Response to interpellation 2025/26:252 on healthcare staffing during crisis and war
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
KD considers healthcare to be an activity of great importance to the total defense 1 and that the government has implemented measures to strengthen the supply of competence 1. KD argues that the government takes responsibility through new legislation for resource redistribution as well as through state grants to the regions 2 3. KD agrees that the preparedness is being built here and now 4 and argues that billions have been allocated to the regions so that they can hire 4. S argues that personnel is the real bottleneck during a crisis and that a national strategy is lacking 5 6. S considers that the government must take significantly more responsibility for the personnel supply 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! Markus Selin has asked the Minister for Civil Defence how he intends to ensure the availability of a sufficient labor reserve within the health and medical care sector in the event of, for example, an armed attack or a prolonged crisis.
Markus Selin has also asked whether the Minister intends to take the initiative to clarify the distribution of responsibility regarding the staffing of the healthcare sector, and if so, in what way.
The work within the government is distributed in such a way that it is I who shall answer the interpellation.
Initially, I want to emphasize that healthcare is a socially important activity that has a central role in total defense. Healthcare must therefore be able to be conducted even under such difficult conditions as may prevail during peacetime crisis situations and even more so during high alert and, ultimately, war.
The staff is the healthcare system's most important resource and the very foundation upon which healthcare rests. The Government has therefore implemented several measures to strengthen the supply of competence in normal conditions. The Government has, for example, tasked Socialstyrelsen with developing proposals for a national plan to improve the healthcare system's supply of competence (S2023/00256). The assignment was reported on 31 May 2024, and the National Healthcare Competence Council then presented 25 different proposals for measures to improve the supply of competence in Sweden.
The proposals concern, among other things, ensuring time and resources for skills development and providing increased opportunities for career paths in order to attract, develop, and retain healthcare personnel. The majority of the proposals fall within the framework of what is currently decided by the respective healthcare provider, university, and college, and I have noted that several good initiatives are already underway to improve the supply of skills within health and social care.
In the budget bill for 2026 (prop. 2025/26:1), the government presented an increased healthcare investment, 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 initiatives within this area. In order for more doctors with education outside the EU, EEA, and Switzerland shall obtain Swedish medical licensure and be able to work in Swedish healthcare, the government allocates 13 million kronor in 2026 and intends to allocate 14 million kronor from 2027.
Since January 1 of this year, the Health and Medical Services Act (2017:30) clarifies what obligations municipalities and regions have to provide care and help each other during peacetime crisis situations, heightened readiness, and states of catastrophe. The obligation to provide help covers all types of resources and can, for example, consist of reinforcement units, i.e., groups with associated personnel and equipment.
In the event of armed conflict or war, healthcare is faced with situations that require different knowledge and methods than in ordinary healthcare activities. Healthcare personnel therefore need to undergo competence-enhancing training and exercises. Socialstyrelsen has the government's mandate to coordinate and carry out national exercises as well as to provide training that strengthens preparedness within healthcare.
The investigation on the civil defense's personnel supply (Fö 2023:03) states in the report *Duty Calls! A modern personnel supply of the civil defense* (SOU 2025:6) the assessment that the need for personnel reinforcement for health and medical care during high alert needs to be met, in part, through civil duty.
Against this background, the government commissioned Socialstyrelsen in April 2025 to analyze and assess which measures are necessary for a system of civil service to be introduced within healthcare. Within the framework of the assignment, it was included to produce assessments of the need for civil service and proposals for positions, training needs, and responsibilities.
The National Board of Health and Welfare reported the assignment in November 2025. The authority notes that the staffing within health care and dental care during high alert and war will largely consist of personnel working in the operation in the normal situation. It will, however, need to be reinforced with additional resources.
The National Board of Health and Welfare therefore assesses that there are grounds to introduce civil service in health and medical care following both conscription and other investigations. These two forms of civil service fulfill different needs in health and medical care in the event of war. The proposals in the report are currently being prepared in the Government Offices.
Markus Selin (S)
Mr. Speaker! The healthcare sector's staffing is already strained today – without a crisis. In a crisis or war, personnel is the real bottleneck. The pandemic showed us in a brutal way that the system lacks endurance.
The government speaks of preparedness, but without staff – that is, without people who do the work – there is no preparedness. Without people of flesh and blood in healthcare, there is no preparedness.
