Response to interpellation 2024/25:380 on the possibilities for those on sick leave to return to work
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
M argues that the government in the budget bill for 2025 has presented measures to strengthen support for returning to work 1 2. M emphasizes that it is a three-part responsibility between the public sector, the employer, and the individual 1 3. M has tasked Försäkringskassan with strengthening the follow-up of employers' plans as well as the coordination of rehabilitation efforts 1 2 3. M has also tasked Socialstyrelsen with promoting knowledge development regarding sick leave and rehabilitation 1 3. M allocates funds for research and primary care's work with mental health 3. M believes that the state, municipalities, and regions should cooperate and work more on the work environment 4. M argues that sick leaves within the public sector cost a lot of money and that knowledge and hours worked are lost 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! I have been asked how I and the government are working to strengthen the cooperation between Försäkringskassan and employers to better support the return to work of those on sick leave. Jessica Rodén has also asked me what initiatives I and the government plan to take to improve the follow-up of the rehabilitation of those on sick leave and the measures that are offered.
It is important that those who are on sick leave receive effective interventions, such as various treatment and rehabilitation measures as well as any coordination measures to counteract unnecessarily long sick leaves. It is also desirable to promote measures that need to be taken in connection with the workplace. In order to be able to provide the right support, good knowledge of effective and proven interventions is required. Especially for persons with psychiatric diagnoses, there is a need for new and increased knowledge.
It is a three-part responsibility, Mr. Speaker, to turn the development around. The public sector has a great responsibility through, among other things, healthcare and our social insurances to help those who have become ill to regain their capacity for work. The employer has a great responsibility in creating sustainable and secure workplaces to prevent injuries and sick leave, but also to adapt and support upon return to work. Among other things, the employer shall establish plans for employees' return to work and provide workplace-oriented measures. But it is also important that those who have been signed off sick also take their responsibility by participating in planned rehabilitation measures and the meetings with employers and authorities that are required for a good and orderly return to work.
Often all these three parts work well, but there are cases where one or more are deficient. Here it is a shared responsibility for the whole to be able to function.
From this starting point, the government has, in the budget bill for 2025, presented a whole battery of measures to improve the support for returning to work.
The employer's actions can be crucial for a sick-leave employee to be able to return to work. Employers are, according to law, obliged to establish plans for return to work when an employee has been on sick leave for more than 30 days. Among other things, the government has tasked Försäkringskassan with strengthening the agency's work in following up on employers' plans for return to work as well as strengthening the coordination of rehabilitation efforts for those on long-term sick leave – to mention some of the measures taken by the government.
The Government will follow up on the assignments that have now been given. The authorities shall, among other things, report on measures taken and planned, as well as expected effects.
Against the background that there is a great need for research and knowledge development regarding sick leave as a measure, as well as measures that promote return to work, Socialstyrelsen has been tasked to investigate and take the measures deemed appropriate to promote knowledge development regarding sick leave and rehabilitation, particularly for persons with psychiatric diagnoses.
Jessica Rodén (S)
Mr. Speaker! We Social Democrats have a fundamental conviction: Those who work and contribute to society should be able to feel secure that society is there when it is needed. When you become ill, you shall receive the help that is needed, and you shall not be met by a wall of bureaucracy and mistrust. The sickness insurance shall be a bridge back to work, not a trap that makes people poor and stuck in long-term ill health.
But we must also talk about why people get sick in the first place. It is not enough to only discuss rehabilitation and return to work. We must also reduce the inflow into sick leave. We must have a better working environment and more preventive measures.
We see a dangerous trend. People are worn out at work and are then left alone when the body and mind can no longer cope. Society loses labor. Companies lose competence, and the individual loses both their livelihood and their health. We simply get a system that creates illness instead of creating security.
The Minister says that there is a battery of measures, but what does it help when the fundamental problems remain? The National Audit Office states that in half of the cases where the exception "predominant reasons" is used, Försäkringskassan does not even contact the employer. We know that stress at work, high workload, and insecure employment lead to sick leave. But where is the government's initiative to strengthen the work environment and prevent people from becoming ill? We know that investments in the work environment save money both for society and at the individual level.
Mr. Speaker! We need a health insurance that sees the entire chain, from preventive measures to rehabilitation and return to work. When will we see concrete changes that make a real difference? It concerns preventive work environment measures and support for those who have become ill from their work.
Statsrådet Anna Tenje (M)
Mr. Speaker! It is, just as the member points out, very important that those who are on sick leave receive effective interventions, such as various treatment and rehabilitation interventions as well as any coordination interventions to counteract unnecessarily long sick leaves.
It is also important, Mr. Speaker, to promote measures that need to be taken in connection with the workplace. It is about working preventively but obviously also about facilitating the return to work.
From this starting point, the government has, just as I described earlier, in the budget bill for 2025 presented a whole battery of different measures to specifically increase the support for returning to work.
Overall, the government's measures aim to facilitate for people to return to the labor market earlier, which also strengthens the work principle, enables self-sufficiency, and contributes to promoting Sweden's growth.
An example that links directly to the member's question about how the employer's measures can be crucial for a sick-leave employee to be able to return to work is precisely this: that the employer plays a very important role both in preventing ill health and in facilitating the return to work. This is also confirmed by a survey recently conducted by Försäkringskassan.
The employer's actions can be completely decisive for a sick-leave employee to be able to return to work. The employer shall, according to law, be obliged to establish plans for return to work when an employee has been on sick leave for more than 30 days.
Through the assignment given to Försäkringskassan, Arbetsmiljöverket, and Arbetsförmedlingen in the regulatory letter for 2025, the work to support people back to work shall be significantly strengthened. Among other things, Försäkringskassan has been tasked with strengthening the agency's work in following up employers' plans for return to work, as well as strengthening the coordination of the important rehabilitation efforts for those on long-term sick leave.
