Response to interpellation 2022/23:176 on the need for more training places for dentists
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The debate concerns the need for more training places for dentists and competence supply within healthcare. L emphasizes that competence supply is a high-priority issue and that the government has high ambitions for adult education 1. L argues that cooperation between educational institutions and healthcare is important 2, that the pandemic's temporary measures have expired 2, and that a mandate exists to solve problems that S has left behind 3. S argues that the government lacks insight and solutions for the competence shortage 4 and is conducting a policy of cuts 5. S wants to invest offensively in education policy 5 and emphasizes the need for a reasonable working situation for dentists 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)
Mr. Speaker! Carina Ödebrink has asked me what initiatives I am prepared to take to improve access to dentists in the future.
The Government is aware of the major challenges regarding skills supply that exist in many areas, and not least within health and medical care. The Government takes part, among other things, in the work carried out at the National Healthcare Skills Council, which is an advisory body with representatives from regions, municipalities, educational institutions, the National Board of Health and Welfare, and the Swedish Council for Higher Education, UKÄ. The Council shall contribute to good planning of the healthcare sector's skills supply. This shall, among other things, occur by supporting and achieving cooperation in skills supply issues at national and regional levels. We follow and will continue to follow the National Healthcare Skills Council's annual reports with great interest.
The interpellor mentions the Foundation Högskolan i Jönköping's application for permission to issue dental degrees, which was submitted in March 2022. The Office of the Chancellor of the Universities has been asked to comment on the application and submitted its response in December 2022. As the interpellor mentions, the authority proposed that the application should be rejected. The Government Offices is currently processing the matter.
Universities and colleges are responsible for the education of several of the healthcare professions. To ensure a good supply of dentists to the greatest possible extent, both high-quality education and that those who are educated choose to remain in the profession are required. That the healthcare's competence supply functions well is a high-priority issue for the government, and we intend to follow the development.
Carina Ödebrink (S)
Mr. Speaker! Thank you, Minister, for the answer! I perceive it as an honest attempt to provide an answer to my interpellation, but I will return to some follow-up questions.
A walk through central Stockholm might give the impression that it must be the residents of our royal capital who have the absolute worst dental health in the country, given how many dental clinics there are. But that is, of course, not the case. Instead, it is a matter of dental care establishing itself in a market in our larger cities with access to patients who also often have good purchasing power. Dental care is deregulated today, and there is a free right of establishment for it. But this deserves another and separate interpellation.
My question, instead, concerns the shortage of dentists that exists in large parts of Sweden today outside of our three major cities but also in the suburbs of our major cities. I want to start by thanking you for the answer, which I actually think is honestly intended.
Sweden is an international model when it comes to dental health and advanced dental care. Many young people, children and adults have never had caries, but just as in other contexts, there are also large socioeconomic differences when it comes to oral health. Furthermore, most elderly people today keep their teeth throughout their lives, and this places great demands on dental care but also on elderly care.
The shortage of dentists is a problem for being able to provide the population with high-quality dental care and preventive dental care, but also for maintaining a good working environment, developing modern methods of work, and providing opportunities for development in working life.
The Swedish Dental Association has for a long time reported that there is a shortage of dentists in 18 of Sweden's regions. According to SCB, more than 50 percent of employers state that there is a shortage of newly graduated dentists, while 80 percent say that there is a shortage of specialized dentists.
UKÄ notes that there will be a shortage of dentists in 15 years. Even if the number of dentists increases by 10 percent by then, the demand will also increase given that we have a growing population.
The Minister says in their response that the healthcare system's competence supply is a priority issue for the government and that they are following the work through the National Healthcare Competence Council. The Council shall contribute to good planning of the healthcare system's competence supply. This shall, among other things, occur through cooperation between national and regional levels.
The need for educational institutions to cooperate regarding the educational offering was highlighted in the government's Steering and Resource Investigation. I would therefore like to ask the Minister how he views the possibility of the academy, but also regions, cooperating to an increased extent when it comes to higher education and what ambitions the government has to steer in that direction.
Niklas Sigvardsson (S)
Mr. Speaker! I would like to begin by thanking the interpellator Carina Ödebrink for the initiative for this debate and also thank the Minister for Education for the answer.
The supply of skills, as was spoken about here earlier, is important within healthcare but also within many other sectors and is something that we must do something about here and now. I can think that the answer that Education Minister Mats Persson gives is a bit too defensive and lacks ambition to do something about the skills shortage.
The Minister chooses not to address to a sufficient extent the great shortage of competence when it comes to dentists, nurses, doctors and healthcare administrators. And it is only within healthcare. We can add the shortage of training places for engineers, game developers and teachers, to name just a few. The Government seems to completely lack insight into and solutions for this problem.
