2024-02-282023/24:FiU26 · p.3FiUEconomy & finance

Profits in welfare services

What's at stake: How profit-taking in healthcare, education and social care is handled affects both private providers and their owners, as well as citizens' trust in and access to welfare services of consistent quality across the country.

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 the possibility of extracting profit from welfare services should be abolished and replaced with other operating and choice models, or whether the matter should wait for ongoing inquiries into ownership review and profit restrictions.

Yes Yes — the committee proposal

The committee wants to await the results of ongoing inquiries into extended ownership and management review, restrictions on profit distribution, and possible state responsibility for healthcare before further measures are taken, and therefore rejects the motions on profits in welfare services.

No No — the reservations

Reservation 4 (S, V, MP)

The reservers want to abolish the possibility of extracting profit from welfare services and develop alternatives to the market and choice models introduced in the public sector, as well as strengthen oversight and take national measures for greater equality and staffing, arguing that society is losing democratic control over welfare and that trust in welfare is threatened by shortcomings in capacity and availability and by uncontrolled privatisation.

Summarised from the committee report. Party labels in the summary come from the report, not from the vote.

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

Yes The committee proposal: rejecting the motions (keeping things as they are).

No Backing the counter-proposal: reservation 4 by S, V, MP.

Abstain The party marks a position of its own that is not one of the two final alternatives.

What each plan points to — and how the party voted

For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.

PlanVoteConfidenceEvidence
Vown reservationNoNo 0/19/0/5follows the planconfidence: highexplicit
Sown reservationNoNo 0/92/0/14follows the planconfidence: highexplicit
MPown reservationNoNo 0/15/0/3follows the planconfidence: highexplicit
CYesYes 19/0/0/5follows the planconfidence: highexplicit
LYesYes 12/0/0/4follows the planconfidence: highexplicit
KDYesYes 16/0/0/3follows the planconfidence: highexplicit
MYesYes 59/0/0/9follows the planconfidence: highexplicit
SDYesYes 61/0/0/11follows the planconfidence: highexplicit

Committee proposal

Parliament rejects the motions 2023/24:1043 by Niklas Sigvardsson et al. (S) items 1 and 2, 2023/24:2022 by Niklas Karlsson et al. (S) items 1 and 2, 2023/24:2617 by Fredrik Lundh Sammeli et al. (S) item 2, 2023/24:2646 by Mikael Damberg et al. (S) item 3 and 2023/24:2661 by Mattias Vepsä et al. (S) item 3.

Original (Swedish)

Riksdagen avslår motionerna 2023/24:1043 av Niklas Sigvardsson m.fl. (S) yrkandena 1 och 2, 2023/24:2022 av Niklas Karlsson m.fl. (S) yrkandena 1 och 2, 2023/24:2617 av Fredrik Lundh Sammeli m.fl. (S) yrkande 2, 2023/24:2646 av Mikael Damberg m.fl. (S) yrkande 3 och 2023/24:2661 av Mattias Vepsä m.fl. (S) yrkande 3.

Riksdag decision: Parliament said no to approximately 40 proposals on municipal issues. The motions concern, among other things, the financial equalization system, long-term financing of welfare services, profits in welfare services, targeted government grants, municipal supervision fees, the law on freedom of choice, conditions for welfare service providers, reporting of how tax funds are used, idea-driven actors and knowledge dissemination within the municipal sector. The proposals were submitted during the general motion period 2023. Parliament refers, among other things, to ongoing investigation work.

Counter-proposals

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.

VVänsterpartietNoNofollows the planexplicit

The election manifesto demands a total ban on all profit-driven activities within welfare and that crimes against welfare are combated by ensuring profits cannot be extracted from children, sick people and the elderly.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The election manifesto demands a total ban on all profit-driven activities within welfare and that crimes against welfare are combated by ensuring profits cannot be extracted from children, sick people and the elderly. The party programme wants welfare to be de-commercialized and governed democratically. The counter-proposal's demand for dismantled profit opportunities and alternatives to market and choice models is precisely this.

Original (Swedish)

Valplattformen kräver ett totalförbud mot alla vinstdrivande verksamhetsformer inom välfärden och att brotten mot välfärden bekämpas genom att vinster inte kan tas ut på barn, sjuka och gamla. Partiprogrammet vill att välfärden avkommersialiseras och styrs demokratiskt. Motförslagets krav på avvecklad vinstmöjlighet och alternativ till marknads- och valmodeller är precis detta.

