Certain issues within the health and medical care sector

Christian Carlsson (KD)

Certain issues within the health and medical care area

Mr. Speaker! Those who fall ill in Sweden are unfortunately not met with equal and accessible care. Swedish healthcare has unfortunately increasingly taken on the character of a postcode lottery, where where in the country you live plays a major role in what care you can receive, and very many people have to wait far too long for care or treatment.

We cannot have it this way. One of the Christian Democrats' and the government's most important priorities for Swedish healthcare is therefore to cut the healthcare queues so that people receive care in a timely manner.

A first step in this work is that the government will now establish a national healthcare brokerage. As a patient, you should be able to see where in the country there is available and accessible capacity so that you can be offered care a bit faster if you choose to receive care in another part of the country. This allows us to better utilize the healthcare system's collective resources, but above all, it is an important reform for individual people and families affected by illness because it gives one at least a little more power over their life in a situation that is often difficult and where it is easy to feel powerless.

The record-long waiting times and healthcare queues that built up during the Social Democrats' time in power need to be countered on a broad front. It is against that background that the government recently entered into an agreement with SKR regarding increased accessibility. The agreement covers the three billion in queues, which aim for the regions to take more measures to increase accessibility and cut the healthcare queues. The goal is, of course, that all patients will eventually receive care according to the statutory healthcare guarantee.

Sweden also needs more healthcare beds. Swedish healthcare has unfortunately been left in a situation where we have the lowest number of healthcare beds per inhabitant in the entire EU, while at the same time hundreds of thousands of people have waited illegally long for care. The situation has in many ways spiraled out of control, and I can say that those who notice it are the people who turn to healthcare but also the hard-working healthcare staff.

Over-layering and outsourcing, i.e., when patients are cared for at completely different healthcare units than those that have the right competence, have unfortunately become a common problem in the country's hospitals. This obviously entails risks for the patients while simultaneously placing the hard-working healthcare staff in a very tough and difficult situation.

Together we must ensure that we reverse this development. The Government has therefore doubled the investment to increase the number of healthcare beds through performance-based grants to the regions. It concerns 2 billion kronor annually to achieve more healthcare beds, and in addition, a national plan for more healthcare beds is now to be developed.

Mr. Speaker! Healthcare staff are the healthcare system's most important resource. Without the staff, there will be no more care beds, and it will become harder to cut care queues and offer people good care. Despite this, the supply of competence has long been a major problem.

I am convinced that measures are needed in both the short and long term and at all levels to improve the conditions for the staff. The government's 3.2 billion for supporting regions and municipalities in the work with skills supply is therefore welcome. It is, for example, about the government investing specifically to increase the possibility for further education to specialist nurse and to increase the number of VFU places.

After so many years of deficiencies in this area, I believe however that there are quite a few, not least healthcare workers, who agree with us Kristdemokrater when we say that an increased national responsibility for the supply of skills is needed in the future.

It is also against that background that the government has now tasked the National Health Competence Council at the National Board of Health and Welfare with developing a national plan for the competence supply of health and medical care. In that plan, the needs shall now be clarified first and foremost, but we shall also develop concrete measures to improve the working environment and conditions so that we get more people to choose the healthcare profession and so that we get more doctors and nurses to want to stay or perhaps return to the profession, if they have once left it.

Mr. Speaker! The announcement by the Riksdag that led to today's communication was directed at the previous Social Democratic government to get it to start acting on a number of important issues for Swedish healthcare. Now Sweden has received a new government, and several important initiatives corresponding to the expectations in the announcement have already been taken. As recently as this morning, on International Women's Day, the government presented further important initiatives for more equal healthcare. It concerns an increased focus on maternity care and more resources for research on women's diseases and health, and not least on strengthening care for women and children who have been victims of sexual violence.

Sweden has a government that is prepared to prioritize healthcare. It is understood that the most important measure to achieve more healthcare places and cut the healthcare queues is to improve the conditions for healthcare's fantastic employees, so that more choose to continue treating, relieving, and comforting those who are ill and need it most.

(Applause)

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

Anders W Jonsson (C)

Mr. Speaker! It is interesting to sit here and listen as Christian Carlsson describes the situation now after the election. The background to this motion is that we have had a very concerning situation in Swedish health and medical care for a long time. Finally, after the urging of the trade union organizations on the healthcare side, we essentially agreed in the committee to take this initiative and pointed to a long series of concrete, structural measures.

When listening to Christian Carlsson, it was almost like hearing a Social Democrat from a year ago explain why one should not at all do anything other than give some assignments to state agencies and perhaps some specially designated grants. But the problems, Mr. Speaker, are significantly more serious than that. This is not something one solves by temporarily giving maternity care extra funds or giving Socialstyrelsen an assignment; instead, structural measures are required here.

What surprises me is that what the Christian Democrats have for a long time always highlighted as one of the absolute biggest problems is the queues – the illegal queues in Swedish health and medical care. But the only thing they have chosen to move forward with is a proposal that the old Social Democratic government pulled out, namely that an office should be started here in Stockholm to mediate available care capacity. The Alliance's most important demand was to give patients the right to choose, including inpatient care, all around the country and to ensure that we get access to good information on how the quality differs between the different care facilities and how long the queues are, among other things.

My question to Christian Carlsson is therefore: Why has the government chosen to prioritize moving forward with a proposal from the old Social Democratic government that was essentially finished, but has not taken any measures regarding the important matter, namely giving patients the power and the right to choose inpatient care throughout the country?

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

Christian Carlsson (KD)

Mr. Speaker! The member requests structural reforms and measures. The Christian Democrats fully understand that structural reforms of Swedish healthcare are needed so that we can increase accessibility and offer people more equal care throughout the country. It is why we, together with our coalition partners, have ensured that we will now investigate increased state responsibility for and increased state governance of Swedish healthcare.

Regarding the healthcare queues and that more people should receive care in a timely manner, this is one of the absolute top priorities from the government's side. The national healthcare coordination is important. It is important for individual people who can see where in the country they can turn to receive care in a timely manner. The purpose of the healthcare coordination is not for there to be an office in Stockholm, but precisely that people should receive information on where they can turn. We agree on what the goal is, namely that as a patient, one should be able to choose to seek out another region to receive a share of the best available care there.

Even when it comes to the issue of personnel supply, we are fully aware that structural measures are required. That is why we speak of an increased need for national responsibility in these matters. One might think it is ambitious to develop a national plan for how we are to manage the supply of skills, but it is necessary. In that plan, the distribution of responsibility between the state and the regions will also be clarified.

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

Anders W Jonsson (C)

Mr. Speaker! That was not an answer to the question at all. More national governance of Swedish health and medical care is something that no one here in the chamber actually opposes. On the other hand, many have been critical of the Christian Democrats' proposal, namely that the state should become the principal for the entire Swedish healthcare system. That is something few out in the healthcare sector support.

It is also interesting, I think, that Christian Carlsson raises the issue of skills supply. The only concrete contribution there has been that work has been initiated to put a stop to labor immigration, that is to say, to ensure that we cannot recruit people to health and medical care who come from countries outside the EU area. This will not contribute to a better skills supply, on the contrary.

But my question was about structural changes. The Care Office in Stockholm, which the Social Democrats proposed, is not for the patients; rather, it is the regions that will be able to turn to it and get help to find available capacity somewhere in the country. This is extremely clear in the investigation proposal that forms the basis for what the government is now proceeding with. It will not result in any decisive difference.

