Response to interpellation 2024/25:232 on women's sick leave due to stress
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
1 M considers the increasing sickness absence due to stress-related ill health among women within the public sector to be serious 1. M wants to promote return to work through increased grants for workplace-oriented rehabilitation support, strengthen Försäkringskassan's follow-up, develop cooperation regarding work environment responsibility 1, investigate work trials over shorter periods with maintained sickness benefit 1 and invest 500 million SEK in primary care's work with mental health in 2025 1. M emphasizes that employers have an important responsibility in rehabilitation 2 and that it is a three-part responsibility between society, the employer, and the individual 3. M emphasizes the importance of employers creating sustainable workplaces and that individuals are motivated toward rehabilitation 3. S argues that the sickness insurance fails women in welfare through rejections and a cold bureaucracy. S considers that the government refuses to address the core problem, the chronically underfunded welfare, and prioritizes tax cuts for high-income earners over investments in welfare and the work environment. S wants a sickness insurance that takes the work environment into account and does not just see the individual's work capacity in abstract terms. S argues that stress-related sick leaves have quintupled since 2010 and that women pay the highest price in a system that reinforces inequality 4. 5 S considers that the sickness insurance is not adapted to women's working conditions and that women in welfare are denied sickness benefit despite high stress and understaffing 5. 5 S argues that the government does not act on knowledge regarding stress-related ill health and that current investments are like putting a bandage on a broken bone because the work environments remain unchanged 5 6. S wants to change the labor market concept in the sickness insurance and invest in welfare 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 Anna Tenje (M)
Madam Speaker! Jessica Rodén has asked me how I intend to act to ensure that the sickness insurance becomes more secure for all those women who are signed off work due to stress-related diagnoses, as well as whether I intend to change the labor market concept within the sickness insurance so that it better reflects women's actual working conditions and health situation.
Madam Speaker! The increasing sickness absence due to stress-related ill health is serious. Employees within the public sector are particularly affected, and women constitute the absolute majority.
Municipalities and regions have over time systematically had significantly higher sickness absence rates than, for example, state and especially private employers. Measures need to be taken by all involved parties to reduce stress-related sickness absence. For the government, it is particularly important that the sickness insurance promotes a return to work and that employers take measures for a return to work in connection with the workplace.
The Government has presented a comprehensive package of measures with this focus in the budget bill for 2025. Among other things, the grant for workplace-oriented rehabilitation support will be developed. The funds will also be increased. The purpose is to facilitate for employers to take their rehabilitation responsibility and take advantage of the occupational health care's expert resources.
Furthermore, Försäkringskassan is granted increased funds to strengthen the agency's work in following up on employers' plans for return to work and coordination of rehabilitation efforts. Additionally, Försäkringskassan and Arbetsmiljöverket will be tasked with developing their cooperation and supervision of employers' work environment and rehabilitation responsibilities.
The fourth point, Madam Speaker, is that the government will also review the possibility of work trials over a shorter period with maintained sickness benefit in order to facilitate things for all parties in the sick leave process.
It is important to counteract the situation where those on long-term sick leave who are assessed to have a permanent reduced capacity for work in normally occurring jobs remain in the sickness benefit system if they have some capacity for work that could be utilized.
Support for the individual needs to be developed so that work capacity, in cases where it is possible, can be utilized in all gainful employment on the labor market, for example in wage subsidy employment. The Government therefore intends to task Försäkringskassan to, together with Arbetsförmedlingen, further develop methods for assessing and utilizing work capacity in gainful employment on the labor market.
Madam Speaker! I also want to mention in this context that the government, in the budget bill, allocates 500 million kronor for a targeted initiative in primary care and first-line work regarding mental health in 2025. Additional funds have been signaled for the years 2026 and 2027. We do this to ensure preventive measures, that people receive care in a timely manner, that the queues to specialized care are shortened, and that return to work after sick leave for psychiatric diagnoses shall be promoted.
The government has also recently decided on two assignments with a special focus on mental health in order to develop the healthcare system's work with sick leave and rehabilitation. The Inspectorate of Social Insurance, ISF, and the Agency for Health and Social Care Analysis have been tasked with evaluating the Act on Coordination Measures for Patients on Sick Leave (S2024/01782). The National Board of Health and Welfare has been tasked with strengthening the healthcare system's work with sick leave and rehabilitation, particularly for the area of mental health (S2024/01779).
These are just a few examples of the solid work that the government is now undertaking specifically to combat mental ill-health and the sick leaves resulting from it, which, not least, affect many women.
