Response to interpellation 2025/26:526 on a reformed equalization system for an equitable welfare_

Civilministern Erik Slottner (KD)

Madam Speaker! Eva Lindh has asked me why I and the government have not yet presented any proposal for a reformed municipal equalization system and how I intend to ensure an equal welfare throughout the country and counteract the fact that sparsely populated and rural municipalities are falling behind.

The municipal fiscal equalization system is important for creating equal economic conditions for the municipalities and regions regardless of settlement structure, population development and other socio-economic factors. At the same time, the system needs to be designed so that it does not counteract efficiency, development and growth. The equalization committee's proposals are being prepared within the Government Offices. I cannot precede that process here in the chamber.

The Government is taking several measures to strengthen capacity and efficiency in the municipal sector, with the aim of creating conditions for good welfare throughout the country. This includes, among other things, investments for smaller municipalities that experience a need to strengthen their ability to perform their mission towards citizens and to meet the challenges that social development entails. The Government has, for 2025 and 2026, granted funds to a total of four constellations of municipalities in different parts of the country to work with capacity analyses in collaboration.

At the same time, the government is taking measures to strengthen the quality and accessibility of welfare throughout the country. As an example, 300 million kronor have been allocated in the state budget for 2026, with a corresponding level estimated for 2027, to specifically support the development of close and accessible care in sparsely populated and rural areas. The purpose is that Sweden's population shall be offered equal, equitable, and accessible health and medical care throughout the country.

Sweden shall have a welfare to rely on. The Government is working broadly to re-establish a strong knowledge school and to improve accessibility and quality in health care and elderly care.

In conclusion, however, it is important to remember that it is tax revenues that account for the absolute largest part of the municipalities' and regions' revenues. The Government pursues a policy to support the economy, increase growth, and get more people into work. This is of great significance for the development of the municipal tax base and thus for the economic conditions of all municipalities and regions. This creates the conditions for good welfare throughout the country.

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Eva Lindh (S)

Madam Speaker! The Swedish welfare model is based on a simple but crucial idea: that people should be able to trust that society is there, regardless of who you are or where in the country you live. Children shall receive a good education, the elderly shall be able to feel security in care, and those who need care shall receive it in time.

Today, however, we see that this principle is being challenged. Municipalities and regions are struggling. Needs are increasing, the population is aging, and the skills shortage is growing. And the differences between the municipalities are becoming ever greater. Municipalities that are smaller, municipalities in sparse and rural areas, and municipalities with large socio-economic challenges are particularly hard hit.

Madam Speaker! Right now, municipal politicians and officials are sitting with budgets that do not add up. They are trying to make elderly care work despite increased costs. They are trying to secure school health when the needs are growing. They are trying to recruit staff to healthcare, school, and social services in a time of growing skills shortages.

At the same time, they are waiting for a decision from the government. They are waiting for a reformed equalization system. The entire Riksdag has agreed that the system needs to be reviewed, in order to ensure equal conditions throughout the country. The investigation is complete, and the referral responses are in. But after two years, the government's proposal is still missing.

It is not just an administrative delay. The Minister must still acknowledge that. A proposal should be able to lie on the Riksdag's table. But nothing happens. Nothing comes. And time and again, the Minister answers that he cannot say anything because it lies on the Government's table. He cannot precede that process.

It is easy. The Minister thinks that one can get away with giving that answer to municipalities and regions.

Everyone understands, however, that this is not just about an administrative delay. It is about the fact that the government – the SD and the government or the SD-government – has actually not agreed on what should be placed on the Riksdag's table. It is obvious.

Despite everything one can refer to or not, this is about what kind of Sweden we want. Do we want a Sweden where the welfare holds the country together, or a Sweden where the differences between the municipalities are allowed to grow?

The municipal equalization system is one of our most important tools for holding our country together. It is about solidarity between municipalities and about the whole of Sweden contributing according to its ability and receiving support according to its needs. Municipalities also, as mentioned, plan their budgets based on this.

It is about political priorities. I believe one must move from fine words about the heartland in a campaign to seriously making the political priorities that mean we have a welfare worthy of the name in the entire country.

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Kalle Olsson (S)

Madam Speaker! Thank you, Eva Lindh, for a very important question!

The proposal for a new equalization system, which perhaps is no longer on the Council of State's table but rather seems to have slipped into the desk drawer, is a very important issue for my constituency, Jämtlands län.

Some time ago, the Minister's party and ministerial colleague, Elisabet Lann, visited the hospital in Östersund. She commented then on the situation in precisely Region Jämtland Härjedalen. She said that healthcare in Jämtland Härjedalen has an "impossible task". By that, she meant that it is very difficult to provide care in a large but at the same time small and above all very sparsely populated region like Jämtland Härjedalen.