Furthermore, it has contributed to employers being able to purchase workplace-oriented rehabilitation support. The support is being developed and increased so that it becomes easier for employers to take their rehabilitation responsibility and also to utilize the expert resources of occupational health services.
Försäkringskassan, Arbetsmiljöverket and Arbetsförmedlingen have, among other things, to report on the plans and measures taken as well as the expected effects, and the government will, of course, follow the assignment given to these agencies very closely.
Jessica Rodén (S)
Mr. Speaker! The Minister describes the challenges we face: that those on sick leave need the right interventions in a timely manner, that employers have a responsibility, and that Försäkringskassan shall follow up on rehabilitation and cooperate better. I agree with all of this, but that is precisely why the government's response is so inadequate.
It doesn't matter how many times we say that those on sick leave need support to return to work if the support is not there in reality. It doesn't matter that employers are required by law to establish rehabilitation plans if no one follows up to ensure that it is actually being done. And it doesn't matter that Försäkringskassan receives new assignments if the authority still lacks the resources to fulfill them.
Mr. Speaker! When people on sick leave are bounced around between authorities, when the coordination between healthcare, Försäkringskassan and employers does not work, and when rehabilitation efforts are missing, it is not the individual who is failing, but the system.
We must see the whole picture. We cannot rehabilitate ourselves out of poor working conditions. If people are becoming ill from their jobs, we must also change the conditions in the labor market.
We know that stress, high workload, and lack of influence at the workplace are the biggest risk factors for sick leave. We also know that a poor work environment creates both more sick leaves and longer periods of sick leave. Why, then, are there no major investments in work environment efforts?
We Social Democrats want to see stronger occupational health and safety legislation, clearer responsibility for employers to prevent ill health, and also a sickness insurance that truly gives people the opportunity to rehabilitate and return.
When will the initiatives and proposals from the government arrive?
Statsrådet Anna Tenje (M)
Mr. Speaker! Let me first take the opportunity to clarify and truly emphasize the issue that the member raises.
The problem has been that the plans that one as an employer is obliged to establish when one's employees are on sick leave for more than 30 days have not been followed up. The point now is that the government, in the regulatory letters to the responsible authorities, has given exactly that assignment. The cooperation between authorities shall now be strengthened. The work must be done, because I agree that it does not help a person whose employer has established a plan if the plan is not followed or followed up.
Now we are tackling the problems and adjusting the system. This is a three-part responsibility between the public sector in the form of healthcare and responsible authorities, the employer – which in many cases regarding sick leave is also public – and the individual.
This cooperation must work. Now we have taken hold of it and also put a substantial battery in the budget for 2025 so that it also works. The previous government did not do that, but this government does. We see the problems, and we take measures that have an effect.
Another important issue that I would like to raise here today, Mr. Speaker, is the issue of knowledge, expertise, and effective and proven interventions, especially for people with psychiatric diagnoses. There is a great need here for new and increased knowledge. We know that the long-term sick leaves are becoming longer and also more numerous, and we also know that the vast majority of them concern psychiatric diagnoses.
That is why we have tasked Socialstyrelsen to investigate and take measures deemed appropriate to promote the development of knowledge regarding sick leave and rehabilitation, especially regarding psychiatric diagnoses.
To improve the knowledge base regarding the most effective interventions, the government also allocates funds to research in the area in the government's research and innovation policy bill. During the years 2025–28, the government allocates 25 million kronor annually to support the formation of centers that work to strengthen knowledge, evidence, and effective interventions for return to work within the area of mental health.
Even healthcare, which meets a person on sick leave early in the sick leave, has good opportunities to contribute to a rapid return to work and to provide the right support and the right help during the sick leave. 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 to work as soon as possible.
Against that background, Mr. Speaker, it is extra important and pleasing that we are now adding 500 million kronor for a targeted initiative on primary care's first-line work with mental health. It is particularly important to strengthen these parts because it is often primary care that first meets the person on sick leave.
Additional funds have been announced for the years 2026 and 2027, for here it is important to be persistent. By shortening the queues and ensuring that people receive care in a timely manner, we reduce human suffering and increase the return to work after sick leave due to a psychiatric diagnosis. That is how we succeed in reducing the number of sick leaves and the unnecessarily long sick leaves.
Jessica Rodén (S)
Mr. Speaker! I would like to thank the Minister for the debate.
The best health insurance is the one we never need to use, which means we must take workplace environment issues much more seriously. We cannot accept a labor market where people are worn out prematurely.
Statsrådet Anna Tenje (M)
Mr. Speaker! I would like to begin by thanking the member for the important and pressing issue she raises in her interpellation.
I believe it has emerged with all desired clarity that this is a very prioritized and important issue for the government and that support for returning to work is very central.
I want to raise the issue that the member brings up regarding improving the working environment and working more preventively. I am responsible not only for the sickness insurance but also for elderly care. There, I encounter many people on sick leave, and we see that sick leaves are increasing in female-dominated occupations within the public sector.
That is exactly why I think it is so incredibly important that the state, the municipalities, and the regions work hand in hand when it comes to supporting individuals, and therefore I recently gathered representatives for the regions, the management of SKR, and representatives for the municipalities for a round-table discussion. From their standpoint as employers and their survival, more or less, it is important that they begin to work to a greater extent with the work environment and the work situation for their employees. We know that sick leaves within the public sector cost a lot of money, but above all, we lose so much knowledge and so many hours of work because so many are on sick leave.
This is an issue that I work with from many different perspectives and which ranks high on the agenda for me. I thank you for the debate today and look forward to more.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.