Jessica Rodén (S)
Madam Speaker and Minister! I want to talk about the women who uphold our common welfare. They are the women who take care of our sick, our children, and our elderly. They toil and toil, often for low wages and with poor working conditions. When their bodies and their minds say enough, when they become ill from stress and exhaustion, what happens then? Well, they are met by a sickness insurance that fails them. They are met with rejections, questioning, and a cold and rigid bureaucracy that does not understand or care about their reality. It is a betrayal, not only against these women but against the entire idea of a society built on solidarity and justice.
Minister Tenje says in his response that the sickness insurance should promote a return to work and that measures need to be taken by all involved actors. That sounds good. But let us look at what it actually means. What does it mean for the nursing assistant who breaks down from stress at a constantly understaffed elderly care home? What does it mean for the teacher who can no longer sleep at night because the anxiety over not being enough has become overwhelming?
Madam Speaker! It means that they are expected to return to the same work environment that made them ill in the first place. Despite all the talk about rehabilitation and despite all the fine words about cooperation between authorities, the government refuses to address the core problem: the chronically underfunded welfare system and the fact that the sickness insurance fails precisely those women who need it.
Madam Speaker! We need to have a sickness insurance that is accurate and that takes into account the reality for those who work irregularly and those who work part-time or have heavy and stressful workplaces. We need to have a sickness insurance that does not just see the individual's work capacity in abstract terms but that actually understands and takes into account the work environment that these women return to.
It is here that the ideological differences become crystal clear. We Social Democrats know that security and welfare are something that one builds together. When someone becomes ill and cannot work, society must be there to provide support. It is an investment in people's health and in the sustainability of the entire society. But from the government and the Sverigedemokraterna, we hear the same tune time and again, Madam Speaker: It is more important to lower taxes for those who already have than to provide security to those who need it most.
We Social Democrats know that politics can and should create and guarantee welfare. We know that it is through political decisions that we build a society where no one is left behind. But then one must dare to see the problems for what they are. One must dare to see that it is the women in the welfare sector who pay the highest price when the government chooses to prioritize tax cuts for high-income earners instead of investing in welfare and the working environment.
My question to the Minister is: Will the Minister and the Government take further measures to strengthen the sickness insurance but also to curb the negative trend that exists in the welfare system, so that women do not have to become ill from their work?
Anna Wallentheim (S)
Madam Speaker! At this time of year, many of us become a little more stressed every year. Christmas presents must be sorted out, and dinners must be planned. And everyone wonders how to get that Christmas spirit to truly arrive. But this year, that stress is different for many. The economic situation has pressured families hard.
Fresh figures from Handels, which arrived as late as today, clearly show that scarce resources affect the everyday lives of retail employees. When they were asked what they would do with an extra 2,000 kronor, most answered that the money would go towards Christmas presents, towards food, and towards the opportunity to travel to meet family. These are basic things that many of us take for granted.
Parents in Sweden are having a tough time right now. One wonders how to make the money last in everyday life and to have a dignified Christmas. There are parents who right now risk having to choose between paying the electricity bill, putting food on the table, buying winter clothes, or buying Christmas presents.
Imagine then living with that stress and that feeling every year, constantly feeling that time and resources are insufficient, always being a step behind, carrying a heavy feeling of being inadequate! And then think about what anxiety it causes if this stress also makes you sick!
For many women within the welfare sector and for retail employees, this is a reality. They face stress both at work and at home. They work under tough working conditions, in long shifts with insufficient recovery and in a work environment that is far from sustainable. And when they come home, a new workday awaits with the family, with the home and with the children.
Figures speak their clear language. Between the years 2010 and 2023, the number of stress-related sick leaves has quintupled. Today, four out of five people on sick leave are women. It is women who take care of our sick, who take care of our children, and who ensure that we can shop both during the day and in the evening and on weekends. It is also they who care for our elderly. But who takes care of them?
We also know that this does not only affect the individual and the family. It also entails costs for municipalities and regions. In 2023, they stood at over 51 billion kronor. That is the highest recording since 2013, if we exclude the pandemic years. It is money that could have been used to improve working conditions, to shorten working hours, and to create a more sustainable welfare. But instead, it goes toward patching and repairing a system that unfortunately makes people sick.
It is time that we stop and realize that this is not sustainable. We must create a work environment that does not break people down but builds them up. And we must have a health insurance that is secure and fair and that sees women's reality.
What does it say about our society if we accept that the women who uphold the welfare state simultaneously pay the price with their health, and that there is also no reliable health insurance when ill health strikes? It is deeply unacceptable that this inequality affects women-dominated occupations, where working conditions are systematically worse and make women sick. But we also have a health insurance that reinforces that inequality.
This inequality would never be accepted in male-dominated industries. Therefore, I wonder why the government accepts this.
Statsrådet Anna Tenje (M)
Madam Speaker! I thank the interpellor and the other member for their contributions.
I do not want to talk down to anyone, but I believe that the correct figure is that two-thirds of all those on sick leave are women, not four-fifths. It is, after all, a significant proportion. However, it has been that way since 2006; no major difference has been seen.
