Response to interpellation 2025/26:94 on the Social Insurance Agency's coordination mandate
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 is implementing measures to improve support for returning to work through increased funds to Försäkringskassan and developed cooperation with Arbetsmiljöverket 1. M emphasizes that the policy aims to lower the thresholds for returning to work 2, clarify expectations for Försäkringskassan's coordination mandate 3 and strengthen the efforts of responsible actors 3. M proposes work trials with maintained sickness benefit 4 and strengthens the healthcare system's work with rehabilitation 4. S argues that the government's measures are big words with little workshop 5. S argues that the coordination mandate is too broad and unclear 5, that the distribution of responsibility is unclear 5 and that the funds for employers are too small 6. S argues that it is good that one should be able to study while on sick leave 6.
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)
Mr. Speaker! Åsa Eriksson has asked me what I intend to do to strengthen the possibilities for effective coordination for persons with reduced work capacity so that more people receive support to return to work.
As I have explained in the response to a previous interpellation from Åsa Eriksson (2024/25:638), the government is implementing a full battery of measures to improve support for returning to work. In the budget bill for 2025 (prop. 2024/25:1), more than 100 million kronor have been added to improve this support. The funds are used to achieve improved working methods at the relevant agencies and effective interventions in the workplaces, as well as stronger cooperation between the actors in the sick leave process with a focus on counteracting many and particularly long sick leaves.
The employer's measures 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. To support the measures in the workplace, the government has developed the grant to employers for the purchase of workplace-oriented rehabilitation support.
The government has also tasked Försäkringskassan with strengthening the work of following up on employers' plans for return to work and the coordination of rehabilitation efforts for those on long-term sick leave. Försäkringskassan has been allocated 50 million kronor for such an increase in ambition.
Furthermore, Försäkringskassan and Arbetsmiljöverket have been tasked with developing their cooperation and supervision of employers' work environment and rehabilitation responsibilities.
The Government has also allocated funds for Försäkringskassan to develop the work of investigating the conditions for work-preparatory or work-life-oriented interventions for persons with activity compensation and sickness benefit in special cases and to initiate interventions when such conditions exist.
To avoid lock-in effects, it is important that the support to the individual is developed so that work capacity, in cases where it is possible, can be utilized in all gainful employment on the labor market, for example in wage subsidy employments. Försäkringskassan has therefore been tasked, together with Arbetsförmedlingen, to further develop methods for testing and utilizing the individual's work capacity in gainful employment on the labor market.
The Government has tasked the National Board of Health and Welfare with distributing state grants to the regions to strengthen and develop primary care's work with mental health. The National Board of Health and Welfare has also been tasked with supporting health and medical care in the implementation of routines for work with sick leave and rehabilitation. The measures are assessed to contribute to improving the possibilities to provide the right care and rehabilitation so that those who are on sick leave can return to work as soon as possible.
The Government has, in the budget bill for 2026 (prop. 2025/26:1), proposed that it should be possible for those who receive sickness compensation or activity compensation to study part-time and have their sickness compensation or activity compensation partially suspended. At the same time, the Government proposes that the trial period for studies with activity compensation be extended from six to twelve months.
Mr. Speaker! In order to further improve the possibilities for those on sick leave to return to work, the government has proposed that it should be possible for those who are on sick leave to, of course in agreement with the employer, undergo a work trial with maintained sickness benefit for a shorter period (prop. 2025/26:53). The purpose is simply to lower the thresholds as much as possible for a return to work.
Mr. Speaker! In summary, the government is taking powerful measures to strengthen all responsible actors' efforts to facilitate a return to work, which in turn improves Försäkringskassan's conditions to carry out its coordination mandate.
Åsa Eriksson (S)
Mr. Speaker! The Minister for Social Insurance listed a whole host of measures. We Social Democrats think some of them are good, and we stand behind them. Others feel more like big words that lead to very little workshop. But Sweden's wage earners may be satisfied that the Moderate minister did not take seriously what she went to the election on, that is, the reintroduction of the "stupstock" in the health insurance and an additional day of waiting period, which would indeed be devastating.
Mr. Speaker! No human being should be forced to fight alone against authorities when the body or the soul has broken down. Welfare should be organized so that it helps people, not opposes them and their needs. That is, at least, the starting point for us Social Democrats.
The Minister did not mention even once in his response the core criticism in the report that I thought was very clear in my interpellation that it is about. It is about the Swedish Pensions Agency's review of the Försäkringskassan's coordination mandate and that it simply does not work.
Mr. Speaker! I shall therefore remind the Minister and her staff – or tell them, if they have not read the report – of the most important points in ISF's criticism.
Firstly, the coordination mandate is too broad and unclear. It is based on legislation from the beginning of the 1990s, even though the labor market, health insurance, and healthcare have changed radically since then. It is therefore a structural issue. ISF proposes structural changes, but the government listed a number of measures with smaller sums in the budget that concern completely different matters.
