Response to interpellation 2023/24:568 on the regulatory framework for the specified professional group
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The sickness insurance shall provide financial compensation in the event of illness and rehabilitation, but the design shall counteract lock-in effects and promote a rapid return to work 1. M has noted that previous legislative changes have led to more and longer periods of sickness as well as increased costs 1. The Government has therefore decided on additional directives for an investigation to evaluate whether periods of sickness become unjustifiably long 1. S argues that the regulatory framework regarding specified occupational groups is necessary to prevent the sick from becoming poor 2. S believes that one must prevent ill health and offer support rather than withdrawing the compensation 3. M wants the sickness insurance to be based on research to avoid long-term exclusion 4.
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)
Mr. Speaker! Åsa Eriksson has asked me if I and the government intend to make any changes to the regulatory framework for the specified professional group.
The sickness insurance shall provide compensation for loss of income due to illness and rehabilitation. People should feel secure that there is a sickness insurance that provides financial compensation if they become ill and cannot work. At the same time, it is important that the regulatory framework does not contribute to lock-in effects. The design shall counteract unnecessarily many and long sick leaves. There need to be incentives for both the individual and other involved actors for a rapid return to work. The focus shall be on rehabilitation with clearly defined assessment points.
The legislative changes implemented in the sickness insurance during the previous parliamentary term have so far resulted in more long-term illnesses and increased costs for the sickness insurance.
From Försäkringskassan's analysis of the new provision on the exception for overriding reasons on day 180 in the rehabilitation chain, it appears that 32 percent of the insured persons who have been granted sickness benefit with the support of this exception remain on sickness benefit even after day 365. Of these insured persons, most remain with the support of the new provision on the assessment of work capacity against normally occurring work in a specified occupational group.
That the long-term sick leaves are increasing again is worrying. The Government has therefore decided on additional directives to the Investigation on the sickness insurance in change - an evaluation (S 2022:07) to submit legislative proposals if the results of the evaluation show that sick leaves become unjustifiably long or if other negative consequences for society or the individual arise (dir. 2023:20).
The investigation has recently submitted its final report. The report will be processed further in the usual order.
Åsa Eriksson (S)
Mr. Speaker! Thank you, Minister - nice to be here again!
The sickness insurance is an essential part of the social contract. It provides security in the event of loss of income when one lacks capacity to work and is an insurance that we all pay into when we work and can expect to receive a share of when we need it. The person who becomes ill shall receive the support required to return to work and have economic security during the time.
Mr. Speaker! I believe many of us will remember how unreasonably hard sick people were affected before the Social Democratic-led government changed the regulations and added specified professional groups during the last parliamentary term.
Thousands of people were denied sickness benefit because they were considered healthy by Försäkringskassan, but according to their employers and according to Arbetsförmedlingen, they were too sick to be able to work. Instead, they were declared fit to work, with the only consequence being that they became poor and sick. Some who were declared fit to work lived on their relatives. Others were forced to apply for social assistance. But common to all of them was that they did not become healthy by also being made poor.
People who lacked mobility in arms and shoulders were told that they could take a common job where they did not need to use their hands, even though some such jobs were not available to apply for.
People with severe social phobia were told that they should seek a job where they did not need to meet people, even though some such jobs did not exist to be sought.
Therefore, Mr. Speaker, we changed the regulations so that if Försäkringskassan denies someone sickness benefit because they believe the person is capable of working, they must also show what type of work that person is capable of performing. It is perfectly reasonable, we Social Democrats believe.
Mr. Speaker! I want to read an open letter that Eva Sjögren at Arbetsförmedlingen wrote before we made these changes and removed the make-believe jobs.
Those on sick leave are urged to seek new, lighter work after having been so ill that it affects their ability to return to a previous job. Many are those who are urged to go to Arbetsförmedlingen, even during strenuous medical treatments. But Arbetsförmedlingen cannot provide new jobs to those who can no longer manage their jobs due to illness. It often happens that Försäkringskassan urges those on sick leave to contact Arbetsförmedlingen to get simpler jobs, but they do not exist.
Mr. Speaker! We cannot go back to the order that prevailed when Kristersson and Reinfeldt slaughtered the sickness insurance and introduced the "hittepåjobben" (made-up jobs). We must keep the specified occupational group or in some other way ensure that, if one is denied sickness benefit because one is considered to have work capacity, it is clear what type of capacity it concerns and what type of job one should then have.
