Response to interpellations 2022/23:332 and 370 on the Swedish shortage of veterinarians and the state veterinary organization in rural areas

Landsbygdsministern Peter Kullgren (KD)

Madam Speaker! Sofia Skönnbrink has asked me in what ways I and the government intend to work to address the acute shortage of veterinarians, how I and the government view the proposed measures in the report Better conditions within animal health and medical care (SOU 2022:58), and which proposed measures we intend to take into account in the continued work.

Daniel Bäckström has asked me how I intend to solve the state veterinary organization in Sweden's countryside in the short and long term.

I choose to answer the interpellations in a context.

Madam Speaker! Sweden's good situation regarding animal welfare and animal health is something we should be proud of and safeguard. That there is access to a veterinarian in the entire country is crucial for animal welfare, animal health, and a competitive food production. It is about ensuring that there are good conditions to live, reside, and work in the entire country. All of Sweden must function, and all animals in human care must receive the care they need when they need it.

As both Sofia Skönnbrink and Daniel Bäckström mention, the situation within animal health and healthcare is problematic. It has been well known for a long time, and it is good that the previous government finally appointed an inquiry.

Above all, within the District Veterinarians, there are difficulties due to the shortage of veterinarians, which, among other things, affects the possibility of maintaining readiness. The strained situation, not least in rural areas, is obviously concerning. The County Administrative Board in Västerbotten County has written to me and described exactly that situation, which I take to heart. I have responded that we in the government are working to find a sustainable and long-term healthcare for animals and that the report Better conditions within animal healthcare, which was submitted in November last year, is part of this work.

From the government's side, we are actively working on the proposals in the report that Sofia Skönnbrink mentions. I cannot, of course, precede that process, but I can say that the work is ongoing and that it is highly topical. It can be stated that the interest from authorities, organizations, and other individuals affected by the proposals in the report has been great. The work of going through the referral bodies' views and analyzing the investigation's proposals is ongoing. In that work, the government will take the referral responses into account. It is an extensive task we have ahead of us as it is an extensive report concerning a very complex and important issue.

As I have said, I cannot comment on which measures the government intends to proceed with or what our position is on individual proposals. However, I want to emphasize the importance of finding a long-term solution for a functioning healthcare system for animals throughout the country, while today's acute problems need to be handled in parallel.

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Sofia Skönnbrink (S)

Madam Speaker! Thank you, Minister, for the answer!

I see that Daniel Bäckström has entered the room. I became a little stressed at the beginning when he didn't show up. It is fun that we three people from Värmland are going to take this debate together. It is a bit extra special.

Sweden is known for its strong animal welfare and its good animal health status and is in many ways a pioneering country when it comes to animal health issues. But for us to be able to maintain this good reputation, it is very important that there is a well-functioning healthcare for animals throughout Sweden and that our animals, as the minister said, receive the care they need when they need it.

Recently, however, we have been able to take note of alarming reports regarding the shortage of veterinarians in Sweden.

Many of us who have pets know how challenging it can be to get a veterinary appointment and how frustrating it is when one is referred to neighboring counties, if one is lucky, or is sent several hours' drive away to other counties.

In some cases, this can be a solution for those of us who have small animals and access to a car. It is worse for Sweden's horse owners and farmers, who are directly dependent on the district veterinarians' mobile operations when acute situations arise.

District veterinarians are many times the difference between life and death. We cannot risk that animals that could become healthy after treatment are euthanized completely unnecessarily because there is no veterinarian available.

The lack of availability is due to major staffing difficulties within animal health and veterinary care, particularly regarding the activities of the District Veterinarians.

During our government, we Social Democrats carried out a significant reinforcement of the veterinary and animal nurse training at the Swedish University of Agricultural Sciences. It was intended to generate an additional 40 places in the veterinary training and 20 places in the animal nurse training every year. But despite the expansion of the number of training places, the problem remains.

Therefore, it is now of the utmost importance that the government continues to prioritize the issue and focuses on formulating proposals for solutions.

Madam Speaker! In Sweden, the state has taken on the responsibility to ensure access to veterinary services throughout the country. There must also be preparedness in the event of outbreaks of infectious animal diseases.

Thanks to the District Veterinarians, there is today access to veterinarians every day of the year and at all times of the day. We must be very careful about this, especially from a rural perspective because private actors often are conspicuously absent there.

