Response to interpellation 2022/23:194 on coordination associations and assistance for the sick to increase their work capacity
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
M believes that coordination unions are an important resource for strengthening people's ability to work 1 and that it is crucial for the economy and welfare to get more people into work 2. M argues that authorities should prioritize those on long-term sick leave and young people with disabilities 1, as well as that the cooperation between region, municipality, Försäkringskassan and Arbetsförmedlingen can become more efficient 3. M wants to evaluate the activities at an individual level 2 and that people should be able to pause certain things without losing the compensation entirely during studies 3. S believes that the coordination unions' activities are extremely important for people without employers 4 and that welfare should be equal 4. S argues that there must be systems to follow individuals over time 5. S argues that the government prioritizes tax cuts for high-income earners over investing in welfare and a robust reporting system 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.
Statsrådet Anna Tenje (M)
Madam Speaker! Åsa Eriksson has asked me whether I and the government intend to take measures to strengthen the coordination associations' opportunities to help more sick individuals increase their work capacity.
For persons who have a need for coordinated rehabilitation interventions, it is possible for Försäkringskassan, Arbetsförmedlingen, regions and municipalities to finance such interventions through coordination associations, Finsam. At the end of 2021, there were 76 coordination associations which included 272 of Sweden's 290 municipalities and all regions.
The coordination associations are an important resource for strengthening people's ability to work, and it is positive that almost all of Sweden's municipalities are part of a coordination association.
As appears from the regulatory letters for Försäkringskassan and Arbetsförmedlingen, the agencies shall work to ensure that the coordination unions prioritize financing interventions for those on long-term sick leave, young people with disabilities, and young people who receive activity compensation in order to strengthen women's and men's ability to engage in gainful employment. Arbetsförmedlingen and Försäkringskassan shall contribute to ensuring that all parties in the collaboration take responsibility for the coordination unions' interventions. Försäkringskassan and Arbetsförmedlingen shall, through the National Council for Financial Coordination, support the development of the coordination unions' activities. Försäkringskassan shall also provide a consolidated report on the target groups and interventions financed by the coordination unions.
I believe it is important to gain increased knowledge about the results and effects of the various interventions of the coordination associations. Therefore, the Swedish Social Insurance Agency, ISF, has been tasked with evaluating the activities of the coordination associations at the individual level. The assignment is to be reported by March 31, 2023. It is, therefore, very soon.
I look forward to taking part of ISF's analysis and conclusions. It will be a very important basis for the government's continued work regarding these issues.
Åsa Eriksson (S)
Madam Speaker! It is very pleasant to see the Minister of State here again on a Tuesday to discuss, among other things, the health insurance. I appreciate that.
I am also pleased that the Minister and I agree on how incredibly important the activities of Finsam or the coordination associations are. The people covered by the coordination associations' activities have no employer. Therefore, an important component is missing in the work to increase their work capacity.
There are countless stories about people who need coordinated support to increase their work capacity. Their voices are very rarely heard in the debate, because their voices are often very weak. We therefore have a responsibility. We must be their voices until they are strong enough to represent themselves in all situations.
Madam Speaker! I want to tell you about a fairly typical participant in the activities of the Södra Dalarnas samordningsförbund that I led when I was the executive official there - there are hundreds of similar examples.
It was a young woman who had a long history of both mental and psychosomatic problems. She lived in social isolation and had lived on social assistance for many years. She had repeated contacts with all the different parts – the social insurance agency, the public employment service, and the various instances of healthcare. But nothing helped.
When she, first against her will, participated in one of the individual-based coaching activities that the coordination association offered, she met a multi-competent team with employed staff - one from Försäkringskassan, one from Arbetsförmedlingen, one from the then county council and one from the municipality's individual and family care. This made that this person after a while felt: Here there are actually people who will truly hold my hand all the way until I have reached a platform where I can stand on my own with self-confidence and manage my own livelihood and a job. Then she opened up. Then all the different needs that existed and things that one needed to work on simultaneously emerged in order to support this individual to health and to full work capacity.
She needed a couple of years in the coordinated activities. Then she left, with her head held high and with work capacity. She chose to educate herself for a shortage occupation, and as far as I know, she still works within that profession and thus has her own livelihood.
