for dentists functioning in a purposeful manner. The Minister for Social Affairs can, of course, better than I explain the details of what that dialogue looks like.

That the government has acted in this matter, presented this bill, and will continue to pursue the issue is very positive, but we are by no means finished with this. I thank you for all the constructive proposals that the Centerpartiet puts forward regarding this. Since the problems are not resolved yet, we will have to see which issues can be taken further forward. We will have to come back to that.

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

Karin Rågsjö (V)

Madam Speaker! This was not expected: that the staff in the Riksdag should be forced to reschedule their vacations so that the SD-dependent government could push through its legislative proposals before September 13. But perhaps it is completely logical and entirely in line with the legislative proposals you have put on the table for four years. It is very consistent.

What I have pointed out in my reply to Christian Carlsson is that you have not listened to the referral bodies – to research and to SKR, lawyers, trade unions, patient organizations and the Council on Legislation. There is some kind of total tone-deafness. You have pursued your own line entirely and ignored research, evidence and referral bodies.

It has been very focused on immigrants, one must still say – we have discussed this here today. It concerns teenage deportations, deportations of families, return grants, and the reporting law. They have completely adopted SD's constant statement that everything is the immigrants' fault.

I think the Sweden Democrats are honest anyway. Ludvig Aspling clarifies without any problems that it is about ethnicity. We have far too many people who are not part of the ethnically Swedish population, and that has caused huge problems in Sweden, says the party's migration policy spokesperson Ludvig Aspling. And a number of government officials appear and say something non-committal.

Over the past four years, you have worked persistently to produce a toxic marinade and pour it over Sweden. It has been a dangerous path. You have found ingredients in Trump's administration and in nationalist think tanks. Everywhere the nationalist far-right movement has been, you in the SD-dependent government have been inspired. It is a very dangerous journey, I want to clarify.

Before I proceed, I shall take the opportunity to move for approval of reservation 1.

The Government proposes in Proposition 2025/26:300 that certain adult foreigners, including applicants for international protection, persons in detention, and persons whose deportation or expulsion has been inhibited, shall pay reasonable compensation to Migrationsverket for dental care that cannot be postponed if they have income or own assets. The Government also proposes that adult persons staying in Sweden without necessary permits shall no longer be covered by the subsidized fee for dental care that cannot be postponed but shall instead pay according to the healthcare provider's fees.

To some ears, this may sound perfectly reasonable, but we in Vänsterpartiet nevertheless oppose this bill. We do so together with a majority of the referral bodies: Migrationsverket, Sveriges Kommuner och Regioner, Socialstyrelsen, and Svenska Röda Korset. Dental care that cannot wait is not elective care, but care where omitted or delayed treatment can lead to serious consequences. It is perhaps more about health than about justice.

Madam Speaker! The Council on Legislation also emphasizes that the concept encompasses more than acute care and refers to situations where even a moderate delay can entail serious consequences for the patient.

Introducing higher fees and more complicated payment models for people in very vulnerable situations therefore risks leading to necessary dental care being postponed or omitted. Untreated dental problems risk worsening and leading to both greater suffering and more costly care interventions later.

The Swedish Migration Agency has strongly advised against implementing the proposal and pointed out that the regulatory framework is problematic and insufficiently designed. The agency has, among other things, highlighted difficulties in assessing what should constitute reasonable compensation, problems with the collection of claims, and that the consequences have not been sufficiently scrutinized. It is noteworthy that the government is proceeding with a proposal where the agency that is to handle central parts of the system itself points out serious deficiencies. But nothing can stop us now, you sing in this government in the final chorus.

This government has ignored the high unemployment among the youth. They have ignored that school results are falling. They have ignored that the working situation for healthcare workers has worsened. There are 750,000 poor people. The food queues outside the Salvation Army and the City Mission have become incredibly long. The welfare mafia has shot themselves further.

The Swedish Red Cross has also advised against the change of the current arrangement with a limited patient fee for asylum seekers and persons without necessary permits. The organization agrees with the investigator's assessment that the proposal risks leading to poorer oral health while simultaneously being judged to become more expensive for the public sector. This is therefore not a concoction, but it is the investigator who says this.

