Response to interpellation 2025/26:156 on an accident commission for elderly care
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The debate concerns the need for an accident commission for elderly care. M argues that the municipalities have the ultimate responsibility and that the state monitors this through IVO 1. M believes that the government prioritizes elderly care through reforms such as protected professional titles, support for relatives, and a proposed language requirement 1. M argues that a new investigation is not needed as existing reports are available 2 and that they have already addressed several recommendations from the Corona Commission 2. M wants to introduce a clear competence requirement, extend the Elderly Care Boost (Äldreomsorgslyftet), and introduce a language requirement to strengthen patient safety and the working environment 3. M emphasizes that language support is crucial for quality 4. V wants a parliamentary investigation to abolish minute-management, introduce shared shifts, increase staffing, and raise wages 5. V wants to investigate resource shortages and profit-seeking 6. V believes that the government refuses to answer questions and instead fabricates 6. V argues that the government misleads by not proposing a concrete language requirement and instead referring all problems to immigrants 7.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Äldre- och socialförsäkringsministern Anna Tenje (M)
Madam Speaker! Nadja Awad has asked me if I intend to work towards appointing a commission of inquiry for Swedish elderly care. Nadja Awad has also asked if the government intends to work towards ensuring that minute-management within elderly care is abolished through legislation and replaced with a system based on trust and the individual's needs. Furthermore, Nadja Awad has asked if the government intends to implement one or more of the proposals mentioned in bullet points in the interpellation, as well as what measures I intend to take to improve elderly care if the government does not implement them.
In Sweden, we have a system of local self-government. Even though the state regulates tasks in law, municipalities have great freedom to design and organize their own activities, and they are responsible for the activities' results, quality, and content.
The municipality is ultimately responsible for the social services, of which elderly care is a part. Activities within the social services shall be of good quality. The social welfare committee shall systematically and continuously monitor, develop, and ensure the quality of its activities.
The municipalities manage their affairs on the basis of local self-government. It is therefore the municipalities' responsibility that the methods, work practices, and tools used are appropriate to fulfill the tasks and thereby comply with the legislation. That being said, the state can inspect how the municipalities manage their tasks. For example, the Health and Social Care Inspectorate exercises supervision according to the Social Services Act (2025:400).
Madam Speaker! Elderly care is definitely a priority issue for the government, which during the mandate period has implemented several reforms and initiatives for a more secure and safer elderly care. A far-reaching reform is that the profession of nursing assistant is regulated and receives a protected professional title, which contributes to maintaining competence within elderly care and simultaneously increasing the status and attractiveness of the work.
Furthermore, the government decided on November 20 on a bill with a proposal that the support for relatives who provide care and nursing should be significantly strengthened and that a fixed care contact in residential care shall be introduced from July 1, 2026 (prop. 2025/26:60).
The Government also recently decided on the referral to the Council on Legislation regarding a language requirement within elderly care (S2025/01922). In the referral to the Council on Legislation, it is proposed that a requirement shall be introduced in the Social Services Act, which means that social welfare committees and operations shall work to ensure that staff have a relevant level of knowledge in the Swedish language.
The Government has taken several other measures to strengthen the quality of care and proposes further investments in the budget bill for 2026 (prop. 2025/26:1) to continue strengthening elderly care as a whole. The municipalities receive, for example, continued state grants specifically for elderly care, the so-called sector grant, which the municipalities can use freely to ensure good care and nursing for elderly people. The elderly care boost has been strengthened and extended to 1.8 billion SEK per year in 2026 and 2027. Furthermore, the competence initiative has been expanded to more areas of education.
Questions regarding staffing and competence development are ultimately questions for the employer; there is no doubt about that. It is, for example, about the municipalities now really needing to raise the bar and become a more attractive employer, invest in leadership, and find solutions for a sustainable working life.
The employer has the primary responsibility according to the Work Environment Act and shall conduct systematic work on the work environment in cooperation with employees and safety representatives. A good and safe work environment contributes to a sustainable working life. The Swedish labor market model further implies that the parties in the labor market regulate wages and other employment conditions through collective agreements.
In procurement, it is important that suppliers provide services of good quality. Konkurrensverket has been commissioned by the government to submit proposals for an efficient, proportionate, and reliable method to assess the extent to which suppliers fulfill quality requirements in public contracts (Fi2025/00078). The idea is to see how one can increase suppliers' ability to compete with quality instead of with the lowest price. The assignment has recently been presented, and we are currently working on it within the Government Offices.
Nadja Awad (V)
Madam Speaker! What would the result be if Sweden actually appointed a parliamentary inquiry into elderly care and subsequently did what was necessary?