I would like to point out a clear contrast. In my constituency, Stockholms läns valkrets, Region Stockholm shows that politics makes a difference. While other regions are cutting staff, Region Stockholm has hired 2,300 more in healthcare. These 2,300 are very suitable even during a crisis and for crisis preparedness.
This is already leading to shorter care queues and that the waiting times for surgery have decreased by three weeks. It has led to the waiting times at the emergency room decreasing by 20 minutes on average, that the availability is at the top in the country, that the confidence in specialist care is increasing and that most, according to the patients themselves, has become better.
Mr. Speaker! Region Stockholm has a focus on permanent employment, the work environment, and continuity. To ensure a robust and cohesive healthcare infrastructure, Region Stockholm has taken over the responsibility for ambulance care and 1177 via telephone. These decisions are based on lessons from reality and from the pandemic, which revealed the risks of a fragmented organization and a lack of control over critical societal infrastructure.
This constituted a direct threat to our preparedness during the pandemic, and in light of the geopolitical reality we face here and now, it is our duty to rectify it. Reduced rental staffing provides more stable care, because rental staff do not function in crisis and war.
The Social Democrats, the Green Party and the Centre Party govern Region Stockholm today in a center coalition and have, for this year, laid a budget that is fully financed. At the same time, they are providing reinforcements to healthcare with 5 billion kronor and to the health centers with 580 million kronor.
Thus, Mr. Speaker, care queues are shortened both for the emergency room and for planned healthcare. This work yields effects for everyone who invests in strengthening the crisis preparedness. On a larger scale, it can be said that all the Defense Committee's representatives here in the Riksdag are working in precisely the same direction. The need for strengthened defense capability is great.
My question to the Minister for Health and Social Affairs is: Why is there a lack of a national strategy that in this way is based on personnel?
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! I thank the interpellor. It is important success factors that are highlighted.
I want to point out that it easily becomes a bit of a regional political debate in the chamber, and it is perhaps not the right context to compare different regions. However, working with continuity and becoming independent of locum doctors is not something unique to Stockholm, but it is something that the regions do. There is also very clear legislation regarding this. We have had a law on permanent doctor contact for many years, but as with other legislation within the healthcare area, this is something that the regions unfortunately succeed in living up to far too rarely.
When I last informed myself about the matter, the interpellant's party wanted the order we have today regarding regional autonomy and the responsibility for healthcare issues. In that case, it also happens that it differs slightly across the country. I do, however, completely agree that important factors for building a robust healthcare system are to work with continuity and to avoid hired doctors – hired staff in general, not just on the doctor side.
Since my first day in this role, I have highlighted the importance of the healthcare system being robust and functioning in peacetime if we are to manage our preparedness at all. The most important preparedness factor is that the healthcare system is so robust that it can manage to deliver the care that is needed in normal conditions. If that does not work, we can work as much as we want with preparedness, but it will not help us.
Parallel to the regions working, with the support of the government and the National Board of Health and Welfare, to eliminate queues, increase continuity and create more robust operations with more care beds, there is also an intensive effort underway to manage, for example, mass casualty incidents. We have new legislation in place that enables the state to redistribute resources in the country in the event of a crisis and disaster so that both personnel and other resources can be moved to handle those types of incidents. Exercises have been carried out and will continue to be carried out. There is, therefore, an incredibly intensive effort underway to also prepare healthcare for catastrophic events and, in the worst case, war.
Markus Selin (S)
Mr. Speaker! I thank Minister for Health and Social Affairs Lann for the answer. To a small extent, I can agree.
Let me be clear: personnel policy is, in everyday life, preparedness for crisis and war. I stand here today because we live in a new era. From this rostrum, I look back to when I myself served my military service in the army at Kungliga Dalregementet in Falun in the 90s. An important message to us soldiers was that in order to dare – in order for us to have personal courage – to face combat and bullets, we needed to know that our nearest comrade-in-arms, our fire team and our battalion knew exactly how the one who was injured would be transported to a safe zone.
In the same way, Mr. Speaker, the trust in the state and society functions when it comes to building defensive will. It is about a confidence that when things get tough – when the crisis and the war are knocking at the door – we never flinch. Healthcare must be there when it is needed.
Staff shortages are not natural; they are politically shaped. Region Stockholm is going against the current while other regions are pulling on the brakes. Permanent employment provides a better working environment. Permanent employment results in lower sickness absence. Permanent employment provides better crisis resilience. The state cannot completely hand this over to the regions. Preparedness requires state governance and planning. Today, a national staff reserve is lacking, Mr. Speaker. A clear division of responsibility is lacking, and a plan for rapid mobilization is lacking.
