2024-05-022023/24:SoU8 · p.1SoUHealth & social services
Continued monitoring and evaluation
Continued follow-up and evaluation of healthcare waiting times
What's at stake: Long waiting times in healthcare can have serious consequences for patients and erode trust in the health system. The question is whether the government's ongoing monitoring is sufficient, or whether more concrete, binding reforms are needed to shorten queues.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The vote concerns whether parliament should call for concrete reforms - such as a binding doctor-to-population ratio in primary care and a dedicated transition office - or whether it is enough for the government to continue monitoring and evaluating waiting times within its existing work.
Yes Yes — the committee proposal
The committee welcomes the audit report but notes it is difficult to draw far-reaching conclusions about the effects the care guarantee and the dedicated queue funding have had on waiting times. Since active work is already under way - including assignments to the eHealth Agency and the National Board of Health and Welfare, and a possible evaluation via the Agency for Health and Care Services Analysis - the committee holds that the government should continue to monitor and evaluate the existing policy instruments, and recommends rejecting the motion calling for more far-reaching action.
No No — the reservations
Reservation 1 (S)
The reserving member holds that attempts to shorten waiting times by legislating the care guarantee have failed and that the government's measures are insufficient. Instead, the reserving member wants a faster transition to good, accessible local care, more resources, and better working conditions for healthcare staff, including a binding target of 1,100 residents per doctor in primary care and a transition office at the National Board of Health and Welfare.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 1 by S.
Abstain The party marks a position of its own that is not one of the two final alternatives.
The decision would have gone the other way
Explicit commitments that contradicted the vote: KDKristdemokraterna, SDSverigedemokraterna
Ja 166–94Nej 91–169
Counterfactual: the parties above are moved to the position their own documents explicitly point at, carrying their whole contingent present. Every other party keeps its real figures, including dissenters and absentees.
How the AI parties would have voted
For each party: what its own plan – election manifesto and party programme – argues for in this case, next to how the party actually voted. The AI can only answer Yes or No; a party can also abstain.
| AI | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | Abstain 0/0/18/6 | differs | confidence: high | explicit |
| S | No | No 0/93/0/13 | match | confidence: medium | not addressed |
| MP | No | Abstain 0/0/13/5 | differs | confidence: high | not addressed |
| C | No | Yes 20/0/0/4 | differs | confidence: medium | not addressed |
| L | No | Yes 11/0/0/5 | differs | confidence: medium | not addressed |
| KD | No | Yes 13/0/0/6 | differsagainst own programme | confidence: medium | explicit |
| M | Yes | Yes 60/0/0/8 | match | confidence: medium | not addressed |
| SD | No | Yes 62/0/0/10 | differsagainst own programme | confidence: high | explicit |
Committee proposal
The Riksdag rejects the motions 2023/24:2797 by Fredrik Lundh Sammeli et al. (S), 2023/24:2802 by Karin Rågsjö et al. (V), and 2023/24:2807 by Ulrika Westerlund et al. (MP) amendment 1.
Original (Swedish)
Riksdagen avslår motionerna 2023/24:2797 av Fredrik Lundh Sammeli m.fl. (S), 2023/24:2802 av Karin Rågsjö m.fl. (V) och 2023/24:2807 av Ulrika Westerlund m.fl. (MP) yrkande 1.
Riksdag decision: The Riksdag has reviewed a communication from the government concerning the National Audit Office's report on the government's work on waiting times in healthcare. The National Audit Office has examined whether several of the policy instruments used by the government to reduce healthcare queues have been effective. The policy instruments are: The care guarantee, which aims to provide care within certain time limits. The queue billion 2009–2014, which meant that the state paid out one billion kronor annually between 2009–2014. The money was distributed to regions based on how well they met requirements linked to the care guarantee's time limits within specialist healthcare. Standardized care pathways in cancer treatment (SVF), which describes, among other things, what investigations and initial treatments should be performed for certain cancer diagnoses. The examination also concerns whether these policy instruments have affected the goal of equitable healthcare according to need. The government welcomes the examination and shares the National Audit Office's view that there is a need to review the effectiveness in order to strengthen the patient's position and the importance of the care guarantee as a state policy instrument. In the communication, the government reports measures taken and planned that are in line with the National Audit Office's findings and recommendations. The Riksdag filed the communication for the record—that is, concluded the matter. The Riksdag also rejected the motion proposals.