Madam Speaker! Despite the government's responsibility in the matter, we have so far not heard any concrete proposals for measures or how one should work to address the shortage of veterinarians.

It surprises me a bit that the question is not higher prioritized, because I know that the Minister for Rural Affairs has a great commitment when it comes to the food strategy and how we can increase the domestic production of food in Sweden. For me, these parts are very closely linked. We often discuss how we should make it more attractive to produce food in Sweden and how we should stimulate generational shifts within agriculture so that more people want to engage in animal husbandry or, for example, grain cultivation. And an important part in getting more to want and, above all, dare to invest in food-producing animals, I believe, is that we can guarantee long-term functioning veterinary services in our entire country.

Madam Speaker! Animal owners all over Sweden are currently feeling a very great concern that we politicians in this chamber must take most seriously. Therefore, I am not quite satisfied with the Minister's answer, but I also want to know what proposals for solutions the government has to address the shortage of veterinarians. Could the Minister tell us a bit about how the thoughts are proceeding and at least give a small answer on how it is intended that this issue should be moved forward?

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Daniel Bäckström (C)

Madam Speaker! Thank you to Minister for Rural Affairs Peter Kullgren for the answer! Thank you also to Sofia Skönnbrink for a very important interpellation from her side!

The perspective I raise with the minister as a government representative is a rural perspective that is rooted in all the work currently underway, work that will be intensified moving forward but also upgraded as the government has intended to revise the food strategy.

There are many different basic prerequisites for good animal health and animal husbandry, but also to be able to achieve growth throughout the country with increased animal production and animal husbandry. In that regard, veterinary and animal healthcare, including emergency animal healthcare, is completely crucial and fundamental for the animals' health but also from an owner's perspective, which also applies to others affected in connection with animal husbandry - family members, stakeholders linked to equestrian activities, and so on. We can see the entire spectrum when we travel around the country.

The situation is extremely concerning, not only linked to educational initiatives and access to increased competence but also linked to working environment conditions. It is a fact that many choose to terminate their employment and move on to other industries or reconsider their decision to stay. The conditions are tough from a veterinary perspective but also from an animal husbandry perspective.

The answers from the Minister for Rural Affairs and from the government are that we have to wait and see what views the government will come to and, eventually, propositions.

This is a question of both funding and how the government, in the upcoming budget work, creates the conditions for the operation to grow. Fundamentally, it is a funding issue to obtain sufficient funds for the operation, but it also requires that the organization functions in practice.

In the county to which we all three are connected, the plans to close the Sunne veterinary station are extremely concerning. Sunne belongs to the western area, which both Sofia and I belong to. We can calculate the distance from where I live in southern Värmland up to northern Värmland. It is over 25 mil. We have livestock owners all the way. Not keeping operations in Sunne creates increased uncertainty around the clock for livestock owners.

I think this frames the entire Swedish situation, from the inland to the coast but also in the outer rural areas. There should be opportunities to develop animal husbandry and also primary production.

We know that both in Fryksdalen, with much milk production and livestock producers, and in the next valley, up towards Sysslebäck, there are many animal keepers and not least breeders, with dogs, horses, sheep and other animals.

It is absolutely crucial that the government takes measures so that operations are not shut down or centralized, which would be a consequence of this and of the government's policy if no measures are taken.

The questions remain, therefore, Minister for Rural Affairs Peter Kullgren. What initiatives will the government and the Minister for Rural Affairs take? When will the proposal to the Riksdag be submitted based on the investigation's proposal? And will it be a government bill this autumn? It is primarily the short-term plan I am calling for. I believe everyone agrees on the long-term goal, but what short-term, active measures will the Minister for Rural Affairs and the rest of the government take to get the acute situation in order?

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Landsbygdsministern Peter Kullgren (KD)

Madam Speaker! It is very good and warmly welcomed that the committee's report was submitted in November. But one can still wonder why it took so long for the previous government, which in its final year consisted only of Sofia Skönnbrink's party and which was supported at all times by Daniel Bäckström's party. The problems had been known for several years.

But enough about this. Now we have this investigation on the table. The government is working on it, and we shall move forward.

Both members wish, in their interpellations and follow-up questions, for answers on exactly what we are to do. But as the members very well know, it would be incorrect of me to go into what we are to do with a report before we have finished preparing it. The work of going through the referral bodies' views is, as stated, ongoing, and in the continued preparation, the government will take a position on how we shall proceed with all the investigation's proposals. I cannot precede that process.