The assistant nurse Therése would no longer have to stand there, with a full bladder, and wonder when she will get her next toilet break while she stresses between users in the home care service. She could breathe. If Roger, 79 years old, absolutely does not want to shower on Wednesday morning, he can do it in the afternoon, or on Thursday, because both he and Therése know that it is she who will come back then.
Think about how Rogers' daughter Anneli would feel then – that her father gets to decide over his own day again. He escapes stress, and she escapes having to step in and take responsibility for his hygiene in the middle of her role as a teacher. She can focus on her students and her life, not on turning her calendar upside down to save the security for her father, because the minute-management, this dehumanizing system where every second counts but never the human, is abolished.
The care assistant Sandra would no longer start her work shift at 7 and end at 21.30 after spending four or five unpaid hours in a bus shelter in the middle of nowhere or in a staff room. She could be home when the children wake up and when they are going to sleep, because split shifts – these completely unreasonable work shifts – are abolished.
The nursing assistant Fatima would work a 33-hour work week on a full-time position, with maintained salary. She gets time with her family, time for recovery, and time for life. She has more colleagues around her, not fewer. She has fewer long-term sick colleagues and fewer pangs of conscience because she is forced to choose between responding to an alarm for a suspected stroke or administering insulin on time. She is less stressed and happier, and above all, Fatima feels that she is enough, because the reduction in working hours and higher staffing have become a reality.
Agneta, who is waiting for a visit, is also feeling better. When Fatima arrives, she always asks how Agneta is doing, and there is time to listen to the answer. Fatima knows exactly where Agneta's medicines are and which coffee cup she prefers. Agneta does not have to repeat herself time and again for new faces. The continuity allows her to dare to relax and feel safe in her own home. There is time for both care and nursing, but also to flip through the photo album and talk about the grandchildren she is so proud of.
And then we have the healthcare assistant Abdi. He belongs to those who have long had one of Sweden's lowest median salaries – 23,600 kronor a month – but when the elderly care home where he works is taken back into municipal management, everything changes. His salary is raised, and he no longer has to choose between a dentist appointment and winter clothes for the children. The money covers both things and a little more on top of that. Abdi also receives a fixed-term employment contract. He begins to think ahead – perhaps he should further his education to become a nursing assistant. The boss encourages him, and the training can also be done during working hours. Suddenly, it doesn't just feel like a dream, but like a door is actually standing ajar – a way forward, a development that is his.
Madam Speaker! This is what I wish for our elderly, for their relatives, and for the workers who carry the entire welfare system on their shoulders. And I actually believe that the government also wishes for this. Therefore, I must ask the question again: Can Minister for Older Persons Anna Tenje imagine appointing a parliamentary commission so that the entire Swedish Parliament can together investigate and rectify the entire elderly care system?
Äldre- och socialförsäkringsministern Anna Tenje (M)
Madam Speaker! Those are beautiful words from the member – fantastic stories. I do not believe there is anyone in here who can oppose that description. There is not a single party that would do so.
My message to the member is: Get down from the stands! Get into the match! Work with the proposals that exist!
A new party-political investigation is not what Swedish elderly care needs. We have the Corona Commission's reports, we have Ivo's reviews, we have the investigation on an elderly care act, from which we have taken many good proposals forward, and we have the new Social Services Act. There is, therefore, no lack of proposals on what can be done to strengthen Swedish elderly care.
If one had been out and conducted many study visits around Sweden's municipalities, one would have clearly seen that there is a very forward-looking approach regarding the full-time journey and the right to full-time work, and with the abolition of split shifts, both to improve the working environment and to strengthen the quality within elderly care.
My message is therefore: Get down from the stands! Get into the match! Stop with the placard politics and populist proposals and work with the proposals that exist!
During my time as Minister for Older Persons, there have been few occasions where I have stood here and discussed elderly care, because there are not many proposals that come from the opposition specifically. I have missed that. I believe, in fact, that it is important that we have these types of discussions.
The failings within elderly care that we have seen testimonies about recently are unfortunately nothing new. It is not only in the last few weeks that we have read about horrors that have been uncovered, such as robberies, rape, and missed visits by staff. This can, of course, never ever be accepted. Therefore, I have also had meetings with Ivo to discuss precisely those Lex Sarah reports that come into the authority and which concern serious conditions and what that says about Swedish elderly care.
In this context, I still want, Madam Speaker, to be very clear and remind that the information in the Lex Sarah reports and the work that Ivo does shows a picture of the operations that actually do the right thing. We politicians must never paint a black picture of the municipalities that do what they are supposed to do, namely to report, but we must encourage the improvement that this leads to. The reports that have reached Ivo are indeed an important part of the operation's quality work. If one takes the deficiencies that are discovered seriously, one does exactly what those municipalities have now done. Working with deviations based on Lex Maria and also Lex Sarah is definitely not a failure in itself. It is a method to ensure that the quality in the operation is raised, that the bar is raised, and to guarantee that this does not happen again.