  • total ban on profits in welfaredecisive»Vänsterpartiet vill införa ett totalförbud mot alla vinstdrivande verksamhetsformer inom välfärden.« (2022 manifesto ↗)“The Left Party wants to introduce a total ban on all profit-driven activities within welfare.”
  • profit ban before control»Brotten mot välfärden bekämpas bäst genom att det inte går att göra vinster vare sig på barn eller på sjuka och gamla människor.« (2022 manifesto ↗)“Crimes against welfare are best combated by ensuring it is not possible to make profits either from children or from sick and elderly people.”
  • de-commercialized welfare»Vi vill att välfärden avkommersialiseras« (party programme ↗)“We want welfare to be de-commercialized”
  • democratic governance of welfare»Välfärden är samhällets ansvar och borde styras demokratiskt.« (2022 manifesto ↗)“Welfare is society's responsibility and should be governed democratically.”
SSocialdemokraternaNoNofollows the planexplicit

The election manifesto's key welfare promise is to prohibit profit extraction in schools and to take back democratic control over welfare by stopping the dismantling through privatization.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The election manifesto's key welfare promise is to prohibit profit extraction in schools and to take back democratic control over welfare by stopping the dismantling through privatization. The counter-proposal requires precisely that the possibility of extracting profit is phased out and that oversight and equality are strengthened instead of market and choice models. The party programme additionally establishes that the supply of welfare shall never be determined by producers' profit interests.

Original (Swedish)

Valmanifestets bärande välfärdslöfte är att förbjuda vinstuttagen i skolan och att ta tillbaka den demokratiska kontrollen över välfärden genom att stoppa sönderprivatiseringen. Motförslaget kräver just att möjligheten att ta ut vinst avvecklas och att tillsyn och likvärdighet stärks i stället för marknads- och valmodeller. Partiprogrammet slår dessutom fast att välfärdens utbud aldrig får bestämmas av producenters vinstintresse.

  • prohibit profit extractiondecisive»Vi vill förbjuda vinstuttagen i skolan och ta tillbaka kontrollen över var och när fristående skolor etablerar sig.« (2022 manifesto ↗)“We want to prohibit profit extraction in schools and take back control over where and when independent schools establish themselves.”
  • democratic control over welfare»Det är dags att ta tillbaka den demokratiska kontrollen över välfärden och att stoppa sönderprivatiseringen.« (2022 manifesto ↗)“It is time to take back democratic control over welfare and to stop the dismantling through privatization.”
  • welfare outside market logic»Tillgången till skola, vård och omsorg får aldrig« (party programme ↗)“Access to school, healthcare and care shall never”
  • increased oversight»Tillsynen av sjukvården ska växlas upp för att garantera kvaliteten.« (2022 manifesto ↗)“Oversight of healthcare shall be increased to guarantee quality.”
MPMiljöpartietNoNofollows the planexplicit

The plan establishes that commercially oriented actors shall be removed from welfare, that the purpose shall not be to distribute profit and that any profit shall be reinvested.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan establishes that commercially oriented actors shall be removed from welfare, that the purpose shall not be to distribute profit and that any profit shall be reinvested. The election manifesto also requires stopping profit-seeking in schools. This is essentially the same demand as the counter-proposal places on phasing out the possibility of taking out profit.

Original (Swedish)

Planen slår fast att de kommersiellt inriktade aktörerna ska bort ur välfärden, att syftet inte får vara att dela ut vinst och att eventuell vinst ska återinvesteras. Valmanifestet kräver dessutom stopp för vinstjakten i skolan. Det är i sak samma krav som motförslaget ställer om att avveckla möjligheten att ta ut vinst.

  • away with profit-driven welfaredecisive»Vi vill därför få bort de kommersiellt inriktade aktörerna och i stället främja idéburna verksamheter inom välfärdssektorn.« (party programme ↗)“We therefore want to remove commercially oriented actors and instead promote non-profit activities within the welfare sector.”
  • profit distribution not the purpose»Syftet med verksamheten ska inte vara att dela ut vinst, vilket också ska framgå av stadgar eller bolagsordning.« (party programme ↗)“The purpose of the activity shall not be to distribute profit, which shall also be evident from articles of association or bylaws.”
  • stop profit-seeking»sätta stopp för vinstjakten i skolan.« (2022 manifesto ↗)“put a stop to profit-seeking in schools.”
  • welfare is not a market»Välfärdens verksamheter får inte hanteras som vilken marknad som helst.« (party programme ↗)“Welfare activities shall not be treated as any ordinary market.”
CCenterpartietYesYesfollows the planexplicit

The plan explicitly defends choice in healthcare and care and wants to open up for more care providers, and the party programme wants to see jointly financed welfare where more actors contribute to innovation, efficiency and quality.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan explicitly defends choice in healthcare and care and wants to open up for more care providers, and the party programme wants to see jointly financed welfare where more actors contribute to innovation, efficiency and quality. Where the plan sees problems, the answer is quality requirements for profit distribution and stricter supervision, not abolished profit possibility. The counter-proposal's demands to abolish profits and replace choice models are therefore rejected.