The market for animal health and medical care has expanded quite significantly for some time now. The ownership structure has changed as a few actors have bought up a large share of the previously independent companies on the market. Demand for animal healthcare has generally increased, especially when it comes to companion animals.

There are now also significantly more advanced diagnostic tools and treatment options, which are in principle fully comparable to those used in the care of humans. Access to more advanced care has resulted in an increased demand for more specialized care for companion animals.

Another contributing explanation for the strong expansion in the market for companion animal healthcare may be that the willingness to pay among pet owners, consumers, has increased.

The government takes the staffing difficulties within animal health and veterinary care very seriously. There are divided opinions on what should be done to resolve the shortage.

When it comes to finding a long-term solution, we are looking at this in the report; that work is ongoing. The investigation had the task of examining which measures need to be taken in order to ensure a sustainable and long-term well-functioning healthcare for animals. And the purpose is precisely this: that we should achieve a system that works in the long term.

We all know that the situation is particularly difficult during holiday periods. Last summer it worked relatively well anyway. The conditions were better than in previous years, thanks to the fact that the pandemic was over.

I have received information from the Swedish Board of Agriculture regarding the situation concerning the challenges of maintaining preparedness this summer and onwards, and how the issue is being addressed. An important part before the holiday periods is information to animal owners to prepare them for situations that may arise. Last summer, the district veterinarians issued information to animal owners for that very purpose.

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Sofia Skönnbrink (S)

Madam Speaker! Thank you, Minister, for the answer! Discussing what the previous government did has been very popular among the government parties during this first period in government. I said in my opening remarks that we increased the number of educational places for both veterinarians and animal nurses.

But I still think that we should try to get a bit into how acute the situation actually is here and now, which my parliamentary colleague Daniel Bäckström also spoke about.

The Minister was mentioning that the County Administrative Board in Västerbotten has sent a communication stating that the pain threshold has been reached. From April 10, the standby duty during evening and night hours in the inland of Västerbotten ceased. The reason is that there are not enough veterinarians available to manage a 24-hour standby.

In the Dingle district in northern Bohuslän, there will no longer be any veterinary standby for horses and livestock as of May 18.

As Daniel pointed out, there are plans in our home county, Värmland, to close the District Veterinarians' clinic in Sunne and instead move the operations to Arvika and Säffle. This would, just as Daniel said, mean that a large number of animal owners, particularly in northern Värmland, would have much poorer accessibility regarding veterinary services. It would also result in a much higher workload for the existing veterinarians in Arvika and Säffle, in combination with much longer travel distances during service.

Madam Speaker! As the Minister has said, the Social Democrats in government commissioned an investigation to examine in what way we could achieve a sustainable and long-term well-functioning healthcare for our Swedish animals. And as the Minister has also said, this proposal was presented in the autumn and has been out for consultation.

There is a proposal in this investigation that I want us to go into a bit deeper because it has caused so much concern among our animal owners in Sweden: that the readiness between 11 p.m. and 6 a.m. is proposed to be removed. The idea behind the proposal is that it should make it more attractive to work for the District Veterinarians and secure the availability of veterinarians during the time of day when the demand is greatest.

Madam Speaker! Even though I understand the intention behind this recommendation, I do not think it is the right way to go because it could have very large consequences for the individual animal owner and their animal. The Swedish Animal Welfare Act is clear: Animals shall be treated well and protected against unnecessary suffering.

A reduction of the veterinary service at night will result in increased unnecessary suffering - it is not so difficult to understand. A horse that has a severe colic attack or a cow that is calving and experiences complications cannot wait for care until the next day. They need to receive care even in the middle of the night, if it happens then.

If we are to be world leaders in animal welfare, we must also have veterinarians who work at night, otherwise the consequence will be that animals that could have recovered after treatment will have to be euthanized for animal welfare reasons. One can also ask who will make that decision and who will perform the euthanasia.

The investigation suggests that digital solutions could be a complement for assessment and advice. But how easy is it, really, to assess whether the family's pony can wait for care until the next day or if it should be euthanized immediately?

The Minister stated in his answer that he cannot provide an answer on exactly which part of the investigation will be chosen to proceed with, as that would be to precede the process. But, Madam Speaker, I would still like the Minister to elaborate a bit on how the government views the specific proposal to phase out the veterinary readiness at night, as this has created very great concern among our Swedish animal owners.

