Response to interpellations 2023/24:305, 306 and 308 on the reporting obligation of healthcare personnel

Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! Yasmine Bladelius has asked me how I intend to act so that the country's healthcare staff can fulfill their mission to, according to the Health and Medical Services Act, provide the entire population with good health and care on equal terms. Yasmine Bladelius has also asked me if I intend to take measures to exclude employees within the healthcare sector from the investigation on the reporting obligation regarding undocumented persons.

Furthermore, Karin Sundin has asked me how I intend to act so that Sweden can live up to the UN Convention on the Rights of the Child and Swedish legislation stating that all children have the right to the best possible health and healthcare. Karin Sundin has also asked me if I intend to take measures to exclude healthcare employees from the investigation on the reporting obligation of undocumented persons.

Furthermore, Dzenan Cisija has asked me if I see any risk that the healthcare personnel's reporting obligation will cause increased mortality among acutely ill undocumented adults and children and if I intend to take measures based on my assessment. Dzenan Cisija has also asked me how I, within my area of responsibility, shall address reduced social cohesion and diminished trust in authorities as well as increased problems with stigmatization and ethnically and skin-color-based profiling, which the reporting obligation may cause.

Initially, I want to emphasize that I have on several occasions stated that the government considers patient safety to be a fundamental pillar. This applies to both children and adults. The protection of children's rights is an important issue for the government.

The Government decided on 30 August 2023 on a supplementary directive (dir. 2023:126) to the Inquiry on strengthened return activities (Ju 2022:12), which the government at that time appointed. The supplementary directive implies, among other things, that the investigator shall submit proposals for a regulation involving increased information exchange between authorities for the purpose of strengthening the work with the enforcement of removal decisions and making it more difficult to live in the country without a permit.

In order for the regulation to be legally secure and not lead to unreasonable effects for individuals, certain situations may need to be exempted from the duty of information. It appears from the supplementary directives that it may be a question of situations where the duty of information would conflict with sensitive values, for example within healthcare. It is part of the investigator's mandate to assess how the regulation should be designed and which situations should be exempted.

It is also part of the investigator's mandate to submit necessary legislative proposals. The proposals shall be in accordance with the international rules and conventions that Sweden has committed to follow, including the European Convention on Human Rights and the Convention on the Rights of the Child, both of which apply as law.

The investigator shall also analyze the consequences of introducing an expanded exchange of information and describe the advantages and disadvantages for the affected entities.

I cannot precede the investigation's work and am now awaiting the investigation's proposals and conclusions.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Yasmine Bladelius (S)

Madam Speaker! In recent months, the anxiety among healthcare personnel in Sweden has only increased. In addition to the fact that we have a healthcare system in crisis, and in addition to the fact that healthcare personnel are on their knees when they do not have time to provide patients with care in a timely manner and see their colleagues leaving the profession because they cannot endure the tough and unsustainable working situation, they are also worried about another issue.

It is about a very great concern about having to report patients to the Police Authority and the Swedish Migration Agency in cases where the patients lack a residence permit. It is about a very great concern that directly after one has performed one's important work, for example by delivering a woman and helping a child come into the world, one will have to pick up the phone and report a newly delivered woman to the police.

Madam Speaker! It is not about a lack of understanding that those who do not have a legal right to be in Sweden should not be here, but about so much more. It is about the very background and the reason why one chose to become a doctor, a nurse, or a nursing assistant. It is fundamentally about pure and simple humanity.

Madam Speaker! The reactions have been clear from all the major trade unions. SKR and many of Sweden's regions have also directed sharp criticism towards the proposal. Some regions have even said that they do not intend to follow the law if it becomes a reality. They see, in fact, a clear conflict between established healthcare ethics and a reporting law. They also argue that reporting of undocumented people can damage trust in healthcare. People in need of care expect the staff to have a duty of confidentiality.

The regions further argue that the proposal will further worsen the conditions for healthcare staff, who already have a full workload in their important tasks. They see a great risk that people in need of care will refrain from seeking healthcare due to the risk of being reported and thus deported.

