Response to interpellations 2025/26:308 and 349 on the working environment in healthcare
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
KD argues that the employers bear the responsibility for the work environment 1, that the government has strengthened Arbetsmiljöverket's supervision 1 and dampened inflation 2. KD believes that Sweden has good resources 3 and that they have taken concrete measures where the care queues have decreased 4. KD argues that administration and political micro-management are problems 3. V argues for higher wages, better working hours and that the state takes a greater responsibility for education and national economic management 5. V also wants to index-regulate state grants 5. S argues that the government's economic policy has worsened the conditions 6, that inflation has eaten up the resources 7 and that the government's response to the work environment deficiencies is passive 7 8.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Sjukvårdsministern Elisabet Lann (KD)
Madam Speaker! Karin Rågsjö has asked me if I intend to initiate a national inquiry to improve the working environment and patient safety within healthcare, if I intend to work towards ensuring that the right to continuing education and specialist training for healthcare personnel shall be regulated by law, how I intend to ensure a coherent national plan for competence supply and distribution of healthcare places, as well as what initiatives I intend to take to counteract the unhealthy workload within healthcare that drives sick leaves and thus large socio-economic costs for stress-related mental ill-health.
In addition, Sofia Amloh has asked the Minister for Employment if he intends to act regarding the serious deficiencies in the working environment in healthcare.
The work within the government is distributed in such a way that it is I who shall answer the interpellation.
Initially, I want to emphasize that the Work Environment Act (1977:1160) clearly places the responsibility for maintaining a good and safe work environment on the employer, which in this case means regions, municipalities, and private healthcare providers. The Swedish Work Environment Authority has furthermore issued regulations and general advice on organizational and social work environment (AFS 2023:2) which aim to address the risks that, among other things, unhealthy stress can give rise to.
The Government has given Arbetsmiljöverket increased appropriations so that the agency can strengthen its supervision. The Government also intends to submit a new work environment strategy to the Riksdag during the spring that meets the challenges of the future labor market.
The staff is the healthcare system's most important resource and the foundation upon which healthcare rests. A prerequisite for a good working environment within healthcare is a functioning supply of competence. On behalf of the government, the National Board of Health and Welfare, through the National Healthcare Competence Council, has developed a national plan to improve the healthcare system's competence supply (S2023/00256). The plan contains 25 different proposals for interventions which, among other things, concern ensuring time and resources for competence development and providing increased opportunities for career paths to attract, develop, and retain healthcare staff.
In January, the government decided to allocate 1 billion to municipalities and regions for the purpose of strengthening the supply of competence within health and medical care and implementing measures based on the national plan to improve the supply of competence in health and medical care (S2023/00256). It is the National Board of Health and Welfare that has been tasked with distributing these funds.
In order for healthcare to have access to the right competence, structures and regulatory frameworks concerning regulated professions, specialist competences and specialist educations, as well as further education and continuing education, must be effective. The Government decided in 2023 to appoint a special investigator with the mandate to analyze what changes may be needed to ensure this. The final report was presented in June 2025 (SOU 2025:63). The proposals are now being prepared in the Government Offices.
Regarding the issue of the distribution of care beds, the National Board of Health and Welfare, following a mandate from the government, has developed a national plan to reduce the shortage of available care beds (S2023/00679). The mandate is closely linked to the authority's work in developing national and regional target values for the need for available care beds, which takes place within the framework of the mandate to contribute to strengthening and monitoring the availability and care capacity at regional and national levels (S2024/01058). The mandate also includes supporting the regions' work to achieve the target value.
In addition, I have recently gathered representatives from professional associations, SKR (Sveriges kommuner och regioner), and relevant authorities to a dialogue meeting to raise issues regarding the working environment in health and medical care. Those invited were all in agreement regarding the importance of the issue and the need for a collective effort.
With that, I would like to thank Karin Rågsjö and Sofia Amloh for the questions and I look forward to the debate.
Karin Rågsjö (V)
Madam Speaker! Thank you, Minister, for the answer!
We have a clear personnel crisis within healthcare – no one can deny that. The results of the Swedish Work Environment Authority's national inspection of acute hospitals and primary care were very clear: Swedish healthcare has a structural work environment problem that is so serious that it affects both the quality of care and the health of healthcare staff.