Counter-proposals
- The counter-proposal wants to shorten waiting times through primary care reform and by introducing binding targets for doctor-to-patient ratios. (S) — Reservation 1
Plan vs actual vote
Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.
The plan explicitly requires more resources for health and healthcare, investments in staff and points out that primary care is far too underdeveloped.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan explicitly requires more resources for health and healthcare, investments in staff and points out that primary care is far too underdeveloped. The counter-proposal's requirement for faster transition to care close to home, more resources, better working conditions and a binding benchmark for doctor density in primary care directly respond to these commitments. The plan also says that it is resources that are needed, not more monitoring models.
Original (Swedish)
Planen kräver uttryckligen mer resurser till hälso- och sjukvården, satsningar på personalen och pekar ut att primärvården är alldeles för dåligt utbyggd. Motförslagets krav på snabbare omställning till nära vård, mer resurser, bättre arbetsvillkor och ett bindande riktvärde för läkartäthet i primärvården svarar direkt mot dessa åtaganden. Planen säger också att det är resurser som behövs, inte fler uppföljningsmodeller.
- more resources and better staff conditionsdecisive»Därför vill Vänsterpartiet satsa mer resurser på hälso- och sjukvården och äldreomsorgen, samt satsa på personalen så att vi samtidigt får bort personalbristen och stärker personalens villkor och arbetsmiljö.« (2022 manifesto ↗)“Therefore the Left Party wants to invest more resources in health and healthcare and elderly care, and invest in staff so that at the same time we eliminate the staff shortage and strengthen staff working conditions and work environment.”
- expanded primary care»Men Sverige har idag minst antal vårdplatser i EU och en alldeles för dåligt utbyggd primärvård.« (2022 manifesto ↗)“But Sweden today has the fewest number of hospital beds in the EU and a far too underdeveloped primary care.”
- resources before administration»Det är resurser som främst behövs, inte formulär för kvalitetssäkring, nya bokningssystem för sjukhussängar eller ännu en managementkonsult som inte kan något om verksamheten.« (2022 manifesto ↗)“It is resources that are mainly needed, not forms for quality assurance, new booking systems for hospital beds or yet another management consultant who knows nothing about the operation.”
- quick access to care»Du ska ha rätt till hjälp snabbt oavsett om du har brutit benet eller blivit utbränd.« (2022 manifesto ↗)“You should have the right to help quickly regardless of whether you have broken your leg or become burnt out.”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
The election manifesto promises that no one shall need to worry about getting timely care, that resources to welfare shall continue to increase and that working conditions in care must improve - in substance the same requirements the counter-proposal raises.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto promises that no one shall need to worry about getting timely care, that resources to welfare shall continue to increase and that working conditions in care must improve - in substance the same requirements the counter-proposal raises. The party programme requires equivalent access to care throughout the country. The plan says nothing about a binding guideline per physician, so coverage is derived.
Original (Swedish)
Valmanifestet lovar att ingen ska behöva känna oro över att få vård i tid, att resurserna till välfärden ska fortsätta öka och att arbetsvillkoren i vården måste förbättras - i sak samma krav som motförslaget reser. Partiprogrammet kräver likvärdig tillgång till vård i hela landet. Planen säger inget om ett bindande riktvärde per läkare, varför täckningen är härledd.
- timely caredecisive»Ingen ska behöva känna oro över att få vård i tid.« (2022 manifesto ↗)“No one shall need to worry about getting timely care.”
- increased welfare resources»Öka resurserna till välfärden i hela landet. Vi vill fortsätta öka statens bidrag till kommuner och regioner.« (2022 manifesto ↗)“Increase resources to welfare throughout the country. We want to continue increasing the state's contributions to municipalities and regions.”
- better working conditions in care»Arbetsvillkoren i välfärden måste spegla hur centrala jobben är för att samhället ska fungera.« (2022 manifesto ↗)“Working conditions in welfare must reflect how central these jobs are for society to function.”
- equivalent care throughout the country»Alla invånare i hela landet ska ha likvärdig tillgång till skola, vård och omsorg.« (party programme ↗)“All residents throughout the country shall have equivalent access to school, care and welfare.”