The Minister for Health and Social Affairs has previously, and also in this response, spoken about a whistleblower law within health and social care and said that exemptions for healthcare personnel shall be investigated. But in the supplementary directives, that question has been both added and removed – and now the minister says it is there again. Therefore, it naturally becomes very difficult for the country's healthcare personnel to understand what is to come. The concern only increases, especially as the minister's government colleagues and government cooperation partners are clear that all public personnel shall be covered by a whistleblower law.

In view of the fact that the Minister is cooperating with the Sweden Democrats, who believe that all public personnel should be covered by the bill, I would like to ask again how the Minister intends for the country's healthcare personnel to be able to fulfill their mission according to the Health and Medical Services Act and provide good care on equal terms to the entire population.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Sundin (S)

Madam Speaker! I would like to thank the Minister for Health and Care for the answer. It is good that she emphasizes that the government considers patient safety and the protection of children's rights to be important issues. That is also the experience I bring with me from my years as a healthcare politician in Örebro County, where the Social Democrats form a majority together with the Christian Democrats and the Centre Party. As a regional councillor, I was never worried that anyone in the cooperation would put a proposal on the table that threatened the fundamental respect for human rights or that questioned the importance of a clear children's perspective.

I honestly could not imagine then that a couple of years later I would be facing a Christian Democratic Minister for Health who professes to a Tidö Agreement which very clearly states that reporting shall be the main rule in the Swedish rule of law and in the welfare state. Employees in municipalities and regions and at agencies whose job is to help people shall, according to the Tidö Agreement, be obliged to report to the Migration Agency and the police when they come into contact with persons they suspect do not have permission to stay in Sweden.

Of course, there is a caveat, which the Minister for Health and Social Affairs would like to emphasize, about letting it be investigated to perhaps, possibly, potentially make exceptions for particularly sensitive cases. But the Christian Democrats' cooperation partner at the national level, the party upon which the government cooperation is based, sees no sensitive cases. The Sweden Democrats are clear that the obligation to report shall apply to all public employees and in all contexts, also in healthcare and when it concerns children.

Madam Speaker! Today's Swedish legislation and the ethical rules governing healthcare stand in complete opposition to the reporting law that is now being prepared in the Government Offices. According to medical ethics, the doctor shall always have the patient's health as the primary goal. The doctor shall, if possible, cure, often alleviate, and always comfort. The doctor shall never depart from the principle of people's equal value and never subject the patient to discriminatory treatment or interaction. The doctor shall observe silence regarding all information concerning an individual patient unless it jeopardizes the patient's well-being.

What the Sweden Democrats and the Tidö Agreement are paving the way for is a radical shift in how public activities shall meet people in Sweden. It means something that we previously criticized authoritarian states for.

With a reporting law, the future law-abiding doctors will say: "Let the children come to me, and I shall heal, soothe, comfort and report. Let the children come to me, and I shall deport them. Let the children come to me, and I shall ensure that the children and their families are expelled from Sweden." I wonder, Madam Speaker, if the Minister for Health believes that this will affect all children's right to care based on need.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dzenan Cisija (S)

Madam Speaker! In Sweden, where publicly employed healthcare personnel today do not report undocumented patients to the authorities, we are facing a worrying change. The Tidö Agreement proposes a reporting obligation for, among others, healthcare personnel upon contact with undocumented persons, which could have fatal consequences.

Acute healthcare is a right for adult undocumented persons, and undocumented children under 18 years of age have the right to the same care as other children in Sweden. That is how it is today. This humanitarian principle is now being threatened.

My fear is that the reporting obligation will lead to increased mortality among undocumented persons, especially in emergency situations. There is a great risk that they will refrain from seeking care, which can lead to serious illnesses worsening or that undocumented persons seek help from unauthorized individuals, with potentially life-threatening consequences.

My greatest concern concerns undocumented women and children. Women may choose to forgo life-saving care, such as maternity care and abortion, for fear of being reported. This poses a direct life threat to both mother and child. Newborns risk missing basic healthcare and vaccinations. For undocumented children, especially those with disabilities, the situation is even bleaker.