The decisive difference would have been achieved if we had proceeded with the demand that we pushed in the Alliance, namely to change the Patient Act to give the individual citizen the right to seek inpatient care anywhere in the country and furthermore gain access to information. This was something that was initiated already within the framework of the January agreement; there was to be access to this via SKR so that one could obtain quality information. It is only when one receives it that one as a patient has the possibility to seek it elsewhere. This could have fundamentally changed the patients' ability to seek out places where the quality is higher and the queues are shorter.

This office in Stockholm, which is supposed to help the regions find available capacity in Swedish health and medical care, will not contribute at all when it comes to shortening what were previously called the illegal queues. Why did you not proceed with the other proposals instead?

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

Christian Carlsson (KD)

Mr. Speaker! I understand that Member Anders W Jonsson would rather speak about a liberal immigration policy than about the actual measures we are taking from the government's side to solve the staffing issue and facilitate things for the regions. I mentioned in my speech the government's 3.2 billion to support regions and municipalities in their work with the competence supply, and I specifically mentioned the possibility of further education of nurses to specialist nurses, as well as a number of VFU places.

But regarding national healthcare coordination, it becomes, frankly, somewhat of a constructed discussion. A national healthcare coordination where you as a citizen and patient can see where the care is located is, of course, not in opposition to a right to receive care in another region. We are now going to get the national healthcare coordination in place – we are working out that proposal. I would like to appeal to Member W Jonsson to, instead of drawing hasty conclusions about exactly how that proposal will be designed and delimited, have some patience and see how this gets in place. The purpose of showing where the availability is is, of course, that one as a patient and citizen should also be able to receive care. This is the most important thing for the Christian Democrats: that the person who is ill receives care in time and that the care is good and equal throughout the country.

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

Karin Rågsjö (V)

Mr. Speaker! I do not think there is a drum that you can conjure with, Christian Carlsson, so that everything becomes very good again. So politics unfortunately does not work quite like that. One would wish it sometimes.

Today is International Women's Day. Healthcare is filled with women – doctors, nursing assistants, nurses and so on. They all testify to a very hard and tough working environment. We can at least agree on that in this chamber.

Mr. Speaker! I have now had contacts with regions and with the various unions. There is still a great concern about what will happen to the working environment specifically in the regions. They simply believe that funds are lacking to build up healthcare in the way that would be needed, specifically after the pandemic. It is about, Mr. Speaker, competence supply, working environment, governance and so on.

Mr. Speaker! I would like to know what Christian Carlsson and KD have for an idea on how to lure back the 13,600 nurses who are standing outside, who have taken leave. They can no longer cope. Or how should one lure back all those who work part-time – midwives, nurses, biomedical analysts and doctors? There are very many who work part-time because they cannot handle their work environment. It has been very clear over a long period, Mr. Speaker, that those who work in healthcare can no longer manage. And this has, as said, great consequences.

I do not see that long-term perspective in the budget you submitted in the autumn, nor do I see it in the proposals you have. That is what I would wish for. Where is the long-term perspective, Mr. Speaker?

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

Christian Carlsson (KD)

Mr. Speaker! Long-term perspective is very much present in the national plan for how we are to manage the competence supply. In that plan, we are not only to clarify whether the state or the region shall bear responsibility for different parts of precisely the competence supply, but there, one shall also map out the regions' needs for healthcare personnel. Concrete proposals shall also be developed on what can actually make more people want to stay within the profession and want to return to the profession.

I naturally have several thoughts about what would certainly facilitate getting more people to return. The wage situation may play a role, but it is not least about how one can structure their time at work and how one can work. We know that many in healthcare perhaps choose to reduce their employment level because they want greater flexibility and freedom, for example, not to have to be called in when they do not want to, so to speak.

There are so many such thoughts and ideas, but I think the most important thing is that we involve the trade unions and listen to the staff when we are to develop the national plan. This must also be done in the regions, at the regional level. We are allocating resources to support the regions in their work with the skills supply, but it is extremely important that one listens to what is needed locally to improve the working conditions.

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

Karin Rågsjö (V)

Mr. Speaker! It is somewhat like watching the fire and trying to see where the fire extinguishers are on the fire truck before one actually gets moving. It is obvious that the crisis is now in the regions. I do not believe that Läkarförbundet, Kommunal or Vårdförbundet are satisfied with there being a plan. Things must also happen in the meantime.

I am extremely worried about everyone who goes down to part-time, because it will of course be reflected in their pension envelopes, and it will not be fun.

You say that you have provided additional funding. You gave 6 billion extra – that may sound like a substantial sum – and some contributions on the side for various initiatives. It is not sufficient. That is what all those involved say – Sveriges Kommuner och Regioner and the regions themselves.

I am, therefore, very worried. It is not just me who is, but it is also those who work within healthcare. How is this going to work? When will things happen? When will they notice anything? Already now, the regions are warning that they must cut back. They can max out themselves and try to ensure that healthcare flows, but when state grants are missing, it will be visible in the regions. That is what will be so unfortunate. In an election campaign, one has, Mr. Speaker, pleaded that it will get better, and then perhaps it will instead get worse. It is precisely about the fact that the state grants are insufficient.

Do you see that during this period there will be such large cuts in healthcare - that is, that people will have to stop working - that it will affect patient safety? Is there any backup plan on the side?

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

Christian Carlsson (KD)

Mr. Speaker! I do not think it has escaped anyone's notice that these are tough economic times. And that these tough economic times will also affect the country's regions and municipalities is obvious. So it is.

Then it is all the more important that the government actually provides these billions to support municipalities and regions in their competence supply.

The crisis is now, and the member of Parliament asked: What are you doing now? The government is injecting the 3.2 billion that I spoke about to support the regions. Now we are improving the opportunity to further educate oneself to become a specialist nurse. Now we are ensuring that we increase the number of VFU places. And as recently as just recently, an additional 252 million was allocated to expand the number of AT positions. That is what is happening now.

I want to emphasize that these investments are required now, but we also need a more long-term approach to the issue of skills supply. That is why it is so important with the national plan and that the state takes a greater responsibility for this part of the healthcare.

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

Yasmine Bladelius (S)

Mr. Speaker! In an interpellation debate with Minister for Health Acko Ankarberg Johansson, I recounted a few days ago a conversation I had with a nurse at Helsingborg Hospital. I intend to take the opportunity today to also give you her story. She says it like this:

I wanted to work in healthcare to help sick fellow human beings, to do everything in my power to care for and heal. But the feeling of not being enough, of never being sufficient, of never having enough time to help, save, heal, and care fully, hangs over me every day.

Patients who are left lying in their own feces because I do not have time to change them. Patients who are forgotten, who are left lying in our corridors, who cry out for help, who die because I do not have time to look at them.

Days pass where I don't have time to eat or even go to the toilet. Patients who cry, who suffer.

I wanted to provide security, and that little extra. But the conditions mean that I simply cannot give as much as I want to. I do not know how much longer I will be able to endure.

Mr. Speaker! Her story is unfortunately far from unique; for everyone who works in healthcare, her feeling and her story are everyday reality. That is how it looks.

We often pat ourselves on the back and say that Swedish healthcare is in absolute world-class. In many ways, it is, but the foundation for our country's safe and high-quality healthcare is its staff. It is those who work on all the different levels of healthcare - those who continue to run and those who continue to endure - who are the foundation.

