2024-04-172023/24:SoU20 · p.1SoUHealth & social services
Elderly care law and strengthened medical expertise in municipalities
A separate Elderly Care Act
What's at stake: The decision affects how the quality, rights and medical competence within elder care are regulated in law, which matters to older people dependent on municipal care, and to how a holistic view of the individual's needs is maintained.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The question is whether elder care should be regulated through a separate Elderly Care Act, as proposed by a government inquiry, or whether it should continue to be governed under the existing Social Services Act.
Yes Yes — the committee proposal
The committee rejects the motions calling for a separate Elderly Care Act. The reason given is that, after reviewing consultation responses, the government has chosen not to proceed with the proposed separate act, since a law that separates elder care from the rest of social services risks undermining a holistic view of the individual's needs. Elder care will therefore continue to be regulated under the Social Services Act, and the government intends to present a proposal for a new Social Services Act; other proposals to strengthen municipal healthcare are being processed further within the Government Offices.
No No — the reservations
Reservation 1 (S, C, MP)
The reservation (S, C, MP) calls for a new Elderly Care Act to be introduced, in line with a government inquiry's proposal, to support elder care of equally high quality based on the individual's circumstances, needs and participation. The inquiry also proposes legislation to strengthen healthcare for people in elder care.
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, C, MP.
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: SDSverigedemokraterna
Ja 176–131Nej 112–195
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 | Yes 20/1/0/3 | differs | confidence: medium | derived |
| S | No | No 0/92/0/14 | match | confidence: high | explicit |
| MP | No | No 0/16/0/2 | match | confidence: medium | derived |
| C | No | No 0/21/0/3 | match | confidence: low | derived |
| L | No | Yes 15/0/0/1 | differs | confidence: medium | not addressed |
| KD | No | Yes 17/0/0/2 | differs | confidence: medium | derived |
| M | No | Yes 59/0/0/9 | differs | confidence: medium | not addressed |
| SD | No | Yes 64/0/0/8 | differsagainst own programme | confidence: high | explicit |
Broke with the party line
| VHåkan Svenneling (V, Värmlands län) | No — party line: Yes |
MPs whose vote differs from their party's majority position in this division. Marked with a dark ring in the chamber view.
Committee proposal
The Riksdag rejects the motions 2023/24:2617 by Fredrik Lundh Sammeli et al. (S) proposal 64 and 2023/24:2705 by Ulrika Westerlund et al. (MP) proposal 18.
Original (Swedish)
Riksdagen avslår motionerna 2023/24:2617 av Fredrik Lundh Sammeli m.fl. (S) yrkande 64 och 2023/24:2705 av Ulrika Westerlund m.fl. (MP) yrkande 18.
Riksdag decision: The Riksdag said no to approximately 70 proposals in motions on elderly care from the general motion period of 2023. The motions deal with, among other things, an elderly care law, strengthened medical expertise in municipalities, staffing and conditions in elderly care. The Riksdag refers, among other things, to ongoing work.
Counter-proposals
- The counter-proposal wants the government to propose new elderly care legislation during the mandate period. (S, C, MP) — 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 election manifesto requires that care and support be provided according to need regardless of housing situation and that dependence on care shall not limit the ability to control one's life, and more resources for elderly care and its staff.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto requires that care and support be provided according to need regardless of housing situation and that dependence on care shall not limit the ability to control one's life, and more resources for elderly care and its staff. A law that shall guarantee equal good quality based on individual need and participation, and strengthened health and medical care for the elderly, is an application of these commitments. The plan does not, however, take a position on legislative placement.
Original (Swedish)
Valplattformen kräver att vård och omsorg ges efter behov oavsett boendeform och att beroendet av omsorg inte får begränsa möjligheten att styra sitt liv, samt mer resurser till äldreomsorgen och dess personal. En lag som ska garantera likvärdigt god kvalitet utifrån den enskildes behov och delaktighet, och stärkt hälso- och sjukvård för äldre, är en tillämpning av dessa åtaganden. Planen tar dock inte ställning till lagteknisk placering.
- care according to needdecisive»Vård och omsorg måste ges efter behov oavsett om du bor på ett särskilt boende eller har insatser av hemtjänsten.« (2022 manifesto ↗)“Care and support must be provided according to need whether you live in a special housing facility or receive home help services.”