For this reason, we appointed the investigation, which the government has changed. The investigators have also been replaced, and it has been clear what intentions are held regarding the investigation. On the basis of this investigation's proposal, I want to ask the Minister if she intends to make any changes to the regulatory framework for the specified professional group.
Statsrådet Anna Tenje (M)
Mr. Speaker! No human wants to be ill, and precisely for that reason it is so important to create security for those who are ill but also to provide support that helps and enables a return to work. If one is too ill to work, one should be on sick leave.
The question I often ask myself is how we can best safeguard people's abilities so that they are not hidden or forgotten in the statistics. We can look back at how it was previously. We clearly remember how the Social Democratic government before the Reinfeldt government medically retired people on an assembly line so that they ended up in a lifelong exclusion. So we definitely do not want the sickness insurance to function that way. We shall not hide and forget people in statistics, but instead, we shall ensure that the sick become healthy and regain their capacity to work.
People who have been signed off from work need to be met with efforts from the entire society to become healthy again and regain their ability to work. Many have a responsibility in this; I have touched upon it several times in this speaker's chair. It is about the employer, the health and medical care, and the state authorities, and it is also about the individual. For me, this is the core of the sickness insurance.
To achieve this, it is important that the sickness insurance is based on research and the best available knowledge of what is appropriate so that people who are on sick leave receive a secure compensation, while at the same time this does not lead to long-term exclusion.
Many major changes have been made in the sickness insurance in recent years. Evaluating these reforms is absolutely necessary to increase the understanding of how it works and to see if the reforms have achieved their purposes. Not even the member can, Mr. Speaker, be satisfied that we now see that the sick leaves are getting stuck and are becoming more and also longer. In that case, we need to take measures so that the sick become healthy and more regain their capacity to work.
Now the investigation is to be sent out for consultation. I received these proposals last week, and I really look forward to seeing what responses and comments the consulting bodies provide. After that, we will simply have to see if it is appropriate to proceed with some parts of the investigation's proposals. But these are the investigation's proposals, not the government's, and we will have to see if we choose to proceed and, if so, with what.
Åsa Eriksson (S)
Mr. Speaker! The Minister is right in at least one thing: We agree that everyone's work capacity should be taken into account and that all people who need it should return to work as soon as this is possible. Then, however, I believe we differ significantly regarding our view of what the investigation that has been presented shows.
After listening to the Minister, I feel compelled to remind [the House] of the quote by Mark Twain: There is a lie, there is a damn lie, and there is statistics. It is clear that the sick leaves became longer when we enabled people to have sickness benefit until they had become healthy and finished with their rehabilitation.
What distinguishes us Social Democrats from the government's party and the government is that we believe that in order for people to be able to become healthy and return to work as soon as possible, measures must be implemented early in the illness, preferably before it even occurs, and prevent ill health instead of removing people's compensation because they have not become healthy fast enough. We know that people do not become healthy by being made poor.
Mr. Speaker! From the Minister's reasoning follows that the shorter the time limits and the lower the compensation levels one has, the healthier people become. In that case, the most effective thing would be to remove the health insurance entirely. Oops! The rate of ill-health became zero. Have people then become healthier? No, obviously not.
We need to have a system that both provides support with rehabilitation and interventions and sets requirements for the employer to take measures so that people can regain their work capacity and return to work as soon as possible - not a system that withdraws their income because they are sick for too long. Tell that to the person who is burnt out or undergoing a long cancer treatment! Everyone who can work shall work, but one must also be given time to be rehabilitated for as long as it is necessary.
Mr. Speaker! When the SD-led government took office, Anna Tenje and her colleagues decided to change the investigation's mandate through supplementary directives. They dismissed the investigator Robert Sjunnebo, whom the Social Democratic-led government had appointed, and instead hired a professor of statistics and an economist to evaluate the changes in the health insurance. That says everything about this government's intentions regarding the health insurance.
What is the Minister's own opinion? One can refer to the commission, but the Minister de facto chose to hold a press conference when she received the commission's proposals. The Government has chosen to proceed with these proposals and is sending them out for consultation. I and many others who are following this debate now want to know. Is there any proposal in this commission that the Minister does not intend to proceed with?
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.