Response to interpellation 2022/23:108 on the conditions for the welfare state

Statsrådet Erik Slottner (KD)

Madam Speaker! Eva Lindh has asked the Minister for Finance what measures she intends to take to ensure that municipalities and regions have sufficient economic conditions to meet their welfare commitments. The work within the government is distributed in such a way that it is I who shall answer the interpellation.

Sweden is in a situation where the finances of households, companies, and the municipal sector are being pressured heavily. In view of the economic situation and the high inflation, the direction of the budget is slightly contractionary. Fiscal policy needs to be well-balanced to bring down inflation and to manage the economic downturn. By following the fiscal framework, it is ensured that there is room for maneuver in a deteriorated economic situation. The Government tests all reform proposals against the economic space and the fiscal framework. Order and discipline in the public finances is a priority task.

Eva Lindh claims that the budget presented by the government and the Sweden Democrats does not involve any increased state subsidies to welfare and that this means that welfare risks deteriorating. This is not true. In the budget bill for 2023, approximately one-third of the reform space is invested in the municipal sector.

The general state grant is increased by 6 billion SEK from this year onwards, in comparison with the level that was previously announced. In 2021 and 2022, there was a temporary increase of the general state grant of 10 and 5 billion SEK respectively. The temporary increase was a way to alleviate the effects of the pandemic and was never intended as a permanent increase of the general state grant. Furthermore, the government allocates around 6 billion SEK in targeted state grants for 2023, including 2 billion SEK to the regions for a performance-based compensation in order to increase the number of healthcare beds, as well as an increased investment in maternity care and women's health with 1.7 billion SEK.

I am aware that municipalities and regions, despite the funds that the government and the Sweden Democrats are now providing in different ways, still face an economically challenging period in the coming years. How municipalities and regions can manage economic turbulence and at the same time work towards a long-term sustainable economy is discussed continuously in the government but also in municipalities and regions. The question is difficult and important. A combination of measures will be needed to safeguard and strengthen the welfare.

More money will not solve all the problems that the municipal sector faces. Municipalities and regions need to continue to work innovatively, streamline their operations, and develop them according to new conditions. Not least, there is a potential in new digital solutions. The state has a responsibility to provide the best possible conditions for this.

The uncertain economic situation means that there is a risk that the economic downturn will be deeper than according to the forecast in the budget bill for 2023. The Government is therefore following the development very closely.

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Eva Lindh (S)

Madam Speaker! The Swedish welfare state is there when we are most vulnerable. Our welfare protects, redistributes power and creates equality and opportunities for a more egalitarian society.

I feel truly proud of the Swedish welfare state. Social Democracy is the champion of the welfare state. We built up the Swedish welfare model, and we will continue to defend and develop it.

A functioning welfare state is the core of a strong society. It is about so many important things, things that are serious and significant for all of us and for our loved ones: that all children should have a good school, that we receive care based on need, and the security of receiving good care in the autumn of life. That is why we also react so strongly when we see deficiencies in the welfare state.

The need for and the importance of a strong welfare state became clear during the pandemic. To safeguard it and meet the challenges of the pandemic, it was important for the Social Democratic-led government to compensate municipalities and regions for the increased costs. During the pandemic, we therefore allocated three times as much to the welfare state as the estimated tax loss in the form of general grants. Economic resources were also added to increase capacity in health and medical care, including by increasing the number of care beds, hiring more people in healthcare, and improving the working environment.

Now, welfare faces new challenges and tough economic times - and with a government that does not prioritize welfare with sufficient resources. At the same time, the number of elderly has increased, which has also increased the needs within healthcare and elderly care. Investments in buildings and infrastructure are also needed, and this costs money for both municipalities and regions. That was also why we Social Democrats added twice as many resources in the budget proposal we submitted in the autumn compared to the one that the government, with the support of the Sverigedemokraterna, submitted.

It is concerning that there are not sufficient resources for the welfare system. It risks worsening the welfare but also worsening the conditions for the staff. They risk being laid off. The staff is the backbone of the Swedish welfare system. Without staff, there is no welfare. Therefore, I return and ask the question again: Will the government change its mind and send more resources—the resources that municipalities and regions need to manage the welfare?

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Adnan Dibrani (S)

Madam Speaker! I want to start by thanking the Minister for being here. But I am now going to say something that many perhaps do not think one as a Social Democrat would say here, namely that I miss the Moderate Finance Minister. I appreciate her! We have sat together for many years in the Finance Committee. When we are to debate such an important issue as the funding of the welfare system, I had hoped that she would be present. But I understand that within the government, different divisions of labor have occurred which mean that the Civil Minister is the one who is to answer.