In the inspections carried out by the Work Environment Authority in 2022–2024, 73 percent of workplaces within healthcare as a whole were required to take measures. In the acute hospitals, it was 80 percent of the care departments that had deficiencies, and for the primary care clinics, the figure was 69 percent. The most pervasive deficiency concerned an unhealthy workload, that is, an imbalance between demands and resources, something that has long characterized healthcare. For several decades, it has, I would like to assert, occurred some kind of bloodletting of public care, financially and in other ways.
This development is structural. It is not temporary but has been ongoing for a long time. It is also, as I said earlier, a consequence of long-term cuts and lack of resources. There is a shortage of care beds across the country, including within intensive care.
The regions have been given the primary responsibility for managing their staffing, but a stronger national governance was also needed, as we discussed in the Healthcare Responsibility Committee. There are many requirements regarding what the state can and cannot do.
Looking out over the country, one can see that it also looks very different. For example, in Skåne, it is extra stressful for the staff. There, the waiting time to receive a measure within healthcare is 93 days. This can be compared with 62 days in Stockholm, even though Skåne has half the population of Stockholm. One must say that is a failure – we will have to return to that here in various debates.
To reverse the development, very powerful measures are needed to improve wages, working hours, and working conditions, and to achieve a reduction in working hours for those who work on-call. The state must take a greater financial responsibility, but also a responsibility for the training of healthcare personnel, and create a more long-term supply of skills that holds over time.
The SD-dependent government has, at least in my opinion, devoted a lot of effort to blaming the entire problem on the regions. One then wonders what the government can do more. The government has now worked through the National Healthcare Competence Council, where a number of proposals have been developed. That sounds good, but unfortunately, it is not possible to see any impact of it in Vårdsverige. We want to see a coherent national plan for competence supply and distribution of healthcare places that holds over time.
The unhealthy workload within healthcare drives sick leaves, which can be read about in, for example, Försäkringskassan's analysis of how it looks in Sweden today. It simply looks grim for the healthcare staff, and I think the government should have addressed that during these four years. I cannot see any trace of it.
Sofia Amloh (S)
Madam Speaker! I want to begin by saying that I took the initiative for this interpellation to have a debate with the Minister for Employment against the background of the deficiencies that have emerged in the Swedish Work Environment Authority's inspections. Eight out of ten acute hospitals had such significant deficiencies in the work environment over the last two years that the Swedish Work Environment Authority ordered measures. This concerns, for example, long work shifts, too much administration, and poor digital tools.
The Director General of the Swedish Work Environment Authority says what needs to be said even if it is terrifying. He says that it is serious because it causes such large strain injuries that some die prematurely. It is one of the consequences of the serious deficiencies in the work environment.
Swedish healthcare is thus being pushed to that limit, and it is the staff and the patients who pay the high price. The consequences are visible in Försäkringskassan's statistics. The hardest-hit sectors are healthcare, school, and care, and healthcare is at the top.
In the response from the Minister today, it is stated, among other things, that this is the employer's responsibility. I share that view entirely; of course, it is the employer's responsibility. What I want to say is that the responsibility of the employers – municipalities, regions, and private operators – is linked to the conditions they are given. This government wants municipalities and regions that wish to raise taxes to pay a penalty fee, while at the same time cutting back on care in all budgets because they need to make tax cuts instead. How then does the government intend for the employer to be able to take this full responsibility?
The second thing we hear in the answer is that a work environment strategy is to be produced during the spring. Absolutely – we are waiting. We have waited a long time for it in the Committee on Employment – it has been announced. We will be at the midpoint or the end of March. It will not have time to be fully processed in the Riksdag before this mandate period is over. I therefore think that it is a very empty answer to provide.
The third part of the government's response concerns the fact that a dialogue meeting has been convened with several important parties in the labor market in some kind of "power gathering." Dialogue and power gathering – what is it supposed to result in? That is my question to the Minister. Is it supposed to result in any actual differences to address the serious deficiencies in the working environment? Or is it just about talking to each other without anything happening afterwards? What content is this supposed to result in?
This should be seen against the background that the Sweden Democrats and the government during this mandate period have reduced state support and worsened the conditions for Sweden's municipalities and regions. In addition, the government's failed economic policy, with high unemployment and low growth, has dealt a hard economic blow.
The situation in healthcare, unfortunately, did not come as a surprise because it was already clear in 2023 that the situation in Swedish healthcare would deteriorate if the politicians did not take responsibility. In 2024, Sweden's regions issued a collective alarm regarding the situation, which was set to become worse. Still, the government has not acted. Why has it not been done? Does the Minister intend to do something about the serious deficiencies that appear in these reports?