There are thousands of similar stories, Madam Speaker, but unfortunately, there are even more stories about people who never received the coordinated support and therefore could not achieve work capacity or health and thus could not enter the labor market and manage their own livelihood.
Madam Speaker! I mean that welfare should be equal throughout the country. This is important for us Social Democrats. According to the national association for coordination unions, there are currently 82 coordination unions in 247 of Sweden's municipalities. This means that in 43 municipalities, 15 percent of the Swedish municipalities, there is no coordination union. There, there is no possibility for this type of seamlessly coordinated intervention, where one can get help with all the needs one has to regain one's capacity for work.
My question is therefore: What does the Minister intend to do so that all people in Sweden with a need for seamless cooperation will also receive it?
Statsrådet Anna Tenje (M)
Madam Speaker! I note that the interpellator and I have slightly different figures regarding how many municipalities are included in these coordination associations. I hope that I am the one who is correct and that Åsa Eriksson is slightly mistaken. But I share Åsa Eriksson's position when it comes to the fact that everyone should be able to take part in the coordination associations' important work. Regardless of whether it is around 240 or 272, I think there should be more.
I share many of the experiences that the interpellator raises in their account. Also, as the chairman of the municipal executive board, I have met many people who have received very great help from the coordination associations. But the different coordination associations work quite differently. Some have achieved greater success than others. Precisely for that reason, it is very important at the individual level to complete the review that ISF is now conducting to find the good examples that can then be scaled up and worked on a bit more extensively across the entire country, so that everyone can benefit from this important work.
I have no other standpoint than that it is absolutely crucial for our country's economy and welfare to get more people into work. And I believe that the coordination associations can play a very important role in exactly this. That people can go from exclusion to inclusion and can stand on their own feet, support themselves, stand tall and be active participants in society is incredibly important. Precisely for that reason, coordination associations are needed in many cases to lead a person all the way to work and self-sufficiency. I therefore have no other opinion than the one the interpellor presented earlier.
Åsa Eriksson (S)
Madam Speaker! I thank the Minister. Those were very positive announcements. I hope that after the debate we can join forces and work to ensure that there are coordination unions everywhere in Sweden in all 290 municipalities. This is because it is needed by the people who are in need of coordinated support.
In order for us to be able to push forward the work and for there to be more coordination agreements, I mean that we must have evidence for what type of interventions work and that they are truly effective.
I noted that the Minister, in his answer, said that results and effect were important. I truly agree with that. But then we must also have systems where we can follow the individuals who are part of the coordination associations' activities, so that we know what happens to them and how long it takes before they reach progression and self-sufficiency. I mean that we owe it to those for whom the measures are intended. But we also owe it to the taxpayers.
For evidence, we must have a good system to follow over time what the interventions have led to. There has been a cumbersome system called SUS. It ceased at the turn of the year. Now, the coordination associations can no longer report individuals in SUS. Where the individuals' development is reported now, I cannot answer. It is worrying, Madam Speaker, because both the Minister and I are keen that both we and others should be able to follow it.
How many parents are not tormented today, for example, over what the future will be like for their children with disabilities?
Ulla-Karin Schön, who is a professor of social work, has studied young people with disabilities and mental ill-health. Her research shows that the young people that the coordination associations come into contact with are largely isolated from society's welfare services and live in great loneliness. It is appalling, and it is a betrayal of society's weakest. They truly need coordinated and good support.
In order for Finsam to be able to exist everywhere in the country and cover more individuals than today, we need a reporting system where the effects of the interventions can be monitored.
I therefore wonder: What does the government intend to do to ensure that we can follow the participants in the coordination associations' activities over time, so that everyone who is in need of coordinated support can also receive it in the future?
Statsrådet Anna Tenje (M)
Madam Speaker! I thank you for the questions from the interpellor.
I too have been made aware that the statistics are not as easy to follow up on now as they were previously. It was perhaps a bit cumbersome and complicated even before. It has also turned out that some coordination associations have turned directly to me to alert me that the system as such is not completely optimal now and that it is becoming difficult with follow-up and with the statistics. But some coordination associations have not even noticed this, given that they perhaps actually did not work in this way previously. I find that noteworthy. I believe it is very important, as the interpellor says, to actually see what works and what does not work. Then we know that not everything works for everyone, especially not for the groups that often meet the coordination associations. On the other hand, it is very important that in those cases where we have successful examples, we can show, document, and pass this on so that it can be scaled up.