During the pandemic, this became all the more clear. All around the country, healthcare personnel adapted their operations in a very rapid and efficient way to be able to meet the increasing needs for inpatient beds, laboratory resources, and diagnostic capacity.

Stressed staff strained to the utmost to ensure that the healthcare's dimensioning met the pandemic's different phases and constantly changing healthcare needs. It was a historical effort with very good results.

But just as clearly as it became during the pandemic how dependent we as a society are on the healthcare personnel's efforts and work, it has become after the pandemic that the Swedish health and medical care is under-dimensioned.

That the healthcare system's capacity never hit its ceiling during the pandemic was due to the staff's immense efforts. But that way of working is not, and must also never be considered, long-term sustainable. That is not how we are to ensure that Swedish health and medical care remains in absolute world-class status.

Mr. Speaker! It is quite obvious that Swedish healthcare needs to be strengthened. It needs a larger suit. Those who work in healthcare need more colleagues and better working conditions. The number of care beds needs to increase to meet the needs of healthcare. And for this, financial supplements to the regions are naturally required.

The previous S government tasked Socialstyrelsen with allocating a total of 923 million kronor to the regions during 2022 to, among other things, hire more nurses, improve the working environment, and expand the number of care beds.

I am completely convinced that this type of state support must be made permanent in order to meet the long-term shortage of staff in healthcare. I therefore believe that the government should return to the Riksdag with proposals for a construction for a permanent state initiative aimed at improving the working environment in health and medical care and providing the staff with better working conditions. In such an initiative, the government should also develop an overall goal for the work of creating more healthcare places and produce a national plan for how the goal is to be achieved.

Mr. Speaker! In order for it to be possible to evaluate how the work to reach the goal is progressing, we believe that the government should also report the development of the number of healthcare beds and improvements of the working environment in healthcare to the Riksdag.

Improving working conditions and the work environment is central to increasing capacity in health and medical care. Therefore, measures in this area should also be guided by a zero vision for work-related ill health. We therefore believe that the government should return to the Riksdag with proposals for such a zero vision, where health and medical care should be a focus area.

Mr. Speaker! I would like, by reason of this, to move for approval of our reservation 1.

(Applause)

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

Karin Rågsjö (V)

Mr. Speaker! Today is International Women's Day. And healthcare is, as we all know, very female-dominated. It is not okay that so many women have to toil in a work environment that is not reasonable. Investments in healthcare are also an investment in equality.

Mr. Speaker! The regions are now warning that the crisis within healthcare will worsen. The major problems concern what we have been talking about in this chamber for so long, namely the supply of competence, the substandard working environment, and the governance.

We must, Mr. Speaker, lure back the 13,600 nurses who have left healthcare entirely. Something is wrong when such a large group leaves their profession. The part-time issue, based on not being able to cope, concerns quite a few. It concerns 800 midwives, 8,000 nurses and 500 biomedical analysts who would be able to work full-time if there were good working conditions. So, of course, we cannot have that.

An equal and egalitarian healthcare system throughout the country would make Sweden a safer and more dignified place to live. The care offered should not depend on one's social class, gender, origin, or where in Sweden one lives.

Mr. Speaker! Within the health and medical care sector, today, admirable employees are performing a better and more extensive work than they are actually scheduled for. With a functioning healthcare system, this should not presuppose that there are heroes. It is about very qualified and society-sustaining work that requires great competence and should be treated accordingly.

Vänsterpartiet wants to create the working environment that healthcare staff deserve. We have also submitted a budget motion that looks very different from the budget from the government and SD. It is about us increasing the general state grants specifically to be able to increase staffing levels and provide higher wages and an improved working environment across the entire welfare sector. The resources will, of course, go to those who have the greatest needs.

I as a Stockholmer in this snowy Stockholm - how are we going to survive this, everyone in Stockholm is wondering right now - cannot help but mention that after 16 years of Moderate rule, which it thankfully is no longer, Region Stockholm lacks the tools to direct resources to where the needs are. It is a bit strange in such a large region. Care must be prioritized according to need, and that has not been done in this region.

According to DN's reviews, the result has been a very uneven distribution of health centers, and child health centers have instead been closed in neglected areas. I think that is something one can reflect on. It is a very important issue to change exactly that.

In the Stockholm Region, healthcare is more privatized than anywhere else in the country, and we should be happy about that. But now the American discount warehouse Costco is also trying to break into the healthcare market in Stockholm. You understand that it can seem profitable to work from the outside of the healthcare market in Sweden. I think we should all reflect on that when there is talk about resources and what they should be used for.

Mr. Speaker! How did we end up here? I think that is something one can reflect on.

Until 2008, funds were distributed based on the population in each area. Then the choice of care was introduced. That can sound great. I also think that patients should be allowed to choose. But now it became more so that it was the care companies that chose where they would establish themselves, and it came at the expense of equality. I think this is an extremely important issue going forward. How are we to achieve equal care? Then we must look at how we should try to arrange the choice of care so that it does not come at the expense of equality.

To increase the number of care beds, increased staffing density is the only reasonable path. And as the population grows and the proportion of elderly people increases, the needs within healthcare also increase. This must, of course, lead to various measures. But the staffing policy must be reformed so that more people want to work within healthcare and so that those who work there stay. Otherwise, it will result in the most experienced people disappearing and new people constantly coming in. It will become a very unfortunate spiral.

It is obvious that the regions now experience that the care will fluctuate during 2023. Those are the signals I receive from politicians, the unions, and so on. It is about insufficient state grants.

The number of care beds cannot increase by having fewer employees per care bed. It deteriorates the healthcare staff's working environment and the quality within healthcare. We risk seeing this during 2023. We must hire more and simply give them better conditions.

In the current communication, the government refers to a targeted state grant, a mapping, and a performance-based compensation to the regions in order to increase the number of care beds. That is okay. But there is a lack of overall responsibility and long-term perspective for investments and measures to specifically increase the staffing density. We all know what it looks like. There are very many investigations and analyses. One can move quickly and look at what needs to be done. I do not believe that one can wait for several years, because then we will get very substandard care in the regions. It will cost.

In the personnel crisis that became so obvious and worsened during the pandemic, I argue that it must lead to a crisis awareness. We believe that it is lacking. We want the government to produce measures to increase the number of care beds and have a somewhat faster pace in this. Therefore, I move for approval of reservation 1.

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

Johan Hultberg (M)

Mr. Speaker! Today's debate is rooted in the previous government's lack of both decisiveness and proposals regarding the major problems that unfortunately exist within Swedish health and medical care - problems that, during the past eight years, have unfortunately become even larger. Not least, it concerns the care queues, which have grown much longer.

Take, for example, the so important child and adolescent psychiatry, Mr. Speaker! There, the queues have tripled during the time with S in government. Cancer care is another gloomy example: S promised before the 2014 election that everyone with cancer would receive care within four weeks, but when the Social Democrats packed their boxes at the Government Offices after the election, the queues had instead grown significantly. After eight years with the Social Democrats and red-green governments, fewer than half of all women with breast cancer received care in time, and not even one in three men with prostate cancer did.

Mr. Speaker! This is a major and serious failure and a breach of promise. And it was thus against the background of the growing healthcare queues, the shortage of healthcare beds, the problems with uneven access to care across the country, and the great challenges regarding recruiting and retaining healthcare staff that the previous Riksdag urged the previous government to take a long series of measures to solve the healthcare system's problems and challenges.