Minister Acko Ankarberg Johansson's answer to this question provides no clarity on what the government wants. Even though patient safety is mentioned and there are exceptions from the duty of information, there are no guarantees that this policy will not harm the most vulnerable.

Madam Speaker! I urge the government to reconsider this reporting obligation. We must ensure that no human being, regardless of status, refrains from necessary care for fear of being reported to the authorities. Our humanitarian duty is to protect these individuals' health and well-being.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Leonid Yurkovskiy (SD)

Madam Speaker! I thank you for the urgent interpellations, which raise a very important issue, and I also, of course, thank the Minister for the answer.

With full respect for some people's completely honest questions regarding what the extended duty of information could mean for, for example, professional integrity or the right to care, I must nevertheless say that it is a bit tiresome that the red-green side, in this case the Socialdemokraterna, constantly seems to seek excuses for an irresponsible stance in migration-related issues. I expect that within a few years we will have to stand here and hear the Socialdemokraterna say: We have always been for the duty of information - it is Reinfeldt's fault that society has lost control! I can, for the latter, agree to some extent. This hypothetical scenario is not so unthinkable, not least considering that the duty of information has in some form been applicable even under Socialdemokraterna governments.

This is no new invention from the government or the Sweden Democrats, but something that already exists to a considerable extent today, as appears in Chapter 7 of the Aliens Ordinance under the heading "Duty to Report", and as has been said, it has also existed under red governments. Current rules apply to Arbetsförmedlingen and Skatteverket, but until 2015, the duty to report also applied to schools and social services.

People speak of this leading to what is called skin-color-based profiling. That is, of course, not true. Whether one is staying in the country illegally or not obviously has nothing to do with one's skin color. That is why we have identification, passports, and so on. But, Madam Speaker, if we set the irony aside for a moment, the member's primary objection and concern seems to be that the fundamental trust in society-sustaining professional groups would deteriorate, and that it would lead to some division in society in various ways.

It is important here to acknowledge some things. For the first, there are people who should not be staying in Sweden. It is that simple. It can involve people who have committed serious crimes, raped, humiliated, lied to take part in Swedish welfare or - which is the most relevant in this case - simply been denied to be here but chosen not to accept Sweden's decision. This is something that society must catch, but it is something that one has failed with until now.

Secondly, it is not the case that the authorities have their primary responsibility towards the citizens of other countries, especially not when these individuals stay here illegally. That being said, one can still fulfill their mandate as an authority. One can, for example, treat a patient even while being transparent that the person in question will not remain in the country afterwards.

Thirdly, one cannot build cohesion in parallel with a shadow society. If social cohesion is to be rebuilt in Sweden, it is absolutely crucial with crime fighting together with a serious migration policy that is in order.

The Social Democrats point out that this would create mistrust among immigrant groups. But it is not a question of homogeneous groups. Those who reside here as immigrants legally are not affected by this proposal in any way, rather it is a measure to reduce the illegal.

To summarize, Madam Speaker: Neither the healthcare system nor the school system shall carry out any kind of expulsion. This does not change their mandate. Care that cannot wait must be available in society, and that is nothing that an expanded duty of information will in any way change.

With that said and with all due respect: Society has a very large problem with people who are in the country illegally. To solve this problem, there must be cooperation, and the correct authorities must be made aware of persons who, for example, stay in Sweden after a deportation decision. If one is serious about addressing the problems that the Social Democrats and the former prison warden have created in the migration area, it is necessary to establish an expanded duty of disclosure.

In this speech, Jonas Andersson (SD) agreed.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Mona Olin (SD)

Madam Speaker! All people have a right to acute care, that is to say, care that cannot be delayed. That is how it is, and that is how it must always be. But it does not mean that we should offer everything to everyone. The right to care is not limitless, and rights are not without requirements. This is not controversial, but it is well-established in international law.