Secondly, ISF points out that the distribution of responsibility between the actors is unclear and fragmented. They write straight out in the report that it is not clear what is the responsibility of the health and medical services, what is the employer's responsibility, and what is Försäkringskassan's responsibility. This naturally leads to important interventions for the person on sick leave being omitted, individuals being bounced around between different actors, and sick leaves being extended. But the minister did not address the distribution of responsibility in his answer at all. Does the government even care about ISF's reports, I wonder.
Mr. Speaker! A third point of criticism in ISF's report concerns the fact that the rehabilitation chain in the sickness insurance is in conflict with the coordination mandate, which Försäkringskassan also has. They thus have two completely different mandates, which work against each other.
One of the heaviest points in the ISF report is that the rehabilitation chain is directed towards rapid assessment of work capacity, while the coordination mandate requires active and long-term coordination. Both are needed, but how should Försäkringskassan act? The Minister mentioned nothing about that.
The mandate period is nearing its end. It is probably those who guard good safety systems who are very happy about this. Soon we will have the chance to vote in a completely different majority in the Riksdag, who can do something about this. It is then about something other than fine words. It is about truly reforming the system.
But the Minister now has the chance to actually address the criticism in the ISF report. How does the Minister intend to act?
Äldre- och socialförsäkringsministern Anna Tenje (M)
Mr. Speaker! It is fantastically interesting to listen to Social Democratic members when they highlight the system. It is always the system before the human being. I tried in my response, Mr. Speaker, to describe what we do to ensure that people find the way back to a return to work and how we strengthen those parts. Then the member comes in and would rather speak about the system.
I always put the human being at the center, and the policy that the government pursues intends to get more people into work and give more paths back to work, precisely because we look at the human being and not at the system.
One still becomes a bit curious. I listed a number of proposals on what we are now doing to find more ways back, a safe and secure return to work. We are lowering the thresholds to make it simpler and easier so that more people can come back. Which of these proposals could Åsa Eriksson imagine being for if it is not instead about the large system? I do not necessarily stay there as often, given that I instead put the human being at the center.
Mr. Speaker! This is a shared responsibility. Försäkringskassan has the coordination responsibility, but there is a shared responsibility for the whole to function. From that starting point, the government, just as I accounted for, has presented a whole battery of measures to improve the support for returning to work.
Overall, the government's measures aim to facilitate for people to return to the labor market earlier. In this way, we counteract the unnecessarily many but also long sick leaves, and in this way we strengthen the work principle, which ensures that one can return to work, strengthen one's opportunities for self-sufficiency and, above all, contribute to Sweden's growth.
It is also important that those who are on sick leave receive effective treatment and rehabilitation interventions, as well as any coordination interventions, specifically to counteract the unnecessarily numerous and long sick leaves.
It is also important to promote measures that need to be taken in connection with the workplace, for we know that it is the employer's measures that are decisive for those who are on sick leave to return to work more quickly.
The employer has, as I said earlier, an obligation to establish a plan for return to work when an employee has been on sick leave for more than 30 days. In order to facilitate the employer's responsibility for rehabilitation and to utilize the expertise of occupational health services, the contribution for workplace-oriented rehabilitation support has been further developed.
Through mandates to Försäkringskassan and Arbetsmiljöverket, as well as in Arbetsförmedlingen's regulation letter, the work to support people back to work shall be strengthened. Försäkringskassan has been tasked to strengthen the authorities' work in following up employers' plans for return to work, as well as to strengthen the coordination of rehabilitation efforts for those on long-term sick leave.
Åsa Eriksson (S)
Mr. Speaker! It is very interesting to hear that the minister who is responsible for both Försäkringskassan and the Inspektionen för socialförsäkringen does not want to talk about systems. If not even the responsible minister cares, who in the government should one turn to when ISF, with stinging criticism, takes down the coordination assignment that is supposed to help people on sick leave back to work?
In the Minister's second response, it becomes clear that neither she nor her staff has read this, as she does not comment on the criticism or provide any measures to change the whole situation. Ulf Kristersson obviously has leadership problems in his government.
We Social Democrats, however, take the criticism of how the systems function very seriously. We mean that these systems exist to help people, and today there are far too many people who do not receive the coordinated support they need to regain their work capacity and be able to support themselves. We find that to be extremely regrettable.
The Minister asked what in the government's budget we can stand behind. We Social Democrats have been very clear about that; it is most recently evident from a written question I submitted yesterday, as well as from previous interpellation debates. There are several things, for example that it should be easier to be able to undergo work training while maintaining sickness benefit. We think that is good. It is also good that one should be able to study while on sick leave. However, we believe there is more to be done there, and therefore there is now a written question in the Minister's inbox.
One thing that we actually think is good, but which you do not take seriously, is that employers must be given significantly better opportunities to help those on long-term sick leave back into work. The Minister states in his opening remarks that the government has increased the appropriations for this and that there are a total of 244 million kronor in next year's budget.
It might sound good, but it is just pocket change. I checked with Tillväxtverket how many private companies there are that have employees – approximately 250,000. Then I asked Upphandlingsmyndigheten how many public employers there are that have employees – an additional approximately 4,000. If these 254,000 employers are to share 244 million kronor, they get barely a thousand each. What do you buy rehabilitation measures for that?