We who were in opposition at the time felt a great frustration over the fact that the then S-government exhibited such a lack of leadership. We were genuinely concerned about the lack of concrete proposals and accountability. Therefore, we submitted a multitude of proposals, and we demanded that the government report back to the Riksdag on how the work was proceeding.

The communication we are now debating is the third and final one in connection with the Riksdag's announcement from March last year. And it does not come from the old, initiative-less S-government – no, this communication comes from the new, action-oriented, Moderate-led government, which has now kick-started the work to tackle precisely the problems and challenges I initially described. The Tidö Agreement, which forms the basis for the government's work, is a reform agenda for a better and more accessible health and medical care.

The Tidö Agreement contains a national competence supply plan, a long-term plan to eliminate the shortage of healthcare beds and the establishment of a national healthcare brokerage. It also contains reforms to create conditions for a better utilization of the possibilities of digitalization to achieve both a more accessible and high-quality healthcare - and furthermore a better working environment. It is about creating a national maternity plan, taking action to improve mental health and prevent suicide, among many other things.

Mr. Speaker! Another major problem I want to highlight today, on International Women's Day, is that Swedish healthcare is actually not equal. We have serious problems within Swedish healthcare. For far too long, women's health has been sidelined. We see it in the range of care. We see it in research, where there has been a skew regarding which research is conducted. We see it in that women need to experience and express more pain to receive help and support. We see it in maternity care, which for far too long has been neglected.

Now we have a government that is also taking action in this area. In the budget, we have made substantial investments in maternity care and in women's health. Work on a national maternity plan has begun, and today three new assignments were presented with the aim of creating more equal health and medical care.

Socialstyrelsen is tasked with carrying out measures for more equal health and medical care.

We give Ivo, the Health and Social Services Inspectorate, a reinforced mandate to work with the supervision of maternity and maternal healthcare to ensure good patient safety.

We task the National Board of Health and Welfare to take measures for more equal and knowledge-based health and medical care for those who have been subjected to sexual violence.

Mr. Speaker! In conclusion, I can state that we still have great challenges and problems within Swedish healthcare, but that we also have an action-oriented government that has proposals for solutions to the problems we face. Furthermore, the government has the opportunity to gather a majority for and pass its policies, Mr. Speaker, and thereby step by step create a more accessible, high-quality, and equitable healthcare.

(Applause)

In this speech, Jesper Skalberg Karlsson (M) concurred.

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

Anders W Jonsson (C)

Mr. Speaker! Fortunately for the Moderaterna and Johan Hultberg, most of those who work in health and medical care do not have the time to follow this debate. Had they had the time, I believe they would have become quite upset by the picture being painted.

Hultberg says that we have problems in Swedish health and medical care because for eight years we have had a government that has not been decisive – but that we have now indeed received a fantastic government that will be able to solve all problems through a decisive agenda. But when one sits down and looks at what the decisive government has done, one sees that it has taken a number of old S proposals and moved forward with them, and then it is a few more targeted state grants and a few assignments to some state agencies.

The question I often encounter in healthcare, however, concerns one of the proposals that is actually being put forward. Women's healthcare is neglected. Maternal mortality is a small problem in Sweden, but it is significantly larger among women who do not speak the Swedish language. There, the risk is also greater that the children will be injured and that the woman will suffer injuries in connection with the childbirth. The Moderates and the Sweden Democrats have pushed through that the possibility of an interpreter should be limited. In Stockholm, proposals have been submitted that it should cost 500 kronor to have an interpreter.

The question I encounter from those who work in maternity wards and emergency rooms is: Who takes responsibility? It could be a situation where a woman is being cared for during childbirth, or where someone coming into the emergency room is being cared for, and where the patient does not have access to an interpreter, which leads to an incorrect diagnosis and incorrect treatment that causes harm – and perhaps even death. Who has the legal responsibility after the Moderaterna and Sverigedemokraterna push through a limitation of the possibility to get an interpreter? This is something that truly worries people out there in health and medical care, I must say.

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Johan Hultberg (M)

Mr. Speaker! Swedish health and medical care has large and serious problems that it has suffered from for a very long time. The accessibility problem can almost be described as a chronic ailment in Swedish health and medical care.

We can nevertheless state that when the Alliance government ruled – and at that time the Center Party also participated in the government – we succeeded in radically improving accessibility. We did that by focusing on the work of creating improved accessibility and through economic incentives to shorten the healthcare queues. When the Social Democratic government took office, they removed the billions in funding. The healthcare queues skyrocketed, and now a renewed focus was needed on creating accessible healthcare. It is precisely this focus that the new government has.

Anders W Jonsson is absolutely right that the problems are large and that this will take time to solve. I will not give anyone the illusion that everything in Swedish healthcare will be perfect in four years - when the sitting government hopefully is re-elected - but I am convinced that we will have taken important steps on the way towards creating a more accessible, high-quality, and equitable healthcare across the entire country.

Member of Parliament Jonsson mocks us for giving mandates to authorities and so on, but that is how the political process looks. We have a new government that has taken over the leadership in the Government Offices, and one governs through its authorities. It is the authorities that are the tools to achieve change, also given that we have a decentralized healthcare system where the responsibility to provide care fundamentally lies with the regions.

I may perhaps return to the interpretation question in my second speech. I will therefore put it on hold, Mr. Speaker - I have an additional two minutes to answer the question in the next contribution.

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Anders W Jonsson (C)

Mr. Speaker! I can state that Johan Hultberg avoided answering the specific question that I asked.

What worries very many midwives, nurses, and doctors out in the health and medical care is precisely the concrete proposal from this government, driven by Sverigedemokraterna and Moderaterna, that the possibility of obtaining an interpreter should be restricted.

Johan Hultberg mentioned women's healthcare. One of the most acute problems there is that, as far as maternal mortality is concerned, even today there is a large difference depending on whether one understands the Swedish language or not.

If the government now politically pushes through proposals that reduce access to interpreters, who then has the patient responsibility in a situation where the doctor makes an incorrect diagnosis because he or she cannot communicate with the patient, or where the midwife loses the opportunity to speak with the pregnant woman? Many doctors and midwives ask who it is that has the responsibility then. The answer to that will be that it is the doctor who has found himself in the situation or the midwife who has worked with the birth who will be affected.

The government – or the Moderaterna and Sverigedemokraterna – will certainly not take any responsibility for that situation. Here, at least the Kristdemokraterna's Minister for Health and to some extent also the Liberalerna have been more honest and said that this proposal will not be presented if it threatens patient safety in the slightest. I have, however, heard nothing such from either Sverigedemokraterna or from Moderaterna.

Therefore, I return to my concrete question. If this proposal leads to more patients being harmed and to more women being affected during childbirth, who then has the patient responsibility? Is it Johan Hultberg and the Moderaterna, or is it the midwife or doctor who has been deprived of one of their most important tools to be able to make the correct diagnosis and prescribe the correct treatment?

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

Johan Hultberg (M)

Mr. Speaker! We now have a government that will absolutely take responsibility for Swedish health and medical care. But we also have a government that will take responsibility for doing something about the very large integration problems that years of failed migration and integration policy have resulted in.

We must somewhere make it clear that Swedish is the language spoken in Sweden and set requirements that those who come to Sweden should as quickly as possible become self-sufficient, learn the language and become a person who contributes to Swedish society and makes our country better.

