Response to interpellations 2023/24:480, 485 and 512 on the resignation of healthcare personnel

Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! Yasmine Bladelius has asked the Prime Minister how he intends, within his area of responsibility, to work to ensure that the regions do not have to lay off staff.

Sofie Eriksson has asked the Minister for Social Affairs what initiatives he intends to take regarding, for example, waiving some parts of the state's large surplus and assets to temporarily assist the regions in their healthcare crisis. Sofie Eriksson has also asked the Minister for Social Affairs what initiatives he intends to take regarding the redistribution of resources to finance the common healthcare in the longer term with, for example, changed tax policy.

Yasmine Bladelius has asked me about the Prime Minister and I agree that the government should ensure that no one is laid off in Swedish healthcare, and if the answer is yes, what initiatives I am prepared to take. Yasmine Bladelius has also asked me when the regions can expect to receive increased state grants so that they do not have to lay off healthcare staff.

The work within the government is distributed in such a way that it is I who am to answer all the interpellations.

Madam Speaker! Initially, I would like to emphasize that the government and I myself are aware of the current economic situation in the regional and municipal sectors, something that has been reported several times here in the chamber of the Riksdag. The conditions look very different in the regions. The need to implement savings varies based on the economic situation that each region finds itself in. There are examples of regions that need to borrow for operations, while others have stronger and more stable economic basic conditions.

The economic situation is complex with high inflation combined with a high interest rate level that affects all parts of society - welfare, companies, and households. The government has followed the issue closely and recently announced an additional economic supplement to the regions, of 6 billion kronor. The supplement comes without formal counter-requirements to be used during 2024, but the government's stated expectation is that the regions use the money to avoid layoffs of healthcare personnel within the core operations.

In the budget bill for 2024, the government has, in addition to this, signaled extra supplements to the regions in the coming years to strengthen health and medical care. Furthermore, the regions' share of the general state grant is added.

I have noted in several debates that it is the healthcare authorities, with directly elected politicians at the municipal and regional levels with taxing rights, who are responsible for health and medical care and that the operations are largely financed by taxes. The state cannot fully compensate for all cost increases, but the government has a responsibility to also provide support when it is difficult. We take that responsibility while politicians at all levels need to work on prioritizing core activities.

The government has now announced increased financial supplements to the regions. At the same time, I want to emphasize that increased financial supplements are not the only solution to the healthcare system's challenges. In this context, I particularly want to highlight that the staff is the healthcare system's most important resource and the foundation upon which healthcare rests. The government has therefore given the National Board of Health and Welfare, with the National Care Competence Council at its head, a mandate to develop proposals for a national plan to improve the healthcare system's competence supply. The national plan shall, among other things, show what interventions are needed for both existing and new healthcare staff to improve the competence supply. The mandate shall be reported by May 31, 2024, at the latest.

With this, I would like to thank Yasmine Bladelius and Sofie Eriksson for the questions. I look forward to the debate.

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

Yasmine Bladelius (S)

Madam Speaker! Healthcare is in the worst crisis in over 30 years. The worst part is that it is a crisis that we have warned about, a crisis that we have seen coming and a crisis that could have been avoided. But instead of curbing the crisis in healthcare, the government chose, as usual, to focus on lowering taxes for high-income earners, removing a plastic bag tax and twiddling their thumbs while the big banks cashed in insane profits.

It is priorities that have now led to mass warnings and cuts in Swedish healthcare.

Madam Speaker! This is actually a crisis that the SD government itself has caused. We others saw the crisis coming. We pleaded and warned, and there were many of us: SKR, trade unions, healthcare staff and politicians from all political parties. The government's own party comrades in the regions wrote letters to the government where they pleaded for support and help. Debate articles were written. Appeals were written from all sides. Here in the chamber of the Riksdag, the crisis in healthcare was raised in countless debates with various government representatives. But they refused to take this to heart. They refused to do anything about it, because it was something else that was more important.

In the budget for the previous year, the Minister for Health and the government reduced, for example, taxes for high-income earners by 12 billion Swedish kronor. That was important. In the wake of the inflation crisis, it was important for the government that high-income earners should be compensated. But investing in healthcare and curbing the crisis was not as important. Nor were investments in healthcare particularly important in their current budget. Despite all the alarm reports about large deficits of nearly 24 billion Swedish kronor in the regions across Sweden, they did not even receive a third of what was needed to maintain today's level.

Instead, the government invested 1 billion in expanding the rot and rut deductions so that those of us with slightly fatter wallets can build a larger pool. Taxes on income were lowered by 14 billion, and that obviously benefited mostly those of us who earn over 65,000 a month.