Vänsterpartiet shares that concern. People seeking protection or living without permits are often in very vulnerable life situations. But that it should be humane and needs-based is not directly the policy that you want to pursue.

The government's proposal that persons without the necessary permits should instead apply for financial assistance from the social welfare committee is not a sufficient solution. It risks creating higher thresholds for a group that already has difficulty seeking support from authorities. It could also become very unequal because municipalities can assess things slightly differently. Furthermore, it will result in a very large amount of administration.

Vänsterpartiet considers that the current order should be maintained. The regions already have an obligation today to offer healthcare and dental care that cannot be delayed to certain foreigners staying in Sweden without necessary permits. It is a limited but necessary right to care, and it should not be eroded.

This government believed, and still believes, that this policy would have the voters cheering all the way to the election. But that has not quite been the case. People are wiser than one might think. It was not the case that all of Sweden shouted with delight when you pushed through your laws on children in prisons, teenage deportations, return migration grants, and so on.

SD speaks completely openly about ethnicity and about a society that is divided. Already in 2014, Björn Söder said that Jews and Sámi are not Swedes. He said that here in the chamber. Perhaps the Moderates, Liberals, and Christian Democrats should have taken that to heart and continued with that until now.

The question we are dealing with today does not affect very many. But it is about something else. You constantly have a signal policy that you manifest.

Madam Speaker! This is my last debate. I would like to take the opportunity to thank the entire secretariat here in front of me, who perform a hard job with us who work all the way into the summer.

I also want to thank all the staff of the Social Affairs Committee. What a fantastic team! Without you, we would have been wandering around the corridors with papers here and there and not understood what we were supposed to do. Thank you for all the hard work! You are fantastic.

Thank you also to the members of the Social Affairs Committee. I am not always kind, but I am very fair.

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

Ulrika Westerlund (MP)

Madam Speaker! I will not drag out the debate for too long. But this is Karin Rågsjö's last debate. Then I must say something about what you, Karin, have meant to me and thank you for your efforts here.

We have known each other for a very long time – for 20 years, perhaps. A very long time ago, we worked together in the HIV council. This is a commitment that we both have had since then. There, we had many discussions about what was smart communication for HIV prevention and how things actually stood. That work is something that is still ongoing. The knowledge that I took away from there, among other things from you, I last used at this year's Stockholm Pride. Jan Albert, whom you also know well, had presented an investigation on an issue that was current even back then.

Many processes are very long. You have been involved in very many of them that I have also been involved in.

Earlier today we thanked Maj Karlsson. You too should be thanked, I think. You are at times each other's polar opposites in the debates. Maj is thoughtful, a bit subtle and low-key, while you really go at it like a whirlwind. This last contribution of yours was truly your trademark: You were yourself all the way into the very last debate.

Thank you for this! Thank you for the commitment and for all the knowledge! It has been very enjoyable to be in the committee with you.

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

Karin Rågsjö (V)

Madam Speaker! It has been fantastic! I was very happy when you, Ulrika Westerlund, joined the Social Affairs Committee. Then you unfortunately disappeared, but you are still involved in these issues. It is a privilege to work with people who know the issues and delve into them, have a political commitment and also a warm heart. Thank you, Ulrika! We will see each other again.

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

Christian Carlsson (KD)

Madam Speaker! I think Member Karin Rågsjö also deserves a thank you from Tidösidan for her efforts in the Riksdag. The Member said here that she was not kind but fair. I can still say that there are Left Party members who are significantly tougher than Karin Rågsjö in the debate.

Even though Karin Rågsjö has a very colorful language and is bold in the debate, I always experience it as being with a twinkle in the eye, and that one can also have constructive and pleasant conversations with her outside the meeting rooms or the plenary hall. I appreciate that.

You are not only an experienced politician who one can learn a lot from, but you are also a cool person and a cool politician. You show that in the debate. I have appreciated your time here in the Riksdag.

Good luck with what you are undertaking, but not too much! I know that you are aiming for Region Stockholm. Thank you very much!