I think it is important to have a discussion about how long it is reasonable for the public - the taxpayers - to finance interpretation for those who have been in Sweden for a long time. That is what this issue is fundamentally about, and it is this that is now to be investigated. There is no concrete proposal, Member Jonsson, on how this should be changed. There is a concrete promise from the Tidö parties to investigate this issue thoroughly. It has, as mentioned, also been given clear assurances from the government that the government will not present a proposal that jeopardizes patient safety.

We will return to the concrete proposal, but the direction from the government is clear. This government wants to increase the requirements for people in Sweden when it comes to learning the language, taking responsibility for their integration, and taking responsibility for their self-sufficiency. We have 1.3 million people in Sweden who are not self-sufficient. It is not sustainable if we are to manage to finance the welfare that is being debated today in the long term. If we are to manage to invest in health and medical care and provide increased resource reinforcements, a strong work line and better integration are required. This is a small piece of the puzzle in the important and urgent discussion.

(Applause)

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

Karin Rågsjö (V)

Mr. Speaker! It is obvious that this government is completely dependent on the Sweden Democrats. It is they who sit back there and rule; it is obvious. The day they get tired or get angry, this government will fall like a house of cards. It is always good to remind of this, I think.

It was interesting to listen to the discussion that the member had with Anders W Jonsson. A little humility is never wrong. I think the member sounded like a promotional brochure for the Moderaterna during the election campaign. Now the election has been held, and we can see the consequences of it.

Of course, the issue of interpretation is very contentious in healthcare, but I will not go into depth on this issue. It is perhaps also not an issue that you in the Moderaterna would have pushed yourselves if you had had the conditions to form your own government.

It is still the case, Mr. Speaker, that it is the regions that are responsible for maternity care and so on; as far as I know, it is not we who are sitting and meddling in maternity care. One should know that the regions were very right-wing led during the previous mandate period. It was Stockholm, which was right-wing led for 16 years, that had the largest number of women who were affected by birth injuries. This is something one can reflect on, I think. Now the other majority, so to speak, has to clean up there.

When it comes to mental health among children and young people, it is probably good if the resources that exist are concentrated in the areas where children have it the hardest. Doesn't the member of Parliament think so? Of course, it is the case that child and adolescent psychiatry will have a harder time if activities that could receive children and young people suffering from milder mental ill-health are shut down.

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

Johan Hultberg (M)

Mr. Speaker! Member Rågsjö thought I sounded like a brochure. I am a proud Moderate. Before the election, I was proud of the policy we in the Moderates campaigned on. I am also proud to now be part of the basis for a government that has presented a substantial program to address the major problems in healthcare, create a social service with a more preventive focus, re-establish the work principle, tackle integration problems, and pursue a more effective environmental and climate policy.

Yes, I am proud, but I do not downplay the major problems and challenges that we have. As I said in the previous exchange, the problems are large and extensive, and they will not be solved in one, two, three, or even four years. Long-term work is required here. The direction is, however, clear: the patient's position shall be strengthened, the quality of care shall be raised, equality shall increase, and accessibility shall be improved.

Now we have a government that takes an increased national leadership. It is true, as Member Rågsjö said, that for example maternity care - just like all other health and medical care - is the responsibility of the regions. But the state also has a responsibility and a role to play in creating more equal care across the country. It is about developing a knowledge base, supporting the regions and, not least, taking a national responsibility for the absolute most important thing in order to be able to provide good health and medical care, namely that there is a functioning supply of competence.

What was presented today included, among other things, a mandate to Ivo to work with the supervision. This is one of the most important tools we have nationally to ensure good patient safety. With intensified supervision, I hope that we will be able to address the patient safety deficiencies that exist within maternity and obstetric care. This is very important, and I am glad that Member Rågsjö seems to share that ambition.

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

Karin Rågsjö (V)

Mr. Speaker! I will now touch briefly on social services and preventive measures. Evicting families where one person is a criminal can hardly be counted as preventive measures, can it? I do not think so, but we will leave that discussion.

It is very good that Ivo gets increased opportunities to go out and look. Last time they were out looking, they had views on 23 acute hospitals, I believe. That can be considered. It is also very good if the state takes a greater responsibility for this.

It is very good with plans, words and so on, but means also count - isn't that right, Johan Hultberg? Then one still has to consider your budget. It is quite stingy, I think, when it comes to the state grants to get momentum for that which is so bad right now.

I think the member has painted a black picture of healthcare in the whole of Sweden in a way that is not okay. These state grants are not sufficient; everyone says so. The regions say it, SKR says it, and all the unions say it.

We will follow up on this. It will be incredibly interesting, Mr. Speaker, to see what the government, with SD as a partner, will do the day when even more people within the health and medical care sector want to quit.

For we are in some way standing at a precipice. Something must be done quite quickly for anything to happen, in order to retain staff and to get the maternity care up to a reasonable level and so on. The regions will fight like animals to fix it. But without increased state grants, it will not work. I believe it is going to be a difficult journey within healthcare.

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

Johan Hultberg (M)

Mr. Speaker! The government has, as stated, increased the general appropriations to the regions and municipalities. We have also made a long series of targeted investments in the budget for the year to, for example, improve maternity care, increase the number of care beds, and improve accessibility.

But it is naturally true that the economic situation we find ourselves in puts enormous pressure on the regions and municipalities, as well as on all households and companies. We have skyrocketing inflation that makes us all poorer. The problem is only that if one were to pursue the policy that the Left Party and Member Rågsjö advocate, the inflationary fire would have been stoked even further. The budget that Member Rågsjö stood here for a few weeks ago and debated was a recipe for increased inflation. The spending trousers were on, and there were deficits in the public finances that were enormous for the coming years. Such a policy we Moderates and this government will never pursue, because inflation is a threat to welfare and to households. We must pursue a responsible economic policy.

That is why it is so important, Mr. Speaker, that we re-establish the work line. Had Sweden only had the corresponding development in the labor market as the rest of Europe, if we had had the average of unemployment in Europe, we would have had 40 billion more for welfare every year. That corresponds to 65,000 nursing assistants. The importance of a strong work line and of pushing back exclusion can therefore not be overemphasized when we talk about meeting the financing of welfare and the large missions ahead.

When it comes to preventive work, Mr. Speaker, I would say that the most fundamental thing is a strong work line in combination with a functioning school. We must ensure that all students get a good start in life through a good school, and therefore we are investing in increasing teaching time and in increased homework help and holiday school so that all our children get a good start in life. It is the best vaccine against future social problems.

(Applause)

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

Anders W Jonsson (C)

Mr. Speaker! I would like to go back about a year. Swedish healthcare had for a long time had a number of quite large problems: lack of competence, long queues, shortage of care beds and a number of other things. Swedish healthcare had then just gone through a pandemic and managed a transition in a completely fantastic way, but was completely exhausted. All reserves were depleted.

In that situation, the trade union organizations, above all Läkarförbundet and Vårdförbundet but also others, turned to the government and said that given how serious the situation is now in Swedish healthcare, it is required that a collective grip is taken, that a crisis commission is appointed, that something is done about the competence shortage, and that we ensure we produce more healthcare places and reduce the queues. This was, therefore, a mandate from everyone who works in Swedish health and medical care.

The current government was quite cold-hearted towards these demands, but in the Riksdag we were then able to find a majority to highlight the most central problems in Swedish healthcare and demand that the government should return to the Riksdag on no fewer than three occasions to report on what measures had been taken to solve the major structural problems that those working in healthcare had so clearly pointed out.

