Response to interpellation 2022/23:128 on increased knowledge of racism in healthcare and elderly care
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The debate concerned increased knowledge about racism in healthcare and care. L argues that the government takes racism seriously and that education should be based on a scientific foundation 1. L emphasizes that there is a broad political consensus that knowledge about racism should be included in degree descriptions for licensed professions 2 and that educational institutions must improve the training to counter discrimination 3. L considers it too early to discuss earmarked funds for research on racism in maternity care 1 and that there is more to be done to achieve equal treatment 4. MP argues that racism risks people's lives and that special measures and equality data are needed 5. MP considers that clearer measures are needed to handle students' perceptions and to provide continuing education for existing staff 5. MP emphasizes that structural racism must be made visible and addressed 6.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Utbildningsministern Mats Persson (L)
Madam Speaker! Annika Hirvonen has asked me if I will work to introduce education on racism as a mandatory component in health and social care education. She has also asked if I will work to earmark money for research on racism in maternity care in the next research bill.
I would like to begin by emphasizing that the government takes the issue of racism within healthcare seriously. Everyone in Sweden should be able to feel secure that public activities, such as healthcare, have the knowledge required to be able to provide high-quality and equal care.
The healthcare and care education programs at universities and colleges shall be based on a scientific foundation as well as proven experience. This naturally excludes assessments based on racist notions. I assume that the colleges that train the future's healthcare personnel have noted the issues mentioned by the interpellor and ensure that their educations provide students with the tools required so that everyone receives patient-safe care with ethical and professional treatment at the center. This is already included today in the degree descriptions concerned.
The question, of course, does not only concern those who are studying. It also concerns those who are already active in healthcare, and there, the employers have an important role to play. The Government therefore continues to provide support to the Socialstyrelsen's work in producing, developing, and disseminating knowledge support to counter the occurrence of racism, promote everyone's equal rights and opportunities within healthcare, and contribute to equitable care. The assignment is one of several interventions within the framework of the national plan against racism and similar forms of hostility and hate crimes and the action programs that complement this. An important part of the work involves ensuring that knowledge about racism and similar forms of hostility is made available and used by various actors.
The interpellator also asks whether I will work to earmark funds for research on racism in maternity care in the next research bill. I think it is still too early to comment on the content of the upcoming research bill.
In conclusion, I want to emphasize that I share Annika Hirvonen's view that racism is unacceptable and should not occur anywhere in our society – least of all in health and medical care, where patients should feel safe.
Annika Hirvonen (MP)
Madam Speaker! In a debate article in Expressen last autumn, 18 representatives from healthcare and various human rights organizations write about how racism puts women's and children's health at risk in maternity and obstetric care, how perceptions of differences between black and white skin lead to different pain relief being given to children of different skin colors, and how undervaluation of symptoms, delayed care, denial of necessary treatment, and harsh handling as well as unpleasant treatment affect patients who are racialized in healthcare.
In the extreme case, racism in healthcare leads to people's lives being risked. One such case is the man who, instead of receiving acute care, was dismissed with reference to something called cultural fainting.
It is obvious that there are racist perceptions that affect the care that people receive. Even though it should be obvious to everyone that healthcare should only be provided on a scientific basis and not at all be influenced by racist perceptions, it is obvious that it still happens. In that case, the government has a responsibility to act.
We in Miljöpartiet made the decision on the national plan against racism and similar forms of hostility and hate crimes during our time in government. It is important that that work continues, but special measures for healthcare are also needed. It needs to be a prioritized area.
Knowledge and competence are central. In several contexts, I have highlighted the need for knowledge about racism itself and so-called equality data to clearly show differences in how people are treated. I want to ask the Minister for Education if he sees a value in producing equality data so that, in the same way we have worked systematically for equality between women and men based on gender-disaggregated data, we can do the same regarding racism.
I think it is good that the Minister for Education takes a clear stand against racism, but I am not satisfied that the Minister assumes that racism is something that is addressed and not passed on in the education. What we see in healthcare is that racist perceptions occur, and in that regard, I mean that it is not enough to assume that the education has handled this sufficiently well. I believe, on the contrary, that clearer measures are needed that also address any racist perceptions that students bring with them when they come to their education, and I am convinced that measures are also needed to provide continuing education for the staff who are already active today. I wonder if Mats Persson is prepared to do more to make that a reality.
Utbildningsministern Mats Persson (L)
Madam Speaker! I want to begin by saying that I share Annika Hirvonen's commitment to this important issue. That one is met with respect in healthcare and that we treat all people based on all people's equal value is, of course, an important starting point for all the politics we conduct but also for all public practice. It should apply in the world of school, within healthcare, and everywhere. It is important.
It is also important that people who have come to Sweden feel that society's heroes – nurses, doctors and nursing assistants – meet them with respect based on all people's equal value. One cannot overstate how important it is for a society that holds together and for a society where people feel that democracy works and that the state is the trust-building actor that we all want it to be.
There are few things as important in a society as trust, and there are few things as important for creating trust as that the citizens, in their encounter with the state and the state's practitioners - whether it is with the school, with healthcare or with the police - feel that there is equal treatment and that society is not corrupt or makes distinctions between people.
This is very important, and given that it is so important, the policy in broad political agreement has decided that it should be clear in the education one undergoes in Sweden when one enters a professional occupation in state service or in the public service. One shall then receive knowledge about racism, about the occurrence of structures and norms, and about the importance of equal treatment and of standing up for all people's equal value.