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

Karin Rågsjö (V)

Madam Speaker! Thank you, Member, for the fact that as a 71-year-old one can still be cool! I will live on that for a few more hours here, at least.

It is fun to work with politics. When one sits in such a political context and emotions flare up here and there, one must manage that – and that is what I have tried to do – and not mix the political with the personal and be angry at people all the time. I do not think that is favorable.

One must have a decent attitude towards everyone and all parties. Then one can think very much, but in the meetings one must be decent. In the debates one can be as harsh as possible. So thank you, member!

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

Anna Vikström (S)

Madam Speaker! The Social Democrats believe that good dental health is an important part of people's well-being and health, and that dental care should be provided on equal terms based on need.

We Social Democrats want the dental care system to be developed with a stepwise expanded high-cost protection similar to that of healthcare. We see now that not all young people receive the dental care they need, as those who are 20 years old are to pay the full price. We want the free dental care that the Sweden Democrats and the government have removed for young people between 20 and 23 years old to be reintroduced.

The bill presented today means that adult asylum seekers, who are referred to in the proposition as "seekers of international protection," who have their own funds to pay for their dental care shall do so. Adult asylum seekers seeking dental care shall, as it is called according to Swedish legislation, receive dental care that cannot be postponed. In retrospect, the Swedish Migration Agency shall investigate whether the person has their own funds to pay a reasonable compensation.

Reasonable compensation is a new concept in the legislation. By this, it is intended that consideration shall be taken of the size of the fee for the dental care treatment in relation to the individual's income or own assets, if any exist. The bill clarifies that asylum seekers shall not pay the reasonable compensation for dental care if they, for example, have means that fall below the norm for social assistance.

It takes us to the 50-kronor fee and the fee that applies today. My understanding is that the 50-kronor fee will remain for asylum seekers, but I did not perceive that it was what the Christian Democrats' preference said. It is not just that one pays 50 kronor, but obviously one should pay for dental care if one has the means to do so. But I understand that the routine is that one still pays the 50-kronor fee when one arrives at the public dental clinic.

Furthermore, the EU's Reception Directive shall continue to be followed. For so-called undocumented persons, there is also a bill in this matter stating that adult undocumented persons shall be given the opportunity to apply for dental care subsidies through the social services. The bill is an amendment to the Social Services Act.

There are many referral bodies that are skeptical about how this will work. But I have read the referral responses very carefully, and no other concrete solutions have been put forward other than the commission's proposals. In this context, it can also be mentioned that a similar arrangement for persons who have subsistence support and who do not have sufficient funds for their dental care applies today. They can apply for funds via social services.

It is very important for the individual's health that dental care that cannot be postponed is provided for these groups because there is a risk of serious follow-up diseases and more extensive care needs in the long run if the dental care problems are not addressed.

It may be of interest to know how many, or perhaps how few, these legislative proposals could be expected to cover. An example exists from Region Stockholm, where there were approximately 900 asylum seekers and 600 undocumented adults who received dental care in 2025 – and at that time, the region has almost 2.5 million inhabitants.

It is important that regions and municipalities receive coverage for their healthcare costs and increased administrative costs to manage these legislative proposals. The compensation has actually been too small for a long time.

For children and young people, dental care shall be provided free of charge to the same extent as is offered to those residing in the regions, just as before.

Madam Speaker! We Social Democrats have chosen not to submit a motion in this matter, but we want to emphasize that it is necessary to follow up on the consequences of the proposals. A follow-up should, among other things, include an analysis of whether the proposals lead to less dental care for persons in the relevant groups, whether the proposals lead to increased administration for dental care providers, municipalities, and regions, and how the proposals affect the working environment for dental care staff, who will now have to handle and assess more rules for fees for the affected groups.

We will follow the developments closely regarding these issues and take necessary initiatives in other contexts.

Finally, we note that the Swedish Migration Agency has stated that the proposals require extensive IT development at the agency and that the dates for entry into force should be postponed. The government has not complied with this. We Social Democrats are therefore considering advocating for a later date of entry into force.