Not even when the government has been forced – with emphasis on "forced", Madam Speaker – to take on the issue because the pressure simply became too great, and not even when the Prime Minister on TV promises that the government will ensure that no one is laid off in Swedish healthcare, do any solutions to the healthcare crisis come from the government's side. Instead, it now turns out that the Prime Minister is backing away from his healthcare promise.

It is the Swedish people who will have to bear the consequences of this. We will have to wait longer for care and meet more stressed healthcare staff who do not have the time. Staff will be laid off. The care will become worse.

The 6 billion, Madam Speaker, which the government called at a large press conference the other day, will not be enough to stop the cuts in healthcare. They will most likely cause the deficits to decrease somewhat. But there will be no stops to the cuts. The government knows this.

What is the Minister for Health and Social Affairs' answer to all those who have been laid off in Swedish healthcare because the government has chosen not to prioritize them? What is the Minister for Health and Social Affairs' answer to all the fantastic nurses and nursing assistants who are worried about their jobs and their working environment? What is the minister's answer to all the worried patients?

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

Sofie Eriksson (S)

Madam Speaker! My interpellation was submitted on the occasion of a debate article in Dagens Nyheter by Social Minister Jakob Forssmed. The interpellation is addressed directly to him based on his own reasoning. Nevertheless, it has now been chosen to distribute the matter to Acko Ankarberg Johansson. It is of course pleasant to be able to debate with her, but the order is most strange given the character of my interpellation.

Madam Speaker! I move on to the subject. The Minister for Social Affairs' article is about the Christian fast. He writes about this matter of renouncing assets for a higher purpose. Forssmed writes: "Renouncing something creates understanding for and increases solidarity with those who do not have. Fasting provides an opportunity to see both ourselves and our surroundings."

He also writes about the value of helping the human being to distinguish between what she desires in the moment and what she actually needs.

I read the article with great interest. It was a refreshing post that prompts reflection. Forssmed argues that this active action, to consciously abstain, is important for the individual to experience, but that it is fundamentally a collective action that exists to create solidarity.

These are nice things – aren't they? But given that the writer is a member of the Swedish government, one begins to wonder from a broader perspective.

Here we are told that individuals should fast to understand how the less well-off have it. Individuals are also urged by a representative of another party to buy cheaper food. At the same time, we now see large savings in healthcare, and households are finding it harder and harder to make ends meet.

Yes, we hear that individuals have a responsibility. But what responsibility does society have? What responsibility does one have for the situation that we now see in Swedish healthcare? We see cancer patients going out in the media and being worried that their care will be compromised. Healthcare staff are now worried about whether they will keep their jobs. What responsibility does society have in that situation?

We are to read from the Minister for Social Affairs that individual individuals shall fast in order to perform a solidary act. One shall fast and abstain for a higher purpose.

In what way does the Minister intend to take initiative so that those with large resources will also relinquish a bit more of their wealth for a higher purpose? It is a question that I had intended to ask Jakob Forssmed based on his own reasoning in his own article. Now, I hope instead to receive an answer from his party colleague.

(Applause)

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

Mattias Eriksson Falk (SD)

Madam Speaker! I would like to begin by thanking the Minister for the answer to the interpellations.

The debate on this issue is naturally important. As recently as last week, issues linked to, among other things, healthcare were handled in the Finance Committee's debate on municipal issues.

The question of Swedish healthcare and its financing is important and is something that the Sweden Democrats and the government handled in the joint state budget and the recently announced supplement of 6 billion directly to the regions, of which 177 million goes to my home county Gävleborg.

In total, I can state that the state is providing 22 billion to municipalities and regions for 2024 in what is now announced - 16 billion in the state budget and 6 billion in the supplementary budget, of which 12 billion are to the regions. These are important supplements. The state needs to do its part to mitigate the effects of, among other things, inflation, and these are important supplements to do so.

At the same time, we must not forget that the responsibility for the policy and the political priorities lies with the respective region and municipality to make decisions on. When it comes to the supplement that comes from the state, the respective region will itself decide how these funds are used.

It is important to see the whole picture here, where the regions have the long-term responsibility to ensure that the operations fall within the frameworks that the municipal councils have set and where state grants are part of the financing, for example through the municipal financial equalization system.

At the same time, I can state that for the last ten years, the Social Democrats have been part of the government in 17 of the 21 regions. Thus, the Social Democrats have had a decisive influence over the governance in 3 out of 4 regions in Sweden regarding policy and priorities.

The result of these ten years is clear – the Social Democrats have delivered 23 tax increases. In three regions, the tax has been raised on three occasions each. It is a worrying signal that tax increases have been the solution to structural problems, deficits, and investments that were not financed from the start. It is simply a lack of management of the operations without funding and without accountability, where the Social Democrats, by making tax increase after tax increase, push problems ahead of themselves a little bit at a time, which is naturally unsustainable.