Original (Swedish)

Planen försvarar uttryckligen valfriheten inom vård och omsorg och vill öppna upp för fler vårdgivare, och idéprogrammet vill se en gemensamt finansierad välfärd där fler aktörer bidrar till innovation, effektivitet och kvalitet. Där planen ser problem är svaret kvalitetskrav för vinstutdelning och skärpt tillsyn, inte avskaffad vinstmöjlighet. Motförslagets krav på att avveckla vinsterna och ersätta valmodellerna avvisas därmed.

  • defended choice in welfaredecisive»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 choice in healthcare and care and conduct activities close to care recipients. Responsibility for healthcare shall not be moved from regions to the state.”
  • more actors in joint welfare»Centerpartiet vill se en välfärd som är gemensamt finansierad men som ger valfrihet och där fler aktörer bidrar till ökad innovation, effektivitet och kvalitet.« (party programme ↗)“The Centre Party wants to see welfare that is jointly financed but offers choice and where more actors contribute to increased innovation, efficiency and quality.”
  • more providers shorten queues»Vi vill öppna upp för fler vårdgivare och öka valfriheten så att patienter tillsammans med sin läkare kan välja vårdgivare och tid då operation eller behandling passar bäst utifrån patientens behov.« (2022 manifesto ↗)“We want to open up for more care providers and increase choice so that patients together with their doctor can choose care provider and the time when operation or treatment suits best according to the patient's needs.”
  • quality requirements instead of profit ban»Vi vill ställa kvalitetskrav för vinstutdelning och stärka rättssäkerheten i betygssystemet.« (2022 manifesto ↗)“We want to set quality requirements for profit distribution and strengthen legal certainty in the grading system.”
LLiberalernaYesYesfollows the planexplicit

The party programme explicitly establishes that profit-driven companies shall be able to operate in the welfare sector as long as quality requirements are met and that choice of provider and freedom of establishment shall apply throughout the country.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The party programme explicitly establishes that profit-driven companies shall be able to operate in the welfare sector as long as quality requirements are met and that choice of provider and freedom of establishment shall apply throughout the country. The counter-proposal's demand to phase out profit-taking and replace market and choice models directly contradicts this. That the plan wants to limit short-term profit-taking in independent schools is a regulation of profit, not an abolishment of private providers.

Original (Swedish)

Partiprogrammet slår uttryckligen fast att vinstdrivande företag ska kunna verka i välfärdssektorn så länge kvalitetskraven uppfylls och att vårdval och etableringsfrihet ska råda i hela landet. Motförslagets krav att avveckla vinstuttaget och ersätta marknads- och valmodellerna strider direkt mot detta. Att planen vill begränsa kortsiktigt vinstuttag i friskolor är en reglering av vinsten, inte ett avskaffande av enskilda utförare.

  • profit allowed if quality metdecisive»Vinstdrivande företag ska kunna verka i välfärdssektorn så länge kvalitetskraven uppfylls« (party programme ↗)“Profit-driven companies shall be able to operate in the welfare sector as long as quality requirements are met”
  • choice of provider and freedom of establishment»Vårdval och etableringsfrihet ska råda i hela landet för den som lever upp till kvalitetskraven.« (party programme ↗)“Choice of provider and freedom of establishment shall apply throughout the country for those who meet quality requirements.”
  • private alternatives drive quality»Enskilda alternativ i välfärdssektorn spelar en viktig roll för att driva på kvalitetsarbetet« (party programme ↗)“Private alternatives in the welfare sector play an important role in driving quality work”
  • profit limitation in independent schools»Vi vill se en ny friskolereform med en samlad friskolelag som sätter stopp för friskolor där kortsiktiga vinster går före elevernas kunskaper.« (2022 manifesto ↗)“We want to see a new independent school reform with a comprehensive independent school law that stops independent schools where short-term profits come before students' knowledge.”
KDKristdemokraternaYesYesfollows the planexplicit

The plan requires that public sector activities as far as possible be based on the absence of monopoly and that welfare services in private operation be given equivalent conditions as publicly operated.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan requires that public sector activities as far as possible be based on the absence of monopoly and that welfare services in private operation be given equivalent conditions as publicly operated. Healthcare should be characterised by quality, diversity and choice and citizens should themselves be able to choose care provider. Eliminated profit extraction and alternatives to choice models go directly against these commitments.

Original (Swedish)

Planen kräver att den offentliga sektorns verksamhetsformer så långt möjligt bygger på frånvaro av monopol och att välfärdstjänster i enskild regi ges lika förutsättningar som offentligt drivna. Vården ska kännetecknas av kvalitet, mångfald och valfrihet och medborgarna ska själva få välja vårdgivare. Ett avskaffat vinstuttag och alternativ till valmodeller går rakt emot dessa åtaganden.

