Response to interpellations 2022/23:5 and 10 on the right to an interpreter
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
1 KD considers that taxpayers should not reasonably be expected to finance interpretation for persons who live permanently in Sweden 1 and that language skills are the key to integration 1. 2 C argues that a limited right to interpretation creates a patient safety risk and unequal care 2. 3 V argues that limited interpretation has negative consequences for healthcare and the staff's working environment 3. 4 SD argues that it is reasonable for persons who have stayed in Sweden for a number of years to bear part of the cost themselves 4. 5 KD argues that the investigation should examine proposals based on laws for health and medical care 5. 6 V argues that the proposal could lead to a reporting society 6. 7 KD argues that patient fees can deter people from seeking care 7. 8 C argues that proposals for a limited right to interpretation are a fundamental blow to patient safety 8. 9 V argues that the palace agreement implies a shift towards unequal care 9.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Statsrådet Acko Ankarberg Johansson (KD)
Madam Speaker! Anders W Jonsson has asked me if I will submit proposals for legislative changes that enable the implementation of the agreement that the governing parties have reached with the Sverigedemokraterna. Karin Rågsjö has asked me if I intend to propose that the right to an interpreter within healthcare should be removed. Karin Rågsjö has also asked me if I intend to propose that an obligation be introduced for employees in healthcare to report persons who they believe are staying illegally in the country.
Madam Speaker! Everyone who comes to and stays in Sweden shall take responsibility for becoming a part of Swedish society. This includes learning Swedish. When integration works, a richer, more tolerant, and more successful society is created. Language is a key to integration, and after a period in Sweden, it is reasonable to set requirements for knowledge of Swedish. With good language skills, the need to provide an interpreter in contacts with various social functions is reduced. It is in light of this that the agreement on a limitation of access to publicly funded interpretation for persons with residence permits and Swedish citizenship, as well as the agreement that it is primarily the individual who shall pay for the interpretation service, shall be read.
On a principled level, it is not a reasonable starting point that taxpayers should finance interpretation for those who live permanently in Sweden. The financing of interpretation services provided by public activities must be based on a balance between a cost-effective and purposeful use of taxpayers' funds and the individual's actual and acceptable needs in contact with various societal functions. The proposals need to be designed in accordance with EU legal regulations and other international commitments. We will return to the exact design of these proposals once they have been investigated and prepared.
Healthcare is a public service with specific needs for well-functioning communication between different parties, for example between patient and treating physician, in order to be able to provide the best possible care. That aspect needs to be taken into account in the continued work.
Within the health and medical care legislation, patient safety is a fundamental cornerstone. According to the Patient Safety Act, healthcare providers have an obligation to conduct systematic patient safety work and prevent healthcare injuries. Healthcare workers are obliged to contribute to high patient safety and have a personal responsibility for how they fulfill their work tasks according to the law. This includes offering expert and careful health and medical care in accordance with science and proven experience, and that the care is, as far as possible, designed and carried out in consultation and close dialogue with the patient. Trustworthy communication between the patient and the healthcare workers is a prerequisite for the workers to be able to fulfill their obligations. Missing information or linguistic misunderstandings can have serious consequences and affect patient safety negatively.
Regarding Karin Rågsjö's question on the reporting obligation for employees in health and medical care, I would like to emphasize the following. According to Swedish law, persons staying in Sweden without necessary permits are entitled to care to a certain extent. Children who have not reached the age of 18 shall be offered care to the same extent as is offered to those residing within the region.
In accordance with the cooperation parties' agreement, proposals shall be submitted for an arrangement with information exchange and a reporting obligation between the police and authorities that may be assumed to come into contact with persons who are illegally in the country. Through the information obligation, the possibilities of living in the country without a permit shall be made more difficult. As stated in the agreement, there may, however, be situations where a report would conflict with compassionate values, for example in healthcare. An investigation with a mandate to submit proposals in the area therefore needs to further investigate the question of exemptions from the information obligation. Furthermore, a new arrangement for the reporting obligation needs to be designed in accordance with EU law and other international commitments and regulations.
Anders W Jonsson (C)
Madam Speaker! I must thank the Minister for Health and Care for the answer.