It is now the third time that a government has reported, and it is such that, Mr. Speaker, the situation is definitely not better in healthcare today. It is rather considerably more serious. 60 percent of the doctors in healthcare are looking to change jobs. The pressure is incredibly hard. IVO, the Inspectorate for Health and Social Services, can state that there is an acute shortage of care beds in virtually all emergency hospitals in Sweden. Patients can lie in emergency departments not just for hours but even for days, several days, waiting for a care bed.

In that situation, it becomes somewhat frustrating, Mr. Speaker, to take part in the journey that we have seen since a year ago. The then government disregarded, I would like to say, much of the pointing out that came from everyone who works in healthcare. We pushed from a parliamentary majority side, and now we hear representatives of the current government, with largely the same script as the Social Democratic representatives before the election, say: Now we have taken a number of very powerful measures. We have given assignments to a number of state agencies, and we have come up with some additional targeted state grants, so now we have dealt with this situation.

As I said earlier: It is probably lucky that there are not so many out in healthcare who have the time on a Wednesday afternoon like this to sit and listen to the parliamentary debate, for the disappointment would be manifest.

That is why, Mr. Speaker, we from the Center Party have a proposal – a reservation, as it unfortunately became. Because we think it would have been reasonable for the government, given that the situation now is rather worse than it was a year ago, to invite a large discussion here in the chamber by returning with further reporting on these central problem areas that the trade union organizations, that is, those who work in health and medical care, raised a year ago. But then we are met, Mr. Speaker, with the usual government speech: Now we have a proactive government, now we will be able to solve this, we have found a few more targeted state grants and some assignments to authorities and furthermore we are going to have an office here in Stockholm that distributes healthcare places.

It is, Mr. Speaker, somewhat frustrating. I would have wished for a bit more humility from the government parties that were actually involved in pushing this through more than a year ago than to simply reject it by referring to the fact that we previously had an incompetent government and that we now have a significantly more competent government.

Sometimes it is easy to both wave sausages and say that we have illegally long queues in Swedish healthcare before an election. But now, Mr. Speaker, it is time for proof. And even if the government refuses to return with reports here to the chamber, which would have been the case if we had received a majority from the Center Party's side, I want to move for the approval of our reservation 2.

I can say that from the Center Party's side, we will continue to follow this development very, very closely and point out where the responsibility lies. Because one devotes oneself more to targeted government grants and assignments to the authorities instead of proposing substantial legislative changes and structural proposals that could solve the problems we have in Swedish health and medical care.

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

Ulrika Westerlund (MP)

Mr. Speaker! We have an important debate on an important day: Working conditions in healthcare is a major women's issue.

The staff's working conditions and work environment are the most important fundamental pillar in health and medical care, and the deficiencies we see today are the greatest challenge we have. That doctors should not have to spend valuable time worrying about where patients can be accommodated is extremely urgent. A physical care unit cannot be kept open if there is no staff to man it. Therefore, the question of care units is strongly linked to the staff's work environment and working conditions.

Care must be able to attract new employees, and those who work in care must want to and be able to stay. Every time an employee starts considering changing jobs, even though they actually think this is the very best job they could have chosen, because they cannot endure the real working conditions, it is a serious failure.

Mr. Speaker! Miljöpartiet wants to see a permanent state initiative for a strengthened work environment and improved working conditions with a focus on more employees and higher wages for healthcare personnel.

One-off initiatives or temporary investments cannot solve the healthcare system's problems. The issues in healthcare need to be solved in the long term. A reinforced state responsibility is needed, but not a state control, so to speak, and a permanent support. The goal must be to create a positive work environment and a positive working climate for the healthcare workers. More people should want to seek out healthcare professions, and more should want to stay. More people should want to and be able to work, get up early again, or seek their way back to the profession. According to several trade and professional unions, there is great potential in that a considerable number of people can be lured back with better conditions. More colleagues and reduced stress are most important, but also salary and other working conditions obviously play a major role.

The government has, among other things, highlighted that they see a need to increase the number of healthcare beds and to introduce performance-based compensation to the regions in order to achieve this. We believe that this initiative is partly misfocused, because the basis for the problems is a poor working environment and poor working conditions for the employees. In that case, it is not good with initiatives that risk worsening this.

We therefore consider that an increased national responsibility and a long-term sustainable major investment in the staff's conditions are needed, with more employees and higher wages in both healthcare and municipal health and social care. A new construction is needed where the state takes a permanent and large responsibility to achieve better conditions for staff in healthcare. We raised this issue in our budget motion, where we allocated around 10 billion kronor additionally for the coming three years. From 2026 onwards, we want to see a permanent state investment of 40 billion kronor annually.

Mr. Speaker! Miljöpartiet also wants to see a continued and increased investment in the recovery bonus, which has existed since 2021 and which Miljöpartiet pushed through. These are funds at Socialstyrelsen that can be applied for by workgroups within healthcare and elderly care that want to test new ways of working to improve the work environment. The purpose is to take advantage of the personnel groups' own development ideas and give them the opportunity to test these.

When the recovery bonus was introduced, there were 300 million kronor in funds, which were applied for by 190 municipalities and 16 regions. From 2022 onwards, it became 1 billion kronor annually. To this, 300 million kronor have been added to remove or reduce so-called shared shifts, and that is valuable. Shared shifts that are not desired by the staff are simply a hostage. In our budget motion, we proposed that the recovery bonus should be doubled, so that staff groups can get an increased opportunity to test their own ideas to improve their own work environment. We hope that the government wants to work towards making the model better known and, in the long run, review the possibility of further strengthening the recovery bonus.

Mr. Speaker! Miljöpartiet wants to see a zero vision for work-related ill health. Health and medical care could be a first focus area. Working life should be health-promoting, and it can be when it functions. Decisive action needs to be taken to counter the problems that today create ill health. We believe there are strong reasons to make just health and medical care a first focus area for such an initiative.

Vårdförbundet, which has been mentioned earlier today, has pointed out in a report that if the work environment were healthier so that everyone could manage to work full-time, it would correspond to a full 790 more midwives, 470 more biomedical analysts, and 7,645 more nurses. These would truly be needed. This could lead to a reduction in stress-related sick leave in health and medical care. We hope that the government wants to return with proposals on how such a zero vision could be introduced within health and medical care.

Mr. Speaker! There is much to be done in the area of the work environment, even within health and medical care. An additional measure that we have tried to highlight concerns improving the work environment by increasing managerial competence, for example through increased knowledge of how to conduct systematic work environment management. We believe that the government needs to review the conditions for introducing a specific training for managers in health and medical care, similar to the principal training within the school system.

There is also reason to review the work environment legislation. While we were in government, an inquiry was commissioned to look into the problem that Arbetsmiljöverket can impose a fine if there are physical deficiencies in the work environment but not if there are deficiencies in the organizational and social work environment. The inquiry has presented its report, where a solution to the issue is proposed. Now, we naturally hope that the government will take action on its proposals. The consultation period expired in December.

In other words, there is much to address to ensure the best possible working environment for staff within healthcare and thus the best possible care. I finally want to bring up the proposals to worsen access to interpreters as well as the thoughts that healthcare staff should be urged to report persons who are without papers in Sweden, which have been mentioned earlier in the debate. This is not something that leads to improved care, nor is it something that increases the attractiveness of working within healthcare. We hope that the government thinks carefully about it and does not present such proposals, which will not lead to better care for anyone.