Sjukvårdsministern Elisabet Lann (KD)
Madam Speaker! Many questions are being asked in somewhat different areas, and I will do my best to try to answer and capture most of them.
I want to start with the economic discussion. The most important thing the government has done for the municipalities and regions is to get a handle on inflation, which was a stranglehold on the municipalities and regions. This has also contributed to a significantly better and stronger economic situation for the regions. During 2025, the regions made a collective surplus of over 8 billion kronor. This matters for their conditions to fulfill their statutory mandate. I would not call the result a failure.
Then we know that the regions have different conditions, and I truly share the concern for the working environment within healthcare.
It is just the balance between requirements and resources that the regions need to review. Sweden is clearly above the EU average and clearly above the OECD average when it comes to how many resources we allocate to healthcare. We are clearly above the average when it comes to the availability of nurses and a bit above the average when it comes to the availability of doctors per 1,000 inhabitants. In other words, we have quite good conditions fundamentally. But it is incredibly important what requirements we place on healthcare and how we organize healthcare. Does the healthcare's medical staff need to spend a very large amount of working time on things that do not create value for the patient and which constitute a work environment problem? There is much to be done here, and some of it actually concerns political micro-management, double steering signals, a lot of administration, and so on. There is an awareness of this all around the country, but people succeed with varying degrees of success.
I have visited several health centers recently that have incredibly fine figures when it comes to sick leave – under 4 percent. It is truly successful, and I believe there is much to be gained from how they work with participation and influence, fixed shifts and routines that make the employees at these workplaces feel involved and enthusiastic and find it easier to perform work that is satisfying and that makes them feel good when they go home after a workday. I hope that we will be able to spread those types of good examples.
The kraftsamling mentioned here was an initial meeting to probe: Is there interest in us gathering together and trying to determine what we can do together to truly make a difference? That is the purpose of this, and now the work of preparation is underway during the spring. What measures do we see that we can agree on together to start somewhere? When everyone runs in all directions at the same time, it is difficult to see results and difficult to achieve movements. But can one agree that here we can start together and by gathering strength, one can also achieve movements. I have great expectations that this can make a difference and, above all, provide support to the regions to improve the working environment within health and medical care.
We have also set as a requirement in our major government grant regulations that one must work with occupational health and safety issues in order to receive the government grants. It is a mandatory requirement. It has not been that way previously.
Regarding the new work environment plan that is being developed: Yes, in the one that the Social Democrats developed, healthcare was mentioned once. I believe we will see a difference in what is to come.
Karin Rågsjö (V)
Madam Speaker! Thank you, Prime Minister, for a little … Prime Minister? I have elevated you directly here, the Minister for Health and Care. My God, the kingmaker has arrived!
We in Vänsterpartiet would have very much liked to see a preparation for health and medical care, just as for defense, i.e., that one works long-term together with all actors. Now we have to see what this becomes so that it is not just a one-time occurrence that one meets in the way that the Minister explained.
I believe that the SD-dependent government has put a great deal of effort into blaming the regions and into having rather fluffy press conferences, if I may put it that way – for example, regarding the healthcare queues, which is also a major stress factor and a factor that makes the healthcare system go to its knees.
There we have somewhat different figures. We discussed them yesterday. The government says that the healthcare queues have decreased by 28 percent. We believe it is somewhat about which periods one measures. We have seen other figures – from January 2023 to January 2026 it was 8.9 percent, and from October 2022 to January 2026 it was 13 percent. That is a bit less. It is also about the fact that we have included all regions while the government excluded nine regions, and some of those regions that were excluded were those that, for various reasons, had quite poor figures when it came to healthcare queues.
In any case, the staff are on their knees. It is about a shortage of care beds. For example, Iva has been affected. It is about the fact that the staffing crisis in the regions has not been solved. Higher wages, more employees, better working hours, and so on are required.
We believe that the state should take greater responsibility for education in all healthcare professions. It also requires a more equitable national economic management within healthcare and also regulation of the entire healthcare market.
I also believe that the staff must see that there are long-term investments, not just short-term ones. Very many people are talking about it. There are opportunities to create the conditions that we all want to see, but then there must be a plan forward where one also looks at care beds and at the whole.
It is also about the state grants. We want to secure the value of the state grants, and that means index-adjusting them. We have looked at this very carefully and seen that the regions would receive 10 billion more if one did so, that is, if the state grants followed inflation. We think it is a fairly modest issue that one could look at – that and perhaps that one invests more in state grants generally than in small grants that are distributed across the country, because those are often difficult to follow. It will not result in much change.