A tax increase is a serious signal that the cost structure in the organization must be addressed. Three tax increases is a very clear and, not least, worrying and serious signal of this. Here, the Social Democrats have failed in their governance of the regions and failed in their economic responsibility. It is very serious.

It is not okay to blame the Social Democrats' shortcomings over so many years on the state. During good years, the economy and results should show positive outcomes, and a portion of this should be able to be set aside for the future in a result equalization reserve. Nevertheless, the Social Democrats in 7 of the 17 regions that they have governed over the last ten years chose not to establish an equalization reserve to be able to balance out in poorer times with money set aside in good times.

I understand why we have this interpellation debate here today. The Social Democrats simply need to shift the focus from their failure in the governance of the regions over the last ten years to the state. It is shameful.

(Applause)

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

Sara Gille (SD)

Madam Speaker! Thank you to the Minister for the answer to the interpellations!

I live in Västerbotten, a region governed by the Social Democrats. In the autumn when the budget was laid, the Social Democrats chose to prioritize money for Norrlandsoperan instead of ensuring that the BB in Lycksele was operational—a BB whose existence or non-existence has been on the table for a very long time.

Today, BB in Lycksele is in operation, but it is after the Social Democrats finally chose to follow the Sverigedemokraterna's proposal in the region. It took almost a year before they came to their senses.

To prioritize opera over BB is a pure scandal and a mockery of the region's inhabitants. Västerbotten is a large region. For those who live furthest away from BB in Umeå, which is the next nearest BB for these people, it takes almost five hours to get to BB.

Sweden's various regions have long faced difficulties and are in a strained economic position. To then deprioritize healthcare in order to instead focus on everything from virtue signaling in the form of LGBTQ+ certification to gender equality integration and other things that have created new administrative services but have not produced added value for the people of Västerbotten does not make the region's healthcare easier or better. It has gone so far that Västerbotten has an opera in operation while BB in Lycksele has been closed despite the opera being more expensive. The Social Democrats choose niche culture and opera over healthcare activities at the expense of those who need care.

At the same time, strange attempts are being made to acquire knowledge and competence for individual municipalities in Västerbotten from the marginalized areas in Stockholm, Malmö, and Göteborg. An irresponsible immigration policy has come to burden the public finances, which affects the amount of funds going to welfare even from the state level. This has naturally led to it becoming more difficult to retain and attract competence.

The region suffers because healthcare has not been truly prioritized - a consequence of the fact that the other parties in Västerbotten have simply chosen to prioritize something else.

The weakest in society should not pay for the region's poor economic management. Nevertheless, we see how poor pensioners and the economically vulnerable are forced to pay the deficit through increased general patient fees.

The Sweden Democrats would rather make necessary savings on administration, culture, and areas outside of healthcare-related activities than place further burdens on healthcare.

The Social Democrats are the party that chooses not to make cuts within administrative activities and culture in Region Västerbotten. To instead use regional development funds for champagne projects while simultaneously attacking the government for not providing sufficient funds for healthcare is, of course, the opposite of taking responsibility.

A big difference between the Social Democrats and the Sweden Democrats is that we are the party that prioritizes the human being over populist culture and focuses on goals that are concrete and possible to follow up on, instead of on visionary constructions erected for populist maneuvers.

That the Social Democrats have the nerve to stand here and criticize the current government for healthcare when it is they themselves who bear the responsibility is a pure scandal.

(Applause)

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

Runar Filper (SD)

Madam Speaker and Minister! The Social Democrats across the country are now attacking the government over the healthcare crisis. But what does it look like in the Social Democrat-led regions out in the country, where they themselves have the responsibility to streamline operations? That is the question.

In Värmland, the regional leadership, which consists of the Social Democrats, the Centre Party, and the Left Party, chose to focus on the core operations instead of tackling all the nonsense bureaucracy and unnecessary administration. Many likely wondered why the regional government once again took on the region's most important core mission, the emergency rooms. Once again, they had to yield to the popular protests. People in Värmland do not take nonsense from anyone. Exactly the same thing happened in the autumn when the regional government wanted to shut down the out-of-hours centers in Kristinehamn and Säffle.

In a situation with a healthcare crisis and galloping cost increases in all areas, it is neither the right time nor the right place to spend 40 million on artistic design for the new Central Hospital, which is in its early stages and beginning construction now, while the healthcare staff are struggling for an extra 58 kronor for inconvenient working hours on weekends and nights.

All parties except SD were broadly in agreement that the region's guidelines for artistic design shall still apply and that the budget shall be 1 percent of the cost for all new public construction. In the case of the new Central Hospital, it was however decided that 57 million was a bit on the high side, so in order to be a bit restrained, it was decided that 40 million would suffice for the art purchases.