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

Carita Boulwén (SD)

Mr. Speaker! Today, the report Certain issues within the health and medical care area is being debated. The previous government submitted two communications on the subject, and the current government has presented the last one.

The Sweden Democrats' and the Tidö parties' work to get the Swedish health and medical care in order began already during the previous parliamentary term, during the previous government's time in power, by us in the Sweden Democrats allowing the government to start the reforms that we wanted to implement. In order for us to get an idea of what the government did, or rather did not do, an initiative was taken which meant that the government was to return to the Riksdag with reports on how the work was progressing. It is these reports, Mr. Speaker, that are being debated today.

Mr. Speaker! Swedish healthcare should be of world-class standard. When Sweden has one of the world's highest tax rates and is one of the countries in Europe that allocates the most resources to healthcare measured as a share of GDP, it is obviously unacceptable that today there are people dying in care queues, that record numbers choose to leave their work within healthcare, and that patient safety is threatened by insufficient care beds across the country. This is a completely unsustainable situation. Sverigedemokraterna have warned against this for a long time and presented concrete proposals for improvement.

A welfare state that Sweden deserves better, Mr. Speaker. That is why I am pleased that the Sweden Democrats and the coalition parties can continue the work that has been started. The Sweden Democrats, together with the Moderates, Christian Democrats, and Liberals in the Tidö Agreement, have agreed on many decisive reforms for the future of Swedish health and medical care.

Mr. Speaker! We have the ambition that Swedish healthcare should be at the forefront and maintain high international quality. It is of great importance to us that patients are treated with evidence-based and effective treatment methods, that the waiting time is within the framework of the Swedish healthcare guarantee, and that one receives patient-safe care throughout the country. It should not matter where in the country one lives.

It is also important that the status of the care profession increases, so that the care sector can both attract new labor and retain the competence and the staff that currently exist. The coalition parties' work is in full swing to ensure exactly this with strengthened competence supply within health and medical care. Socialstyrelsen is tasked with producing proposals for a national plan to improve the competence supply. This, I believe, Mr. Speaker, is an important step in the right direction.

At the same time, the number of care beds needs to increase to ensure that we maintain a patient-safe and secure care. Therefore, Socialstyrelsen is tasked with allocating nearly 2 billion SEK in performance-based compensation to the regions to increase the number of care beds.

Furthermore, the Sweden Democrats have pushed for a healthcare guarantee office with a national waiting list where treatments and operations are presented to them with the longest healthcare queues. The patient shall also be able to seek care freely in the region where the care is located. Here too, the coalition parties have agreed on important reforms. A national healthcare brokerage under state administration, which we refer to in the Tidö Agreement, shall be developed.

Mr. Speaker! I mean that we are very clear in the Tidö Agreement. We need a national plan and concrete management of the skills supply to map out the need for healthcare personnel. The mapping shall also show which measures for existing and new healthcare personnel may be needed to improve the staffing supply. The national commitment for the skills supply shall be strengthened so that we can meet the need in all of Sweden in the long term. Finally, the healthcare beds need to be prioritized and expanded. Not least, this is important to guarantee patient safety and give everyone safe and secure care.

Mr. Speaker! With the Tidö Agreement as the basis, there is now a clear plan for Swedish health and medical care, and I can guarantee that the Sweden Democrats, together with the other coalition parties, will prioritize Swedish health and medical care during the mandate period.

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

Anders W Jonsson (C)

Mr. Speaker! If one looks at the government's policy in the healthcare area, which is now expected to have these dramatic effects in Swedish healthcare, one can say that there are three types of proposals. One type is those originating from the old Social Democratic government. Another is a number of Alliance proposals. But then there are two proposals that come from the Sweden Democrats.

One has been discussed previously. That is to reduce the right to an interpreter. The other concerns this matter of the reporting obligation. If a patient appears at an emergency room or in healthcare and does not have the last four digits, that is to say, does not have permission to stay in the country, the doctor or nurse shall, before taking any measures, call the border police and report that the individual has arrived there.

Confidentiality in Swedish healthcare is extremely strong. It is essentially only if someone has committed a murder or a crime that carries a prison sentence of more than two years that one as healthcare personnel has the right to call the police.

That is why the proposal that has been included in the Tidö Agreement is extraordinarily remarkable. It is, in itself, with the reservation that one shall see what consequences it may have in healthcare. But when the Sverigedemokraterna themselves have pushed for it, that reservation has not been there at all.

It is about starting to do so in Swedish healthcare for everyone who does not have the right to stay in the country, that as soon as they contact healthcare, it shall be reported to the police. It will have very large consequences. To receive that assignment from the Sweden Democrats via the government is another thing that healthcare personnel have really turned against.

Mr. Speaker! I have a question for the Sweden Democrats. When you have presented the proposal that there should be a reporting obligation, how have you then considered what consequences it will have for people's ability to seek medical care when they need it for life-threatening conditions?

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

Carita Boulwén (SD)

Mr. Speaker! Thank you, Anders W Jonsson, for your question!

First and foremost, it applies that if one does not have the right to be in our country, one should also not be able to enjoy the Swedish welfare benefits that we have in this country. That is what I want to start by saying.

Regarding the proposals we have developed, it is not set in stone exactly how they should look. An investigation must show that. It is the authorities, the police and so on who shall ensure that we do not have persons in our country who do not have the right to stay in our country.

We have said that we want to investigate the possibility and see if there might potentially be mitigating values, for example when it concerns healthcare. If people seek healthcare and do not have the right to be in the country, perhaps there is another possibility where these measures do not need to be taken.

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

Anders W Jonsson (C)

Mr. Speaker! When it comes to the others, the three government parties can always hide behind the wording that it shall be investigated and that one shall see what consequences it has in health and medical care. But for the Sweden Democrats, it is something that one has pushed for a long time completely without reservation.

If you look at how healthcare is structured, there is the requirement of confidentiality. If you have committed a crime punishable by imprisonment of more than two years, essentially kidnapping and murder, a doctor or nurse has the right to call the police, but otherwise not.

The idea is that no person, whether it is a burglar or someone else, in a situation where they need emergency medical care should even hesitate to seek out the emergency department for fear that the doctor or nurse will contact the police.

There is a very clear reason why it is that way. Everyone should have the right to healthcare to save their life. Furthermore, this proposal, alongside the interpreter proposal which also comes from the Sverigedemokraterna, is something that has caused great upset within the healthcare sector.

It is not enough that it is tough to work at the emergency department as a nurse and a doctor. Now they are also supposed to call the police as soon as someone is missing the last four digits.

Since the Sweden Democrats have pushed for this for a long time, I assume they have considered the consequences. That is why my question to Carita Boulwén concerns exactly that. What consequences have you assessed it will have for healthcare in a situation where those who lack the last four digits do not dare to go there because of the risk of being reported to the police?

Should it also apply to others that the secrecy should be reduced? That would be logical. If it is now murderers and those who do not have permission to be in Sweden who are to be reported to the police when they seek care at the emergency department, perhaps there are reasons to also look at others, according to the Sweden Democrats.

How have you considered what consequences this will have for healthcare staff and people who are in urgent need of medical care?

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

Carita Boulwén (SD)

Mr. Speaker! As I mentioned earlier, one must review whether there are exceptions that can be made when people seek healthcare.

What we want to achieve is precisely this. If one does not have the right to reside in the country, one should also not be able to take part in our welfare. That is the basic principle in the proposal.