- participation and self-determination»Att du är beroende av omsorg ska inte, som idag, begränsa dina möjligheter att styra över ditt liv.« (2022 manifesto ↗)“That you are dependent on care shall not, as today, limit your ability to control your own life.”
- more resources for elderly care»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 medical care and elderly care, and invest in staff so that we simultaneously eliminate staff shortages and strengthen staff conditions and work environment.”
- comprehensive approach instead of fragmentation»Vården och omsorgen har styckats upp, mellan nivåer och aktörer, människor bollas runt i en stor administrativ apparat« (2022 manifesto ↗)“Care and support have been fragmented, between levels and actors, people are passed around in a large administrative apparatus”
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 contains an explicit commitment to a new elderly care act that ensures everyone receives equally good care throughout the country and access to nurses around the clock.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto contains an explicit commitment to a new elderly care act that ensures everyone receives equally good care throughout the country and access to nurses around the clock. This is exactly what the counter-proposal demands, together with strengthened healthcare within elderly care. The party programme also requires equal access to healthcare and care for all residents throughout the country. The plan therefore supports the demand.
Original (Swedish)
Valmanifestet innehåller ett uttryckligt åtagande om en ny äldreomsorgslag som säkerställer att alla får en lika bra omsorg i hela landet och tillgång till sjuksköterskor dygnet runt. Det är precis vad motförslaget kräver, tillsammans med stärkt hälso- och sjukvård inom äldreomsorgen. Partiprogrammet kräver dessutom likvärdig tillgång till vård och omsorg för alla invånare i hela landet. Planen stöder därför kravet.
- new elderly care actdecisive»Vi vill ha en ny äldreomsorgslag som säkerställer att alla får en lika bra omsorg i hela landet och tillgång till sjuksköterskor dygnet runt.« (2022 manifesto ↗)“We want a new elderly care act that ensures everyone receives equally good care throughout the country and access to nurses around the clock.”
- equal healthcare and care»Alla invånare i hela landet ska ha likvärdig tillgång till skola, vård och omsorg.« (party programme ↗)“All residents throughout the country shall have equal access to education, healthcare and care.”
- more and better educated in care»Fler ska utbildas och anställas inom äldreomsorgen och tillsynen av personalens arbetsmiljö ska förbättras.« (2022 manifesto ↗)“More shall be educated and employed in elderly care and supervision of staff working conditions shall be improved.”
- security and fixed care contact»Det ska vara tryggt att åldras i Sverige. Vi vill att alla med hemtjänst ska ha en fast omsorgskontakt för ökad trygghet.« (2022 manifesto ↗)“It shall be safe to age in Sweden. We want everyone with home care to have a fixed care contact for increased security.”
The party programme demands secure and good elderly care that is based on the elderly's individual needs and that everyone should be able to trust the quality regardless of provider; the election manifesto promises better care and services for the elderly and strengthened home healthcare.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme demands secure and good elderly care that is based on the elderly's individual needs and that everyone should be able to trust the quality regardless of provider; the election manifesto promises better care and services for the elderly and strengthened home healthcare. Elderly care legislation that should provide equivalent quality and strengthened health and medical care is a means for that. The plan's requirement for a holistic view of the patient, however, suggests that the elderly's needs should not be fragmented.
Original (Swedish)
Partiprogrammet kräver en trygg och god äldreomsorg som utgår från de äldres individuella behov och att alla ska kunna lita på kvaliteten oavsett utförare; valmanifestet lovar bättre vård och omsorg för äldre och stärkt hemsjukvård. En äldreomsorgslag som ska ge likvärdig kvalitet och stärkt hälso- och sjukvård är ett medel för det. Planens krav på helhetssyn på patienten talar dock för att äldres behov inte får styckas upp.
- elderly care according to individual needsdecisive»Därför är det viktigt med en trygg och god äldreomsorg som utgår från de äldres individuella behov.« (party programme ↗)“Therefore it is important to have secure and good elderly care based on the elderly's individual needs.”
- strengthened elderly care»förbättra vård och omsorg för äldre och stärka resurserna till hemsjukvården.« (2022 manifesto ↗)“improve care and services for the elderly and strengthen resources for home healthcare.”
