Response to interpellation 2025/26:221 on competence supply within health and medical 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 competence supply within healthcare. KD argues that the staff is the most important resource and that the government has allocated billions to strengthen the competence supply 1 2. KD emphasizes that the government has a better grasp of the shortages, that a new law for unified employment has been implemented 2, and that the National Board of Health and Welfare's planning tool enables long-term planning 3. KD sees hope in the record intake for nursing education 4 and emphasizes the importance of constructive cooperation 3. S argues that the government's response lacks concrete information and that current state grants are insufficient 5. S wants structural measures such as national coordination of continuing education 6 and emphasizes that a sustainable work environment is required for the staff to stay 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.
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! Anna Vikström has asked me whether I and the government have implemented any measures that the National Health Competence Council has proposed to the government so far in the interim reports, final reports, or the national plan, and which of these measures we will implement.
Anna Vikström has further asked how I and the government intend to proceed with the proposals in the investigation Strengthened patient safety through the right competence – based on the needs of health care and dental care (SOU 2025:63) as well as what other measures I will take to strengthen the national commitment for the competence supply of health care.
Initially, I want to emphasize that the staff is the healthcare system's most important resource and the foundation upon which healthcare rests. The Government therefore tasked the National Board of Health and Welfare to develop proposals for a national plan to improve the healthcare system's competence supply (S2023/00256).
The assignment was reported on 31 May 2024, and the National Health Competence Council then presented 25 different proposals for measures to improve the supply of competence in Sweden. The proposals concern, among other things, ensuring that there is time and resources for competence development and providing increased opportunities for career paths to attract, develop, and retain healthcare personnel. The majority of the proposals fall within the scope of what is currently decided by the respective healthcare provider, university, and college, and I have noted that several appropriate measures are already underway to improve the supply of competence within health and medical care.
The Government decided on 19 October 2023 to appoint a special investigator with the mandate to analyze what changes may be needed in regulations and structures regarding regulated professions, specialist competencies and specialist educations, as well as further education and continuing education within health care and dental care to meet the challenges that these activities face (SOU 2025:63). The final report was presented on 3 June 2025. The investigation proposes, among other things, that continuing education becomes a legal requirement for both employers and healthcare personnel, as well as new rules for specialist educations and protected professional titles. The proposals are now being prepared in the Government Offices.
The Government decided on 1 June 2023 to appoint a parliamentarily composed committee to produce a decision basis enabling a gradual and long-term introduction of full or partial state ownership of health and medical care (SOU 2025:62). According to the final report presented on 2 June 2025, the committee assesses that the state should take increased responsibility for a number of areas, of which competence supply is one, in order to create better conditions to meet the healthcare needs. The proposals are now being prepared in the Government Offices.
The Government allocated in 2025 just under 5.9 billion to be distributed under the Ordinance (2024:1252) on state grants to regions for strengthened accessibility and increased care capacity within specialized health and medical care, and just under 3.7 billion SEK to be distributed under the Ordinance (2024:1253) on state grants to municipalities and regions for the development of good and close care. In order to receive these funds, the primary providers must carry out measures concerning improved competence supply and working environment.
In the budget bill for 2026 (prop. 2025/26:1), the government presented an enhanced healthcare initiative, among other things to secure the supply of competence in both the short and long term. For this purpose, the government allocates 450 million kronor per year until 2028. The government also allocates 50 million kronor in 2026 for governance efforts within this area. To ensure that more doctors with education from outside the EU, EEA, and Switzerland obtain Swedish medical licensure and work in Swedish healthcare, the government allocates 13 million kronor in 2026 and intends to allocate 14 million kronor from 2027.
With that, I would like to thank Anna Vikström for the questions. I look forward to the debate.
Anna Vikström (S)
Mr. Speaker! I thank the Minister for Health and Care for the answer, which I must say does not contain any announcements.
It is good that the state grant for good and close care is linked to the requirement that the main employer must take measures for the work environment and competence supply, but it is not enough. Recently, the Work Environment Authority issued a report on health and medical care which shows a shortage of staff and serious deficiencies in the work environment. A shortage of competence within health and medical care causes a poorer work environment and a risk that patients do not receive the care they need. Today, Försäkringskassan also issued an alarm regarding the constantly high stress-related sick leave rates for, among others, healthcare and care personnel.
There is an increased influx of patients, of whom more and more are elderly and multi-morbid, which places high demands on healthcare staff, not least within primary care. But many health centers lack permanent specialist doctors in general medicine, and the need for more specialist doctors is generally great. This also applies to district nurses. There is a calculation showing that approximately 900 district nurses are missing at the health centers. Furthermore, for several years there have been fewer people studying to become specialist nurses, even though there would need to be 20 percent more for the shortage not to worsen. It is not sufficiently attractive to continue education after basic training, but this must change because healthcare is in great need of specialist-trained doctors and nurses within primary care, psychiatry, and other areas of activity.