This is all just coffee money and fine words, but there is no concrete workshop, and that is our core criticism.
Mr. Speaker! I meet many people who for years have been bounced between Försäkringskassan, healthcare, social services, and Arbetsförmedlingen. They are not asking for any miracles – they are only asking that someone takes responsibility and ensures that they receive the support they need to regain their work capacity, their foothold, and their opportunity to support themselves. Then Försäkringskassan's coordination mandate must be changed so that one can help with that.
I want to remind of another criticism in ISF's review, and that is that Försäkringskassan's coordination works worst for those who lack an employer. It is truly serious, but the minister does not mention anything about that either. Therefore, I want to ask the minister again: What does the minister intend to do during this final year to help the unemployed and those on sick leave back to work?
Äldre- och socialförsäkringsministern Anna Tenje (M)
Mr. Speaker! The complexity surrounding the coordination mandate is well known, and the government is well aware of this. I can reassure the member of that.
All responsible actors – Försäkringskassan, Arbetsförmedlingen, and the health and medical care services – need to contribute for the support for return to work to function effectively. In this work, Försäkringskassan has a very central role, and the government will, of course, more closely analyze precisely those conclusions that ISF points out in its report and the recommendations that are there regarding Försäkringskassan's coordination mandate.
At the same time, I do not intend to merely await further analyses; instead, we are taking a number of measures here and now to help people into a first job or, in part, back into work. To mention a few additional examples, the government has improved the possibilities for those on sick leave to return to work and has proposed that, provided an agreement is reached with the employer, it shall be possible for those on sick leave to undergo work trials with maintained sickness allowance for a shorter period. The purpose is simply to lower the thresholds to work.
The government also strengthens the conditions for the healthcare system's work with sick leave and rehabilitation, which in turn improves the possibility for those who are on sick leave to return to work as soon as possible.
Mr. Speaker! Regarding especially those who are on sick leave and do not have an employer, we know that it is significantly more difficult, given that employers have a large and important role to play when it comes to returning to work. For that very reason, society needs to take a greater responsibility in those cases, and we have ensured to support that with both money and mandates.
The government has also tasked Socialstyrelsen with paying out state grants to the regions to strengthen and develop primary care's work with mental health. That was a large part of the budget, not least last year. I want to remember that the member actually both appreciated and saw that it could contribute positively, given that many sick leaves are based on mental health. Knowledge is not as great there, and there we need to do significantly more. The government has given Socialstyrelsen the assignment to support the health and medical care's work with sick leave and rehabilitation with a special focus on that area.
But the question is complex, just as the member says. It is extremely important and is also prioritized by the government. Therefore, we are moving forward with many measures that have been both requested and longed for for a long time. This is not least about the possibility of work testing, i.e., reaching an agreement with the employer to do this. Previous governments had the same possibilities but chose not to do anything. We are doing it now.
Åsa Eriksson (S)
Mr. Speaker! A secure health insurance is not a luxury. It is a prerequisite for ordinary people to be able to live their lives without falling helpless when illness strikes.
We Social Democrats will not be satisfied until welfare is shaped around people's needs and helps when it is needed instead of opposing people, because when the system cracks, it is never the strongest who fall first. It is those who already carry a heavy burden.
I heard the Minister say that there are both funds and assignments to solve this. Does that mean that the problem with the coordination assignment that ISF describes is solved? What I mean is that it is not. ISF points out that there is a lack of national follow-up on how the coordination assignment functions. They point out that the regions' coordinator efforts vary greatly across the country. They point out that Försäkringskassan lacks indicators for the coordination to succeed. They point out that Försäkringskassan does not have the mandate to ensure that the other actors do what they are supposed to do within the framework of the coordination assignment – plus all the other points that I have already gone through.
The government is merely scratching the surface with its coffee money. Several of these measures are good, but they are too small, and they are not enough. The government does not have the strength to tackle the structural problems that need to be solved so that people who are on sick leave and/or unemployed can receive coordinated support. Therefore, I want an answer to one final question. It is a simple yes-or-no question: Is the coordination mandate, in the opinion of the Minister, purposeful?
Äldre- och socialförsäkringsministern Anna Tenje (M)
Mr. Speaker! I would like to begin by thanking the member for once again, in an interpellation debate, giving me the opportunity to speak about all the good and important reforms that the government is making to help people into a first job or, for that matter, back into work.
During my limited time here today, I have raised countless examples of measures that the government is taking or has already taken, including to strengthen Försäkringskassan's important role in promoting necessary measures that are identified and taken by responsible actors. The government has also clarified its expectations for Försäkringskassan's coordination mandate and given the agency increased resources to strengthen its work in this important issue.
In summary, the government is taking powerful measures to strengthen the efforts of all responsible actors to facilitate a return to work, which in turn has a positive impact on Försäkringskassan's opportunities to carry out its coordination mandate.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.