For us Social Democrats, a functioning welfare state is the core of a strong society. It concerns so many important issues that are significant for us: security, good elderly care, ensuring that people receive equal healthcare, a good school, and good conditions to succeed in life. Therefore, it is always important for us to prioritize welfare, and we have done so in every given situation where we have presented a budget.

In the latest budget, which the new government presented, they invested very many billions in lowering the tax for the very richest. Double as much of the reform space, one could argue, was invested in lowered tax instead of on municipalities and regions. We invested double as much in ensuring that municipalities and regions have the resources they need. They need even more than what we presented, but it was a good start.

I have become stuck on a sentence in the minister's response where he says that the municipalities will not solve all problems just by receiving money. One might agree with that, but my question to the minister is: What does that say to the staff who are currently on their knees out there? Is the answer that they should work more innovatively?

Let me zoom out from this: Many times when one is to find new ways of working to manage the economy and other things and become more productive, one usually submits more funds until the new ways take hold and one can reap the rewards, if we are to speak in those terms. But here, one has not submitted new funds but rather underfunded the entire system. The answer from the minister is that money will not solve this, but that the one who works more efficiently and more innovatively will be able to handle this.

I feel sorry for the staff out there, and I give the Minister for Civil Affairs the opportunity to answer those who are currently on their knees: Does the Minister think that there are sufficient resources and that they need to work more efficiently, or will more funds be provided in the future?

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Statsrådet Erik Slottner (KD)

Madam Speaker! I truly agree with the warm, committed words that have just been uttered here regarding welfare. The Christian Democrats are a welfare party. This is what makes many people drawn to the Christian Democrats. There is an enormous commitment to elderly care, LSS and healthcare. This is what constitutes the selling point, as it is sometimes said, for the Christian Democrats, which is a conservative party with a strong social voice.

During the previous parliamentary term - when I was the elderly care councillor in the city of Stockholm - in the capital, I myself was involved in providing historically large appropriations to specifically elderly care. I therefore know what it means to be engaged in the welfare system and to prioritize the welfare system. That is why the government is providing a large supplement to the municipal sector and the welfare system, and that is why we choose to allocate a third of the reform space to both increased general state grants and targeted state grants to municipalities and regions - precisely to secure the core of the welfare system.

The state subsidy of approximately 4 billion kronor that was used to strengthen elderly care during the pandemic, and which the Christian Democrats and the Moderates pushed through in the Committee on Finance during the previous parliamentary term, is now permanent and will remain in the future. This is important.

The increased appropriations to municipalities and regions that were granted during the pandemic were something we were completely in agreement on in the Riksdag, and the Christian Democrats were a very active party here in getting through increased appropriations for welfare during the pandemic. But we also said collectively that the appropriations were precisely pandemic appropriations. They were temporary appropriations to municipalities and regions to manage to maintain welfare in a very strained time. According to the plan, the extra contributions were to be phased out, both in the Social Democratic government's budget then and in the budget that we are presenting now.

Compared to the appropriations that would have been granted next year, we are now increasing the appropriations by approximately 12 billion kronor in general and targeted government grants to municipalities and regions, which constitutes approximately one-third of the total reform space.

We in the government are, of course, prepared to return with increased resources if we see that needs arise. We are following the developments in the municipal sector very closely to see what the needs look like moving forward. If one looks at the 2023 budget in the municipalities, one can see that five municipalities have chosen to raise the tax and that seven municipalities have chosen to lower the tax. In principle, almost all municipalities are letting the tax remain unchanged during 2023, and that is an indicator that the municipal sector makes the assessment that they, with the supplements now being provided, will manage to keep an economy in balance.

The municipalities have over the years built up so-called result equalization reserves, and there now lie approximately 40 billion kronor that can be used to offset the recession that we are expected to enter. I think it is wise management from the municipalities to build up such reserves that can be used as a kind of airbag when we now enter poorer economic times. Then the municipal sector becomes less dependent on the state constantly offsetting poorer economic times with increased state grants. It becomes a greater long-term perspective.

Dibrani asked some questions that I will have to return to in my next contribution, as I see that the speaking time has ended. But I want to summarize by saying that the government is very committed to the welfare issue. The Christian Democrats are a welfare party, and that is why it is no coincidence that we are often given responsibility for precisely the welfare issues, both in the government as well as in municipalities and regions.

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Eva Lindh (S)

Madam Speaker! It has been estimated that the Christian Democrats often express a commitment to the welfare state and to the important Swedish welfare model, but what matters is what happens and what one does. Commitment must be transformed into action.