However, we now see a large difference regarding the reason for the sick leaves. Previously, approximately 30 percent were psychiatric diagnoses for their sick leave. This figure is now up to nearly half. It is probably that serious.
Försäkringskassan recently published a report on stress-related sick leave. Their analysis shows that stress-related ill health has increased significantly in recent years and now accounts for a large part of the increase in sick leave. In the report, Försäkringskassan highlights deficiencies in the work environment and the burden in private life as two contributing causes of the stress-related ill health.
We know that sick leave has increased, particularly among women, and this applies to stress-related diagnoses for people within healthcare, school, and care, which is serious. Deficiencies in the work environment within these areas are an explanation. It is important that the public employers take their work environment responsibility. No one should have to become ill from their work.
Employers also have an important role in rehabilitation. This is shown by various studies. These also show that an engaged, participating employer reduces the risk in preventive work so that sick leave should not occur at all. But once one has been signed off sick, the possibility of returning to work has much to do with how active and participating the employer is.
The government therefore has in the budget bill a package of measures to improve support for returning to work with a particular focus on the employer's responsibility. Collectively, these measures aim to facilitate for people to return to the labor market earlier – that one can become healthy and that one can return to work.
During the last two weeks, I have met with municipal councilors and regional councilors from different parts of Sweden as well as the leadership of SKR to discuss their work in preventing and reducing sickness absence rates in municipalities and regions. Mental health was one of the major topics of discussion, but we also spoke about good examples of what has been done and succeeded in order to reduce sickness absences. We also spoke about the importance of there being a local political leadership - municipal and regional - that takes the issues seriously.
Madam Speaker! I naturally took the opportunity to mention many of the measures that I also touched upon in my opening statement. It concerns the investments that the government has in the budget for 2025.
To facilitate for employers to take their rehabilitation responsibility and take advantage of the occupational health care's expert resources, the grant for workplace-oriented rehabilitation support is being developed. The rehabilitation support consists of services that employers can purchase from an approved provider, for example an occupational health care, to facilitate for employees who have or risk having reduced work capacity due to illness or injury so that a sick leave is prevented or so that the employee can return. This appropriation is increased by 20 million to 134 million kronor in the year 2025.
I touched upon several other of the measures we are taking, but I am not closing the door. I am willing to work forward together with municipalities and regions to find more ways forward to reduce and prevent sick leaves.
Jessica Rodén (S)
Madam Speaker! I am frustrated to see how women in the welfare system are betrayed day after day by a system that is not built for them. But I am also frustrated that the government, despite beautiful words, refuses to tackle the real problems.
The Minister speaks about rehabilitation support, about cooperation between Försäkringskassan and Arbetsmiljöverket, and about work trials as if it would be enough to solve the deep crisis that both the sickness insurance and the welfare system are in. But we know that is not where the shoe pinches. The problem is not that the rehabilitation is poor, but it is that far too many women never get the chance to enter rehabilitation because they are denied sickness benefit from the very beginning.
For a woman who has worked part-time in healthcare, who has exhausted herself with double shifts and who has come home late in the evenings and still managed to make everyday life work, it is a mockery to hear that she is not sick enough. It is a mockery to hear that her capacity for work is suitable for some other job. But for what job? Where are these magical workplaces where there is no stress, no pressure, or any risk of new sick leaves?
It is easy to talk about "normally occurring work" from an office at Försäkringskassan or from a government that does not want to see reality. But for the women in the welfare sector, there is no "normal." Their reality is constant stress, irregular working hours and understaffing, and when they are broken down by this, they are left alone.
This is no coincidence. It is the result of a policy based on the idea that the individual must bear their own responsibility. It is a policy that says that if you do not manage your work, it is your own fault.
We Social Democrats stand for a different view. We stand for a health insurance that provides security. We stand for a society where we do not leave those who need support the most behind.
Madam Speaker! What additional measures does the Minister and the Government intend to take? I perceived nothing about welfare initiatives. What work environment will these women return to after perhaps months of sick leave? It cannot just be about returning to work. What work environment do these women face when they come back?
Anna Wallentheim (S)
Madam Speaker! I thank the Minister for the answer. I also turn to my colleague Jessica Rodén with a thank you for an important interpellation that gives us the opportunity to raise these issues.
It is clear that our system does not reflect the reality that many women are in. Stress-related sick leave has increased significantly over the last five years. It concerns a stress-related ill health that particularly affects women in the ages of 30-39, and these are women who often have small children at home.
When the sickness insurance is also not adapted to women's working conditions and health situation, the inequality is further reinforced, which I tried to highlight earlier.