As has been said, rapid training of staff is also needed. It is very many within health and medical care who say that they do not receive any rapid training. It is not statutory. It is something that we want to do – we want to regulate specialist training for healthcare staff. We want to regulate competence enhancement in different ways. It cannot be up to each region to decide how the staff shall further develop their knowledge.
I would still like to know what additional initiatives the minister intends to take in this matter, as the reports from both Försäkringskassan and Arbetsmiljöverket are so alarming. This is a fundamental issue for the staff, who would also need these more long-term conditions.
Sofia Amloh (S)
Madam Speaker! It is very good that the government is working on the work environment strategy. It has been worked on for quite a long time. We just haven't seen anything yet. I really look forward to us getting a product to read. We hear about many parts of it, and it is exciting, but I would also like to see it. And that it actually comes into use is a delivery that must be made if it is to be usable as an answer to the question of whether one is actually doing something to improve the work environment.
Now, the situation is that eight out of ten emergency hospitals have had such significant deficiencies over the last two years that Arbetsmiljöverket is making these serious strikes. And the question remains: Exactly what does the government intend to do about it – now?
During this mandate period, we have actually not seen any initiatives at all. We have seen cuts. We have seen that people have let inflation eat up the resources in healthcare instead of securing them with a basic platform, as we Social Democrats propose, like the one the Left Party just described here. We want healthcare and welfare to be protected from being affected by inflation. But the government has not done that.
Now I hear the Minister say that this is the beginning of an initiative to have a dialogue. So, now, at the end of the mandate period and despite all the alarm signals, you are starting a dialogue about problems that are well-known and that the Work Environment Authority has said required measures for here and now because they are so serious. I do not think it is a concrete proposal from the government.
We Social Democrats have, among other things during this parliamentary term, had completely different priorities than the government. We have, among other things, proposed twice as large resources for welfare as the government in the budget for 2023. In the budget for 2024, we doubled the resources for healthcare again compared to the government. For 2025, we proposed a supplement of 6 billion kronor more in general state grants to municipalities and regions. Altogether, it is many billions more than in the government's budget. They would have played a role, especially when it comes to a work environment with long shifts, too much administration, stress-related illnesses, and high sickness absence rates. Ultimately, it is about resources for the staff to give them the work environment and the conditions they deserve.
Why then has the government not responded by increasing the state grants, when this has been so incredibly clear? During the high inflation, the government has chosen not to inflation-protect healthcare but has instead let the care queues become longer and the work environment deteriorate, only to then say that this is due to the inflation. It is incredibly passively done by the government. There have been options for action, but one has still chosen to do nothing. One has stood and waited out the inflation, and now one says that one can take initiatives for dialogue meetings based on this.
My question remains: What does the government intend to do about the serious deficiencies in the working environment for the staff who work at our emergency hospitals?
Sjukvårdsministern Elisabet Lann (KD)
Madam Speaker! I am pleased with this commitment to issues regarding the working environment within healthcare, because healthcare is so incredibly important.
It would, however, have been appropriate if the commitment had been just as great when you were in power, but in 2022 the then Social Minister, Sofia Amloh, said no to a crisis commission for the working environment in healthcare. Now I have sat in this chair since September, and when the reports from Arbetsmiljöverket and Försäkringskassan arrived, I took the initiative to call for a crisis meeting.
We have had that meeting, and now we are in agreement that we will continue to work together. It has been marched along quite quickly, but it is clear that one would have gladly seen the regions have solved the working environment issue earlier and that they had worked systematically with the working environment problems. The report from Arbetsmiljöverket shows, after all, that the systematic working environment work is not in place in the way that the employers are actually obliged to ensure it is.
Now we are taking action. We have restructured the state grant so that we impose requirements on the regions to work with the work environment. With the organization we have, we are not moving away from the fact that it is the employer who has responsibility for the work environment.
Regarding the requests for consolidated plans that Karin Rågsjö highlighted, we actually have exactly that, both regarding the competence supply and regarding the healthcare beds. The government has done this during this mandate period to get a better grip on what the competence supply looks like and what the forecasts look like so that we have a common picture and can plan to support the regions in their planning work. We will constantly follow up on how many healthcare beds we have and how many we estimate we will need moving forward, in order to facilitate the planning work.