When I follow the government and listen to the Minister for Health and Care today, it sounds as if nothing applies here and now, today. Preparedness instead is a bit about later, somewhere else. In relation to crisis and war, this is too late and too little.
The Minister for Health and Care refers to the National Care Competence Council's 25 proposals. I am sorry, but I have reviewed them, and what I can see is that—even with goodwill—only 2 of the 25 proposals in any way relate to crisis and war.
I see that the military defense today faces exactly the same challenges as healthcare. More personnel are needed already today and also in the future. More are needed who can train, more arms and more legs – more flesh and blood.
Mr. Speaker! Today we see cuts in many areas of healthcare. Let me be clear: Cuts in healthcare today are completely the wrong direction for building staffing for crisis and war. My question therefore goes back to the Minister for Health: Does the government intend to take any initiatives toward some national coordination of healthcare personnel for crisis and war, and if so, how and when?
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! I do not know if the interpellor did not hear what I said in my previous contribution. The Government has taken the initiative, and things are happening. There is today a national unit that can act. It has practiced – I was present at the exercise in the autumn – and can be called in and assist in the event of a catastrophe or crisis situation when needed. So, a lot is happening now, for real.
Socialstyrelsen has been tasked with working to support the regions in this work. A concept has been developed called the PLUS concept, where PLUS stands for personnel, premises, equipment, and management. This work is being further developed, but it is about providing the regions with support to secure basic capacity and to be able to scale up capacity during peacetime crises, high alert, and ultimately war.
So, work is ongoing. Furthermore, the Government takes a national responsibility also through the new legislation which makes it possible to allocate both personnel and resources in the event of a crisis situation and war. The work is ongoing, and exercises have been conducted. Some questions are still being prepared.
I would, however, like to point out, regarding the praises of Region Stockholm and permanent employment, that one should be careful not to conclude that other regions do not offer permanent employment and that this is the reason they use hired personnel. It could be perceived as almost an insult to those regions that are struggling very hard with vacancies and sometimes have no applicants. It is therefore not something new and absolutely fantastic that Region Stockholm has discovered here by offering permanent employment, but this is a problem that very many regions are dealing with.
As said: When it comes specifically to preparedness, the government is truly taking a great responsibility in helping the regions both financially and with a great deal of knowledge. Specifically in the area of staffing, the regions can apply for state grants through the ordinance (2023:489) on state grants to regions for healthcare preparedness. They can apply for state grants for measures concerning, among other things, staffing within the preparedness, as well as training and exercises that strengthen the staff's competence within healthcare. It is just one example of the measures and activities that are ongoing.
Markus Selin (S)
Mr. Speaker! Let me summarize and give a politically well-intentioned appeal with the current security policy situation as a backdrop: Sweden – we – cannot build crisis preparedness on worn-out margins. Healthcare personnel are a security policy resource, Mr. Speaker.
The Social Democrats, the Green Party and the Centre Party govern Region Stockholm – my very own constituency – as a center coalition. There, they show that more employees in healthcare is possible and that the dependence on hired staff can be reduced. What works regionally should be scaled up nationally. With the current security policy situation as a backdrop, the government must and can take significantly more responsibility for the staffing supply. The government must see healthcare as a part of the total defense.
Mr. Speaker! In conclusion: Preparedness does not begin when the crisis arrives. It is built every day, Mr. Speaker – even right now, today – through political choices and decisions.
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! I agree with the interpellor that the preparedness is being built here and now, and that is what we are doing. I almost get the feeling that the posts are written a bit in a vacuum without the interpellor having inquired and investigated what is actually being done.
I can only answer that what you are requesting is being done, Markus Selin. The government is investing. We have invested 18 billion so far, and just this year we are investing 6–7 billion to strengthen competence in the regions through state grants. Billion after billion has during the entire mandate period gone to the regions so that they can hire; that is what the money goes to. It does not go to premises or anything else, but the money that the government injects into the regions goes to personnel specifically.
Regarding the area of preparedness, an incredibly intensive work is underway. I look forward to us either in the next interpellation debate or at a special session being able to compare what this government has done to strengthen the healthcare system's preparedness compared to what the Social Democratic government did during its eight years to strengthen the healthcare system's preparedness.
Thank you very much 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.