- equivalent quality in care»Alla ska kunna lita på kvaliteten och tryggheten i omsorgen, oavsett vem som utför den.« (party programme ↗)“Everyone should be able to trust the quality and security of care, regardless of who provides it.”
- holistic view of the individual»Vi vill att vården ska ha en helhetssyn på patienten« (party programme ↗)“We want healthcare to have a holistic view of the patient”
The plan wants to improve the quality of elderly care and strengthen municipal healthcare through increased cooperation between municipal and regional care, with the individual's perspective as the starting point.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan wants to improve the quality of elderly care and strengthen municipal healthcare through increased cooperation between municipal and regional care, with the individual's perspective as the starting point. Legislation that strengthens healthcare for people in elderly care is therefore in line with the plan. However, the plan does not take a position on separate elderly care legislation and simultaneously values that responsibility is not moved upwards, so the conclusion is uncertain.
Original (Swedish)
Planen vill lyfta kvaliteten i äldreomsorgen och stärka den kommunala hälso- och sjukvården genom ökat samarbete mellan kommunal och regional vård, med individens perspektiv som utgångspunkt. Lagstiftning som stärker hälso- och sjukvården för personer i äldreomsorgen ligger därför i linje med planen. Planen tar dock inte ställning till en separat äldreomsorgslag och värnar samtidigt att ansvaret inte flyttas uppåt, varför slutsatsen är osäker.
- strengthened municipal healthcaredecisive»Genom en platsmiljard och ökat samarbete mellan kommunal och regional hälso- och sjukvård ökar vi möjligheterna att nå målet om en beläggningsgrad på 90% på våra sjukhus.« (2022 manifesto ↗)“Through a 'place billion' and increased cooperation between municipal and regional healthcare, we increase the opportunities to achieve the goal of 90% occupancy rate at our hospitals.”
- improved quality in elderly care»Kvaliteten i sjukvården och äldreomsorgen ska lyftas.« (2022 manifesto ↗)“Quality in healthcare and elderly care must be improved.”
- the individual's needs in focus»Samhällets aktörer ska inta individens perspektiv.« (party programme ↗)“Society's actors should adopt the individual's perspective.”
- care close by and with choice»Vi vill försvara valfriheten inom vård och omsorg och bedriva verksamheten nära vårdtagarna. Ansvaret för vården ska inte flyttas från regionerna till staten.« (2022 manifesto ↗)“We want to defend freedom of choice in healthcare and care and conduct operations close to care recipients. Responsibility for healthcare should not be moved from regions to the state.”
The election manifesto explicitly requires that the prohibition against municipalities employing doctors in elderly care be removed, which is the counter-proposal's requirement for strengthened medical expertise in municipalities.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto explicitly requires that the prohibition against municipalities employing doctors in elderly care be removed, which is the counter-proposal's requirement for strengthened medical expertise in municipalities. The plan also establishes that quality differences between municipalities are far too large and that good elderly care is a right regardless of economics, which speaks for clearer regulation of equal quality. The right to equivalent care regardless of place of residence bears the same conclusion.
Original (Swedish)
Valmanifestet kräver uttryckligen att förbudet för kommuner att anställa läkare i äldreomsorgen tas bort, vilket är motförslagets krav på stärkt medicinsk kompetens i kommunerna. Planen slår också fast att kvalitetsskillnaderna mellan kommunerna är alltför stora och att en god äldreomsorg är en rättighet oavsett ekonomi, vilket talar för en tydligare reglering av likvärdig kvalitet. Rätten till likvärdig omsorg oavsett bostadsort bär samma slutsats.
- doctors in municipal elderly caredecisive»För att öka tryggheten vill vi ta bort förbudet för kommuner att anställa läkare i äldreomsorgen.« (2022 manifesto ↗)“To increase security we want to remove the prohibition against municipalities employing doctors in elderly care.”
- equivalent elderly care»Skillnaderna i äldreomsorgens kvalitet är alltför stora mellan kommunerna.« (party programme ↗)“Differences in elderly care quality are far too large between municipalities.”