In the Tidö Agreement, it states that a broadened review of the regulatory framework surrounding internal immigration controls shall be conducted for more effective work in detecting persons staying illegally in Sweden. In the directive, it clearly states that the proposals shall be in accordance with the international regulations that Sweden has committed to follow, including the European Convention and the Convention on the Rights of the Child. Thus, it is absolutely clear that what is stated in the Convention on the Rights of the Child regarding children's rights shall be taken into account. It is nothing else. Karin Sundin from the Socialdemokraterna claims otherwise, but that is not correct at all.

It is stated in the Tidö Agreement that situations may arise within, for example, healthcare that can be exempted because they involve sensitive values, but it does not mean that the entire healthcare sector would be exempted. No activities shall be excluded in advance from the duty of information, and the investigator shall themselves make an assessment of which situations should be exempted. All Tidö parties stand behind this. How the legislation will then look - if anything is to be exempted and if so what - will be awaited based on the investigator's conclusions. It is not possible to say anything about that today.

In one of the Socialdemokraternas speeches, it was about a woman who had just given birth. There are already today recommendations from Socialstyrelsen in what is called guidance for the social services. There are written recommendations regarding situations where a child is born to a woman who does not have permission to reside in Sweden. First and foremost, it must be ensured that the care needs are met. In the next step, health and medical care and social services shall cooperate to resolve the issue of travel to the home country.

Those who live in Sweden illegally inevitably become dependent on crime to survive and therefore risk becoming a support for the very gang crime that plagues our country and which we are trying to combat. Society must cooperate to tackle the shadow society. It is unreasonable that one authority works to deport and another instead helps illegal residents stay here. The duty to report is important to ensure that people who are in Sweden also have the right to be here. Otherwise, we can never achieve safety and trust in Sweden.

In this speech, Leonid Yurkovskiy (SD) agreed.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Carita Boulwén (SD)

Madam Speaker! The background to all the interpellations from the Social Democrats' members is the supplementary directive to the ongoing investigation on strengthened return activities. The previous government, in June 2022, commissioned an investigator to examine various measures related to return, including increased information exchange between authorities, however with exceptions for school and healthcare. In the current supplementary assignment, the Sweden Democrats and the government have changed the conditions so that no activity shall automatically be exempted from the duty of information. The investigator shall now himself assess which situations may need to be exempted.

Madam Speaker! In order to address the growing shadow society and the sharply increasing crime in the country, society must cooperate. We cannot allow authorities to work against each other. The Tidö Agreement's proposal on the duty to inform means that municipalities and authorities, within the framework of their activities, inform the Swedish Migration Agency or the Police Authority if they come into contact with persons staying illegally in the country.

Living illegally does not only pose a danger to the individual but also constitutes a breeding ground for crime and other societal problems. Those who live illegally inevitably risk becoming dependent on crime to survive and thus risk supporting the gang crime that plagues our country. Previous governments' laxity regarding the view of people who are in Sweden illegally has enabled the enormous shadow society that has spread, which has resulted in consequences such as increasingly violent crime, corruption, and insecurity in our country.

Therefore, it is necessary that we now do it over and do it right so that authorities, through mutual information sharing and cooperation, can identify and act against those who are in the country illegally.

Madam Speaker! It is important to establish that the proposal concerns those who have had their asylum applications rejected and who have been assessed as having no grounds to stay in the country. If one has received a no, it shall be a no, and then one shall leave the country.

The duty of disclosure is also nothing new in Swedish law. It applies, for example, in cases of suspicion that a child is being harmed or that crimes have been committed. Hiding from a deportation decision also constitutes a crime.

Madam Speaker! All people have a right to care that cannot be delayed. That is nothing that will be taken away. But to enable those who are illegally in the country to continue to fully participate in our welfare, school, care, and healthcare is counterproductive if we are to be able to have regulated immigration.

Regulated immigration requires that persons who have had their application reviewed also leave the country when they have received a deportation decision. We cannot go against our own legislation. It is not controversial but should be a self-evident matter.

In this speech, Mona Olin and Leonid Yurkovskiy (both SD) concurred.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! Thank you, members, for your contributions, both the interpellants and others who have participated!

Someone mentioned that we practically had absolute secrecy. We do not have that for healthcare personnel. There are several secrecy-breaking provisions. I am happy to mention them if someone wants them in detail, even though that is not what it is about today.