It was an interesting and perhaps somewhat unexpected statement. One can see it as an honest and sincere assessment by the Minister, who perceives that this government is not succeeding in ensuring accessible, equal healthcare throughout the country.

For my part, Madam Speaker, I see the statement as something of a capitulation. The given counter-question is: Why do the Minister and the government not ensure that the task is also made possible for a small region like Jämtland Härjedalen? Why does the government not do more to level the structural differences that we cannot influence, such as the fact that it is 13–14 miles from Gunnarvattnet in Krokoms municipality to the hospital in Östersund – that is just how it is – or that it is more expensive, per citizen, to maintain a healthcare chain that covers 12 percent of the country's area but only contains 1.2 percent of the country's population. It is a sparseness that means that 25 percent of the population has more than an hour's travel time to the nearest emergency room, compared to 2 percent in the country as a whole.

So yes – without a strong state commitment, it is, if not an impossible, an extremely challenging task to provide health and medical care under these conditions.

But, Madam Speaker, it doesn't actually have to be this way. Erik Slottner could make the Equalization Committee's proposal a reality, which has, in fact, been with the minister for several years. For Jämtland Härjedalen, it would mean 145 million in the first year, and then it would be scaled up to 185 million. It can hardly be sufficiently emphasized what this would mean for the possibility of providing safe and accessible care in our entire large county.

The same question can be asked to the Minister here in the Chamber today: Why does the Minister not see to making the care mission possible also in Jämtland Härjedalen? Or, to use Eva Lindh's question: What does the Minister intend to do, for real, to ensure equal care throughout this country?

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Civilministern Erik Slottner (KD)

Madam Speaker! This is now developing almost into a healthcare policy debate with Kalle Olsson's contribution. I may not engage in that fully, but I still want to say that Kalle Olsson's entire contribution was a major argument for nationalizing healthcare. I even heard talk of a greater state involvement. We Christian Democrats want the state to take over healthcare to create more equal healthcare in the country. Then the problems that have been raised here would be avoided or even disappear, and individual regions would avoid becoming dependent on other regions' cost and income equalization grants within the system. So thank you, Kalle Olsson, for a fine contribution for a nationalization of healthcare and an abolition of the regions! Elisabet Lann has now also extended a hand to the Social Democrats to join forces on this issue.

Just as Eva Lindh says, we received a report from the Tax Equalization Committee, where we were not entirely satisfied with the conclusions; we saw some shortcomings. We wanted to create stronger incentives for municipalities to join together in order to be able to stand on their own feet more clearly than today and not be as vulnerable as one is in today's fragmented municipal organization. We also wanted to ensure that stronger growth incentives were provided in the equalization system and did not quite think that the committee had delivered based on the additional directives we gave. We sent out a new memorandum stating that we would, for example, compensate for sparseness more than the committee suggested, which would benefit, for example, the interior of Västerbotten and many Jämtland municipalities.

Since then, we have not been able to come forward with a joint proposal because this is still being prepared. Many comments have been received on both the committee's and the memorandum's proposals. Many have weighed in, and many comments exist.

This is a technical question. If you pull on one parameter, it has major consequences in other parts. That is why the government has not come forward with a unified proposal yet, as the preparation is still ongoing.

I do not think that any municipality should budget based on a new system; instead, one must budget based on the system that currently applies. I am myself a former municipal politician and truly understand the need for predictability, but one should not count on decisions being made this autumn regarding a new tax equalization system that would come into effect on January 1, 2027. Should this happen, some form of supplementary budget would have to be presented later in the autumn. But I do not think that as a municipal council member, one should count on this in their budgets.

We are talking about the tax equalization system, which this interpellation is about, but I still think it is worth reminding that the municipalities' finances are now generally improving in the country. The municipal sector is projected to make a surplus of around 40 billion kronor.

The government has also directed special state grants to particularly critical sectors in municipalities and regions. We have provided money for capacity investigations so that the municipalities, through various analyses, shall demonstrate how they will manage their welfare mandate within a ten-year period.

We have given the National Agency for Public Procurement sharper tools to guide municipalities in making better public procurements. Not least the AI workshop and many other initiatives on digitalization represent a huge opportunity for Swedish municipalities to become more efficient and get more quality for every tax krona they put in. It is very important to include even these measures when we talk about the municipalities' finances.

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Eva Lindh (S)

Madam Speaker! I thought the Minister was here as the government's representative, not as a representative for the Christian Democrats. Then I wonder: Is it the entire government's opinion that healthcare should be nationalized? It is more of a rhetorical question; I do not intend for us to have a debate on healthcare here right now, even though I would gladly debate it. It is extremely important, and the equalization system is a prerequisite for us to be able to have good healthcare throughout the country.