Against the background that measures needed to be taken for the long-term supply of competence in healthcare, the previous Sledda government appointed the National Healthcare Competence Council. The Council has submitted a large number of reports and presented, as the Minister mentioned, in May 2024 also a national plan for the supply of competence in health and medical care. In these reports and in the national plan, there are well-elaborated bases for proceeding with measures to strengthen the supply of competence at a national level.
It is true that the plan contains proposals for measures aimed at the principals, such as regions and municipalities, and at educational providers, such as colleges. But proposals are also aimed at the government, which my interpellation is about. Some proposals to the government are to review the possibilities for national coordination of systematic and continuous continuing education for healthcare professions and to task the appropriate authority with developing a national leadership program for managers within healthcare and dental care. Other proposals are to ensure that agreements for health science education, learning, and research, so-called Vulf, are introduced for certain healthcare educations to strengthen the conditions for workplace-based education, to ensure research funds for more healthcare educations, and to stimulate universities and colleges to coordinate certain healthcare educations with few students.
In May, the report "Strengthened patient safety through the right competence – based on the needs of healthcare and dental care" was also released with a number of proposals.
It has now been almost four years since the government took office, and I would very much like to know what the government is doing with the proposals that are directed at the government specifically – not to the regions or to the universities, but specifically to the government. Which proposals have been implemented, and which will be implemented?
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! This is an important issue, and the staff is healthcare's most important resource. It is the staff who carry this socially important activity, and citizens value healthcare as one of the most important issues. Therefore, competence supply and the work environment are also included in the regulations that condition the state grants for good and close care and accessibility. The Government has so far allocated 18 billion to increase accessibility in health and medical care, of which the majority of the money has gone to the regions. These funds shall be used for competence supply.
At the same time, I share the frustration that it is moving too slowly. This is a long-standing problem, but it is also a problem that takes time to solve because there is a long lead time regarding both personnel and competence. We have 21 self-governing regions and 290 municipalities. One problem is that we have not even known what the shortage of and need for competence has looked like because all regions and municipalities have worked individually. But now the government has done a job and gained a better overview, and we will be able to work more systematically moving forward – something we are also doing with the help of the National Board of Health and Welfare.
I am pleased that all parties in the Care Responsibility Committee stand behind that the state should take a greater responsibility for competence supply. The committee presented its report in June last year – so it has not been that long – and many parts are now being prepared in respective departments. Regarding the parts that concern the Education Department, it is appropriate for the member to turn to the relevant department as I cannot go into details nor comment on what is currently being prepared there.
Something has already been implemented. Since June 2025, a new law has been in place that enables combined employments. This applies to several professional groups, including assistant lecturers. Other proposals are, as stated, still being prepared at the ministry.
Much rests on the regions, but the government also takes responsibility here by providing state grants. We will also return to how the funds for 2026 shall be distributed to help the regions make further investments in securing the supply of competence moving forward.
Anna Vikström (S)
Mr. Speaker! Clarifying what the needs are is good. It is also good with joint employments.
I have previously asked the government six questions regarding what is intended to be done with the various reports from the National Health Competence Council and with the national plan, but I have not received any answer so far. What I am looking for are the structural measures. The competence supply problem means that it is not possible to increase the number of healthcare beds – something that the National Board of Health and Welfare says is necessary – and as I mentioned earlier, there is a shortage of both specialist doctors and district nurses in primary care. There were 6,800, or 2.4 percent, more monthly employees in healthcare in Sweden's regions in 2024 compared to 2022, and that is not enough for either today's needs or the personnel supply in crisis and war, which Markus Selin will debate in the next interpellation debate. The staff constitutes the foundation for the entire health and medical care, and therefore it is important to look ahead and take long-term, structural measures to promote the competence supply.
There are many proposals that the government can adopt or reject. It might be worth testing some of the proposals and seeing what effect they have. One might not need to wait for another investigation since there are already quite a few. The Minister for Health and Social Affairs is a strong advocate for increased national governance of health and medical care, and in that regard, competence supply is a good area to address concerning the parts that rest under state responsibility. It concerns, for example, national coordination of systematic and continuous continuing education, a national leadership program, specific leadership programs for primary care, agreements for health science education, learning, and research for several of the healthcare professions, and so on.
The investigation "Developed cooperation for activity-based education" was submitted two or three years ago, but the government has not presented any proposal based on it. Two years ago, the National Healthcare Competence Council also came forward with several proposals at the state level as well. These concerned, among other things, the supply of competence for doctors in primary care, who truly have a need for more specialist doctors.