The matter today also includes proposals for new transitional provisions due to the permit requirement for private healthcare providers. We support that proposal.

Madam Speaker! Since this is my last speech here in the Riksdag, I would like to conclude by saying that I would gladly have stood here today and debated a proposal that dental care after violence in close relationships should cost as little as a regular doctor's visit.

There is a completed investigation. It has been on the government's desk for over three years. I have repeatedly asked the Minister for Social Affairs if he intends to proceed with the proposal, but the government has not prioritized the issue. Therefore, dental care for injuries after violence in close relationships is still a financial issue for the person who was subjected to it. It should not be.

I would like to conclude by thanking the chair, the secretariat staff, and all the members I have served on the committee with. It has been a very enjoyable time, and I truly appreciate the dialogues we have had in every possible way. I have a special greeting to Karin from Vänsterpartiet who is now leaving, just as I am.

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

Christian Carlsson (KD)

Madam Speaker! I would just like to extend a personal thanks to Anna Vikström for her fine contribution in the Social Affairs Committee during the time we have worked together. It has not been very long, but I know Anna as a conscientious person who is always very well-prepared and constructive.

We have had a good cooperation, so I would like to take this opportunity to wish you the best of luck with whatever you do in the future!

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

Anna Vikström (S)

Madam Speaker! I would then like to thank the Chairman of the Committee on Social Affairs for the kind words and wish you good luck on a more personal level – perhaps not with the election result – with the tasks you will undertake in the future. It has been good leadership. Thank you for that!

(THIRD DEPUTY SPEAKER: I can tell you that it is cloudy outside, so it is difficult to see the partial solar eclipse, if you had wondered about that.)

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

Christofer Bergenblock (C)

Madam Speaker! Here in the chamber, we constantly move between sun and eclipse, and perhaps we do so in this debate as well.

Tonight we are debating dental care, but not just dental care. The debate is also about the government's overall strategy to make life as difficult as possible for people who have come to Sweden. It is also about how the government, with its unclear governance, has made life difficult for many dentists across Sweden, albeit with good intentions.

Let us begin with the first part, which concerns dental care for certain foreigners, which in this case refers to adult asylum seekers, persons in detention, and persons whose deportation has been temporarily stayed. In the bill, it is proposed that the current dental care fee of 50 kronor for acute dental care be replaced with a requirement that the individual shall be able to pay reasonable compensation and that those staying here without authority support shall bear the cost themselves.

It is naturally not unreasonable that those who have their own resources also provide for their own dental care, but the problem is that the government has, as usual, lost touch with reality and ignored the referral bodies.

Centerpartiet agrees with the principle that those who have the financial means should pay for their own dental care just like everyone else. It is fundamentally a reasonable requirement, but the proposal that the government presents is neither grounded in reality nor proportionate.

The absolute majority of the persons affected by the regulation are judged to lack the ability to pay, which is clearly evident from the referral responses. The criticism of the proposal is massive and comes from almost all referral bodies. The consequences of abolishing the current regulation on the dental care fee risk becoming tangible on several levels.

Firstly, Madam Speaker, it risks leading to seriously impaired oral health in an already very vulnerable group. Delaying dental care usually does not lead to the need disappearing, but rather to it escalating and the treatments further ahead becoming more extensive and costly, both for the individual and for society. Poor oral health is also intimately connected with general health and ill health and can lead to follow-up diseases that place an additional burden on health and medical care.

Secondly, the administrative overhead costs of collecting payment for dental care from a group that already largely lacks the ability to pay are likely higher than what will actually be able to be collected. It is a bad deal both for the state and for the taxpayers, and an arrangement that also risks creating a protracted bureaucratic process without a real outcome. There is also an obvious risk of cost shifting to other parts of the healthcare system.

It is also interesting that none of the Tidö parties believe that undocumented people will be able to pay for dental care, as they also want to make an amendment to the Social Services Act which provides an opportunity for municipalities to pay out financial assistance to those who are unable to pay for their acute dental care.

Overall, we from Centerpartiet judge that the government's proposal does not achieve the claimed savings effect. Against that background and based on the massive referral criticism, we will vote no to these parts of the government's proposal.