- elderly care as right»En god äldreomsorg är en rättighet för alla som behöver den, oavsett ekonomi.« (party programme ↗)“Good elderly care is a right for all who need it, regardless of economics.”
- equivalent quality regardless of location»Oavsett bostadsort har individer rätt att få likvärdig kvalitet på vården, omsorgen, socialtjänsten« (party programme ↗)“Regardless of place of residence, individuals have the right to receive equivalent quality in healthcare, care, social services”
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 increased medical competence in elderly care, which is the counter-proposal's second part.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto explicitly promises increased medical competence in elderly care, which is the counter-proposal's second part. The party programme requires dignity guarantees within care and elderly care and that individual needs, integrity and self-determination are the starting point, which is exactly what an elderly care act for equivalent good quality should secure. The plan therefore speaks in favour of the counter-proposal's demands.
Original (Swedish)
Valmanifestet lovar uttryckligen ökad medicinsk kompetens inom äldreomsorgen, vilket är motförslagets andra led. Principprogrammet kräver värdighetsgarantier inom vård och omsorg och att individuella behov, integritet och självbestämmande är utgångspunkten, vilket är just det en äldreomsorgslag för likvärdigt god kvalitet ska säkra. Planen talar därför för motförslagets krav.
- strengthened medical competencedecisive»Ökad medicinsk kompetens inom äldreomsorgen.« (2022 manifesto ↗)“Increased medical competence in elderly care.”
- dignity guarantees in care»Därför ska det finnas värdighetsgarantier inom vård och omsorg som konkret anknyter till de villkor under vilken verksamhet bedrivs.« (party programme ↗)“Therefore, there shall be dignity guarantees within care and elderly care that concretely relate to the conditions under which the activity is conducted.”
- individual needs and participation»Individuella behov ska vara utgångspunkten för service, vård och omsorg och förhållningssättet ska genomsyras av respekt för den enskildes integritet och rätt till självbestämmande.« (party programme ↗)“Individual needs shall be the starting point for service, care and elderly care and the approach shall be permeated by respect for the individual's integrity and right to self-determination.”
- world-class elderly care»Sverige ska ha en äldreomsorg i världsklass.« (2022 manifesto ↗)“Sweden shall have world-class elderly care.”
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 requires that medical expertise and continuity are strengthened in elderly care and that the patient-responsible physician contact becomes the hub in elderly care.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan requires that medical expertise and continuity are strengthened in elderly care and that the patient-responsible physician contact becomes the hub in elderly care. The program furthermore establishes that elderly have the right to a secure and dignified old age that is based on the individual's own circumstances, which is the same thing the counter-proposal wants to enshrine. The demand for legislation that strengthens health care within elderly care therefore goes in the direction of the plan.
Original (Swedish)
Planen kräver att den medicinska kompetensen och kontinuiteten stärks inom äldreomsorgen och att den patientansvariga läkarkontakten blir navet i äldres sjukvård. Programmet slår dessutom fast att äldre har rätt till en trygg och värdig ålderdom som utgår från den enskildes egna förutsättningar, vilket är samma sak som motförslaget vill lagfästa. Kravet på lagstiftning som stärker hälso- och sjukvården inom äldreomsorgen ligger därför i planens riktning.
- strengthened medical expertisedecisive»Den medicinska kompetensen och kontinuiteten måste stärkas inom äldreomsorgen.« (2022 manifesto ↗)“Medical expertise and continuity must be strengthened in elderly care.”
- physician contact as hub»Se till att den patientansvariga läkarkontakten ska utgöra navet i äldres sjukvård« (2022 manifesto ↗)“Ensure that the patient-responsible physician contact becomes the hub in elderly care”
- dignified old age according to own needs»Äldre har en självklar rätt till en trygg och värdig ålderdom som utgår från den enskildes egna förutsättningar och önskemål.« (party programme ↗)“Elderly have a self-evident right to a secure and dignified old age that is based on the individual's own circumstances and wishes.”
- same quality requirements for elderly care»Samma krav ska naturligtvis kunna ställas på äldreomsorgen, när den behövs på ålderns höst. Det är en anständighetsfråga.« (2022 manifesto ↗)“The same requirements should of course apply to elderly care, when needed in old age. It is a matter of decency.”