As I mentioned in my opening remarks, elderly care is a priority area for the government. We have been working proactively from the day I took office. One can look at the Corona Commission's report on deficiencies and the measures and recommendations contained therein. Within my area alone, we have now addressed nine of the eleven recommendations in the Corona Commission's report. Including my colleague Elisabet Lanns area – health and medical care legislation – there are even more things that we have added.
Just to mention a few things briefly: It is about strong support for relatives. It is about a fixed care contact in residential care, just as we have within home care. It is about a fixed care contact so that one does not fall between the cracks. It is about reinforced medical competence. We are now introducing a medically responsible person for rehabilitation and access to medical competence 24/7 both within home care and within residential care.
Nadja Awad (V)
Madam Speaker! I want the Minister for Older Persons to answer my question. I am starting to get a bit tired of having recurring interpellation debates with the Minister for Older Persons, but also with other ministers in this government who refuse to answer the question and who love to fabulate in the debates and mislead those who listen and watch us here. One could almost believe that you have taken a rhetoric course from Trump, for that is what you do day in and day out in this chamber.
We in the opposition are here to hold this government accountable. Therefore, I think, Madam Speaker, that all the ministers of this government must begin to answer our questions.
It is not okay for Minister for the Elderly Anna Tenje to accuse me of not presenting any proposal in this debate. The entire interpellation regarding a disaster commission specifies everything from the poor working conditions and the lack of resources to the pursuit of profit within elderly care. It is a number of different proposals in the collective proposal for a disaster commission in elderly care that I want to debate here and now with Minister for the Elderly Anna Tenje, because people out there want to know: Do you want to investigate elderly care for real, or do you want to cherry-pick what suits you just now?
I understand that this government thinks that language requirements in elderly care is the best policy right now, because you are dependent on the Sweden Democrats. This government is dependent on the largest party in this government base, the Sweden Democrats, who are eager to refer to all social problems as the fault of immigrants and want to portray it as that all shortcomings in elderly care could be addressed with more language training.
It is part of this. We are going to invest in language competence in elderly care. We are going to invest in all languages, because all languages will be needed. Swedish and other languages will be needed, because the elderly group has become more and more ethnified. We will need all languages. But it is not only that investment that is required. We need other investments too, don't we? That is what I want to discuss in this debate. I understand that it is convenient to refer all social problems, such as the challenges in elderly care, to immigrants. But that is to mislead and fabricate. I think we should stick to the substantive politics.
That is why I want an answer to my question regarding the Left Party's proposal for a disaster commission, which concerns a parliamentary investigation where the entire Swedish Riksdag is represented to get to the bottom of all the problems we have in elderly care.
Twelve people have died because of the deficiencies we see in the working environment within home care. Five people alarmed for a stroke but did not receive help in time. How is language training supposed to help those people? It was not a question of the Swedish language leading to them not receiving help in time when they alarmed, it was because there is a shortage of staff. It is because of the inhumane time planning system with minute-by-minute control. Those are the proposals that we want to discuss in the chamber.
Again: I want an answer to the question based on what I have raised in the interpellation regarding a parliamentary commission. Will the former Minister for Justice appoint such a commission, yes or no?
Äldre- och socialförsäkringsministern Anna Tenje (M)
Madam Speaker! I think I was quite clear. I understand that it concerns the recipient's ability when it comes to answering or receiving an answer, so let me be clear again.
It is not an accident commission and a long, large investigation we need. We have investigated Swedish elderly care. We have reports from the National Board of Health and Welfare which clearly show, for example, that the problems with the work environment look the same now as they did 20 years ago. It is a great failure for everyone here in the chamber, completely regardless of political party, that we have not done anything about what we knew applied 20 years ago and which still applies. I am clear. I think we need to do something about those things. But it is, therefore, not a new investigation we need.
My point is: Get down from the gallery! Get into the match! You want to deceive and downplay the importance of the language requirements. Read the Corona Commission's clear recommendations regarding exactly the language! That is the foundation. In my previous posts, I did not mention the language requirement at all, so I know which of us two is fabricating and trying to mislead in such cases.
Let me still get to this, because now we are doing this from the government's side: Step by step and reform by reform, we are now strengthening the quality and raising the bar. We are also increasing the requirements to work within Swedish elderly care. We are now moving forward with a clear competence requirement. We are extending and strengthening the Elderly Care Boost (Äldreomsorgslyftet). We are working very proactively with a protected professional title to raise the status and the attractiveness of these important professions so that more people want to enter, stay, work more, and move from part-time to full-time, but above all so that they receive a receipt for the important education they have. Competence is incredibly important precisely for the quality.