The EU Commission predicted as recently as yesterday that Sweden will have the worst growth of all EU countries, and analysts, including the government itself, fear that we are heading into a recession. In that case, the government, through the budget decided before the turn of the year, chooses to cut funding for adult education. This applies to municipal adult education but also to universities of applied sciences, colleges, and universities, which the interpellation concerns most. In total, it concerns 1.2 billion for adult education, of which approximately 200 million is for universities of applied sciences, colleges, and universities. That is why many of the empty answers to the interpellation are so worrying.
We cannot as a country back away from the future. If there is ever a time when it is truly appropriate to invest and commit to education, it is when we may be heading into a recession. Sweden must be strengthened as a knowledge nation. I have heard the Minister for Education speak about this in the chamber and hope that he also believes so. It will not secure the supply of skills if we back away from the future. It will not help Sweden's business sector in the green transition. And it will not make it so that we can feel secure about the availability of dentists in the future.
I would therefore like to ask the Minister for Education: Can he answer how the government intends to meet the challenges of shortages in many professional groups, such as dentists, in light of its budget cuts?
Utbildningsministern Mats Persson (L)
Mr. Speaker! I thank the interpellator and the other debaters for an important question. The shortage of competence within the welfare sector is not a new issue, but it is something that has been on the agenda for a long time and which it is important to address and meet.
I believe it is important to have better cooperation between universities and colleges and, in this case, healthcare. It can be about how one handles the work-based education so that it works better for the students and that one can thereby produce students who feel that there is a connection in the education to what professional and working life looks like.
I believe that we will need to have a clearer structure for how cooperation should look in the future, because the issues of skills supply are strategic for Sweden as a nation.
I think it is important to emphasize the importance of ensuring that we have quality in the education. One could have expanded the education with a stroke of a pen by admitting more students or expanding operations in more places in the country, but this must occur with maintained quality so that we are sure that the dentists who graduate hold the highest quality, so that we as patients and citizens can feel secure that we receive good care when we go to dental care.
Mr. Speaker! Dental care is an area that is very popular among the Swedish people. There are few areas within welfare that have as satisfied users as dental care, not least the private dentists, who in every measurement every year always score very high. This is something that we want to preserve and ensure. To ensure that the quality is good is something to stand up for.
I note that the Social Democrats want to give the impression that the government does not have high ambitions when it comes to the expansion of adult education. Nothing could be more incorrect. The government has high ambitions when it comes to ensuring that people, regardless of whether they are 15, 18, 20, 25, or 30 years old, have the opportunity to pursue an education and further their education and the opportunity to learn new things throughout their lives. It does not become any truer because the Social Democrats continue to stand and lie in the rostrum, but the government has very high ambitions when it comes to skills supply.
Mr. Speaker! Lastly, I would like to say something regarding places for dentists. This is something that we are following closely. Regarding the current issue linked to Jönköping, the educational institution there has the opportunity to have a dialogue with the expert authority, the Swedish Council for Higher Education. They have until the end of February. I therefore do not want to anticipate the discussions taking place there. Therefore, that issue is being prepared in the Government Offices.
Carina Ödebrink (S)
Mr. Speaker! Now it is Jönköping University College together with Linköping University that is behind the application. It is not so much about the location or that I should only see this from a Jönköping perspective, but it is actually about the fact that there is an acute shortage today of precisely dentists but also other dental care personnel around the country. This leads to an unsustainable situation.
The proposal to establish a new dental education is actually the first application in 50 years. And it is an important piece of the puzzle in addressing this shortage and achieving a better supply of competence.
Today, the dentistry program is available in four locations in the country - Malmö, Göteborg, Umeå and Stockholm - and over time the number of places at these educational institutions has been essentially constant.
Mr. Speaker! I think it is important to emphasize that it is, of course, the quality that determines all education. We shall not conduct any education that is of poor quality.
I do not go into the details of the assessment that UKÄ has now made. I see it more as a process. Should UKÄ say yes in the future, it will then become a question for the government directly as to how this shall be financed.
I see that the process is important because it extends over a fairly considerable period of time. It is part of the educational institution's work to create the best conditions for a high-quality education for the students, but also for the activities that receive part of the future workforce.
Jönköping University and Linköping University together with the Odontological Institution in Jönköping and Region Jönköpings län are those who have joined forces around this. It is a unique and modern education.
It should also be said that, at the current time, a letter of intent has been signed with 13 of the country's regions that have problems. This education is intended to be very close to the clinical reality. Should this move forward, which I am convinced it will, they will correspond more closely to 4 million of Sweden's population who, at the current time, have said that they are prepared to enter into this cooperation.
The concept behind this arrangement is borrowed from Norway, from Tromsø, where it has been observed that students often choose to stay in the region where they have completed their internship.