The Minister mentioned many good things in his first speech but also in the second. I do, however, feel that a holistic picture is missing, which my colleague Jessica Rodén pointed out. We cannot only speak about what concerns this area but also about things that land on the Minister's desk otherwise.
We Social Democrats believe that the Council of State and the government must act. It is time to change the concept of the labor market in the sickness insurance so that it reflects women's actual reality, but also ensure that women do not even end up in this situation. One must invest in the welfare sector and the women who work there.
We know what causes stress-related sick leave. We have the research. We have the reports. Yet we see that the sick leaves continue to increase. It is not about ignorance, but about the fact that we do not act on the knowledge we have.
We Social Democrats are trying to put forward proposals for solutions and improvements in the area, but we unfortunately experience that the bourgeois government and the Sweden Democrats are not sufficiently responsive. We know that the solutions exist. It is about an improved working environment, equal wages, and a sickness insurance that does not leave women behind. Therefore, we naturally wonder what the government is waiting for.
Statsrådet Anna Tenje (M)
Madam Speaker! It is difficult for me to assess which proposals the member perceived. In my first two speeches, I accounted in each case for ten different proposals that the government is now implementing with the budget for 2025.
I want to emphasize clearly that it is not solely the individual's responsibility. It is important that all involved parties make efforts in connection with sick leave to reduce the risk of long-term illnesses. Here, the plans for return to work that the employer prepares constitute an important piece of the puzzle, which I have been careful to describe today.
It is also important that Försäkringskassan takes coordinated actions more often and earlier in the cases of illness, but there is also a need to continue improving the support for returning to work. Against this background, the government has allocated 50 million kronor annually to Försäkringskassan to strengthen the work of following up on employers' plans for return to work as well as coordinating rehabilitation efforts. The government will also task Försäkringskassan and Arbetsmiljöverket with developing this cooperation. It is important in order to specifically follow up on the plans we now want people to be clearer about. Money is also provided for that.
It is clear that there are also other issues and other parts of society that have an important role to play when it comes to sick leaves and tackling, above all, the psychiatric diagnoses given that they have increased sharply during recent years. At the same time, I want to say, Madam Speaker, that the knowledge regarding effective interventions is deficient. In the recently decided research proposition, a commitment is therefore made to strengthen knowledge and evidence regarding effective interventions for return to work. We have that part included there as well, precisely because this is so important.
The government also allocates 25 million SEK per year 2025-2028 to support center formations that work to strengthen knowledge and evidence on effective interventions for return to work within the area of mental health.
Healthcare is an important actor that meets individuals on sick leave early in the process and has good opportunities to contribute to a rapid return to work and a quick recovery. That the healthcare's work with sick leaves and rehabilitation is developed is therefore a very important piece of the puzzle in the government's work to reduce sick leaves and help people back into work as soon as possible. Against that background, the targeted investment of 500 million on primary care's first-line work with mental ill-health becomes particularly important.
Additional funds have also been announced for 2026 and 2027. They are to be used to shorten the queues and ensure that people receive care in a timely manner, which can contribute to reduced human suffering and to a significantly earlier return to work if one risks being signed off sick as a result of a psychiatric diagnosis.
Jessica Rodén (S)
Madam Speaker! It is very interesting to hear about the different initiatives that the Minister brings up. I also think it is important to talk more about how we are to ensure that no more women become ill because of their jobs. It is very good to gain more knowledge about these issues. Today, however, it is like putting a bandage on a broken leg, because the women in the welfare sector will return to workplaces that look exactly the same as when they became ill from them. It is stress, the same pressure, and the same understaffing. The government must, therefore, do more here.
Madam Speaker! Health insurance is not a luxury; it is a right. And no one should have to become ill from their work.
Statsrådet Anna Tenje (M)
Madam Speaker! I thank you for the interpellation and for the debate that the members participated in. I think it has been a very good and clarifying debate. I just want to conclude by being clear that it is a three-part responsibility to turn around the development of sick leaves in our society.
Society naturally has a great responsibility when it comes to both healthcare and sickness insurance, which is an important part of helping those who have become ill back to work.
The employer has a very great responsibility to create sustainable and safe workplaces, prevent illness and injury, and also adapt and support during return to work. When I discussed this with the public employers, who have the highest number of sick-written women, they were completely in agreement that there is important work to be done.
The political leadership in municipalities and regions needs to be clearer. We need to work much more on preventing ill health, improving the work environment, and letting employees work with something else within the organization. The member also described that the risk if one becomes signed off sick is that one will return to the same work that did not work or where the stress becomes too tough. This is something we must work on.
The employer shall, among other things, establish plans for return to work, and I believe that will become very important. But it is also important that the person who has become ill and is on sick leave is motivated to participate in rehabilitative work so that they can return. It requires that all three parts function.
I wish you both a Merry Christmas and a Happy New Year.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.