We Sweden Democrats consider this absurd, as likely also an overwhelming majority of the people of Värmland do. Of course, it is nice to talk about values, produce fine programs for artistic representation, have courses in Agenda 2030, hire equality strategists, and market and spread one's brand and how good, fine, and great one is as a region. However, we do not see what this provides in terms of concrete benefit for the patients who are waiting in endless surgical queues, cannot reach their health center, or are waiting for help within psychiatry. We in Värmland have the country's second longest healthcare queues, while at the same time the starting salary and the workload scare everyone away from healthcare.

The regional government shows with all clarity that they still have not understood what it means to prioritize the core mission: healthcare. The vague trends spreading within publicly funded activities must be heavily deprioritized to provide space and finances for realistic work that provides real benefit for the region's citizens. This means, among other things, cutting back on, for example, art purchases. The absolute majority of us residents would not notice any major difference if the budget for art purchases were lowered to 14 million, which was SD's proposal, instead of 40 million, which has now been decided. The former might even be more appreciated.

(Applause)

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

Fredrik Lundh Sammeli (S)

Madam Speaker! One of these three interpellations is addressed to Prime Minister Ulf Kristersson. I would have liked to see him here in the chamber tonight to answer the questions from the interpellante Yasmine Bladelius and myself. Even though I know very well what the Minister for Health and Social Affairs' portfolio looks like and am glad that the Minister for Health and Social Affairs is here, I think, however, that it is not quite fair that she should have to stand here and answer why the Prime Minister, a month ago, gave all of Healthcare Sweden a clear promise: It is the government and the coalition partner that will present the budget that will ensure that we do not lay off people in Swedish healthcare.

We have repeatedly requested concretization from the Social Democrats regarding this promise. When will the regions receive notification? How much money is it about, and how will the money be distributed? We have repeatedly pointed out the importance of giving notification, because it is now that the crisis is unfolding. It is now that the stakes are being set. It is now that the action plans that one has been forced to work with are being realized.

Yesterday, the announcement finally arrived. But honestly, Madam Speaker, it is not what was promised. Is it only I as a Social Democrat who am critical? No, the criticism is quite compact, from right to left and from regions to trade unions and professions. A lackluster announcement, insufficient to alleviate the economic crisis, artificial respiration for underfunded operations – these are not exactly accolades one can find in the media today.

The Prime Minister did not come to the chamber tonight, but we could already yesterday conclude that the Prime Minister's handling of Swedish healthcare is a fiasco. First, one drives forward a national healthcare crisis. Then, one promises to present a budget where no one shall be laid off. And then, one delivers something else. Yesterday's announcement will not stop cuts and layoffs in healthcare.

My question to the Minister for Health and Social Affairs is whether she believes that these funds are sufficient to fulfill the Prime Minister's promise that no people shall be laid off in Swedish healthcare.

(Applause)

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

Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! Thank you to the members for your contributions and to the interpellants who have asked the questions! Let me, in the next contribution, return to Sofie Eriksson's question, as it deserves its own round.

The proposal that the government submitted yesterday was necessary, because the regions are currently suffering under the consequences of inflation on the pension costs they have. It is a temporary cost that affects them in 2023 and 2024 but hopefully quite little in 2025 because we are slowly pressing down inflation. It is therefore a temporary event that requires temporary support. It is therefore necessary that the government provides support.

The government's and the coalition party's view, when we jointly presented the proposal yesterday, is that we shall do everything we can so that healthcare staff do not have to be laid off. Can the government ensure that it becomes exactly so? No, of course not. We have a regional self-government as stipulated in law. The government cannot make decisions on matters that directly elected politicians make decisions on. Everyone knows that, and no one has suggested to anyone that we should take over the regions' responsibility for healthcare right now. This is being tested in a state parliamentary inquiry.

But the announcement we gave yesterday is linked to what we have seen happening in our regions now, where around 5,600 people have been given notice of redundancy. I am aware that not all notices of redundancy usually result in layoffs. But a large part of them concern healthcare staff, and therefore we have now announced a sector support that goes directly to the regions, which corresponds to 7,000 nurses. This means that there is an opportunity to reduce the number of redundancies that have been issued.

Yesterday at the press conference, it emerged that we shall retain healthcare staff as far as possible, but that we must simultaneously also work with the other issues, which have been allowed to become larger than they needed to be. Vårdfokus, which is Vårdförbundet's own magazine, has year after year shown that the number of employees working far from healthcare has increased, and fewer of those who are employed work close to healthcare. It should be the opposite; more who work close to healthcare should be employed. It is about medical secretaries, nursing assistants, nurses, speech therapists, physiotherapists, doctors, and all the others.