There may be reasons that make one deviate from those principles. This can, for example, be the case regarding healthcare.

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

Malin Danielsson (L)

Mr. Speaker! Almost exactly one year ago, we urged the previous government to promptly take measures to increase the number of healthcare beds, shorten the wait for sick people to receive care, strengthen the working environment in healthcare, and ensure that employees have enough colleagues.

Since then, we have changed governments. Some of the measures we demanded that the S-government take have now been started and are well underway, while other things the new government has already made a reality.

I want to highlight the following first and foremost. We intend to increase the number of care beds. It is difficult to compare distant countries with one another. But it is not reasonable that our neighboring countries have so many more care beds than we do. A national plan was needed for how the shortage of care beds should be addressed. One billion has been allocated for this for this year and more will come. 1.5 billion will be added in 2024.

The second thing I want to bring up is that the care that exists in the country should be used wisely. 50 million has been allocated to establish a national healthcare brokerage, and for travel for patients who need longer journeys, 100 million kronor has been allocated for both 2023 and 2024.

Today is International Women's Day. The conditions in healthcare are, to the highest degree, a matter of equality. Every employee in healthcare should know that they, or as it most often is within healthcare - she, has enough colleagues.

The new government has made budget investments in skills development and skills supply and investments in further education for nurses and better development and career opportunities. Measures are also underway to provide language studies for persons with foreign higher education within healthcare.

The government is also reviewing the working environment within healthcare. It is a very high-priority issue. The Swedish Work Environment Authority is now conducting an inspection of the working environment within health and social care. More than 1,500 inspections are to be carried out for the sake of the employees and the patients.

More is coming. Each one of us should feel that we will be able to receive good care if and when we become ill. This applies to whatever may affect us, whoever we are and wherever in the country we live. The Liberals' goal is simple: no one should be afraid of the future.

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

Anders W Jonsson (C)

Madam Speaker! I am pleased that Malin Danielsson highlights how important the work environment is for health and medical personnel. But one can ask how the work environment will be affected for nurses and doctors in Swedish healthcare in a situation where they are given a reporting obligation if someone lacks permission to be in Sweden or, even worse, where the right to an interpreter is restricted. It sounds somewhat false to my ears.

But that was not why I requested the floor. I requested the floor when I heard Malin Danielsson point out that we must increase the number of healthcare beds. Everyone knows that it is not beds or rooms that are in short supply, but staff and competence in healthcare.

As many as 25-30 percent of all those who work in healthcare have a foreign background. It is very important for most regions to be able to recruit from abroad and, with the help of labor migration, to be able to bring here nursing assistants and nurses but also doctors.

That is why it is so strange that the Liberals have stood behind a strong limitation of labor migration and that one must have a high monthly salary to even be able to gain access to the Swedish labor market. This will hit green industries, the tourism industry, and so on, very hard. But it will also hit the Swedish healthcare system hard.

My question to Malin Danielsson from the Liberals is: How can you stand for this in a situation where you identify a shortage of skills as a major problem? There are many measures that should be taken there. But to limit the healthcare heads' ability to recruit from abroad through this draconian proposal regarding labor migration – how can the Liberals stand behind that?

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

Malin Danielsson (L)

Madam Speaker and Anders W Jonsson! I want to begin by saying that I am here because of the snow chaos. My dear colleague Lina is stuck in the snow falling outside. It is very beautiful, but it creates a number of problems.

Regarding the lack of space, it is exactly as Anders W Jonsson says: It is not about beds. It is about staff who can help, support, examine, and treat those who need care so that one can avoid doing it in a corridor. But it is also about having staff on site who can work through the queues due to the long waiting times that we sometimes have.

It is fully reasonable that we do much more so that the competence that exists within Sweden's borders today can participate and contribute in healthcare. We must do that. I have been on a study visit in Örebro, where there was an entire group of pediatricians who sat without being able to work as pediatricians because they did not receive language studies that meet the requirements to obtain a license and be able to practice in Sweden. We have an incredible amount of competence that already exists in the current situation, and we need to take advantage of that.

In many industries, we also need to recruit from outside our country. We have the entire EU with a free movement that we are very proud of and will continue to be proud of. But we may also need to recruit from third countries.

I believe that in the future we need to look at which shortage occupations we have and how we handle such a situation. How it is to look like going forward is difficult to answer now. What the government is presenting now concerns language studies for persons with foreign higher education within healthcare, and it is much awaited and wise. Let us take advantage of all the competence that exists in the country today!

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Anders W Jonsson (C)

Madam Speaker! Well, no one is saying that it is bad. There is much more that can be done to ensure that those who are already in the country enter the healthcare system in a state where they have that competence.

But what I cannot understand is why the Liberals and the government want to turn off again the tap that is so important for the healthcare providers and the regions, namely the ability to recruit nurses, doctors and also other staff from outside the EU. Why do you want to turn off this tap by setting a requirement for a monthly salary of more than approximately 33,000 kronor per month?

This will create even more concerns for our regions. Someone might argue that a doctor earns more than 33,000 and that one can also well pay a nurse more than 33,000. But it doesn't work that way in healthcare in practice, because when one recruits a skilled pediatrician from Syria, he or she will not enter on a senior physician's salary of 95,000, but they will enter on a position that has a significantly lower salary. One must see if this is a person who can handle the job. They then have to learn the language and gradually grow into it.

That is why the proposal from the Liberals and the government will also have consequences for the recruitment of doctors. But above all, it is about the recruitment of nurses. What I cannot comprehend is that this is being done in a situation where everyone agrees that the shortage of competent staff is one of the biggest problems we have in healthcare. That is what causes us to have a shortage of care beds.

Why then turn again one of the 25 different taps that one must open in order to be able to contribute to a solution? How can the Liberals agree to restrictions on labor migration, which, besides leading to problems in a long line of other areas, also affect the Swedish health and medical care?

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Malin Danielsson (L)

Madam Speaker and Anders W Jonsson! I intend to be someone who asserts that one has sufficiently high wages within healthcare - at least in certain parts. This applies to midwives and doctors. There will still be great opportunities to recruit from outside Sweden with these regulations.

Certain issues within the health and medical care area

Certain issues within the health and medical care area

I also want to point out that we have a large amount of unemployment in our country at the current time. We have many who do not have a job to go to and who cannot feel the freedom that comes with receiving a salary. Their children do not see their parents go to work every day, and I see this as one of our great challenges. It is a mismatch we have on the labor market with a large amount of unemployed people and a large skills shortage. We must deal with this.

Once again, it is about the issues regarding the work environment. We need to get those who have left the healthcare sector to come back. They are the ones who already have the competence today, and we need to recruit from there. Then, one also needs to look at other issues and, just as Anders W Jonsson says, look beyond the country's borders.

But above all, I believe we must begin to work with all those who are in Sweden today. They also need to receive the freedom that you and I have: to come home to our children, to be able to provide for them, to be able to put food on the table and to be able to feel the freedom one has when one has a salary.

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Ulrika Westerlund (MP)

Madam Speaker! You surely understand why I am standing here again. I forgot to move for approval of reservation 3, so now I do so.

As a final word, I will now take the opportunity to point out that it is not only International Women's Day today, but also part of Endometriosis Awareness Month. That is why I am wearing a yellow ribbon. Perhaps we will have reason to raise that issue more often during this month.

The deliberation was hereby concluded.

(Decisions were made under § 21.)

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