Madam Speaker! Let us now continue with the part concerning the possibility for private healthcare providers to provide dental care. Since the decision on requirements for permits to provide dental care, problems have surfaced frequently during the spring with dentists who have invested large sums of money in new practices but have not been able to open, and dentists who have taken over existing operations but have not been able to open. At the same time, there are many dentists who have operated practices for years who have missed that they must register with Ivo to be able to continue operating their business.

The problem, however, is not the requirement for a permit as such. Centerpartiet completely agrees that such a requirement should be imposed. The problem is the government's clumsy handling and management of the authority responsible for the permit review, that is, Ivo.

Since many dental practices have not submitted any notification regarding their operations on time, that is, before March 2, which was the requirement, the government now proposes an extension for the rest of the year, and we in the Center Party stand fully behind this. At the same time, we note that this and other problems linked to the licensing activities are due to the government's inability to provide Ivo with the conditions required to fulfill its mandate.

The situation that has arisen regarding dental care permits exposes Ivo's unacceptably long processing times. From the time the new permit requirement came into force at the turn of the year until even May, Ivo had only granted permits to a single operation. After that, they have granted permits to an additional fifty-something operations – an outcome that cannot be described as anything other than completely insufficient.

The long processing time risks affecting serious dental care providers and, in the long run, also their patients. Centerpartiet believes that the government should have actively worked to address Ivos' capacity problems and clarified what requirements the authority should direct towards the dental care operations. Against this background, we from Centerpartiet propose three announcements to the government.

Firstly, we want to see transitional provisions for businesses that change owners. In connection with a dental practice being transferred or taken over, there is a risk of a stoppage in the operations during the licensing process, even though the business may have been conducted both seriously and legally for many years. It is not reasonable that staff and patients should be affected by such an interruption, and therefore the government should develop transitional provisions that ensure the business can continue to be operated even during the licensing review.

Secondly, we want to see a clarification of the requirements that are now being placed on dental care operations. One of the contributing reasons why the licensing process at Ivo has taken far too long is the lack of clarity regarding which requirements are reasonable to impose. Centerpartiet believes that the government should give Ivo clearer directives on a reasonable level of requirements so that the review process can be standardized and streamlined.

For the third time, the processing rate at Ivo must increase. Ivo needs to urgently produce a plan to increase the pace in the permit processes for dental care activities. The current processing rate is not acceptable. The Government needs to task Ivo with presenting a concrete action plan for how the processing of permit cases within dental care can be streamlined and accelerated.

With that, Madam Speaker, I would like to move for the approval of reservation 2 in the committee report, which contains these three announcements.

In conclusion, I would also like to take the opportunity to express my thanks to our chairman of the Committee on Social Affairs during the mandate period, Christian Carlsson, for very good leadership and for the fact that we have been able to have a very good sense of community, even though we in the committee have very different political starting points. Many thanks for that!

I would also like to take this opportunity to thank our outgoing members, Karin Rågsjö, who has conducted debates and politics with great commitment and robust debate contributions, where we may not always have been completely in agreement regarding private care or farm sales, but where we have had very pleasant exchanges of views, and Anna Vikström for her commitment, thoroughness, and sharp analytical skills, which have helped the entire committee in its work. Many thanks!

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

Christian Lindefjärd (SD)

Madam Speaker! First, I would like to move for approval of the committee's proposal for a decision.

After ten years of waiting, we will finally remove an unjust system. That it should take an entire parliamentary term to investigate and arrive at this important decision is actually surprising. This is something the Sverigedemokraterna have fought for since you others introduced it.

But now we are finally here. When the Riksdag votes through this, it is a victory for diligent and hardworking people in Sweden.

We have for a long time had a system where persons staying here illegally have been able to receive dental care that cannot be postponed, after assessment by a dentist, for a symbolic fee of 50 kronor. It is a system that is difficult to defend.