We must reverse this development, and therefore it is wise that some regions – Östergötland is one of them – are now looking at whether they have given assignments or established functions that may not be necessary and which also burden healthcare with detailed reporting, new administrative routines, and meetings that result in not having time for the patients. That part of the warning must therefore be upheld, because we need to free up resources for healthcare staff.

The government's support therefore corresponds to 7,000 nurses, and each region has to handle this in its own way. Several - not all, of course; SVT had a good account of this on Friday - have issued warnings. Others have chosen to introduce hiring freezes, and there the money makes it possible to work in other ways to retain healthcare staff. That question belongs to every regional politician, who must now assess the situation.

I also note that things are often mixed up regarding the question of how large a deficit SKR assessed it would be for the whole of 2024 in its forecast in October. That question needs a bit of extra thought, because it is not the same thing as the savings that the regions are making. The forecast is based on what was calculated regarding the development of the tax base and the tax increases that had been made; that concerned Örebro län at that time.

Which savings are de facto made were decided partly later, some even at the beginning of this year. It is the changes one makes that affect healthcare staff that the government has targeted. That is why we provide support equivalent to 7,000 nurses, which enables regions to mitigate the savings and do what they can to retain healthcare staff.

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

Yasmine Bladelius (S)

Madam Speaker! I will later in the debate comment on the Sweden Democrats' contribution and also the Minister's response. But let me first briefly tell you about Sabina.

Sabina reached out to me in despair a while ago. She wanted to tell her story, her own experience of the healthcare crisis. Sabina is a formerly healthy young woman. She has worked and trained and has two fantastic children whom she is a single parent to.

During the late autumn of last year, she began to experience back pain. After two weeks of constant pain, she understood that it wasn't just ordinary muscle soreness, that she had lain incorrectly or lifted something too heavy. No, it was something that was wrong. And here, Madam Speaker, the healthcare chaos began, the waiting, the despair and waiting again, that being sent around, you know, getting different answers from different doctors and at the same time not being able to work, not being able to take care of the children as usual, not being able to shop, having to ask for help all the time, feeling guilt and anxiety over asking for help. And the pain again, the indescribable pain that does not go away.

One day during this waiting, it simply didn't work anymore. It became an ambulance to the emergency room where, finally after an MRI, a large disc herniation was determined. Two days later, Sabina was discharged from the hospital again with a confirmed disc herniation, pain, and waiting for a time for surgery.

The days pass, and Sabina is in pain. She has difficulty making everyday life function. She cannot work. She still cannot take care of her children properly as she has been able to previously. She has to get help from friends. Time passes - no news.

Sabina is strong in herself. I notice that when we talk. She is eloquent. She finds things out herself. She makes calls. Finally, the message from 1177 arrives. I would have read it out in detail, but Facebook has been down and I received it from her on Facebook. But it says approximately like this: You are placed on a waiting list. It will take time. You will not be able to invoke the healthcare guarantee, it stated explicitly. It can take seven to eight months before you get an appointment for surgery.

Chocken, Madam Speaker, and the anxiety. Seven to eight months of waiting with the pain that she constantly needs to endure, having to be helped with most things, not being able to work and being on sick leave. When we spoke, I clearly noticed the panic she felt.

Madam Speaker! Sabina is unfortunately far from alone in her experience. She and all others deserve so much more and better than this, and it can be prevented, Madam Speaker. It is not easy or done in a heartbeat, but the state can step in and help the regions financially in a crisis. It is entirely possible to prioritize money for healthcare over, for example, tax cuts. It is entirely possible to tax the completely insane profits that the big banks make and instead use the money to curb the healthcare crisis. But the government simply does not want to, because other things have been and are more important.

What is the Minister for Health and Social Affairs' answer to Sabina and all others who are waiting illegally long for care in Sweden?

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

Sofie Eriksson (S)

Madam Speaker! I return to the article by Jakob Forssmed. He wrote: "To abstain can provide perspective and make us turn our gaze inward, outward, and upward."

Madam Speaker! I am convinced that many are currently being forced to forgo due to a meager economy. I am convinced that they turn their gaze inward, outward, and upward. At the same time, they hear from Jimmie Åkesson that one can just buy slightly cheaper food.

Madam Speaker! I am also convinced that many believe that banks, large corporations and food giants should be able to make some kind of sacrifice right now, that they could forgo a small, tiny part of their abundance to contribute something more to the common good. I am convinced that there are many who believe that private individuals with large assets and incomes should also be able to forgo something of their non-god-given wealth in the same spirit.

But we see nothing of that. Instead, we have lowered taxes in this country in a way that has affected our common commitments.

We have seen a structural underfunding, and it is revealed as worst in times of crisis. Welfare has almost subscribed to austerity measures for so many years.