I say exactly as Member Mona Olin just said. It is completely impossible today to say what an investigation will come to. It is impossible to say what referral bodies will think of a proposal that does not yet exist. Therefore, we also cannot speak about what assessments the government makes.

The government and the coalition partner Sverigedemokraterna agree on what is stated in the Tidö Agreement and the additional directives that we have submitted. Now, it is an investigator who works in the usual manner, goes through the material, follows the directives, and makes their independent assessment. Then we have a good procedure where we also send the investigation's proposal out for consultation to hear many people's opinions. Only after that does the government weigh the options.

I think it is a good procedure. One also gives customary time for an investigation and referral process. There are some questions where one sometimes thinks it needs to go fast. I have respect for that. But this is a typical question where one needs to go through everything properly so that one knows what one is doing.

Many interpellations will surely be submitted on the issue in the coming years. But it is only in about a year's time that we will know what the investigation has proposed and what the referral bodies have thought, and after that, the government will weigh the options.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Yasmine Bladelius (S)

Madam Speaker! One of the Sweden Democrats' representatives said a moment ago in the other speaker's chair that it is a tiresome debate. But this debate, Madam Speaker, is not based on any political game. The debate is based on a genuine concern from us interpellators, from the welfare workers, and from all of the major trade unions. To be honest, Madam Speaker, the minister may correct me if I am wrong, but I also believe that the minister has a strong concern in this matter.

Madam Speaker! Even though I know that the Minister has a strong commitment to the welfare and healthcare workers, especially in this issue, the problem is that the Minister does not lead the government alone. The government is built on a base of support from the Sweden Democrats and Jimmie Åkesson. The government and the Minister need to do what the Sweden Democrats want. Otherwise, there is no support, and otherwise, they can bring down the government.

Madam Speaker! This is exactly the kind of issue where Jimmie Åkesson has been very clear. All public employees shall be covered by a reporting law. If one does not follow the law, one shall be punished. My question to the Minister for Health and Social Affairs nevertheless is: How will it work to potentially obtain an exemption for healthcare personnel when it comes to a reporting law?

It is very easy to stand here in the chamber or to go to the media, worried trade unions and healthcare staff and say: We will investigate an exception for painful values. But will the minister and the government go against the support party's party leader? That is the party that the entire government base rests on.

Will you go against them if the investigation were to show that healthcare personnel constitute precisely that sensitive exception? Will you then exempt the healthcare personnel despite the fact that Jimmie Åkesson and the supporting party have been incredibly clear on the issue that all public personnel shall be covered by a reporting law and that those who do not follow the law shall be punished? It is an honest question, based on genuine concern, which I pose to the minister.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Sundin (S)

Madam Speaker! It appears that the Minister for Health and Social Affairs is hiding, and right now in this debate also the Sweden Democrats, behind the non-binding press release regarding exceptions for particularly sensitive values. I wonder what particularly sensitive values actually mean in schools and in healthcare, which we are debating right now.

It sounds like it is about individual, well-defined and sympathetic cases. Does it mean all healthcare and all patients? No, it does not. Does it mean all children? No. Does it perhaps mean children from certain countries and of certain religions but not others?

What do cherished values mean for a Christian Democrat, and what do cherished values mean for a Sweden Democrat, who are the ones governing the government? Perhaps it doesn't matter that much. The message that the Tidö parties want to send, that Sweden shall be a country for only Swedes and that everyone else, children as well as adults, should watch out, still comes through.

I believe that legislation which has as a main rule that healthcare personnel shall report persons who turn to them for support, help, and healthcare will hinder the conditions for the staff to do their job. I believe that it will destroy many children's futures.

In Sweden, all children have an equal right to healthcare. Sweden has signed the UN Convention on the Rights of the Child and made it into Swedish law. It stipulates that children have the right to the best possible health and healthcare. In the Patient Act and in the Health and Medical Services Act, there are corresponding formulations stating that when healthcare is provided to children, the child's best interests shall be given special consideration.