Furthermore, I believe that many of the municipalities we are talking about here, municipalities in sparsely populated areas and in the countryside, probably wonder where those surpluses are. This is what we are talking about in this debate: that the conditions are so incredibly different in the municipalities in Sweden.

I do not think that municipal representatives expected this government to betray the entire country to such a great extent as it actually has. I believe that perhaps one still expected from the parties that claimed to stand on the side of the countryside and spoke about the heartland that they would do something to make things easier for those municipalities.

But that is not what was done. They were betrayed, not just by not introducing a new equalization system. The Government is, therefore, so very preoccupied with merging municipalities that a new equalization system has not been produced. That is how it can be interpreted. In every debate and in all priorities, this seems to be a big thing, so then there will be no equalization system.

Furthermore, municipalities and regions have received insufficient resources, and targeted resources to municipalities in sparsely populated areas and rural areas have been specifically removed, something we Social Democrats introduced while waiting for a new equalization system because we saw that the inequalities were too great. This has also been removed.

But what do we have now, then? We have, therefore, had an investigation that all parties have participated in. The Government simply says that the investigation is not sufficient, even though the Christian Democrats also participated in it.

Despite the fact that representatives from all parties were involved and that all parties jointly submitted a proposal for an investigation, it is simply being brushed aside. The investigation was tabled on 1 July 2024, but nothing has happened.

I am upset, because I think Sweden should make a different choice. I believe that all of Sweden is worth having a welfare to count on. It should not be possible to have different conditions for an equal welfare throughout the country.

I come from Östergötland. I know how different reality can look within the same county. I know that the conditions look different in larger cities than in smaller municipalities. I know that people love their hometowns and want to stay there, where they have their families, their jobs, and their lives.

What does the Minister intend to do if he receives renewed confidence on this point?

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Kalle Olsson (S)

Madam Speaker! It may not have come as a huge surprise that the Minister would fall back on the issue of nationalization when it comes to healthcare. One should have invested a little money in it.

This is a very important issue. Just as Eva Lindh says, it is about the prerequisite-creating measures for something that is completely central in people's lives. The operation of health and medical care is special in the sense that there are not so many alternatives. If money is lacking in the culture school, one can always cancel some violin lessons. One can stop mowing the grass on the football fields. One can skip giving the staff a Christmas gift at the end. But one cannot close the intensive care unit. One cannot cut back on chemotherapy treatments, and one cannot refrain from letting the ambulance helicopter continue to fly.

We are a society where we care for our sick. It is perhaps primarily a moral and ethical commitment, but in connection with the government's response regarding the state's commitment, I would like to emphasize that the state also provides very many governing principles, both those that are adopted here in the chamber and those that come from our authorities.

The Health and Medical Services Act stipulates that it is the patient's needs that should guide the prioritization of care. We have the Patient Act, which gives patients the opportunity to seek care in other regions on their own, and that is care that is then to be paid for by the home region. We have the private healthcare providers, and it is the same thing there, i.e., that it is the home regions that pay.

What we see is a very tangible state steering. But what we lack, on the other hand, is a government that is prepared to fight so that the whole country functions and so that healthcare in the countryside also is secure and accessible.

Now it is practically too late to hope for this government. Now we must work for another government that is prepared to take responsibility for ensuring that we also have safe and accessible care throughout the entire country.

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Civilministern Erik Slottner (KD)

Madam Speaker! I believe, as I said, that the odds have been quite low, so Kalle Olsson probably shouldn't worry too much about not putting any money into that bet. And to Eva Lindh, I want to say that it, as is known – the member admitted that it was a rhetorical question – is not the government's view that the state should take over healthcare, but it is the Kristdemokraterna's view. It is very correct that I stand here as the government's representative. But I also said that I was speaking specifically about Kristdemokraterna when I said this. I belong to that party, as is known.

If one were to enter the debate directly without knowing what the parties thought or anything else, one would almost get the impression that the government is against a system for cost equalization and income equalization. That is not the case. We have a fairly extensive equalization between the country's municipalities and regions. For some municipalities, a fairly large part of the revenue comes from the cost equalization. We agree that we are to have such a system. It is very important if one is to be able to live, work, and reside in the whole country.

We have, as we have said, also received an investigation on the table that proposes certain changes to this system in order to adapt it more to today's data and reality. But fundamentally, we are completely in favor of there being such a system.

Everyone who knows anything about the issue is also well aware that even small changes can have large effects and some marginal effects. This is what we would like to avoid. Therefore, we have referred a proposal with certain adjustments which would, among other things, benefit growth and rural areas but also encourage more municipal mergers or at least not disadvantage such.

