Response to interpellation 2023/24:136 on the future of occupational health 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 the future of occupational health care and the current skills crisis where many occupational physicians are over 65 years old. L argued that occupational health care is important for preventive work environment measures and that the government shares the view of the problem regarding skills supply 1 2 3. L emphasized that Mynak has a government mandate to coordinate the skills supply and that they are waiting for the results of the investigation in February before concrete measures are taken 1 2. V criticized that the issue has ended up in an investigation loop without concrete political proposals 4. V argued that the education lacks public funding and demanded that the government secure future funding and clear coordination 4 5.
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 Paulina Brandberg (L)
Madam Speaker! Ciczie Weidby has asked me if I intend to work for the government to decide to give an authority the overall responsibility to coordinate the educational assignment for the additional specialty in occupational medicine, if I intend to work for the government to secure future funding for the education, how I intend to strengthen the quality within occupational health care and how I intend to make the regulatory framework for occupational health care more purposeful.
I would like to begin by thanking Ciczie Weidby for the questions and the commitment to occupational health care.
Occupational health care is a mix of several actors who can contribute to the work of creating healthy workplaces. The work of occupational health care is important, not least in preventive work environment work and to facilitate return to work.
Through its role as an independent and cohesive expert resource, occupational health care has good conditions to see the work-related connections between health and the work environment. But for it to be possible for occupational health care to contribute in a good way, good competence supply and high quality are required. It can be stated that there are few doctors who are trained in the additional specialty of occupational medicine.
The Swedish Work Environment Authority (Mynak) has therefore received a government mandate to coordinate efforts to promote the occupational health care's supply of competence regarding doctors (A2021/02080).
Within the framework of the assignment, the agency shall be a coordinating body by, among other things, coordinating involved actors as well as following the development of relevant educational instances and networks for doctors' specialist training within the occupational environment area. The assignment also includes promoting doctors' opportunities for continuing education, good access to mentors and study directors as well as relevant networks, but not that the agency itself shall be a training provider. Within the framework of the coordination, Mynak shall also set up one or more national networks for relevant actors within occupational health care. The assignment also includes proposing how the responsibility can be handed over to a suitable actor. The assignment shall be final reported in connection with Mynak's annual report for 2023.
It is important to improve the competence supply of occupational health care. I look forward to taking part in Mynak's reporting of the assignment, and I therefore do not want to anticipate its results and proposals.
I will follow the occupational health care issue closely going forward.
Ciczie Weidby (V)
Madam Speaker! Thank you, Minister, for the answer!
I asked four questions in my interpellation, and unfortunately, I did not receive an answer to a single one of them. The Minister refers to and does not want to anticipate the mandate that the Swedish Work Environment Authority, Mynak, received in 2021 from the previous government.
The issue of the occupational health care's competence supply has been investigated by Mynak on several occasions. There should be sufficient facts and proposals for concrete political proposals to be presented. But unfortunately, this issue seems to have fallen into some kind of investigation loop, and nothing concrete is happening. In the meantime, the occupational physicians just get older and older. Of more than 1,100 doctors, 80 percent are over 65 years old.
Occupational health care has a central role in work environment work and in our workplaces. They identify, prevent, and minimize risks in the work environment, which in turn, of course, creates better conditions for a long, sustainable, and safe working life without accidents. Furthermore, it actually states in the Work Environment Act that the employer is obliged to ensure that the occupational health care that the working conditions require is available. Access to occupational health care is also emphasized in the regulations on SAM, that is, systematic work environment management.
Madam Speaker! It cannot be that the Minister and the government have no ambition or any interest in or any idea of what the future of occupational health care should look like. Or are we to interpret this as that whatever Mynak comes up with in February will be implemented?
In the government's work environment strategy, which by the way is a very good strategy, the occupational health care is highlighted, just as the Minister stated in his introduction. It is important. It should contribute to healthy workplaces. And one must ensure a good supply of skills and a high quality. But unfortunately, the supply of skills is anything but good today. They are truly suffering from a serious skills crisis.
In order to be able to work as an occupational health physician, one needs a specialist education. Unlike many other specialist educations, this one lacks public funding. As it stands now, the doctor's employer must bear the cost, and this has resulted in only a few specialists being trained each year over the past few years.
Madam Speaker! I give the Minister the opportunity to answer whether she will work to ensure that the government secures future funding for this education. I also wonder how she intends to strengthen the quality within occupational health care.
Statsrådet Paulina Brandberg (L)
Madam Speaker! To begin with, I would like to say that the government shares the interpellator's view that occupational health care has an important role when it comes to being a support and to counter, among other things, ill health and sickness absence in working life.