Politics makes a difference. When we Social Democrats led the government, 100,000 more people were employed in the welfare sector. It makes a difference when one reprioritizes and turns their commitment into strength and action. What we see now is that half of the municipalities and 17 of 21 regions expect to run a deficit during the year. They may not be raising taxes or planning to do so because they know that the challenges during the coming year 2024 will be even greater.

We are concerned, and have reason to be concerned, about the development of the welfare in the future. What municipalities and regions face now is that they receive insufficient resources and do not receive more this year than they received previously. In addition to this comes the high inflation, and this, together with the higher interest rates, hits them just as it hits all of us in the entire society. This means even greater costs and expenses beyond what they already had previously, i.e., that which we saw before. It is clear that this is concerning.

I was a municipal councillor in Linköping the last time the bourgeois government ruled. I recognize this. The government at that time chose to lower taxes instead of increasing the state grants to the municipalities. Then we saw that the employees paid the price and that the welfare cracked. Now history is repeating itself, and we are worried that exactly this will happen once again.

We have heard several times that money is not everything, but staff must be able to be hired. For this, resources are needed. More staff are required in the welfare sector. It is about, just to take an example, that more and more people are getting older, which is very good. The Swedish welfare has ensured that we live longer and have better health. But people are getting older and need elderly care, and then staff must be hired within elderly care. More colleagues are needed there who can help to provide the good care that we want to be able to manage to provide. The staff also need to have a good working environment where they enjoy themselves and can devote themselves to the right things and where they choose to stay.

As said: Money matters. Politics makes a difference. When healthcare, schools, and elderly care do not receive sufficient resources, it means cuts in the welfare system. I am still waiting for the commitment that the Kristdemokraterna often show for welfare to make a difference in the budget and in the priorities moving forward.

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Adnan Dibrani (S)

Madam Speaker! As the interpellator Eva Lindh mentioned, during the years we have governed, we have had over 100,000 more in welfare. That is because we have invested in our municipalities and regions - record-breaking investments that they have truly appreciated.

The Minister mentioned in his answer that the municipalities have an airbag through the result equalization reserve. We should be happy about that. They have it because the Social Democratic-led government invested enormous sums that the municipalities and regions have been able to save to use when times are a bit tougher. This has nothing to do with the current government.

My concern concerns both the future and the time we are living in now. I asked the minister what it means to work more innovatively and efficiently and why more money does not need to be added to the municipal sector.

I will add two things to highlight the problem here and now. Today, we have municipalities where they cut back on fruit snacks for small children or cut back on an egg for the children. One can wonder what this results in, but it is what they need to do to try to achieve balance in the finances. In that situation, they are told that they do not need more money and that they must work more efficiently.

What am I supposed to answer, according to the minister, to the children who right now think it is quite difficult not to get fruit, eggs, or whatever it may be? But, above all, what am I supposed to answer to the staff who think it is incredibly difficult to say no to the children? In these economically harsh times, this may be the only fruit the children get because they are having a tough time at home.

Here and now we have concerns. The economy is extremely difficult in our municipalities, and I would have wished that the minister had answered. He might do so in his next contribution by saying that we need more resources. That does not mean that one does not need to work efficiently. But more resources are needed.

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

Statsrådet Erik Slottner (KD)

Madam Speaker! I share the assessment that more money is needed for welfare and that more money is needed for municipalities and regions. That is also why the government is providing more resources and allocating a third of our reform space specifically to the municipal sector. I really want to get this said. Because a different picture is being presented by my Social Democratic opponents during this debate.

I am also worried about the future. I have several times in this speaker's chair said that I also feel a concern for the municipal sector's future challenges in maintaining the welfare, perhaps not primarily for the economy, as I believe we will solve that together because Sweden has strong public finances. And we have presented a responsible budget so that we will be able to meet needs that may arise. But I feel a great concern for the skills shortage and skills supply and for the fact that the need for new labor is increasing so much, as well as how we are to get young people to want to educate themselves within these sectors. It is perhaps the greatest challenge that the municipalities face.

Then I want to say to Eva Lindh that the Alliance's resources to the municipal sector increased. The municipalities had a good economy during the Alliance years. The municipal sector's economy increased, not primarily due to increased state grants but because the economy grew, because more people entered employment and because the tax base for the municipalities grew. The most important conditions for the municipalities are that the tax base increases, that the number of hours worked becomes larger and that sick leaves decrease. These are important issues for the municipalities, and this happened precisely during the Alliance years.