The plan wants to invest in primary care, shorten queues across the country and raise salaries and ensure good working conditions in healthcare.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan wants to invest in primary care, shorten queues across the country and raise salaries and ensure good working conditions in healthcare. The counter-proposal's demands for faster transition to good and accessible care, more resources, better working conditions and a staffing benchmark for primary care are in line with this. The exact benchmark of 1,100 residents per doctor is missing from the plan, but the direction toward a strengthened primary care as the foundation is stated.
Original (Swedish)
Planen vill satsa på primärvården, korta köerna i hela landet och höja lönerna och säkra en god arbetsmiljö i vården. Motförslagets krav på en snabbare omställning till god och nära vård, mer resurser, bättre arbetsvillkor och ett bemanningsriktvärde i primärvården ligger i linje med detta. Det exakta riktvärdet 1 100 invånare per läkare saknas i planen, men riktningen mot en förstärkt primärvård som bas är uttalad.
- investment in primary caredecisive»satsa på primärvården och öka tillgången till vård för psykisk ohälsa.« (2022 manifesto ↗)“invest in primary care and increase access to care for mental illness.”
- shorter healthcare queues»korta köerna till behandling i hela landet.« (2022 manifesto ↗)“shorten queues for treatment across the country.”
- better conditions for healthcare staff»höja lönerna och säkra en god arbetsmiljö i vården.« (2022 manifesto ↗)“raise salaries and ensure good working conditions in healthcare.”
- primary care as the foundation»Primärvården ska utvecklas och är basen i vården.« (party programme ↗)“Primary care shall be developed and is the foundation of healthcare.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan's guiding healthcare commitment is that waiting times should be shortened and that healthcare should be provided closer to residents with better conditions for staff — precisely the transition to good and accessible healthcare that the counter-proposal demands.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan's guiding healthcare commitment is that waiting times should be shortened and that healthcare should be provided closer to residents with better conditions for staff — precisely the transition to good and accessible healthcare that the counter-proposal demands. The requirement for fixed doctor contact and reasonable list sizes also lies close to the plan's promise of the right to a fixed doctor contact. A dedicated office is, however, not something the plan seeks, and the plan does not want to move responsibility from the regions to the state.
Original (Swedish)
Planens bärande vårdåtagande är att köerna ska kortas och att vården ska bedrivas närmare invånarna med bättre villkor för medarbetarna — precis den omställning till god och nära vård som motförslaget kräver. Även kravet på fast läkarkontakt och rimliga listtal ligger nära planens löfte om rätt till en fast läkarkontakt. Ett särskilt kansli är däremot inte något planen efterfrågar, och planen vill inte flytta ansvaret från regionerna till staten.
- shorter waiting times and state supportdecisive»Vi vill korta köerna och skapa fler vårdplatser där det behövs genom satsningar på fler sjuksköterskor och bättre statligt stöd till regionerna som är anpassade efter deras förutsättningar och behov.« (2022 manifesto ↗)“We want to shorten waiting times and create more healthcare places where needed through investments in more nurses and better state support to the regions, tailored to their conditions and needs.”
- healthcare close to residents throughout the country»Vi är övertygade om att vägen till en bättre välfärd går genom att bedriva den närmare invånarna i hela landet« (2022 manifesto ↗)“We are convinced that the path to better welfare goes through providing it closer to residents throughout the country”
- right to fixed doctor contact»Vi vill ge alla rätt till en fast läkarkontakt.« (2022 manifesto ↗)“We want to give everyone the right to a fixed doctor contact.”
- regional responsibility»Ansvaret för vården ska inte flyttas från regionerna till staten.« (2022 manifesto ↗)“Responsibility for healthcare shall not be moved from the regions to the state.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The election manifesto promises a personal primary care physician and the party programme wants to strengthen the role of primary care through a primary care system, which is the core of the counter-proposal's demand for faster transition to good and accessible care with reasonable physician staffing.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto promises a personal primary care physician and the party programme wants to strengthen the role of primary care through a primary care system, which is the core of the counter-proposal's demand for faster transition to good and accessible care with reasonable physician staffing. The plan also requires better working conditions and more colleagues in healthcare, as well as a care guarantee that covers the entire care pathway. However, the binding target of 1,100 inhabitants per physician has no counterpart in the plan.