Diagnostics in healthcare are based on two things: anamnesis, i.e., medical history, and status – the objective findings. What is absolutely crucial is precisely the medical history, and that relies on the doctor being able to understand what the patient tells and the patient being able to answer the questions the doctor asks. It is the basis for a safe diagnosis.
We have stood here in the chamber many times and talked about how important it is with a more equal healthcare. One of the biggest gaps we have in healthcare in Sweden is the one between those who are foreign-born and those who are born in Sweden. There are several explanations for that, but one is of course the problems with language and communicating.
That is why it was with great surprise that not only I but everyone else within healthcare read the Tidö Agreement, which forms the basis for this government. It became clear there that the right to a public interpreter would be strongly restricted. There was not the slightest mention or consideration that it should not apply in health and medical care.
One of many voices from healthcare was the second vice-chairman of Sjukhusläkarnas, who wrote: "To limit the right to an interpreter is a betrayal of our patients - a barrier to their ability to communicate and make themselves understood. It can create a patient safety risk and, ultimately, unequal care."
That is why many of us in healthcare breathed a sigh of relief when the Minister for Health took to the Svenska Dagbladet, where she said that there are no legal possibilities to remove the right to interpreter support in Swedish healthcare, despite the issue being part of the Tidö Agreement. Removing the right would conflict with several strict laws regarding patient safety and equal care.
But it didn't take long before the Sweden Democrats sent out their deputy group leader Linda Lindberg to state what actually mattered: She claimed that neither the Sweden Democrats nor the government parties consider that the proposal means that patient safety is compromised. Here there is an agreement, and it is a common stance. She thinks it is unfortunate that Acko questions this in his role as minister.
That is why it is so important now that the Swedish healthcare system is informed about what applies. Is it what the Minister for Health and Social Affairs has said previously? Or is it what representatives for the largest government party in the government base say?
That is exactly why I have asked the Minister for Health and Social Affairs to come here to the chamber with a coordinated answer on the issue, that is to say, signed by all four parties. After now having heard the Minister for Health and Social Affairs' answer, it is obvious who it is that decides in the government base. It is noticeable that it is the Sverigedemokraterna. Half of the Minister for Health and Social Affairs' answer is about how important it is that everyone should learn Swedish. And well, no one thinks otherwise. But it is few who have the ambition to withdraw the right to healthcare in order to pressure those who do not have Swedish as a mother tongue to learn the language faster.
The Minister for Health and Care further says that it is a reasonable starting point that taxpayers should not finance interpretation for those who live in Sweden. She concludes by saying that it is the healthcare provider who has the responsibility for patient safety, and that it is personal.
I see how the interpreters disappear from healthcare and the healthcare staff stand there well aware that when one can no longer understand the patients, patients will be harmed. In that case, it is the individual in healthcare who bears the responsibility. Would it not be more reasonable, I ask the Minister for Health and Social Affairs, that it is the government that in those situations takes responsibility for the damages that this will certainly entail in healthcare?
Karin Rågsjö (V)
Madam Speaker! I thank the Minister for the answer, and I congratulate him on the assignment.
Perhaps the writings in the palace agreement, the so-called Tidö Agreement, were influenced by the surroundings in and around the palace. The agreement is not directly forward-looking, but rather it is more backward-looking.
I am also thinking of all Swedes with an immigrant background in healthcare who uphold the care. They are nursing assistants, doctors, nurses and cleaners - all the immigrated Swedes who uphold the entire welfare system. But the palace agreement completely ignores that perspective. According to the agreement, immigrants are to be socialized. It is very clear that they are a burden.
In the palace agreement, the following can be read under the heading "Limitation of the right to interpretation for persons with residence permits and Swedish citizenship": "The right to publicly funded interpretation shall be limited. The starting point shall be that the individual shall primarily pay for interpretation services. It shall be considered to introduce a fee for newly arrived persons after a certain period has elapsed since a residence permit was granted."
What focus did you have when you wrote the agreement, Acko Ankarberg Johansson? Is there anyone who has pushed the issue hard, other than the Sverigedemokraterna? Will the care become better? Will the staff's working situation become better? Instead, this is about direct indoctrination, directed at immigrants: Learn Swedish or pay for your interpreter yourself.