During this mandate period, the state governance in precisely this area has increased significantly, and I return to the fact that the previous work environment plan hardly mentioned healthcare. Now things are happening. We are taking initiatives in several areas, and we are setting requirements that the regions must work on the work environment in order for them to even be eligible to receive the large state grants.
The most important thing we have done for the regions' economy is to dampen inflation. It may sound like the opposition has more money, Madam Speaker, and when they present their budget in year one, they have it. But even if we do not calculate the dynamic effects in our budgets, those dynamic effects are there, and we have a responsibility for the dynamic effects that arise when we dampen growth, drive unemployment, and in the long run create fewer resources for welfare. That is not taking responsibility for sustainable financing for healthcare.
Karin Rågsjö (V)
Mr. Speaker! It is not only the Minister who has taken care of the issue, but KD has done so for four years. I must say that it has not looked so brilliant during these four years.
To reverse this development, very powerful efforts are needed to improve wages, working hours, and working conditions. This also applies to the reduction of working hours for those who, for example, work on-call.
The state may have to look at and take greater responsibility for the education of healthcare personnel and for creating a long-term plan for skills supply and a stronger national economic management of healthcare to reduce regional differences. This was in the proposals from the Healthcare Responsibility Committee, where both I and the Minister sat. I wonder where the proposals from the committee have gone. Will anything come of them? Is there any plan for that?
It requires political will to compensate for rising wages and demographic changes. Vänsterpartiet wants to increase the state grants quite a lot, and we also want them to be indexed. It would have helped very much if that model had been found quite a long time ago.
I believe that one must look at the concrete proposals that came from the Care Responsibility Committee when it comes to, for example, what we should do regarding the possibility of getting more competent staff onto the scene in all regions.
We can also see deviations in the healthcare market regarding the private actors. The regions must now build up their own FBI-like operations to fix this, and that also costs money. We have a wild west syndrome within healthcare that also must be restricted.
When it comes to that, I think politicians on the right side have been very passive. It is time to put one's foot down against the healthcare mafia. It would also benefit healthcare in the long run.
Sofia Amloh (S)
Mr. Speaker! Inflation must be fought; we are in complete agreement on that. There is no party in this Riksdag that is against fighting inflation. But the thing is that one can do several things at the same time and that one can protect businesses and political areas and so on.
Welfare is something that we Social Democrats wanted to protect from being hit by inflation, because it is so important to do so while one is fighting inflation. That is the difference.
After this debate, I can only state that we Social Democrats, during this parliamentary term, have doubled the money for healthcare budget after budget. The government has not allocated the money that has been required to maintain things and reduce the care queues, or to ensure that there are good working conditions and a good working environment for the people who work within Swedish healthcare.
Now, after four years, one is told that a meeting has been called – that is the response from the government. It is the result of how one has handled Swedish healthcare. For me, it is utterly deplorable, especially when Arbetsmiljöverket points out how poorly the situation is with the serious workplace environment deficiencies within Swedish healthcare. Then this government chooses to call a meeting.
There are no more resources announced, and there is nothing that promises that the Christian Democrats in government intend to do what is required within Swedish healthcare so that we can be the exemplary welfare country that we have been. I hear that the government is quite satisfied with calling a meeting.
Sjukvårdsministern Elisabet Lann (KD)
Mr. Speaker! Naturally, all parties want to fight inflation. It is a mission for everyone, regardless of government, but we can state that it differs slightly between the previous government and the current government when it comes to how successfully one has succeeded with this.
This is of very great importance for the regions' conditions to be able to manage their costs. We see this now as well when we close the books for 2025 and the regions make a combined surplus of over 8 billion.
Just last year, the pension costs were more than 25 billion lower. These are enormous sums of money that are in these items, and it plays a major role. I just want to emphasize that.
Then I want to say that we are doing a lot of things. The meeting here in some way symbolizes what has been done during the mandate period, but it is just one initiative. It was taken after Arbetsmiljöverket's report, which arrived sometime in November or December, and Försäkringskassan's report, which arrived in January. The day after it arrived, I called a meeting. It was a first meeting to gather us together and hear what people think we should do. Now we have agreed on how we shall work further during the spring. It was a response to those reports.
Before that, we have worked on restructuring the state grants with requirements for the regions to work with occupational health issues. We have worked on developing planning tools for the regions, both regarding skills supply and regarding healthcare beds. These are concrete measures that we have taken during this mandate period – and which have yielded results. After eight years of Social Democratic rule and doubled healthcare queues, we now see a decline in the queues. 28 percent of the queues have gone down.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.