We hear Member Eriksson Falk say at one moment that it is the regions that must take their responsibility. But then he stands and complains in the speaker's chair over the measures that the regions have taken when the state has withdrawn through unfunded tax cuts for high-income earners. Then they have been wrong. And always this relativizing. We cannot afford culture in this country. In other contexts, one can hear that we cannot afford swimming pools where the kids can learn to swim. But we always have the means, Madam Speaker, for unfunded lowered taxes for high-income earners. We also hear here about various small amounts of money that one should save on this and that.

I naturally think it is important that one does not spend money on the wrong things, and I completely agree that the staff should primarily be those who work close to the healthcare. But can the small amounts of money that are often referred to cover 1.1 billion, which the projected deficit now looks to be in Region Dalarna after one has implemented a savings package of 500 million and emptied the result equalization reserve? Will the savings on some artistic embellishments cover that deficit? No, they will not.

Madam Speaker! I am not getting any answers here - we shall see if I get them in the next contribution - on what the government thinks we can do with the taxes in this country so that healthcare can be financed in the long term in a spirit where those who have very much can forgo a little more of their wealth for a higher purpose. I have not received any answers on that, but I hope that I will receive them.

We have had a development such that through various types of new deductions or abolished taxes, one has let the money roll to those who already have, while the welfare subscribes to austerity packages. Then one stands here and talks about small change for some artistic decoration. I actually think it is a scandal, to reuse terms that have been utilized in just this debate. We are constantly told that it is someone else's responsibility.

(Applause)

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

Mattias Eriksson Falk (SD)

Madam Speaker! As this is my last opportunity, I naturally want to take the chance to thank the Minister for the interpellation debate on this very important issue.

I note that the Sweden Democrats and the government are providing funds to the regions, while at the same time we point to the regions' responsibility for the management of respective operations.

The Social Democrats also govern a majority of the regions in Sweden today. When one has this responsibility, it is not sufficient, as the Social Democrats do in, for example, Region Värmland, to choose to purchase art for 40 million and then deliver a saving at the emergency room. It is a signal that one is saving on healthcare and choosing art.

Of course, it is the Social Democrats in the region who make that prioritization, but one cannot demand that the state should pay for it. That the Social Democrats save on the emergency room and would rather put up fine art is a prioritization that I am extremely skeptical and reflective about.

Unfortunately, I know that we will not see any accountability from the Social Democrats here. They will not admit their failure over the last ten years in the regions with 23 tax increases, while they also held government power.

It becomes quite hollow when the Social Democrats, the "workers' party," claim that the previous government prioritized welfare when they delivered 23 tax increases in the regions—tax increases that hit ordinary wage earners such as the assistant nurse in elderly care, the childcare worker in childcare, and the construction worker building the new school.

How do the Social Democrats explain that they have raised taxes 23 times in the regions when there is no money now in worse times, even though it was under their own government that the tax increases were made? At the same time, we can see how the Social Democrats pour money into luxury projects and fine art instead of prioritizing healthcare. It is shameful.

(Applause)

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

Sara Gille (SD)

Madam Speaker! I thank the Minister for the answer. If the interpellants consider that the population is worth so much more, why do the Social Democrats then not prioritize care throughout the regions better?

The Sweden Democrats are the party that year after year has emphasized the importance of investing properly in health and medical care so that it leads to good working conditions for our staff. Unfortunately, the Social Democrats are a party that has not wanted the same thing.

The Sweden Democrats are the party in Västerbotten that would rather make savings on party subsidies etcetera than on healthcare. Unfortunately, the Social Democrats do not want that. Furthermore, we consider that, for example, Ibn Rushd should not receive a share of regional tax funds, which the Social Democrats do not agree with.

That the Social Democrats in Region Västerbotten choose not to make the priorities that are necessary for the healthcare to receive the best possible conditions simply shows the Social Democrats' focus on picking up cheap points and a reluctance to truly prioritize healthcare.

Madam Speaker! I believe that the Social Democrats can start by reviewing their own policies and what they themselves have actually failed at before criticizing a government that has to clean up after the red-green mess.

(Applause)

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

Runar Filper (SD)

Madam Speaker! The Social Democrats can spend 40 million on art but not 23 million to preserve an acute hospital. A sound organization that has fallen into insolvency begins by reviewing costs that are not entirely necessary. The last thing they touch is the core operations, that is to say, that which is the purpose for which the organization exists.

That is not how it works within the Socialdemokraterna in Region Värmland. Reflexively, they propose drastic and panicked cuts in healthcare instead of starting by looking at how much could be saved through cuts in other, not entirely necessary, areas.

For the Sweden Democrats, healthcare, public transport, and regional infrastructure come before the Social Democrats' priorities of artistic expression, Ibn Rushd, and extensive administration regarding value base development. Healthcare is about life and death, unlike the other areas. A life insurance is to have a proper hospital at a reasonable distance in the event that misfortune strikes. We Sweden Democrats promise all the residents of Värmland – the people – that the absolute last thing we will cut back on is the physical healthcare production in Värmland.