Of course, those who come to Sweden should be able to speak Swedish. That is the goal, and for many, it can be a long journey. Already now, there are many Swedish-speaking people who feel insecure in healthcare. It is a direct class issue how the communication works. Regarding equal healthcare, I wonder in what way this of setting requirements by removing interpreters benefits healthcare. Is it cost-effective? I am skeptical.
A limitation of the right to an interpreter for persons with residence permits and Swedish citizenship may have major negative consequences for healthcare. Some might perhaps bring relatives as interpreters. That is not quite okay. The lack of interpretation can also affect the healthcare staff's working environment. What doctor wants to make decisions on shaky grounds? What shall apply if healthcare staff want to use an interpreter while the person in the bed does not want to?
We can also note that it is difficult to get a holistic grasp of this. Minister Acko Ankarberg Johansson told DN on October 23 that there are no legal possibilities to remove the right to interpreter support in Swedish healthcare, even though this is part of the Tidö Agreement. That sounded a bit hopeful. But I do not feel the same hope now that I have heard the interpellation answer.
There is great concern within all the trade unions representing healthcare workers - those who know that an interpreter is important for patient safety, those who know that if an interpreter is removed, great ethical dilemmas are created instead. Shall the child interpret for their mother? Shall the man interpret for his wife? The proposal to limit the right to an interpreter does not rest directly on science and research, but instead the proposal rests on the Sverigedemokraternas politics, which is always repressive in relation to Swedes with an immigrant background.
The three parties that sit in the government sit there thanks to the support given by the Sverigedemokraterna. I find it difficult to see under what premises the government can imagine proposing that the right to an interpreter within health and medical care should be removed.
Linda Lindberg (SD)
Madam Speaker! I have noted both interpellations concerning the Tidö Agreement and our proposal on interpretation costs. I feel, of course, compelled, Madam Speaker, to intervene in the dialogue in the chamber today.
The question of interpretation is something we in the Sweden Democrats have looked at for a long time, and the question is also raised by both interpellants. Just as the Minister says, it is important that those who come to Sweden and have a permanent life here also become a part of Swedish society. We all know how important language is and that it is a decisive key.
I assert that it is humane to have expectations and to set requirements. It is rather inhumane not to dare to set requirements or create conditions and incentives for each individual to become a part of Swedish society. Strengthening each individual's independence is fundamental, and this requirement is seen as such. It is precisely the lack of requirements that has shone brightly through the previous government's model for governance.
Today's debate is prompted by the agreement which states that a fee should be considered for newcomers after a certain period has elapsed since they were granted residence permits. We are therefore talking, Madam Speaker, about persons who, as a rule, have resided in Sweden for a number of years. It is the financing we are talking about, not the right to an interpreter. It is a significant difference.
Is it not reasonable, Madam Speaker, that a person who has resided in Sweden for a number of years should bear part of the cost themselves in cases where one is in need of an interpreter? Is it reasonable, Madam Speaker, that interpretation costs should be covered for life by Swedish tax money, that is, the tax collective, even though incentives are simultaneously presented to make individuals employable and investments are made in expanding language skills?
In the debate, it has also emerged that language requirements are something we highlight in the health and medical care policy area. I want to assert that there is a solid chapter in the Tidö Agreement where there are proposals for strong incentives and good reforms to strengthen Swedish health and medical care. I am well aware that both interpellants are aware of this.
But there is a question that it would be interesting to get an answer to from the interpellants. How long do the interpellants actually believe the tax collective will need to pay? It can be added that in Region Stockholm in 2017, there was an interpretation cost of approximately 142 million kronor. For the country as a whole, it is significantly much more. These are funds that instead could be used in child and adolescent psychiatry. It is an example of a neglected and urgent area.
The Sweden Democrats and other coalition parties in the government agree that it is reasonable to investigate the issue. It should be in all parties' interest.
Proposals must, just as the Minister says, be designed in accordance with the EU's legal provisions and other international commitments. This is obviously fundamental. The question of interpretation also concerns various social functions and not just healthcare.
It is therefore important that the investigation also takes into account the patient safety perspective and the fact that linguistic misunderstandings can have undesirable consequences, particularly in health and medical care. As an example, one could take into account that there may be individuals who, due to age or physical or mental condition, cannot acquire or use the Swedish language. But obviously, I should not precede the design here, but it shall have its usual preparation and investigation so that everything lands perfectly right.