But the right to healthcare will be undermined if the doctor, the nurse, and the nursing assistant are to report the patients. It will affect how and when parents seek care for their sick children. As Kommunals chairman Malin Ragnegård formulated it during a demonstration in Fatbursparken in Stockholm last autumn, the fear of going to the emergency room will be greater than the fear of the appendix bursting. Children will have time to die in the stomach before the parents dare to seek care, because they are afraid of being deported.

Profit can therefore impossible be the child's best interest. It is the child's best interest that I think we need to have in focus in this issue. The children will have to bear the burden and the punishment because their parents have made a decision to reside illegally in Sweden.

From a child's perspective, legislation providing for the deportation of undocumented persons represents an institutionalized original sin.

Madam Speaker! I wonder how the Minister intends for a reporting legislation to be compatible with the provisions of the UN Convention on the Rights of the Child that all children have the right to the best possible health and healthcare.

(Applause)

The speech at riksdagen.se, in Swedish (opens in a new tab)

Dzenan Cisija (S)

Madam Speaker! In light of the Tidö parties' proposal regarding the reporting obligation for public employees, I have posed a question to the Minister as to whether it is possible to ensure that healthcare personnel are exempted from this obligation. It is crucial that patients' trust in healthcare is maintained and that international conventions and constructive Swedish laws are complied with.

I have also questioned how the Minister intends to handle the broader societal consequences of the reporting obligation, such as reduced cohesion in society, a crisis of confidence in authorities, and the risk of increased stigmatization and ethnic profiling. The reporting obligation can potentially undermine social cohesion, worsen public health, increase crime, and create social unrest. It risks reducing citizens' trust in one another and in important social institutions, such as healthcare.

The reporting obligation can also reinforce and consolidate the stigmatization in already vulnerable areas, where undocumented persons often stay. The Tidö Agreement implies that authority personnel may come to demand identity documents and perhaps decisions on residence permits, for the purpose of avoiding reporting suspected persons to the police. This practice risks leading to ethnic and skin-color-based profiling, which can exacerbate the already existing segregation and increase the gaps in society.

Madam Speaker! With these concerns and consequences in mind, I strongly urge the government to reconsider the reporting obligation for healthcare personnel. It is important that we continue to reflect in our laws the humanitarian and ethical values that our society has long stood for. We must act to protect the most vulnerable in society and maintain a cohesive, just, and inclusive nation.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Leonid Yurkovskiy (SD)

Madam Speaker! Thank you, my fellow members, for the contributions! The debate is of course not tiresome – otherwise, I would not have stood up here. What is tiresome is that the Social Democrats are trying to facilitate illegal migration. The Social Democrats are worried about the social experiment, which has so clearly failed.

I intended to address some of the objections that have come up now during the second round. The first is this matter regarding a reporting society. With reporting, one usually means that people in their private lives at an individual level are expected to report neighbors, acquaintances, or other fellow human beings. Right now, we are talking about authorities or at least public employees, who already today need to report in certain cases.

Society must cooperate. We must work together to tackle the shadow society, and it is unreasonable for one authority to work to deport a person who should not be here while the other authority facilitates the situation in the opposite direction. So we cannot have that.

With this said, I want to strongly assert that the word "prescriptive society" is categorically wrong. In that case, Germany, which is perhaps the primary example, would be a prescriptive society, and I do not think anyone views the matter that way.

Then we have the problem with illegal stays. A notorious example could be the terrorist Rakhmat Akilov, who, instead of leaving the country when he was denied, chose to go underground. Despite Säpo's warnings, it was only when the police were tasked with executing the deportation that it emerged that he did not live at the address where he had registered, and the deportation was not carried out. Therefore, innocent people could be harmed and die.

"It is about the children" is another argument I have heard. Children should obviously not be seen as responsible for their parents' actions, but precisely with regard to the children's perspective, we cannot tolerate that they are forced to grow up in an illegal shadow society in Sweden. It must be handled so that the child is allowed to stay either legally here or legally in another country.