Let me take a good example from reality. Imagine the construction worker Anders, 50 years old. He wakes up one night with severe toothache in a cheek tooth. The pain is pulsating and radiates into the jaw and ear. He takes painkillers, but it only helps temporarily. In the morning, he calls the dentist. There are both public dental care and private dentists to call, and Anders chooses the healthcare provider who can offer him an emergency appointment fastest.

During the visit, it is noted that Anders needs a root canal on a tooth. This is not about cosmetic dentistry. It is about treatment to stop pain and treat an infection. It is, therefore, care that cannot be postponed.

Anders is also not 67 years old or older and can therefore not take part in the favorable dental care that the Tidöregeringen has introduced for the elderly. His cost can, depending on the healthcare provider and which measures are required, amount to between 5,000 and 8,000 kronor, despite the general dental care support.

At the same time, we have had a system where a person who stays illegally in Sweden and works illegally can receive equivalent care for 50 kronor.

Madam Speaker! It is this absurdity that we are now addressing. It is not reasonable that the person who works, pays tax and behaves correctly should be able to be faced with a dental care bill of several thousand kronor, while a person who has no right to stay in the country can receive the same care for a symbolic sum.

It is about what kind of society we want. We shall have a welfare system that primarily exists for those who are a part of our society – for those who work, pay taxes and contribute.

If a person who lacks the possibility to pay for their dental care finds themselves in a situation where the care is necessary, there are possibilities to seek support through the social services in the municipality where the person is staying. It is a significantly more reasonable arrangement than that taxpayers should automatically cover the care through a special system for persons staying illegally in the country. And do we know which persons are in the country?

We shall have a dental care system that is fair. The person who works and does right by others should not end up last in the queue. The person who has taken responsibility for their life and for society should be able to expect that society also treats him or her fairly. Therefore, today's decision is important. We are now taking another step towards a more fair and sustainable welfare system.

Madam Speaker! I also want to say something about the licensing requirement that we have introduced for private dental providers.

I want to be clear: the licensing requirement is both good and necessary. For a long time, we have seen how welfare crime has spread in our society. Therefore, we must ensure that the operations that are allowed to provide dental care maintain high quality and that the taxpayers' money goes to serious actors.

When we introduced the permit requirement, however, a problem also arose that we must take seriously. Many serious entrepreneurs have done what was expected of them. They have submitted their applications and acted correctly, but then the processing times have become far too long. It cannot be the intention that a serious entrepreneur should risk bankruptcy because they are waiting for a permit from an authority.

We have placed an important and extensive assignment on Ivo. Therefore, the new transitional provisions regarding the licensing requirement for private dental providers are important.

I want to particularly highlight the work that Minister for Social Affairs Jakob Forssmed and the Ministry of Social Affairs have done. They have listened to the problems, been in contact with Ivo, and worked out transitional rules to resolve the situation as quickly as possible. And – it is important to say – the new transitional rules enter into force as early as August 23.

This is a good example of how politics is also about being able to correct when one sees that a reform has unwanted consequences for serious actors.

We shall have a permit requirement. We shall continue to fight welfare crime. But at the same time, we shall ensure that serious entrepreneurs are given the opportunity to continue their operations while their application is being processed.

Madam Speaker! There is also an important lesson here: It is not possible to pile more and more tasks on an authority without ensuring that the authority has the competence and resources to fulfill its mandate. In that case, a reform that is both necessary and correct risks affecting the people and companies who actually do the right thing. It is a lesson that we must take with us moving forward.

We must be tough against welfare crime, but we must also be fair to the serious entrepreneurs. That is how we build a secure, legally sound, and sustainable welfare system.

I move again for approval of the committee's proposal for a decision. At the same time, I would like to thank my colleagues in the Social Affairs Committee for everything during this period. I joined after two years. Thank you very much!

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

Ulrika Westerlund (MP)

Madam Speaker! The proposal we are debating today means that some of the most vulnerable people in society will have significantly worsened opportunities to receive dental care that cannot be postponed. We consider it an ill-considered and poorly elaborated proposal that will not only affect individuals and their health but also worsen the working environment for dental care staff and place a great responsibility on the regions. Therefore, we do not stand behind the proposal.