Once again, Madam Speaker: The Tidö Agreement does not say that anyone should be forbidden from interpretation, but the question lands on who should pay. How much can one expect from the tax collective, and what is a reasonable cost for each to bear?
Statsrådet Acko Ankarberg Johansson (KD)
Madam Speaker! It is extremely important that we improve SFI and social orientation. I think we have fallen short in this for quite a long time, not least when we have used forms for procurement and looked too little at quality and that the result actually becomes good. We do not always provide the best conditions for people who come here.
In our agreement, it is about both strengthening SFI and social orientation and, after a period of time, setting requirements for being able to speak Swedish for those who have a residence permit and are Swedish citizens. It is both of those things that must be fulfilled, and it is reasonable that we do both. Had we only done one, it would have been difficult to see the connection to the other, regardless of which of them we had done, so the government's efforts are necessary to enable better conditions for every person who comes here and wants to live and reside in Sweden to also be integrated.
The investigation is in no way about healthcare; rather, it is about reviewing the limitation of the right to an interpreter regarding fee exemption across all sectors of society.
What is it that the Minister for Health and Social Affairs has said? I have not said anywhere that it violates the law. Those are not my words. However, I have said that I see difficulties from the fact that we have a strong patient safety, and that is the basis for everything that takes place within health and medical care. The investigation will need to face those difficulties.
Those who want to see what I myself have said and written can go to the large media platform Twitter. On a Thursday evening, when several professions had a debate article on a very interesting subject, I answered them that patient safety is a fundamental pillar in healthcare, and in the investigation that will be carried out, one will need to test any proposals in relation to what applies for the various governing laws of healthcare.
An investigation shall therefore be appointed - I have never claimed otherwise - and patient safety is a fundamental pillar in healthcare. As with all government investigations, it applies that one carries it out - one goes through what applies, for we conduct the operations under the laws - and then presents a proposal. I do not have the possibility to speak in advance about what an investigation will come to. It will have to present it itself, and then the government will, in the usual manner, prepare the matter and return after it has been out for consultation. But it is necessary that one tells what one thinks and feels and, not least, that one raises the concerns one has, regardless of the operation. That is how we work within the public sector. There is something we want to do. We highlight opportunities, problems, and deficiencies and weigh these together before we make a decision. That is what we will do also in this issue. There is a security in that we have the Swedish investigation system. We do not rush off and make decisions. We find out what applies, and then we present a proposal.
The government's position, I believe, is clearly evident from the interpellation response. An investigation will be conducted for all sectors of society, and when it comes to health and medical care, any proposals will be examined based on the laws that apply specifically to health and medical care.
Anders W Jonsson (C)
Madam Speaker! There is no one in this chamber who holds any other opinion than that we should do everything we can so that everyone in Sweden learns the Swedish language. There are very many measures that can be taken here, but we are never prepared to, for that reason, jeopardize patient safety.
Here I see, nevertheless, that there are two different lines from the government side. The Minister for Health and Social Affairs says that patient safety shall not be compromised, and that is the sharp point on which it shall be decided whether this becomes legislation for health and medical care or not.
I just have to describe the reality in a maternity ward. Maternal mortality is, thank goodness, something extremely rare in Sweden, but among the women in the population who do not master the Swedish language, it is twice as high. This can be seen area by area. Here in Stockholm, the average life expectancy is ten years longer if you live along the northern part of the red line than if you live along the southern part. It is clear that there are many explanations for that, but one of them is the problems with language.
To then proceed from this government's side with this proposal would directly worsen things for this group, because that is what it means. When those who already today have difficulties communicating in the Swedish language are in need of healthcare, they should not be given access to it via an interpreter, but instead, it will be up to the findings of the examination.
It also shows a bit when the Sweden Democrats are up at the rostrum. Yes, yes, one shall get as much access as possible, they say – but one must pay for it. It is roughly the same as saying that one shall get access to a childbirth, but one must pay the 10,000 kronor that it actually costs. One can get access to specialized medicine in Sweden, but one must pay the half million that it costs.