The Social Democrats' proposal to dismantle the hospital in Arvika, Värmland's second-largest municipality, led to an unprecedented atmosphere of rebellion in Västvärmland, where up to 2,000 people gathered in Arvika's square in protest against the Social Democrats' insane proposal - in 25-degree cold, moreover. I know, because I was there on site, and I froze. People were *rasen*; they were *sinnig* - if one translates it, they were thus furious, cursed.

I shall conclude by saying that the Social Democrats rather withdrew the proposal after the popular outcry.

(Applause)

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Fredrik Lundh Sammeli (S)

Madam Speaker! I can say that the answer to my question to the Minister for Health and Care is no. It will not stop warnings, layoffs. Just hours after yesterday's press conference, Sörmland announced that the warning regarding 700 employees remains. Östergötland also gives the same message, where 900 people are still being warned of layoffs. These are just two of the country's 21 regions, both governed by Moderates and Christian Democrats. Not even the minister's own party colleagues believe in the government's promises.

When listening to this debate, one can get the impression that it is Social Democratic rule in all regions across the entire country and that they are standing against an SD government. The reality is that the regions, regardless of who is in power, are struggling with the national healthcare crisis. Regardless of who sits as the chairman of the regional council, the message is clear: We need help. The government must be prepared to step in and ensure that we do not head towards an even more deepened healthcare crisis.

To be honest: 24 billion in estimated deficit is due neither to LGBTQ+ certification nor to the regions fulfilling their mission linked to public transport, regional development or culture.

It is serious. There is a crisis here and now. It has been ongoing for two budgets where the government has prioritized other things. I want to know what the Minister for Health and Social Affairs intends to do so that the regions do not have to lay off staff. In what way will the Minister take responsibility to ensure that the national healthcare crisis, which the government itself has driven forward, is not deepened?

(Applause)

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Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! I thank the members once again for the contributions.

The regions are having a really tough time. It is due to inflation. It is due to the pension agreement one has signed which is adjusted with inflation. To then say that it is the government that has driven the crisis is quite bold.

Of course the government supports the regions; anything else would have been impossible. But to say that we should take over the entire cost burden is completely unreasonable - two parties enter into an agreement and then one asks a third to cover the costs. Support, however, we do provide.

I am a bit surprised that the Social Democrats are saying today that 6 billion is insignificant – 6 billion is what the difference was between our budgets in the autumn. The Social Democrats did not exactly put 6 billion more into healthcare, shall I say, the government, but they put 1 billion more than us directly into healthcare, and then there were an additional 5 billion in general state grants to the regions. But if we are kind and say that it was still 6 billion that was to go to healthcare – would they then be the entire difference in the autumn but completely insignificant now? It is an interesting thought.

I believe that these 6 billion have significance, and therefore the announcement is important. It corresponds to 7,000 nurses, but how they are used is decided by each region.

Just as Member Fredrik Lundh Sammeli says, it actually hasn't mattered who has been in charge. We have regions today that do not need to make a single cut and that have a stable economy - about four of them. They are governed by both the right and the left. But we also have regions that are having a really tough time. The majority of them have underlying large problems. They are also governed in different ways. We therefore cannot draw any conclusion from this. They are having a tough time, quite simply.

Just the fact that so many have underlying problems is also one of the reasons why we do not just have 6 billion in the package, but we also have more measures. The delegation that will now receive 250 million annually for six years shall work on providing long-term support to regions that need to work over several years to change the structure to achieve a change that ensures money goes to healthcare instead.

I believe this delegation is essential. We shall ensure that it is staffed now. They start on July 1 and will begin the first application on January 1, 2025. We need to work out how this is to be done, and we will, of course, do that in close cooperation with SKR. I spoke with them already yesterday afternoon about this. It is necessary that we provide long-term support, and therefore it is set at six years with 250 million annually. I believe that it is an important component.

However, the fact that support is coming now is significant. The investments that the government has made in the budget in total are, of course, important for the whole of this year. It is a restrained budget to slowly press down inflation. But 40 percent still went to welfare, and 40 percent went to households to reduce the consequences of inflation, and some other money, of course. It was a clear investment in households and a clear investment in welfare. It is clear that it is important to be able to keep more of one's salary and one's pension. This was in the government's budget that applies this year. It has made it easier for households to manage the inflation.

I note that those who made tax cuts for the very richest, that is, removed the wealth tax, were the Social Democrats. That was done during the previous parliamentary term. We have not seen any such change now, but it is the Social Democrats who bear responsibility for the decision that ensured the very richest did not have to pay any wealth tax.