In this speech, Jonas Andersson and Mona Olin (both SD) agreed.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Mona Olin (SD)

Madam Speaker! A restrictive immigration policy must mean that those who reside illegally in our country are found and deported. A crime-fighting policy must mean that the illegal residents in our country are found and deported, this being because those who live illegally in Sweden inevitably become dependent on crime.

All authorities must work together to find those who are staying illegally in Sweden. This is not an individual measure within the migration area but one of many measures to address the major societal problems that we grapple with today, for example crime, gang crime, areas of exclusion, and so on. If we are to regain the safety and trust in Sweden that many experience has diminished and in some cases disappeared, it must be ensured that the people who are in Sweden also have the right to be here.

In this speech, Jonas Andersson (SD) agreed.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Carita Boulwén (SD)

Madam Speaker! Until 2013, there was an obligation for social services and schools to notify the police if there were persons without residence permits among those who were registered or granted interventions. It is totally misleading when the opposition describes this reporting obligation as a reporting law and argues that we are getting a reporting society. I strongly oppose this description of reality.

I wonder: Did the Social Democrats, therefore, previously maintain a reporting society? Did we really have such a society before 2013?

Madam Speaker! To live in a shadow society is horrible for an adult. For a child, it must be even worse. It makes me seriously concerned if children are to live in shadow societies.

If the Social Democrats were truly concerned about the children they are talking about, they should not want to make it easier for children to live that way. And to say that it would be about skin color, religion, or a certain ethnicity is pure nonsense and tastelessly expressed, I would like to say. It is about persons who have had their asylum applications rejected. They have been found not to have the right to stay in the country. They have received a deportation order, and it shall be carried out.

When it comes to whether people may choose not to seek care because of this, it should be remembered that a legally sound assessment of their situation has been made. That is to say, they are to be sent to a place that is judged to be safe. They have an obligation to respect the decisions.

(Applause)

In this speech, Jonas Andersson and Mona Olin (both SD) agreed.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! I am pleased by the commitment. It is necessary that we commit to good health and medical care and to ensuring that it functions. It is also for that reason that the government, together with its coalition partner, has been careful to write directives that hold the policy together. That is why it explicitly states – which is also included in my response – that the investigator's proposals shall be in accordance with the international rules and conventions that Sweden has committed to follow, namely the Convention on the Rights of the Child and the European Convention. That is already clear. Then one does not need to question whether they will do so, because those are precisely the directives that exist.

Regardless of which investigation the members will ask me questions about - this one, the healthcare responsibility investigation, or any other - I will not speculate on how it will turn out or what consequences it will have if one does this or the other. This is something that ministers shall not, or even may not, do. We have appointed an investigation, we agree on the directives, and we await the investigator's response.

And I want to convey to the members that it might end up a bit skewed in the debate if one asks whether it will apply to all healthcare. No, it will not, because persons who are what we call undocumented do not have the right to all healthcare. They have, which I perceive all parties agree on, the right to care that cannot be postponed: acute care, abortion care, and some other things. They do not have the right to all care, but it concerns care that cannot be postponed.

The care that is precisely necessary, one has a right to when one is here, even if one does not have a right to do so. It is this question that concerns, not all healthcare.

A member reasoned about what constitutes compelling grounds. It is, of course, a legal question, where it is always clarified what constitutes particularly, special or compelling grounds and so on. But can the members imagine anything more compelling than care that cannot be delayed? I cannot, as it is the baseline in some way. Care that cannot be delayed is indeed what is compelling.

This is what the investigator has to look at. One always looks at how things are usually regulated, one looks at the laws in force, where I highlight that patient safety is a fundamental pillar, and then one makes their assessment. When the investigator comes with their proposal in the autumn, it is sent out for consultation, and after that, the government makes a decision on how we should weigh all the views. We will, of course, gladly return in debates and conversations with the members of Parliament regarding the proposal before the Riksdag makes its decision.

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Yasmine Bladelius (S)

Madam Speaker! I had actually intended to waive my closing remarks, but I felt that I had to stand up and comment and state a few things.