Regarding the second question on language requirements, which I am happy to speak about at length, it is fundamental. In the single case in the member's example, it was perhaps not the language that was decisive, but a deficiency that we definitely need to address. But in the case in Västerås with the woman who had suspected sepsis and was also demented, the ambulance personnel were alerted to the residence and met by staff who did not speak a single word of Swedish. The ambulance personnel could not get answers to questions about whether the elderly woman had a fever, if she had eaten and drunk, what her general condition was, or if she had had an infection – this was because the staff, in fact, did not speak a single word of Swedish. There, it was a matter of life and death, and it was directly life-threatening that they did not speak the Swedish language.
I understand that you in Vänsterpartiet are not interested in introducing a language requirement in Swedish elderly care, but it is definitely us. It is about the elderly person's right to be able to understand and make themselves understood, to be able to influence the freedom of choice in everyday life in the small as well as in the large. It is about how things should be carried out in everyday life on one's own terms with both integrity and self-respect intact. It is also about freedom of choice in the large – to be able to influence who one has as a provider but also which residence one lives in.
Language is, however, fundamental for the elderly to be able to understand, make themselves understood and make their voices heard. It is important for us.
But it is also about patient safety and the work environment. If the employees cannot talk to each other and have a secure handover, and also sit at the coffee table and chitchat about how the weekend was, how it's going for the son in swimming lessons, or what to do for Christmas, they will not become a cohesive team. Then the work environment will not be particularly good, and then fewer will seek out these very important professions.
The third requirement we are now putting forward, and which I understand that the Left Party also has major problems with, is to enable proper background checks to ensure that those who work in elderly care are also suitable.
Nadja Awad (V)
Madam Speaker! This is exactly what I mean by that this government constantly fabricates and misleads. Not even you are putting forward a concrete language requirement. The Minister for Health and Social Affairs himself has said so in media statements and press conferences. The government's own investigator on a language requirement also did not recommend a concrete language requirement, as it would lead to an increase in the staff shortage in elderly care. Therefore, the government is not putting forward a proposal on language requirements as sharp as the one it initially did. According to the minister, they do not want to exacerbate the problems that already exist within elderly care with high staff turnover and a large staff shortage. That is what I mean by that this government constantly misleads.
I understand that it is convenient for the government not to deviate from what the Sweden Democrats want the government to do, which is to attribute all problems, everything from the challenges in elderly care to the record-high unemployment, to the fact that they are the immigrants' fault. That pensioners cannot afford to buy food or buy their medicines is the immigrants' fault. That we have contract killings among young people is also the immigrants' fault. All problems are to be attributed to immigrants.
I understand that the government has received a commission from the Sweden Democrats to refer all political proposals to attacking immigrants. Right now, those who work in elderly care are being deported on an assembly line, even though they are part of upholding the welfare in exactly the same way as everyone else. It is unworthy, I think.
Äldre- och socialförsäkringsministern Anna Tenje (M)
Madam Speaker! I would like to begin by thanking the member for this interpellation debate. I believe it has been very clarifying.
Swedish elderly care is carried forward by hard-working nursing assistants and care assistants. A very large proportion of these have an origin that is not necessarily Swedish. They do an outstanding job and are incredibly important for us to be able to work on raising the quality, raising the bar and addressing the deficiencies that exist within Swedish elderly care, which I am passionate about us being able to do.
In Sweden, however, we have undervalued the importance of learning the Swedish language. It is therefore not their fault who work within Swedish elderly care today. That is exactly why it is incredibly important that we now ensure that we raise the bar significantly.
The elderly care boost is now being extended and increased to 1.8 billion so that the municipalities can access these funds to carry out extremely good language support measures, both for the staff they already have and for those they will newly hire. Then we have the requirement to achieve B2 according to GERS. It is a fairly high and tough goal, but the municipalities I have spoken with are also inspired to adopt this. The importance of the Swedish language is seen so that the elderly can understand and make themselves understood, so that patient safety can be strengthened, and so that the work environment can be improved. If this is, we are completely in agreement.
Vänsterpartiet, however, definitely does not seem to be on that track. Then, Madam Speaker, I become curious: Is it a statement from Vänsterpartiet that they are not interested in introducing a language requirement within Swedish elderly care? I believe that would be a very important statement to the Swedish people, given that investigation after investigation and review after review shows that it is precisely the language deficiencies that underlie many of the quality deficiencies we see within Swedish elderly care.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.