  • equivalent conditions for private operationdecisive»offentliga sektorns verksamhetsformer ska så långt möjligt bygga på frånvaro av monopol. För att öka mångfalden, stimulera initiativtagande och effektivitet måste produktion av välfärdstjänster i enskild regi eller via« (party programme ↗)“public sector activities should as far as possible be based on the absence of monopoly. To increase diversity, stimulate initiative-taking and efficiency, production of welfare services in private operation or via”
  • diversity and choice in healthcare»av kvalitet, mångfald och valfrihet. Flera olika vårdgivare kan stimulera till nytänkande« (party programme ↗)“of quality, diversity and choice. Several different care providers can stimulate innovation”
  • free choice of care provider»Medborgarna ska ges frihet att själva välja vårdgivare.« (party programme ↗)“Citizens shall be given freedom to themselves choose care provider.”
  • easier to start own healthcare activity»Fler vårdcentraler på landsbygden och enklare för enskilda läkare att starta egen verksamhet - så att vården finns nära till hands.« (2022 manifesto ↗)“More care centres in rural areas and easier for individuals to start own activities - so that healthcare is close at hand.”
MModeraternaYesYesfollows the planexplicit

The party programme makes freedom of choice a central part of the welfare model and establishes that a diversity of providers is a precondition for renewal and innovation, and that welfare needs greater diversity.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The party programme makes freedom of choice a central part of the welfare model and establishes that a diversity of providers is a precondition for renewal and innovation, and that welfare needs greater diversity. Phasing out the possibility of profit and replacing market and choice models with other forms stands in direct conflict with this. The election manifesto instead conditions profit distribution on high quality requirements instead of prohibiting it.

Original (Swedish)

Idéprogrammet gör valfriheten till en central del av välfärdsmodellen och slår fast att en mångfald av aktörer är en förutsättning för förnyelse och innovation, samt att välfärden behöver större mångfald. Att avveckla möjligheten till vinst och ersätta marknads- och valmodeller med andra former står i direkt strid med detta. Valmanifestet villkorar i stället vinstutdelning med höga kvalitetskrav i stället för att förbjuda den.

  • freedom of choice in welfaredecisive»För Moderaterna är valfrihet en central del av den svenska« (party programme ↗)“For the Moderate Party, freedom of choice is a central part of the Swedish”
  • diversity of providers»En mångfald av aktörer är också en förutsättning för förnyelse och innovation.« (party programme ↗)“A diversity of providers is also a precondition for renewal and innovation.”
  • quality requirements, not profit prohibition»Se till att skolor som drivs i företagsform lever upp till högt ställda kvalitetskriterier för att få göra vinstutdelning samt dra in tillståndet för skolor som allvarligt brister« (2022 manifesto ↗)“Ensure that schools run in business form meet high quality criteria in order to be allowed to distribute profits and revoke the license for schools that seriously fall short”
  • more can invest in welfare»Också här behöver vi en större mångfald.« (party programme ↗)“Here too we need greater diversity.”
SDSverigedemokraternaYesYesfollows the planexplicit

The plan explicitly defends choice within welfare and market economy, and the party programme states that there is no inherent value in who operates the activity as long as quality per krona is best.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan explicitly defends choice within welfare and market economy, and the party programme states that there is no inherent value in who operates the activity as long as quality per krona is best. The counter-proposal's demands to phase out profit opportunities and replace choice models therefore go against the plan. That the plan shares the demand for national quality requirements is not enough to support the proposal substantively.

Original (Swedish)

Planen försvarar uttryckligen valfriheten inom välfärden och marknadsekonomin, och partiprogrammet slår fast att det inte finns något egenvärde i vem som driver verksamheten så länge kvaliteten per krona blir bäst. Motförslagets krav på att avveckla vinstmöjligheten och ersätta valmodellerna går därmed emot planen. Att planen delar kravet på nationella kvalitetskrav räcker inte för att stödja förslaget i sak.

  • choice in welfare defendeddecisive»Sverigedemokraterna ser att marknadsekonomi, valfrihet inom välfärden och internationell handel gynnar samhället och är viktigt att försvara« (2022 manifesto ↗)“Sweden Democrats see that market economy, choice within welfare and international trade benefit society and are important to defend”
  • operationally neutral quality per krona»vår ledstjärna är bästa möjliga vård per krona« (party programme ↗)“our guiding star is best possible care per krona”
  • regulated market economy»reglerad marknadsekonomi, byggd på långsiktigt tänkande, är för oss självklar.« (party programme ↗)“regulated market economy, built on long-term thinking, is for us self-evident.”
  • national quality requirements»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality requirements in healthcare and care must exist and must not be fallen short of.”

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Sources and documents

Documents under consideration

Source: The Swedish Parliament