I and the government also share the problem picture regarding the fact that we have a skills crisis. We face the problem that the doctors we have now are old. We need to manage this skills crisis in some way.
Madam Speaker! The Government has, as I have said, given a mandate. There is a government mandate to Mynak. It is a government mandate that is to be reported in February, that is, in three months. It would be foolish of me to stand here and anticipate that investigation. In three months, I can take part in what experts consider needs to be done in order to specifically be able to promote the competence supply of occupational health care. Of course, we need to listen to what the experts propose. This will, of course, then be prepared in the Government Offices, and then we will return with measures. But I want to emphasize that we share the interpellant's problem picture.
Ciczie Weidby (V)
Madam Speaker! It is not the current government that has given this assignment. It was the previous government that did so. It was in 2021 that this was done. But the issue of competence regarding occupational health care has been investigated and prepared by several agencies and departments for many years. And everyone notes the same thing, exactly what the Minister says. This crisis will not solve itself, and it certainly will not solve itself by once again giving an assignment or waiting to see what new experts will say.
It is still the case that it boils down to the fact that there must be a clear coordination and a financier for this. Previously, the occupational health physician training was funded by the state, and the Institute for Work Life had the coordination responsibility. But the Alliance government abolished the Institute for Work Life in 2007, and after that, the competence needs of occupational health care have been left entirely to its own fate. Neither the previous government nor the current one has taken any concrete measures, despite saying that this is incredibly important.
Madam Speaker! For the sake of the debate, I want to say something about what I have experienced in my role as a safety representative, which I have been for many years, and when I have been in a safety committee at a large workplace. It has been clear what incredible competence the occupational physicians specifically have and how important it is that it is someone independent who comes in, who has a different set of eyes on a workplace. They also have an immense knowledge in a lot of different areas. It is everything from work injury investigations, ergonomics, crisis support and lifestyle issues to leadership issues. They have an incredible competence. It becomes difficult to find at a single actor. Then it becomes several other actors. Therefore, it is extremely important that one really ensures to secure this.
As said: This has been investigated several times before. The question is also why one believes that one will get a different answer in February than what has been presented previously.
I want to emphasize one more thing, and that is that there are several socially important occupational categories where one needs a fitness certificate to be able to work. Without that certificate, one is not allowed to work. It is basically only occupational physicians who issue it. This applies to firefighters, train drivers and pilots. This will also be important, for how are we to ensure that they receive their certificates if we do not ensure the occupational health care?
I understand that it is a limbo. One should say: I will wait for the investigation. But it is not enough to just say that. It must be shown through concrete proposals and there must be a will to say that this is an important issue. I would still like to try to coax out some more information from the Minister.
Statsrådet Paulina Brandberg (L)
Madam Speaker! I shall keep it brief. The interpellor explains in a good and clear way how important occupational health care is and what function it fulfills. Just as the interpellor emphasizes, the employer must, according to the Work Environment Act, already today ensure that employees have access to the occupational health care that the working conditions require. It is then clear that it must also work in practice.
The assignment that has been given to Mynak is an assignment that was given before this government took office - that is correct.
I think it is a good initiative that the previous government took to solve the skills crisis and find ways to handle the issue.
Once again, I want to emphasize that when such a mission is now with Mynak, it would be foolish and strange to anticipate that investigation. The reasonable thing is to wait and see what comes out of the investigation and then prepare this within the Government Offices.
Ciczie Weidby (V)
Madam Speaker! I shall also keep it brief and state that both I and Sweden's occupational health services are eagerly awaiting what the government and the Minister will present for solutions after February 2024 to secure the future of occupational health care.
However it may be, our Swedish society and our economic system are built in many ways on our ability to work and to be able to have a good, long working life. Work has, besides of course its own economic significance, actually also some kind of deeper meaning. One wants to be involved in building society and so on and contribute to the common good. As Karl-Bertil Jonsson tells us every Christmas: A well-performed job provides an inner satisfaction and is the foundation upon which society rests.
Everyone will want to contribute to this, but we must also be given the conditions to be able to work and contribute with what our society needs.
Statsrådet Paulina Brandberg (L)
Madam Speaker! I completely share the interpellator's view that people generally feel good about being at work. Therefore, it is clearly important with measures that make us reduce sick leave and also facilitate rehabilitation for those who need it.
We need to reduce the sickness rates and also prevent sick leaves. This is something that everyone benefits from, primarily the individual employee of course, but sick leaves obviously involve costs for everyone involved.
It is important that we have a functioning occupational health care in Sweden, and these are measures that everyone wins from.
I would like to thank you for the debate. I look forward, as I have said, to receiving the investigation in February and will return with how we are working with the issue.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.