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 explicitly requires a new care for the elderly act that strengthens legal support for good living conditions, because reasonable living conditions do not suffice.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan explicitly requires a new care for the elderly act that strengthens legal support for good living conditions, because reasonable living conditions do not suffice. The counter-proposal's requirement to introduce a new care for the elderly act and legislation that strengthens health and care within care for the elderly is precisely this. The plan therefore supports the requirement, in line with the requirement for national quality standards that must not be undercut.
Original (Swedish)
Planen kräver uttryckligen en ny äldreomsorgslag som stärker lagstödet för goda levnadsvillkor, eftersom skäliga levnadsvillkor inte duger. Motförslagets krav på att införa en ny äldreomsorgslag och lagstiftning som stärker hälso- och sjukvården inom äldreomsorgen är precis detta. Planen stöder därför kravet, i linje med kravet på nationella kvalitetskrav som inte får underskridas.
- new care for the elderly actdecisive»En ny äldreomsorgslag måste stärka lagstödet för goda levnadsvillkor då den nuvarande benämningen med skäliga levnadsvillkor inte duger.« (2022 manifesto ↗)“A new care for the elderly act must strengthen legal support for good living conditions as the current term of reasonable living conditions does not suffice.”
- world's best care for the elderly»De äldre i Sverige förtjänar att få tillgång till världens bästa äldreomsorg.« (party programme ↗)“The elderly in Sweden deserve access to the world's best care for the elderly.”
- national quality requirements»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality requirements in care and welfare must exist and must not be undercut.”
- age with dignity»Alla människor skall kunna åldras med värdighet.« (party programme ↗)“All people shall be able to age with dignity.”
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:SoU20)
- Committee report full text (HB01SoU20)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2023/24:1190 — Värdighet för äldre och professionalisering av äldreomsorgen av Markus Wiechel (SD)
- Motion 2023/24:1204 — Stärkt äldreomsorg av Johanna Haraldsson m.fl. (S)
- Motion 2023/24:1274 — Att bryta ofrivillig ensamhet och isolering av Marie-Louise Hänel Sandström (M)
- Motion 2023/24:1300 — Ny lagstiftning för att värna säkerhet och trygghet för personer med demenssjukdom av Hanna Westerén (S)
- Motion 2023/24:1427 — Pilotprojekt - seniorhälsa av Ann-Sofie Lifvenhage (M)
- Motion 2023/24:1858 — Lagen om valfrihetssystem av Markus Kallifatides m.fl. (S)
- Motion 2023/24:1974 — Fallolyckor hos äldre av Linus Sköld m.fl. (S)
- Motion 2023/24:1976 — Stärka undersköterskornas yrkesroll av Zara Leghissa m.fl. (S)
- Motion 2023/24:2033 — Förbehållsbelopp för utsatta äldre av Jim Svensk Larm m.fl. (S)
- Motion 2023/24:2072 — Folkhälsan i fokus av Carina Ståhl Herrstedt m.fl. (SD)
- Motion 2023/24:2154 — Språkkrav inom vård och äldreomsorg av Johanna Rantsi (M)
- Motion 2023/24:2210 — Språktest för arbete i omsorg/äldreomsorg av Ann-Sofie Lifvenhage (M)
- Motion 2023/24:227 — En trygg äldreomsorg för jämlikhet av Karin Rågsjö m.fl. (V)
- Motion 2023/24:2308 — Kommunala läkare av Ann-Sofie Lifvenhage (M)
- Motion 2023/24:2309 — Krav på registerutdrag för arbete i hemtjänst och äldreomsorg av Ann-Sofie Lifvenhage (M)
- Motion 2023/24:2310 — Rimliga avgifter inom äldreomsorgen av Sten Bergheden (M)
- Motion 2023/24:2313 — Språkkrav för vissa jobb inom omsorgen av Sten Bergheden (M)
- Motion 2023/24:2314 — Äldres rätt att välja sin mat av Sten Bergheden (M)
- Motion 2023/24:2366 — Bemanning i verksamheter nära medborgarna av Gunilla Svantorp m.fl. (S)
- Motion 2023/24:2461 — Förbättrade måltider för äldre i det offentliga av Catarina Deremar (C)
Source: The Swedish Parliament