Healthcare in Sweden shall be available to everyone and distributed according to need, not depending on whether one masters the Swedish language or not.
I still see an opening in what the Minister for Health and Social Affairs is saying now – that the decisive factor is actually patient safety. If the consequences of the bill to be developed in accordance with the Tidö Agreement result in that patient safety is worsened, then I take it from the Minister for Health and Social Affairs that it will not apply to health and medical care.
I hope that the Minister for Health and Social Affairs is also driven by improving health and medical care and not, as this proposal could imply, worsening it for a group that is already vulnerable today.
My question to the Minister for Health and Social Affairs will be this. If this investigation were to conclude that a reduced availability of interpreters means that patient safety is compromised, which everyone in healthcare already realizes, I interpret the Minister for Health and Social Affairs' answer as that this proposal will in that case not be presented regarding healthcare.
When it comes to the other matter we are debating in this interpellation debate, namely that healthcare personnel shall be obliged to report those who do not have permission to stay in the country, we can see when we read the Tidö Agreement that a reservation has nevertheless been included that one shall look closely at whether this should apply to healthcare. But that has not been done on the interpreter side, and that is what makes me worried.
I still see an opening in that the Minister for Health and Social Affairs here actually highlights that patient safety is fundamental. It must not be compromised. If withdrawing the interpreters from healthcare would entail serious threats to patient safety, as all of us within healthcare see that it does, I see a glimmer of hope that this deterioration of healthcare will not be implemented.
Karin Rågsjö (V)
Madam Speaker! I entered this debate to discuss with the Minister for Health and Social Affairs, and I know that the Minister for Health and Social Affairs has excellent competence in most of the healthcare issues.
There is a glimmer of hope in what we hear from the Minister, just as Anders W Jonsson says. One must look at patient safety, and if it is undermined or hindered, one must put one's foot down. I expect that. The healthcare unions that are worried about this probably expect it too. This is not a simple question. This is a difficult question, because it concerns equitable care.
Madam Speaker! The SD-dependent government's project to actively worsen the situation for people with an immigrant background shows a view of humanity that is quite striking. That can be seen here today.
For Vänsterpartiet, it is obvious that we should go in the other direction. We shall improve access to good care and ensure that everyone receives the care they need. This is called equal care. I am, like perhaps many others, very disappointed that Kristdemokraterna are joining the chorus of politicians who do not safeguard everyone's right to equal care. It is sad.
The parties that are in the government now must adapt to the Sweden Democrats. You are completely dependent on them; without them, there is no government anymore.
One of the points in the Tidö Agreement has already been given the name the reporting law, and the term captures exactly what the point aims for: an obligation to provide information, meaning that it is the responsibility of authorities and municipalities to report often already vulnerable people to the police. This is not only ethically questionable – it also risks creating legal problems.
It is about an exchange of information. A doctor, for example, who sees that a paperless person is coming, will report this directly to the authorities. This is a dilemma that not only doctors but also others within healthcare see ahead of them, and one wonders what will happen. Where is the ethical boundary? We will have to see, because this is to be investigated.
All children, including those who have the right to stay here without a residence permit, have the right to healthcare; it is also written down. Within healthcare, strict confidentiality prevails - we are very aware of that - for information regarding an individual's health status and other personal circumstances. The EU's data protection regulation has an even stronger protection for personal privacy. This is a super important issue, and here perhaps the hope is greater than when it comes to interpreters, I must say.
The proposal would instead establish some kind of reporting society, where independent professions such as teachers, social workers, doctors and other healthcare personnel would find it more difficult to perform their actual work tasks. It would also lead to increased suffering among the undocumented children who might no longer have secure access to basic rights such as healthcare.
I think we have simply ended up on the wrong track. Does the Minister intend to propose that an obligation be introduced for employees in health and medical care? It shall be investigated, and we will follow this very closely. I believe that those who work within health and medical care will also do so, because this is about their everyday lives.
Linda Lindberg (SD)
Madam Speaker! I think the Minister has been very clear in the debate regarding what is intended. I believe the interpellants need to look up a bit. We have in the Tidö Agreement our own section concerning the Swedish health and medical care, where we are extremely clear about the state governance of the Swedish health and medical care in order to increase equality. There are many important, heavy reforms there to increase equality.