The Social Democrats are welcome to tell the nursing assistants in elderly care that the job tax credit, which gave him or her approximately 1,500 SEK more per month to move around with, would never have been introduced. I do not think the nursing assistants will really appreciate such a message. And the Social Democrats have not proposed in their budgets that any of the five job tax credits that the previous Alliance government introduced should be removed. I still think it is interesting given the rhetoric being put forward here.

Money plays a major role - this government also shows that - but it does not play all the role. I think it is important to say that sometimes. If one thinks that the challenges facing the municipal sector in the future can be solved solely with increased state grants, and especially if one simplifies this, I think one is misleading the citizens. Working more efficiently is not about running faster in the corridors and giving fewer hugs, as is sometimes said. But it can involve digitalization.

I sometimes return to my time as a senior citizen councillor, and I think one sometimes gets to refer to what one has done in previous assignments. We tried then to use digital tools to free up time within elderly care. It could be about such simple things as, instead of trained staff going to the grocery store to buy food, one could, for example, make online orders for food. That having digital keys instead of physical keys saved a lot of time within elderly care. Not letting trained nursing assistants clean or iron but letting other professional groups do it is a way to make the operations both more efficient and more optimized.

Getting more people to work full-time is another important issue to meet the competence supply moving forward and create a better working environment. Getting people to work longer, to have the strength and desire to work longer, is also another way to enable municipalities and regions to be able to handle the challenge of staff shortages moving forward.

There are, therefore, many other issues that we must also be able to discuss. I think it becomes too narrow if we only discuss whether a state grant in a single year should increase by 6 or 12 billion kronor. The debate becomes poor. We need to go deeper than that to truly manage the challenges of the welfare system.

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

Eva Lindh (S)

Madam Speaker! Let me begin where the Minister for Civil Affairs finished. We see that there are major competence shortages. There is a lack of staff within a long line of professional groups within the welfare sector. If there is no staff to hire, we must, of course, act to remedy that. What worries me even more is if there are no resources, training places, or elderly care initiatives, which have actually worked. There are some this year, but there are none in the budget for coming years. Then it is an even greater problem. We therefore need resources, and we also need to prepare for the staff shortage that will come and that already exists today.

It can absolutely make a difference with digitalizations, but it does not make all the difference. It is not the big thing. I have worked in elderly care. I know therefore that even if one were to facilitate the conditions for elderly care through digitalization, it is a lot of time and effort that we both shall and should spend sitting and holding that hand and providing the care that is needed.

We Social Democrats want to double the investments in welfare because we know that resources matter. Welfare matters both for our loved ones and because it creates the conditions for an equal society, a society that holds together, and a Sweden where the whole country shall live and grow. It requires resources. That is why we become concerned when we see that there are not sufficient resources for welfare moving forward.

I thank the Minister for Civil Affairs for the debate and for that we can stand here today, not to talk about but at least to debate the issue.

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Statsrådet Erik Slottner (KD)

Madam Speaker! I also want to thank Eva Lindh and Adnan Dibrani for this debate, which I think has been good. It is impossible to miss the commitment that nonetheless exists for the welfare, which I think is very good. I am pleased that as many parties as possible are truly considering how we can strengthen the welfare moving forward and how people who need society's support in different phases of life can truly receive care and the warmth that everyone who works with welfare provides to both children and the elderly, but also to people who, in the middle of life, need the welfare.

I want to say again, as I have done in all posts so far, that it is for that reason that this government is allocating more money in state grants to municipalities and regions, both increased general state grants and targeted state grants.

Within the Ministry of Social Affairs, where the Christian Democrat Jakob Forssmed is head of the department, several targeted state grants have been introduced, among others, to break involuntary loneliness, for more care beds within healthcare, for strengthened maternity care, and for women's healthcare. And many other initiatives have been made. I therefore think that very much is being done.

Eva Lindh pointed to Äldreomsorgslyftet, which I think has been a very good initiative, even though for various reasons it has been difficult to spend all the money in the different municipalities. Linköping, moreover, was one of the municipalities that was featured in a segment on SVT a few years ago and which had major problems spending the money. It was a three-year initiative. It was planned to be phased out even by the previous government. How we proceed with the elderly care initiatives and other competence development initiatives when their time expires, the government will have to return to in the next budget. We had very little time to present a budget – from the time this government took office until it was to present a budget bill to the Riksdag.

Exactly how we continue to fulfill these initiatives we will have to return to. But competence supply and vocational training will be absolutely crucial to meet the challenges of the welfare system ahead.

The interpellation debate was hereby concluded.

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