This is therefore included in the degree descriptions for all regulated professions within healthcare. It is about students during the education showing that they can take ethical aspects into account and that they consider human rights. This is very important. The fact that this is included in the degree descriptions is an expression that the politics broadly in Sweden agree that this is important and that we want it to permeate our educations.
How does it work then? It is difficult for us in the Swedish Riksdag to know exactly how it works in the education programs. We have chosen to let our expert authority, the Swedish Council for Higher Education, map out 188 education programs with regard to human rights. Their assessment is that the education and teaching on this in general works well.
Did this mean that we are immune to the occurrence of discrimination, hidden structures, or racism in healthcare? No, I do not think so. I believe that we, despite the fact that the trainings work, are not immune, but this can occur, which is of course very serious. It means that we constantly need to ensure that the trainings are improved and that we constantly pursue a broad and deep dialogue on how this should be improved.
Madam Speaker! Lastly, I would like to thank Annika Hirvonen for the commitment the member has in this matter. I hope that we together, in as broad political agreement as is possible, can continue to work on this issue. Questions regarding human rights and racism are important to talk about, and it is important that we do something about this and jointly do everything we can.
Annika Hirvonen (MP)
Madam Speaker! I thank you for the answers. It is clear that Mats Persson admits that this is a pressing problem. What is not as clear is whether the Minister for Education will take any further measures or if he considers that the mapping that has been carried out shows that it is sufficiently good today in the training for healthcare professions.
Then we have the question that the Minister for Education himself was touching upon, that it is difficult to know how it works and what it looks like. There are many descriptions, anecdotes, and individual cases of discrimination that show that there is racism within health and medical care. What is missing in Sweden is systematic knowledge at a structural level. Therefore, not only do we in Miljöpartiet, but also the EU and the UN, believe that Sweden would need to introduce some form of equality data, based on voluntariness, anonymity, and self-identification, which on a structural level can make visible what the racism looks like.
I have myself, just as the Liberals as a party, worked with equality policy for a long time and seen how central the gender-disaggregated statistics have been to achieve success - so that different descriptions of lack of equality or the perception that wages are unequal etcetera cannot be brushed aside. If it is clearly established what the situation looks like, it becomes easier to reach an agreement, in politics and with authorities and managers throughout the public sector. One has a common problem picture and can act based on it.
Therefore, I want to ask the Minister for Education if he will take the initiative so that equality data can be developed. I believe that the universities and colleges here could play a completely central role in developing good methods. Since equality data that makes racism visible would need to differ from the gender-disaggregated statistics, which are based on personal identity number data, it is required that one carefully considers and weighs in how voluntariness, self-identification, and anonymity can both be ensured and affect equality data and results. Does the Minister for Education intend to take the initiative so that we get equality data?
Utbildningsministern Mats Persson (L)
Madam Speaker! Thank you for the contribution, Member Hirvonen! I believe it is very important that we focus on how the content of our educations, in this case in the healthcare sector, can be improved and how we can ensure that work is constantly being done to develop the educations and ensure that they become better at capturing issues regarding human rights.
Now, the state's expert agency UKÄ has conducted a review of very many educations and concluded that this basically works well. But as I said in my previous post, this does not mean that we can swear that there is no discrimination, racism, or unequal treatment in healthcare. It may very well occur, and it is important that we have an awareness of that.
I also believe that it is important to constantly let the programs at the educational institutions work with these issues, so that one is constantly working to improve, refine, and develop the programs to go even further – that one does not act as if everything is already solved and everything is perfect. That is not the case, but there are constantly things to improve in this.
I think there is a great strength in the fact that there are degree objectives that have been developed together with expertise, interest organizations, and other authorities, and that interest organizations have been listened to in order to capture views and develop the degree objectives as much as possible. This then has an effect in the next stage on how the programs are designed.
I think, therefore, that it is important that there is a high level of awareness about this out in the educational institutions. From the political side, it is important that we point out that we have a high expectation in this area. There must not be any racism or discrimination in healthcare, and an important part of succeeding with this is that our educations function and address these types of issues and provide our nurses, doctors, and psychologists with the right tools. Since these are regulated professions, there is an opportunity to link the degree objectives to the license. One does not become a nurse if one has not completed such an education; there is no possibility of bypassing this. I think that is a great strength.
But, as I said, it is also important that one constantly improves and refines this, and I foresee that this will take place at the educational institutions. We are following this very closely.
Annika Hirvonen (MP)
Madam Speaker! It is unacceptable that people in Swedish healthcare are treated differently based on skin color. It is unacceptable that people die as a result of racist notions among healthcare staff. It is a completely central task for society to ensure that structural racism is made visible and addressed.
I am very pleased that the government will continue to work with the national plan against racism and similar forms of hostility and hate crimes that we in Miljöpartiet launched during our time in government. I expect that there will be more measures—that racism in society is made visible through initiatives such as equality data and research initiatives, and that we both provide continuing education for existing staff and ensure that those who are to work in health and medical care in the future have knowledge of how racist perceptions affect the care people receive.
This is a vital issue. It is a question of human rights and of access to equal care.
Utbildningsministern Mats Persson (L)
Madam Speaker and Annika Hirvonen! I hope that we together in the Riksdag can work more deeply and in a constructive spirit to improve these areas. It is important that people feel trust in their encounter with healthcare, that there is no racism or discrimination, and that equal treatment prevails. I am convinced that there is more to be done in this area to go all the way, and I look forward to, in a constructive spirit together with other parties here in the Riksdag, taking these issues further and forward.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.