This, which I in some sense think the interveners are looping around, is an overarching desire – to look at when, how, and at what stage one should fund its own interpretation service. I do not think it is particularly alarming or distressing. Somewhere it is about one's own independence.
Of course, there are a lot of boundaries, especially when it comes to the Swedish health and medical care and the patient safety perspective, which we must take into account. I also think the Minister has been very clear about that.
So I think that from the side of the interveners, one can sit a bit calmly in the boat and refrain from drawing hasty conclusions. In the Tidö Agreement, there are many fantastic reforms to strengthen the Swedish health and medical care and make it more equal, in contrast to how it has been now during several parliamentary terms. I look forward to the continued work of realizing parts of the Tidö Agreement.
Statsrådet Acko Ankarberg Johansson (KD)
Madam Speaker! Just as Member Linda Lindberg, I look forward to implementing the Tidö Agreement, not least because the first section concerns health and medical care. It is one of the priority areas for the parties. Unfortunately, not all policy areas are included in the agreement. There might have been a clearer pressure if all sections could have been included. But health and medical care has a clear place and is the first section that is included in the agreement.
In connection with all government inquiries, one must as a minister refrain from speculating on what the result will be. It is very difficult! It is much simpler when one as a member, and not least when one is in opposition, which I have tried for a while, can say what one wants and how one imagines the result will be. But as a minister, I must hand it over to an independent committee, an investigator, who has to judge from the directives themselves what this will result in.
We also have a procedure for sending for consultation and assessment. Then one arrives at a finished product, and the government shall be judged based on that, when it finally arrives.
I am glad that Member Anders W Jonsson raised fees in health and medical care. One is not there without cost today. Everyone pays a patient fee when one is there. Not everyone can bear it, and I know that even today there are problems with many refraining from seeking care because they do not have the financial means they would have desired – even though we have a high-cost protection. So yes, we have fees in health and medical care today, which also sometimes become a problem for the individual and deter people from seeking care. Should a proposal regarding fees for interpreters come, it will involve the exact same issues, which of course also need to be weighed in in a future investigation.
We do have fees, even though healthcare itself is free of charge. But we have patient fees, and I do not shy away from the fact that they are burdensome for some people and actually deter people from seeking care today. We need to see that this is how reality looks.
When it comes to the duty of disclosure, it is exactly as Member Karin Rågsjö says: It appears that the exception regarding healthcare will be investigated. It is always good when conducting an investigation to assess different sectors against each other to see where it is appropriate, where it is very bad, and where it is possibly appropriate. It is therefore not so bad for the investigation to have all societal sectors included and assess them based on existing laws.
It is a reassurance that the government also so clearly writes in that this shall follow the EU legal and international commitments and regulations that exist. The same applies to our own law, which we have enacted. We conduct Swedish public activities under the laws, and I have strong confidence in the laws that govern healthcare: the Health and Medical Services Act, the Patient Act, the Patient Safety Act, and very many other laws that affect the operations. They are strong, and I hope that we can collectively ensure that they become even stronger in certain parts. I believe that, not least, patients' rights would need to be strengthened in the future in various ways.
Based on the questions I have received, I can state that an investigation will be conducted - it has been clear from the start. When it comes to the duty of information, it appears that exceptions regarding healthcare will be investigated, because it is an area that is sensitive in itself. When it comes to the possibility of limiting the right to an interpreter and introducing fees, this will be done for all sectors of society. When it comes to healthcare, questions regarding patient safety will be one of the heavy parts, for it is the cornerstone of it all.
If I am, for example, a doctor, like member Anders W Jonsson, and receive my license, it is about to alleviate, cure, and not harm. It is on those premises I enter. Then we must have an activity that functions in accordance with this, and every investigation will need to look at that, regardless of which issue one is examining - including this one.
Anders W Jonsson (C)
Madam Speaker! I can understand that a representative for the government parties would very much like to talk about everything else within healthcare and not about just the two points that we have raised in the interpellations. These are, in fact, basic shots against patient safety in Swedish healthcare. These are proposals that will mean that inequality will increase significantly - definitely not decrease.