Is the government's budget sufficient then? That cannot be said with certainty, as each region is responsible for its own costs and for how it allocates these. But it is a substantial supplement that makes it possible to reduce savings and retain healthcare staff. This will be important and decisive moving forward, and this line we will maintain from the government's side.

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Yasmine Bladelius (S)

Madam Speaker! It becomes clear in this debate that the Sweden Democrats are in a state of complete panic because the crisis in healthcare has now received a media focus that they know can affect them and their voter figures negatively. The voters know that the Sweden Democrats govern the government.

The Sweden Democrats are just as responsible for the healthcare crisis as the rest of the government, and in their panic over the fact that they now must take responsibility for the crisis they have created in healthcare, they blame the Social Democrats. But, Madam Speaker, when we governed Sweden and sat in the government during the previous healthcare crisis that Sweden went through, which admittedly was not the same kind of crisis as this crisis but also a crisis that hit healthcare extremely hard, we took responsibility. We ensured that the regions were compensated several times over.

Madam Speaker! After today's debate, I can state that the Sweden Democrats are satisfied with today's situation. They are satisfied with 24 billion in deficit in Swedish healthcare. They are satisfied with mass warnings and layoffs. They are satisfied with cuts. We Social Democrats are not satisfied. We would have prioritized differently in the healthcare crisis.

(Applause)

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Sofie Eriksson (S)

Madam Speaker! First, I want to address that point about the wealth tax. It was another party that, in the government negotiations, thought the most important issue was to lower the tax for high-income earners, and that is a party that is in the government today: the Liberals. It was their demand. It is unfortunate that this was one of the most important issues for the party to push in the government negotiations to reach an agreement, but that is for this party, which also governs our country today, to answer for.

Madam Speaker! From the Moderate youth, we are now told that an action to counter the healthcare crisis that is now hitting our country is to pamper the regions and that it is like asking mom to Swish. It is far from a discussion about solidarity and shared responsibility.

I want to return to the discussion that my interpellation concerns, namely the arguments regarding fasting and abstaining for a higher purpose. I do not believe that maximum private ownership can be the meaning of life, but rather that it is to live in a society where everyone has the security of receiving the care they need. This is both smart and right.

It is true that the government has announced new money. They are of course welcome, but they are not sufficient. The deficits have grown recently. One can also wonder why these funds were not included already in the autumn budget, when the situation was known, so that it would have been possible to plan in a better way.

We can also observe that the cost development has been significantly greater in Sweden than in comparable countries - price increases have been 30 percent higher in our country compared to others.

We in the Social Democrats want to see an indexing of the state grants so that long-term planning can be done. We want a tax reform that can manage to finance healthcare in the long term, but from the government parties, we hear instead pride that the tax levels are so low that they do not manage to finance our healthcare.

I am sorry to have to say it, but I do not hear the wisdom that explains the Christian fast when we discuss the welfare.

(Applause)

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Statsrådet Acko Ankarberg Johansson (KD)

Madam Speaker! Thank you, everyone who has participated in the debate!

Now I will address Sofie Eriksson's very interesting interpellation. Let me put it this way: To sacrifice something for a higher purpose - was that what the Social Democrats did during the last parliamentary term when they deliberately lowered the wealth tax to retain power? Yes, perhaps that was the case.

I have listened carefully to what Sofie Eriksson has said, and I believe that she and Jakob Forssmed are very close to each other in their thoughts regarding discussing a social community and what is required for it to work. I believe it.

I believe it is good to achieve such conversations and that politicians sometimes dare to take the step outside the political bubble where we always read each other with ill will and instead try to understand each other benevolently and even dare to write in the culture pages. I believe it is welcome that more dare to do this, just like the discussion that the member Eriksson highlights. It is entirely good and well to do this.

That it was I who answered the interpellation is due to the questions posed by the interpellator. It is the questions that determine which minister is responsible for this. It is I who have responsibility for the regions' finances when it is healthcare that is referred to. I regret that there was not a discussion with the writer themselves.

This is how it is when one discusses healthcare. It is truly the core of the welfare state, and then we must ensure that we have a long-term perspective in health and medical care. We do not have that now. The money that came during the pandemic was welcome, and we said yes to it as a whole Riksdag. But it resulted in a record surplus.

The regions have thus moved from a period with record surpluses in 2020, record surpluses in 2021, and a fairly large surplus in 2022, which meant that they managed 2023 quite well. Furthermore, an improved tax base forecast arrived, which was the result just before Christmas, but these funds have been used to smooth out the economy now that inflation is arriving.

This shows that temporary supplements are difficult. Now we have provided a temporary supplement because it is a temporary cost for inflation, but it is the long-term work that we need to unite around. How do we ensure healthcare a stable economic base? This work we need to tackle together.

Thank you for the debate!

The interpellation debate was hereby concluded.

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