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Daniel Bäckström (C)

Madam Speaker! The Minister for Rural Affairs does not answer at all particularly concretely on how the government views the difficult situation.

It is almost two weeks since I was present at dinner time and helped deliver a foal at home. The birth - or perhaps I should call it the birth - went well.

But suppose that Sunne's veterinary station had been closed and I had needed assistance from one of the district veterinarians and that person was on an assignment four hours north. How in the world would I then have managed a problematic birth or whelping?

This is what animal owners fear day and night, regardless of whether it concerns calving, foaling, lambing, or whelping. The response times are absolutely crucial, as is that the basic preparedness of veterinary services exists in all parts of Sweden, in every region. It is a regional issue. It is also a completely fundamental development issue.

If the government does not make any concrete efforts in the short term now, this will be further proof that they are not living up to what they say they want to do, to safeguard the conditions for starting up production even more in the whole country. No measures will be taken that make this possible. The uncertainty among livestock owners is so fundamentally great that they choose not to invest in breeding activities or in rejuvenating for future generations in the herds.

This is a completely fundamental agricultural policy issue. It is a completely fundamental animal welfare issue and a completely fundamental rural issue, Minister for Rural Affairs Peter Kullgren, that this activity not only remains but is also developed and strengthened. It is linked to skills supply. But it is also linked to the government having to ensure that the working environment conditions and the conditions for the employees are so good that they choose to stay at the workplace – to stay and develop in order to take greater responsibility and receive more tasks. It is also about seeing, in the long term, how the state part can be developed throughout the country. If the state does not take responsibility, who will then do it? Who will then come when the animal owner needs assistance at four in the morning because something acute has occurred?

These are the fundamental questions. The previous speaker was touching on Västerbotten. It is a very interesting example of how it looks today, since April 1st. Vilhelmina, which is located 11.6 miles from Lycksele, has since April 1st no longer had any activity at night. The distance is approximately the same as from Karlstad to Magnor on the Norwegian side. That is the perspective.

The distances are absolutely crucial, and therefore proximity must exist. How does the Minister for Rural Affairs view the situation in Västerbotten concretely here and now? What measures will be taken to facilitate so that animal owners in the deepest inland of Västerbotten can also count on receiving the help and support they need around the clock this summer?

Given all these different issues, it would be very interesting to receive an answer that looks forward and establishes what the Minister for Rural Affairs and the rest of the government have for responsibilities, instead of an answer that looks backward and is about the government having only been in office for a few months, which is what one otherwise often hears.

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Landsbygdsministern Peter Kullgren (KD)

Madam Speaker! Both members are asking questions about what we should do in light of the investigation and so on. But I do not intend to anticipate that process. On the contrary, I believe it would attract a lot of attention and opinions if I were to choose to precede the process and today tell exactly how I intend and what the government intends regarding the handling of the investigation and the referral responses that have been submitted. The regular handling is not finished yet.

I have a very great understanding of the complexity of the issue. The Government has not yet landed on which of the investigation's proposals it intends to proceed with. Preparation is ongoing.

We can, however, observe that we are spending more and more time and money on the care of our pets. A significant portion of the costs for animal healthcare is financed by insurance. Pricing is free on that market.

The working environment for veterinarians can, as has been said, also be a cause of the veterinary shortage that prevails. It is important to safeguard the working environment for those who work with caring for our animals. In addition to an sometimes pressured work situation, it also occurs that animal health personnel are subjected to threats, which is of course completely unacceptable. The responsibility for the working environment being good rests primarily on the employers, as in all sectors. This applies both within animal health and veterinary care as well as in other areas. It applies to both private and state employers.

One reason behind the difficulties in recruiting veterinarians and animal nurses can also be understood as the number of veterinarians being trained is too low relative to the strongly growing demand. As mentioned earlier, the government has initiated an expansion of the training of both veterinarians and animal nurses at SLU. My government intends to complete this. It is good that we have political consensus on this in any case.

For the government's part, it is difficult to present measures that quickly resolve this situation. I believe that was also the case for the previous government, which Sofia Skönnbrink's party sat in and which Daniel Bäckström's party supported. They were essentially grappling with the same problems as we have today without finding any quick solution. In that case, time becomes the deciding factor de facto. Just as many years as that government sat, that many months I have been responsible for this area. And it takes many years to train a veterinarian.