Currently, asylum seekers and undocumented persons pay a flat fee of 50 kronor for dental care that cannot be postponed. This is therefore about care which, if provided in a timely manner, can prevent a more acute condition from developing. We consider it both inhumane and socio-economically unwise to significantly worsen access to such care for a specific group by using economic steering measures. Missed or delayed dental care can cause great personal suffering, worsened health status, and in the long run, a greater need for more extensive and expensive care. This increases the costs for the regions.

Miljöpartiet argues that dental care should be provided based on need, not based on ability to pay or migration status. The groups affected by the government's proposal often have small economic margins. When it comes to asylum seekers, many have the allowance from Migrationsverket as their only income, and they also, due to the government's policy, no longer have the possibility to work at the beginning of the asylum period. It can be assumed that a raised fee for dental care in practice means that more will completely refrain from seeking care.

The government tries to describe the proposal as a matter of justice, but in practice, it excludes vulnerable people from receiving necessary dental care.

Madam Speaker! The criticism against the proposal from the referral bodies is extensive. A majority, including the Swedish Migration Agency, the National Board of Health and Welfare, SKR, and the Red Cross, reject or are negative. They point to the risks of impaired health, increased inequality, higher thresholds to care, and increased costs. In light of the collective criticism, we think it is remarkable that the government is proceeding with the proposal.

The criticism from the Swedish Migration Agency is particularly heavy. The agency goes so far as to strongly advise against all proposed changes and points out, among other things, that the provisions are problematic and insufficient in their design, as well as that the proposals are administratively burdensome and lead to increased costs for both the agency and the regions. The Migration Agency also emphasizes the difficulties of deciding on dental care compensation long after the fact and assessing what constitutes a reasonable amount.

The Swedish Dental Association, the Swedish Dental Hygienist Association and several regions have warned that dental care personnel are forced into new ethical dilemmas as a result of the government's proposal and are thus also experiencing increased stress and a more strained work environment. The investigation also emphasizes that the pressure on staff to make the correct assessment of the relevant foreigners' migration law status will increase, because the healthcare provider otherwise risks facing difficulties in collecting payment for the dental care provided.

The government's response to these risks is that it is up to the regions to develop appropriate routines to facilitate for dental care staff to manage the implementation of the proposals. Furthermore, the government addresses views on the increased pressure on dental care in a very short paragraph. Therefore, we believe that these consequences cannot be considered sufficiently examined. The government does not take responsibility for its proposal.

The government's proposals in this part are poorly substantiated and heavily criticized by the stakeholders involved and risk creating greater problems than those they are claimed to solve. For example, the Council on Legislation questions whether the stated purpose of the proposals, increased justice, will be achieved given the difficulties in assessing what constitutes reasonable compensation and in collecting the amounts in cases where a liability for compensation is decided. The proposals will also affect already vulnerable people, worsen the conditions for healthcare staff, and increase the administration and costs for the Swedish Migration Agency and the regions.

We think it is strange that the change is being pushed through despite the pointed out consequences. For us, it is central to ensure care that cannot wait, including dental care, to asylum seekers and undocumented people. Health is a human right.

Approval has already been proposed for reservation 1, but I also do so.

We welcome the new transitional rules that have been mentioned by other speakers regarding private dental providers. We consider this to be a positive part of the proposal.

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

Thomas Ragnarsson (M)

Madam Speaker! We are debating the committee report SoU40 Obligation to pay for dental care – new rules for certain foreigners, and I would like to begin by moving for the approval of the committee's proposal for a decision.

Madam Speaker! The Moderate-led government has implemented a historically large number of reforms during the mandate period, and the legislative work surrounding these reforms has been massive. When one implements large reforms, it also has an impact on surrounding legislation, and therefore it is natural that we make changes based on the reality that exists at the moment.

Madam Speaker! The bill entails new rules regarding dental care fees for certain foreigners, for example, applicants for international protection, foreigners held in detention, and foreigners who have received a decision of deportation but where enforcement could not be carried out. They shall pay reasonable compensation to Migrationsverket for dental care.

The proposal applies to persons over 18 years of age if there is an income or own assets.