I also mentioned the investigation Strengthened patient safety through the right competence, which came with many proposals, including regarding regular continuing education to ensure good care and an obligation for the employer to offer regular continuing education. The investigation proposes, among other things, a healthcare profession lift based on the Lärarlyftet model. We think it is important to take this further.
What is happening with these investigations? Will the government take the proposals forward, or will they be shelved permanently? And what happens with all the proposals in the approximately 20 reports from the National Health Competence Council? As someone who has been in the industry for quite a long time, I think there are proposals there that address the competence supply problems in a new way and that are worth taking forward.
We Social Democrats have also submitted a proposal for a commission on the welfare and healthcare's competence supply. It is a way to take a collective grip on all proposals to the government that are currently at the Government Offices and have an uncertain future.
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! As I said, I will not be able to comment on ongoing preparations of proposals, and the member understands why I cannot do so. I do, however, very gratefully accept more input, because this is a complex area with difficult things to solve.
Negative spirals are easily created where the lack of competence leads to a worsened work environment and further lack of competence. Challenges are also created for colleagues who need to cover for colleagues who receive competence development during working hours. This is a complexity that we need to collaborate on at all levels to address, so that counterproductive effects and further pressure are not created in a sector that today is severely plagued by many additional burdens and work tasks that make it difficult to make working time, hands, and colleagues suffice.
This is a complex area, and I therefore believe that it is very important that all actors are involved in the work. As I said, I gladly accept good proposals even from the Social Democrats on how we can continue to work with this area.
I still want to say that important work is underway. That Socialstyrelsen has developed a planning tool is an example of a structural change that makes long-term planning possible in the first place. Those prerequisites did not exist at all previously. This has only recently been put in place. I believe we need to be humble and understand that it will take some time before we can see the effects we desire, but the more of this type of help and support that is in place, the better the conditions will be to move forward.
When it comes to, for example, national leadership programs, SKR currently has a leadership program that they offer to officials, managers, and leaders within health and social care. In that case, it is important that we do not create too many parallel tracks. There are therefore already quite many actors involved in this work.
It is important that we find good and constructive ways to cooperate instead of creating double structures for different parts. That is why some of the proposals and the work need to be prepared carefully. This is not something we will solve in a heartbeat. I believe that the member also understands this, Mr. Speaker. I am grateful that there is an engagement in the issue, and I believe that together we can come up with more good proposals on how we should move forward.
Anna Vikström (S)
Mr. Speaker! Thank you, Minister for Health and Social Affairs, for the answer!
It is important not to leave additional burdens on the regions and municipalities. There, I want to point out that the national plan has been worked on in such a way that it has been anchored with the heads of departments. When the final proposal was presented, it was therefore well-elaborated and anchored with the various heads of departments. It was therefore not the intention, but there is an agreement that these are important proposals.
I mentioned earlier that the number of monthly employees within healthcare increased by only 2.4 percent compared to 2022. Furthermore, the increase is very unevenly distributed between the regions. It is sad to see how hard the healthcare crisis has hit, for example, Region Östergötland, which during the period even decreased the number of healthcare employees by 474 people.
At the same time, it is very positive that Region Stockholm has succeeded in getting 2,340 more monthly employed workers in healthcare. This means that Region Stockholm accounts for 34 percent of the total increase in the country. Region Skåne has also increased its monthly employees.
Overall, however, this is not enough. The need for more employees exists throughout Sweden, and the staffing issue is fundamentally a question of the patient's needs. It is about patients receiving the care they need in a timely manner and that the quality of care should be strengthened. To succeed with that, a sustainable work environment is required. The entire issue of continuing education, competence development, and training, which the council has presented, is very much about finding ways that make the staff want to stay in healthcare and are given the conditions to do so in a more positive way.
None of the proposals that have been put forward can solve this alone, but we agree that competence supply is one of the most crucial future issues for healthcare.
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! I and the member are in complete agreement regarding the problem picture and the extra layer in the problem – that it is unequally distributed and that the regions are actually also competing for the labor force that exists. This makes it a bit more difficult in some respects to cooperate on it, as each region is keen to retain its employees, which is understandable.
What is positive in this is that we have a record intake in the nursing education this year. During the autumn, it was an all-time high when it comes to the number of admitted to nursing educations. We also have an increasing demand for medical educations. But again: There is a long lead time for staff, so it does not solve today's competence shortage here and now. It does, however, show that there may be light on the horizon. It is incredibly important that we help each other to stick to that so that we retain those who have entered the educations and, not least, retain those who are in the operations.
I want to thank you for an important debate.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.