Original (Swedish)
Valmanifestet lovar en personlig husläkare och partiprogrammet vill stärka primärvårdens roll genom ett husläkarsystem, vilket är kärnan i motförslagets krav på en snabbare omställning till god och nära vård med rimlig läkarbemanning. Planen kräver också bättre arbetsvillkor och fler kollegor i vården samt en vårdgaranti som omfattar hela vårdkedjan. Det bindande riktvärdet om 1 100 invånare per läkare saknar dock motsvarighet i planen.
- fixed physician in primary caredecisive»Du ska ha rätt till en fast läkare på din vårdcentral som har tid för – och som lär känna – just dig.« (2022 manifesto ↗)“You shall have the right to a fixed physician at your health centre who has time for – and who gets to know – you.”
- strengthened primary care»Primärvårdens roll i sjukvårdssystemet ska stärkas. Ett husläkarsystem där patientansvaret ligger i primärvården gynnar särskilt multisjuka och äldre medborgare.« (party programme ↗)“The role of primary care in the healthcare system shall be strengthened. A primary care system where patient responsibility lies in primary care especially benefits multi-morbid and elderly citizens.”
- better working conditions in healthcare»Anställda i svensk hälso- och sjukvård måste få bättre arbetsvillkor och fler kollegor.« (party programme ↗)“Employees in Swedish healthcare must receive better working conditions and more colleagues.”
- care guarantee entire care pathway»Vårdgarantin ska omfatta hela vårdkedjan, från diagnostik och undersökningar till återbesök och rehabilitering.« (party programme ↗)“The care guarantee shall cover the entire care pathway, from diagnosis and examinations to follow-up visits and rehabilitation.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The election manifesto explicitly promises a cap on number of patients per doctor through fixed doctor contact, which is the same thing in substance as the counter-proposal's binding target for primary care.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto explicitly promises a cap on number of patients per doctor through fixed doctor contact, which is the same thing in substance as the counter-proposal's binding target for primary care. The manifesto also promises more health centres near people, more care at home and improved conditions in care's shortage professions. The plan thus sees queues as a result of insufficient nearby care and staffing, not as something solved by continued monitoring.
Original (Swedish)
Valmanifestet lovar uttryckligen tak för antal patienter per läkare genom fast läkarkontakt, vilket är samma sak i sak som motförslagets bindande riktvärde för primärvården. Manifestet lovar också fler vårdcentraler nära människor, mer vård i hemmet och förbättrade villkor i vårdens bristyrken. Planen ser alltså köerna som ett resultat av otillräcklig nära vård och personalförsörjning, inte som något som löses med fortsatt uppföljning.
- cap on number of patients per doctordecisive»Inför fast läkarkontakt med en namngiven läkare och tak för antal patienter för att möjliggöra relationsbyggande mellan patient och läkare.« (2022 manifesto ↗)“Introduce fixed doctor contact with a named doctor and a cap on the number of patients to enable relationship-building between patient and doctor.”
- better conditions in shortage professions»Utbilda mer personal för sjukvården. Förbättrade villkor i vårdens bristyrken och minska behovet av dyr inhyrd personal.« (2022 manifesto ↗)“Educate more personnel for healthcare. Improved conditions in care's shortage professions and reduce the need for expensive hired personnel.”
- care close to home and in the home»Ökad möjlighet att vårdas i egna hemmet, särskilt för multisjuka, genom mobila sjukvårdsenheter som kan ge vård i hemmet.« (2022 manifesto ↗)“Increased opportunity to receive care in one's own home, particularly for multimorbid, through mobile healthcare units that can provide care at home.”
- expanded nearby primary care»Fler vårdcentraler på landsbygden och enklare för enskilda läkare att starta egen verksamhet - så att vården finns nära till hands.« (2022 manifesto ↗)“More health centres in rural areas and easier for individual doctors to start their own operations - so that care is close at hand.”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
The plan shares the problem image – queues are a failure – but assigns other means: an extended performance-based queue fund and a national care mediator that moves patients to free capacity.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan shares the problem image – queues are a failure – but assigns other means: an extended performance-based queue fund and a national care mediator that moves patients to free capacity. A binding guideline on number of inhabitants per doctor and a new office for the transition represent centralization that the plan does not lend support to. The demand is therefore rejected in substance.