Madam Speaker! For people who stay in the country on an improper basis in the form of non-executed agency decisions, or who are evading deportation or expulsion, dental care that cannot wait should not be subsidized. But where there is a need for dental care that cannot wait, the proposal is that this is handled by the regions' and municipalities' operations for financial assistance. In the bill, the government allocates 108 million to cover costs that arise and are shifted onto the regions and municipalities.

Madam Speaker! I think it is highly reasonable that one bears their own costs when it comes to dental care if one has an own income or own means. Nevertheless, it is reasonable that society helps those who have dental problems that cannot be postponed but who lack means. Two main principles that the municipalities work according to today – it is not uncommon that assistance is given to persons who need help with dental care – are that people should be able to chew food and that they should not feel pain. These are two very reasonable principles.

Madam Speaker! The bill also contains a section on the licensing requirement for private dental providers. When the licensing requirement was introduced, there was a transitional rule which meant that actors who had started their operations before January 1, 2026, would have submitted an application before March 2, 2026, which some missed.

These operations are now granted permission to continue provided that an application is submitted before January 1, 2027. This means that these clinics may continue to conduct their operations even in the future without an approved permit from Ivo, but this obviously does not apply to operations that have received a rejection of a previous application and where the rejection has become legally binding.

Madam Speaker! There is no one in this chamber who is satisfied that legislative proposals aimed at ensuring quality and that operations are conducted in a serious manner should be prevented from conducting their operations because the licensing authority does not handle the cases sufficiently quickly. Ivo's mandate and workload have changed radically during this parliamentary term. At the same time, funds have been added to the authority to fulfill the mandate. Unfortunately, the transition work has not proceeded sufficiently quickly.

I know that the authority is working very hard with the transition work to catch up with the handling of incoming cases. The change does not solve all problems, but it is a very important step in the right direction – especially for those actors who have been caught in the crossfire due to the current transitional rules.

Finally, as the last speaker this evening – hopefully – I want to thank our fantastic civil servants, our speakers, and an incredibly pleasant committee. It is a bit of a sad day that four members of the committee are to leave us.

The person who has stood closest to me is, of course, Malin, my party colleague. We have had fantastic fun together these four years, and she is an incredible human being. She is well-read, and she drives the entire party forward in the issues. She has been an incredible force.

Maj has left the chamber for the day. Maj and I have talked about all sorts of things. Politically speaking, we are great opponents. We are rarely in agreement politically, but we have had many conversations about all sorts of things. She is an incredibly empathetic person, whom I will also miss.

There is another Left Party member, namely Karin. She is perhaps the opposite of Maj. She is incredibly sharp in the speaker's chair. One always knows that when Karin requests the floor, it will not be easy. She is rock-hard, sticks to her line, and you can feel yourself being squeezed in the speaker's chair when you try to respond. But when one leaves the speaker's chair and takes Karin by the hand, she usually whispers: "That was fun!" She does it with a twinkle in her eye. Politically, Karin and I are basically never ever in agreement, and we probably won't be, but outside of the debate she is a wonderfully pleasant person, incredibly fun to talk to – and spirited for her age, one can truly say!

Last but not least, Anna! She does not speak much. She is a bit quiet, but she is incredibly well-prepared. She is the person in the room who sits and analyzes the rest of us. She is thoughtful with incredibly wise contributions in the committee, and she always has a soft and friendly tone. Regardless of whether she is happy, angry, or upset, she has a tone of voice that creates a calm in the room.

You will be missed in our committee, and I truly hope that you have experienced that we have had four really good years in the committee together thanks to our chairman Christian. He has held the committee together in a good way.

The most important thing for me when it comes to politics is that we should disagree in politics. That is what democracy is, meaning that there is an opposition. But we must distinguish between politics and the person, and I think we do that in a good way in the Social Affairs Committee. Thank you very much!

(Applause)

(THIRD DEPUTY SPEAKER: I have noted that there have been many thanks during the day. Members who are to leave the Riksdag have previously, in connection with the conclusion, received a thank you from the Speaker and the entire chamber.)

The deliberation was hereby concluded.

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

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