But what gives me a small glimmer of hope is that the Minister for Health and Social Affairs nevertheless raises this with patient safety. Everyone who works in healthcare knows, however, that proposals involving a reduction in the right to an interpreter will mean that patient safety is compromised, and it will lead to illness, injury, and perhaps death. There is no doubt about that. When the Minister for Health and Social Affairs now says that one is not prepared to compromise patient safety, I still see a glimmer of hope that this will not happen. This cannot be implemented in health and social care, because it would have such severe effects.
But what, on the other hand, causes concern is that it is the Sweden Democrats who are entirely decisive for this government's future. It is they who have the dominant influence, and it is also they who will have the right of interpretation. I feel quite certain that the argument that this endangers health and life for those people who do not master the Swedish language will carry very little weight for the Sweden Democrats in the negotiation that will take place between the four parties.
I and largely everyone within the healthcare sector view with great concern that precisely this has been introduced, and it has not been done with the aim of improving Swedish healthcare but with the aim of making life even tougher for those who do not fully master the Swedish language.
Karin Rågsjö (V)
Madam Speaker! Thank you, Minister, for all the answers or perhaps rather non-answers.
In the palace agreement, the healthcare section is the most relevant section. I must say that. But it implies a shift towards more unequal care.
Then there is this matter of patient safety. There is a very great concern for patient safety in the various groups working with healthcare. All unions are concerned, because it can mean disaster if one does not take patient safety into account.
Madam Speaker! There are very many Swedes with an immigrant background who feel singled out by the new government. The Palace Agreement, the Tidö Agreement, is a statement where very much is the immigrants' fault. Pure racism is legitimized when parties fuel the fire.
The Swedish healthcare system would absolutely not manage without those who were born abroad. This is very rarely highlighted, and it is absolutely not done in the Tidö Agreement. It is 26 percent of the employees - every fourth employee - within healthcare and elderly care who were born abroad. Among the doctors, the proportion is 34 percent. Among the healthcare assistants, it is 40 percent. Among the nurses, the proportion is 12 percent and among the nursing assistants 26 percent. If they were to stand up and leave, we would face enormous problems. This must also be highlighted. Immigrants are not a problem. They are an asset. Like all Swedes, they can become problems, and it is usually about class in different ways.
Now the immigrants are to be disciplined. It is, so to speak, a statement in the agreement. They shall not be given an interpreter, which goes directly against the legislation. But I still see some hope. You in KD are the senders of the palace agreement, but just like the other parties, you are completely dependent on the Sweden Democrats. Without the Sweden Democrats, no government. That is how it is.
It will be interesting to follow this journey. Will the Christian Democrats fight against things such as the interpretation proposal and the disclosure act? I unfortunately do not think so, because it is the Sweden Democrats who decide.
Statsrådet Acko Ankarberg Johansson (KD)
Madam Speaker! One or another of the interpellants has been in government during the Alliance years and knows that it was not the rule of the strongest that applied. It was four parties that agreed on every issue. At least, this was the story I was constantly made a part of during eight years: It was four parties that met every day on issues, and it was not about one party getting two of its proposals through just because another party had gotten two of its through.
In the same way, this government works. We are four parties who stand behind the Tidö Agreement and look at issues, reach agreements, discuss and negotiate. In all other issues, we are three parties in the government who do that. That is to say that it is an equal relationship, because that is just how one can get the whole thing to work. One listens to each other's arguments and finds a common solution.
I am certain that healthcare will need major reforms ahead. Not least, we point out in the Tidö Agreement that this is an area where we want to influence and change. But integration is just as important, precisely for the reasons that Member Karin Rågsjö raises. A large proportion of those who today are employees in healthcare come from other countries. Think how fantastic it is that they come here and want to work in Swedish healthcare! We have everything to gain from the fact that those who come here, receive a residence permit, become citizens and want to have their lives here also work in healthcare, because we need many employees there. The same applies to elderly care. But none of us have thought that we would lower the requirements for that reason.
Every person is important. Every human being is an investment, regardless of who they are and where they come from. But when one works in healthcare, one must have the required competence. We are fortunately fortunate to have many with a foreign background working in healthcare. They are important employees today.
See every person who works in healthcare as an investment! Our big problem today is deficiencies in the work environment. We need to make significant changes, which is also reflected in the government's budget, which was submitted this week.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.