An additional advantage is that the clinics receive a share of and a close connection to a clinical operation. And the academy gets close to the practical reality. It is therefore a new and exciting concept.
I would like to ask the minister one further question. He spoke about the need for a clearer structure moving forward. But it is not enough to follow the development. One must also be involved in driving the development and changing the future if we are to reach this goal. I would therefore like to hear some additional concrete thoughts.
Niklas Sigvardsson (S)
Mr. Speaker! We Social Democrats will continue to describe the government's policy as a policy of cuts when it actually is.
In the budget proposal under Expenditure Area 16, which concerns this area, we can clearly read on page 13 that the state support, i.e., 1:19, for vocational college educations is actually reduced by 104 million kronor. We can go through institution by institution and add up 81 million kronor for colleges and universities. I have not spoken about municipal adult education and the like, given that this interpellation is primarily about dentists.
To stand and say that we Social Democrats are lying at this rostrum when we are actually pointing out what the government has presented in its budget bill and what this Riksdag actually decided in December, I think is a bit of a stretch.
What we Social Democrats want instead is to invest offensively in education policy in these times. We want more people to be given the opportunity for an education so that the skills supply can be met in our entire country, but also in health and medical care, which is what we are talking about here and now.
I must ask the Minister for Education to answer whether what I read from the budget bill is correct, because I am being accused of lying in this rostrum.
Utbildningsministern Mats Persson (L)
Mr. Speaker! It is not true that this government has low ambitions when it comes to education, adult education, and when it comes to ensuring that people can educate themselves in the middle of life.
The Social Democrats and this chamber decided on a number of temporary measures during the pandemic. These measures have now disappeared because the pandemic is over. As far as I know, we do not have a pandemic. And as far as I know, the Public Health Agency does not consider that we have a pandemic. Then these various temporary measures expired, and they have therefore not been extended either. That was also the intention.
When it comes to the dental education and the shortage of dentists, I think it is an important discussion that we have right now. It is a good initiative that we discuss these types of questions. I believe it is good that different types of local initiatives come from below and that different initiatives are taken to try to manage this shortage. I also believe that good cooperation will be needed between educational institutions and, in this case, health and medical care to ensure that there are good competencies.
It is also important that we have an order where politicians in the Riksdag are cautious about overriding or interfering with the assessments of expert agencies. I believe it is important that we have an order where we have expert agencies that assess what is reasonable and whether there is sufficient quality in an education when a higher education institution applies to receive the right to grant degrees or to be given the opportunity to start an education. I believe, in fact, that it is better for experts and professionals to judge it than for us in the Riksdag to overrule the expert agencies and the assessments they make.
It is important that we in this situation have full focus on ensuring that we can secure the supply of skills and that we can achieve better cooperation between educational institutions, business organizations, and the healthcare and the education sector as a whole. I believe that is the way forward to get closer.
Carina Ödebrink (S)
Mr. Speaker! I would like to take this opportunity to thank you for the debate. I appreciate that we are having it. Had I intended to, I would have brought a small piece of material that I could hand over. But there may be more interpellation debates in the future on this subject.
I really want to say that I agree. We shall not compromise on either quality or on a process where the politics must be present in the way it should be. Now we have a situation where this project application is being rejected for the second time. I am convinced that the work will continue and that, in the long run, it will be possible to start an education in Jönköping because the need exists. But it must rest on the structure we have, because that guarantees that it will be good in the long run. There are, therefore, no differences.
In conclusion, I would like to take the opportunity to say that, in addition to educating more dentists, it is important to ensure that there is a reasonable working situation for today's and tomorrow's dentists. There needs to be a balance between production and the opportunity for professional development in the profession. With a shortage of dentists, there is a risk that what must be done will end up being the priority. And it is, of course, clear that we must take care of the children and the urgent cases, but that risks reducing the space for this matter of professional development.
I know that thoughts have occurred in the discussion that one could lower the age limit for dental care for children and young people. I would like to ask the minister if this is something that has been up for discussion in the debate on enabling a more reasonable working situation. It would be devastating, however.
Utbildningsministern Mats Persson (L)
Mr. Speaker! I thank the interpellor and Niklas Sigvardsson. There were very dark clouds in the description of reality, especially from Niklas Sigvardsson, and I share that picture.
It is a very vulnerable situation. The picture being painted of the skills supply in our country is bleak. And it is clear: After an eight-year Social Democratic government, there is now much to clean up. During the period 2014-2022, the Social Democrats governed Sweden, and we now see the consequences in a number of different areas - unfortunately also in this. I regret it. The voters did, however, vote for a new government, and we now have a mandate to tackle the problems that the Social Democrats have left behind. I look forward to doing that.
I think this has been a very pleasant debate. I thank Carina Ödebrink for a very relevant and important question. I hope and believe that the debate continues.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.