First and foremost, I want to address the argument from the Sverigedemokraterna members that a reporting law would counteract the shadow society. I assert the opposite, with determination. It is naturally not the case that someone living in a shadow society seeks out healthcare or another authority more easily or preferably because there is a reporting law, on the contrary.

If there is a reporting law and I live as an undocumented person in a country that has a reporting law, I do not seek healthcare. I might even let my appendix burst rather than seeking healthcare, because I have a child with me in a safe country like Sweden. When I live in a shadow society, I might even rather have a serious complication in my pregnancy than seek healthcare, if we have a reporting law. I therefore strongly oppose the argument that the shadow society would be countered by a reporting law, Madam Speaker.

I also want, during the short seconds I have left, to point out the fact that we just had a very long debate on the healthcare crisis in Sweden where no Sverigedemokrater chose to sign up for the debate. But in this debate, when it concerns a reporting law, all three Sverigedemokrater in the Social Affairs Committee sign up for the debate. That says a lot, Madam Speaker.

(Applause)

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Karin Sundin (S)

Madam Speaker! I am concerned when I hear the Minister for Health dodging this issue. It is the same minister who has clearly told the media that, in order for her to take the ministerial post, it was crucial for her that it stated in the Tidö Agreement that an exception for mitigating circumstances should be investigated. Nevertheless, she is not to anticipate anything in the investigation's work, but she is waiting for proposals and conclusions.

I remind of what Yasmine Bladelius said earlier regarding the very clear statements that the Sweden Democrats' party leader Jimmie Åkesson has made about that reporting legislation should be introduced for all public employees in all operations.

I mean that the Minister for Health and Social Affairs is playing a high-stakes game when she tries to push all her problems into the future, because the investigations regarding the supplementary directives will eventually land on the table. What is she going to do then? What measures will she be able to take to ensure the best interests of children when the government's entire existence is built on the Sverigedemokraterna and Jimmie Åkesson getting what they want in fundamentally important issues?

How high a price are the Christian Democrats prepared to pay to keep the Tidö cooperation together and remain in a position of government? I am afraid that the price will be measured in children's lives and health, I am afraid that children will die in their mother's womb, and I am afraid that children will completely disappear into the shadows with this proposal.

(Applause)

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Dzenan Cisija (S)

Madam Speaker! I am deeply concerned about the consequences of a mandatory reporting obligation for healthcare personnel. It stands in direct conflict with both the duty of confidentiality and the ethical and moral principles upon which healthcare rests. Forcing healthcare personnel to act as informants for the police would mean a dangerous transformation of their role and damage the fundamental trust that patients have in healthcare.

Such a destructive law would lead to a society characterized by denunciation, where both the rule of law and personal privacy are threatened. It would increase suspicion and division in our society and spread fear and uncertainty, especially among immigrants. Therefore, I stand firm that healthcare personnel in particular should be exempted from this reporting obligation.

We must protect the fundamental values in our society and safeguard a safe and trusting relationship between healthcare personnel and the patients they are tasked to help. I truly hope that the government takes these concerns seriously and acts accordingly.

(Applause)

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Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! Thank you, the interpellants, for raising this issue!

These are difficult questions – when one is to investigate something and it takes time before one receives an answer. We also have a procedure for how one should behave when one is a minister, which means that one does not anticipate a government inquiry, because then the KU will come and speak about one having made a mistake. It becomes so silly to pretend that someone is dodging when the rules and the forms we have are followed. I think this is important.

I would very much like to anticipate the entire investigation on the responsibility for care. I have, after all, struggled with this issue for a very long time. But I do not do so because I know that in this case we have handed it over to a parliamentary investigation. I cannot influence anything of what they do, because I will not be able to do so as a minister.

The same applies to the special investigator appointed by the Social Democrats who has now received additional directives. One should not be influenced by the government when one has received directives; instead, one should work in accordance with them. Then comes the government's mandate. When the referrals have been submitted, they shall be weighed. Then we shall discuss what is right and what proposals the government has. I will gladly return to this issue, Madam Speaker, when we know this.

Many thanks for the debate and the conversation tonight!

(Applause)

The interpellations debate was hereby concluded.

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