I have, therefore, been alerted that the reporting system is not optimal. I have posed the question to my officials. They are following up and looking into the matter and have promised to get back to me. I promise that I will keep an eye on this because this is very important. And, as said, several coordination federations have already contacted me to alert me to the issues but also to emphasize the importance of actually having statistics and being able to conduct follow-ups in order to constantly improve and reach more people and achieve better results.
I look forward to the review that ISF is conducting and which is to be reported. They have been given an additional four months of extended time, which we have decided to give them precisely because I think it is so important that we receive this information in part. The review will arrive on March 31, 2023. I will read it carefully, follow these questions, and then follow up on this in the reporting system.
In the regulatory letters, we have given assignments to both Försäkringskassan and Arbetsförmedlingen. It is also possible to follow this important work there.
But I also promise that in my work, when I am out on my site visits and meet many of our municipal and regional representatives, I will bring up that these issues should be highlighted. It is exactly as the interpellor points out, i.e., that this is a somewhat overlooked issue. Municipal representatives work very much with this, I would like to say. But it is not always that it reaches the media spotlight, and it is perhaps not always that the general public is aware of this type of activity.
As a parent to a child who will have it tough and difficult, it is extremely important to know that there are others in society who are also there to help, support, and guide the person in question toward a job so that he or she can stand on his or her own feet.
Åsa Eriksson (S)
Madam Speaker! I also look forward to the ISF report. It is truly long-awaited. But the Minister did not actually answer my question. It is, after all, no news that SUS, the old system, cannot be used since the turn of the year. Thus, for over two months, it has not been possible to report individual data and follow individuals. We have a gap. Right now, no one knows how it is going for the participants in Finsams activities all around Sweden.
The National Network for Coordination Associations wrote a letter to the Ministry of Social Affairs on November 22 and pointed this out and that a new system must be established. Furthermore, Försäkringskassan wrote in its 2022 budget proposal that this system needs to be phased out, and they requested 31 million kronor from the government to develop a new system. What has the government done?
What we see is that the government prioritizes completely different things than the weakest in society, for example a large tax cut for high-income earners such as the minister and myself, which we do not need. I mean that it would have been much better to invest these funds in welfare and on, for example, a good and robust system where we can follow individuals so that we know which interventions are effective and so that we have evidence and can push forward so that there are coordination associations in all of Sweden's 290 municipalities. That is what we owe to all of us who work in coordination activities but above all to all those thousands of individuals who suffer from mental ill-health, who may have some disability and who are unemployed.
I wonder: What is the Council of State's message to all these people?
Statsrådet Anna Tenje (M)
Madam Speaker! My message to persons who are in contact with coordination associations or who, for that matter, might be in need of being in contact with coordination associations is that I stand on their side.
I think that the work carried out by the coordination associations is extremely important, and I believe that much more can be done. I believe that the cooperation between region, municipality, insurance agency, and employment service can become significantly much better. I believe that it can become more efficient, I believe that it can become smarter, and I believe that one can learn significantly much more from each other between the coordination associations.
But I also believe that it is possible to cooperate significantly more with other parts of Försäkringskassan, with the municipalities, and also with the regions - and why not the Arbetsförmedlingen. In that way, one can help even more people and also intervene much earlier so that people do not spend far too long in an exclusion before they enter the system and receive help from the coordination unions.
I believe there is an incredible amount to be done on this point, and precisely for that reason, it is important that one can follow and evaluate the efforts being made. But one must also start significantly earlier by both ensuring that there are opportunities, of course, and that people can move in and out of certain different systems. One should be able to pause certain things without having to fear losing the compensation entirely because one, for example, tries studying.
Sometimes it is the information that is lacking. There, I believe that both authorities, the municipality and the region can become significantly much better.
First, I am now looking forward to the evaluation that ISF is conducting. I want to assure the interpellor that I have also noted the problems with the system as such. I have pointed this out, and I am to be contacted with what they intend to do. Then I can also get back to the interpellor and explain what the government intends to do in the matter.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.