The government has also indicated that we intend to proceed with a new proposal for tax equalization, but we have not yet presented any such proposal. But we have, therefore, stated in the budget bill that we intend to present one, so let's see when that will be done. But we are not there yet. That is how it is.

We have increased the general government grants by 16 billion kronor during the mandate period. The targeted government grants have increased much more than that. I do not have the exact figure in my head, but in total, it is over 40 billion kronor in increased government grants to the municipal sector. Much of it is targeted towards health and medical care and towards the school. Much also goes to elderly care. It is very good.

We now see clear effects in the form of shorter healthcare queues. The healthcare queues in the country have generally decreased by 36 percent since the change of government in 2022. This shows that with targeted funds and increased state governance, we can actually reduce healthcare queues and increase the accessibility of care. It is very positive.

During this parliamentary term, we have also moved from the bottom of the EU in terms of growth to now being one of the strongest growth countries, according to the forecasts that are available. This will also mean incredibly much for the municipal sector's economy moving forward – much more than changes in the tax equalization system.

There are very many issues affecting the municipalities' finances moving forward. I also want to refute the rumor that Eva Lindh is spreading, that we have not received a government bill on a new tax equalization system because I have been so burdened by the issue of municipal mergers. That issue has not taken up so much time. On the other hand, I have a very broad portfolio with very many political areas of responsibility. I can admit that, and sometimes it feels like one occasionally has to prioritize unnecessarily hard. However, the conclusions of the municipal merger investigation have not contributed to the fact that the issue of the tax equalization system is still being prepared at the Government Offices. I can refute that here and now.

(THIRD DEPUTY SPEAKER: Everyone is, of course, aware that interpellations are about scrutinizing the government and the ministers' performance of their duties.)

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Eva Lindh (S)

Madam Speaker! Exactly, and it is the opposition's role to do this.

It is obvious that the Minister thinks he has a very tough task. He doesn't have time to visit the municipalities. It takes far too much time, so he gathers them all at once, so he doesn't need to waste time on it. He also doesn't have time to address an equalization system that would mean a decisive difference for many municipalities. He implies that one is sort of neglecting the issue and does not think it is that important.

But for every year that has passed during this mandate period, the equalization system becomes less and less equalizing. Not everyone knows that. One might feel it, but this is exactly what is happening because the figures are no longer being updated. For every year that passes, there are thus larger and larger differences between regions and between municipalities. The government is responsible for this.

The government has not prioritized this. They have not bothered to address an equalization system, even though they have had an investigation completed and ready on the table. But it is not sufficient. The most important thing for this government seems to be to ensure certain municipalities that already have better conditions or to merge municipalities. That seems to be more important for the minister than anything else.

But if one is working on it now, if there is an investigation and it also states in the budget that a proposal is to be submitted – when will it come? It is starting to get quite tight on time, and it does not look like this government will receive renewed confidence. When will the proposal come?

I want an answer from the Minister. And I truly hope, for the sake of the entire country, that there will be an S-led government this autumn that takes this seriously and wants an equal welfare across the whole country.

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Civilministern Erik Slottner (KD)

Madam Speaker! I may have to remind the member of the expression "pride goeth before a fall."

I must nevertheless say that I find it both ridiculous and comical. I believe that Eva Lindh is actually the only one in this country who criticizes me for traveling too little among municipalities in Sweden. Others may receive praise; one should rarely do that for oneself. But I very often receive appreciation for being so present around the country and for visiting all counties already during my first year as minister. It has been incredibly appreciated. Among municipal representatives, it was very appreciated, I must say, that I actively requested their presence when I visited county governors – sometimes at a castle, sometimes at other places.

A common question I get from followers on social media is: How do you manage to travel as much as you do? Don't you get tired of all the traveling around the country? Yes, I do, but it also gives me a lot of energy. I believe that as Civil Minister, I should be out in the country a lot. My perspective is always: I have my office in Stockholm, but my field of work is all of Sweden. Not least with the portfolio and the responsibility I have, it becomes even more important. I have truly prioritized being out in the country and visiting, among other things, municipal representatives but also county governors and many operations within civil society and much of the fine and rich business sector we have in our country.

I want us to present a new tax equalization system – update the tax equalization system. I want to create a system that increases the incentives for growth even further. I would like to see a system that compensates for sparseness rather than being small in the organization. Above all, I do not want a system that counteracts municipal mergers, because I believe that would go in the completely wrong direction moving forward and make Kommunsverige even more vulnerable.

We have not reached there yet, and I have no timeline for this. But my ambition is that this shall be presented.

Thank you for the debate!

The interpellations debate was hereby concluded.

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