Original (Swedish)
Planen delar problembilden – köer är ett misslyckande – men anvisar andra medel: en utökad prestationsbaserad kömiljard och en nationell vårdförmedling som flyttar patienter till ledig kapacitet. Ett bindande riktvärde om antal invånare per läkare och ett nytt kansli för omställningen är en centralstyrning som planen inte ger stöd för. Kravet avvisas därför i sak.
- performance-based queue funddecisive»Utöka kömiljarden genom att rikta särskilda prestationsbaserade resurser till köerna inom cancervården respektive barn- och ungdomspsykiatrin (BUP)« (2022 manifesto ↗)“Expand the queue fund by directing special performance-based resources to queues within cancer care and child and youth psychiatry (BUP)”
- national care mediator»Inrätta en nationell vårdförmedling som ska hjälpa patienter med lång väntetid att få vård i en annan del av landet där det finns ledig kapacitet« (2022 manifesto ↗)“Establish a national care mediator that shall help patients with long waiting times to get care in another part of the country where there is free capacity”
- queues are a failure»Köer till välfärdstjänster är ett misslyckande« (party programme ↗)“Queues for welfare services are a failure”
- better work environment in healthcare»Stärka vårdens medarbetare, bland annat genom att förbättra arbetsmiljön och möjligheterna till vidareutbildning« (2022 manifesto ↗)“Strengthen healthcare's employees, among other things by improving the work environment and possibilities for further education”
The plan requires that waiting times for care are abolished and that a genuine care guarantee is introduced as rights legislation, with a special care guarantee office for waiting times.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan requires that waiting times for care are abolished and that a genuine care guarantee is introduced as rights legislation, with a special care guarantee office for waiting times. That corresponds to the counter-proposal's demand for more forceful measures and a separate office for the transition work. The plan furthermore wants to invest in primary care with patient-responsible physician, which is the same direction as the demand for close care and better doctor density.
Original (Swedish)
Planen kräver att vårdköerna avskaffas och att en riktig vårdgaranti införs som rättighetslagstiftning, med ett särskilt vårdgarantikansli för vårdköer. Det motsvarar motförslagets krav på mer kraftfulla åtgärder och ett eget kansli för omställningsarbetet. Planen vill dessutom satsa på primärvården med patientansvarig läkare, vilket är samma riktning som kravet på nära vård och bättre läkartäthet.
- genuine care guarantee and care guarantee officedecisive»En riktig vårdgaranti bör införas som en rättighetslagstiftning för medborgarna. Det ska inrättas ett vårdgarantikansli för vårdköer under Socialstyrelsens regi.« (2022 manifesto ↗)“A genuine care guarantee should be introduced as rights legislation for citizens. A care guarantee office for waiting times should be established under the Social Board's governance.”
- abolished waiting times»Avskaffa vårdköerna och införa en riktig vårdgaranti« (2022 manifesto ↗)“Abolish waiting times for care and introduce a genuine care guarantee”
- strengthened primary care»Satsningar på primärvården med större patientkontakt och samordning av en patientansvarig läkare kan avlasta akut- och specialistvården genom snabbare vård.« (2022 manifesto ↗)“Investments in primary care with greater patient contact and coordination by a patient-responsible physician can relieve acute and specialist care through faster care.”
- prioritized primary care»Satsa på primärvården« (2022 manifesto ↗)“Invest in primary care”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
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Sources and documents
- The committee report on riksdagen.se (2023/24:SoU8)
- Committee report full text (HB01SoU8)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2023/24:2797 — med anledning av skr. 2023/24:48 Riksrevisionens rapport om statens arbete med väntetider i vården av Fredrik Lundh Sammeli m.fl. (S)
- Motion 2023/24:2802 — med anledning av skr. 2023/24:48 Riksrevisionens rapport om statens arbete med väntetider i vården av Karin Rågsjö m.fl. (V)
- Motion 2023/24:2807 — med anledning av skr. 2023/24:48 Riksrevisionens rapport om statens arbete med väntetider i vården av Ulrika Westerlund m.fl. (MP)
- Motion 2023/24:2814 — med anledning av skr. 2023/24:48 Riksrevisionens rapport om statens arbete med väntetider i vården av Anders W Jonsson m.fl. (C)
- Regeringens skrivelse 2023/24:48 — Riksrevisionens rapport om statens arbete med väntetider i vården
Source: The Swedish Parliament