When it comes to the future, I can say that we will, of course, do everything we can to move forward and resolve this situation. There are many good thoughts and ideas in the report that has now been presented, and we will return to that.

I can also say that we have an ongoing dialogue with the relevant authority, Jordbruksverket. I have personally been to the authority and met with them early in my term of office, and even my State Secretary has ongoing contact to keep as good a track of the situation as possible. But, as said, I will not comment on the investigation's proposals in detail any further today, but I will let the work proceed in the Government Offices.

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Sofia Skönnbrink (S)

Madam Speaker! Thank you, Minister, for this answer as well! But let me just clarify: My question was not what the government intends to do in light of the commission's proposals, but I wondered more how one viewed specifically the proposal that the night-time readiness should cease. It would have been interesting to hear how one stands on that - not necessarily exactly what one intends to do in the matter.

A great focus in this debate has so far been placed on animal owners and their situation, but it is also important to talk about the situation at the veterinary clinics, which the minister also did in his speech. When I was on an internship with district veterinarians in Arvika in January, we discussed one day why it is so difficult to find veterinarians who want to work in that activity and what needs to change so that more can be attracted to work as a district veterinarian. Some of the things that were highlighted as problematic were the inconvenient working hours, the on-call work, and the heavy work with agricultural animals. This causes many veterinarians to choose to seek employment at the country's small animal clinics instead, as they are usually open during the day from 7-16. There, one has no inconvenient working hours and no on-call work either.

Madam Speaker! The district veterinarians need to work to become an attractive employer, just as the Minister said, where veterinarians want to take jobs. But to succeed with that, political support and the right tools are also required. The veterinary preparedness provides a very great social benefit, and the resources directed there need to be in proportion to this.

Madam Speaker! I would therefore finally like to ask the Minister for Rural Affairs if there are any thoughts or ideas from the government's side regarding how the attractiveness of the district veterinarian profession could be strengthened.

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Daniel Bäckström (C)

Madam Speaker! Yes, but I also remember what Peter Kullgren said during the election campaign, before Peter Kullgren became Minister for Rural Affairs, and how clear he, as a representative for the Christian Democrats, was in several debates regarding the view on rural policy and what should be done in a government position.

The Christian Democrats, the government, and the Minister for Rural Affairs Peter Kullgren perhaps need not just one year but two years to understand how serious the situation is regarding the veterinary situation. It has almost been a year since Peter Kullgren became Minister for Rural Affairs, and one has not returned with sharp proposals on how the proposals of this investigation should be handled by the government. Time is passing, and the situation is getting worse and worse.

We can look at the responses from employees within the veterinary operations that have come in when surveys have been conducted and presented. 38 percent answer that they experience a good working environment. Among the state-employed veterinarians, every other veterinarian wants to change workplace. Many newly trained receive on-call duty in practice, and after a while on call, they choose to move on to other workplaces.

If it takes time to understand that part based on how the current situation looks and it is not addressed, I wonder where the government's focus lies. And if the minister says that there are divided opinions on what should be done, the question is even more pertinent: How does the government intend to tackle these issues to find solutions?

I would like to thank you for the debate and look forward to continued dialogue on these important and fundamental issues for Swedish food production and animal husbandry.

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Landsbygdsministern Peter Kullgren (KD)

Madam Speaker! Of course, we view the situation as extremely serious. That we finally have a report on our table and that I note that we shall let that work proceed does not mean, Daniel Bäckström, that we do not see the situation.

I have also heard what Daniel Bäckström and other Center Party members have said in election campaigns. Then, one still ends up supporting a government where Miljöpartiet has a veto over all the important rural and agricultural issues, and that goes directly against what has been said in an election campaign.

That is not the case in this situation. We will absolutely carry out as much as possible of what we promised in a campaign.

All of Sweden must function now and in the future. Therefore, the solutions must be long-term sustainable and take into account the specific conditions that exist for the veterinary services throughout the country. At the same time, we need to find measures that can solve today's situation. There is a dialogue between the Swedish Board of Agriculture and the private actors so that they can try to find solutions moving forward.

With that said, it is the government's responsibility to now get improvements for animal healthcare in place. The work we have ahead of us is extensive, and it is obviously quite complex.

With this, I would like to thank both the interpellants for this debate with an extra finely-sounding dialect.

The interpellations debate was hereby concluded.

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