2023-11-302023/24:SoU5 · p.2SoUHealth & social services
Accountability of services to individuals
Care providers' duty to inform and involve individuals affected by care injuries and malpractice
What's at stake: The outcome affects how much say patients, older people, and their relatives have when something has gone wrong in healthcare or elder care, and whether care providers are actually required to involve them or merely encouraged to.
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 government should be instructed to strengthen individuals' and relatives' right to be informed, involved, and able to give their perspective when serious care injuries and instances of malpractice occur — for example through new binding requirements on the National Board of Health and Welfare — or whether the support already provided by legislation and guidance should be considered sufficient.
Yes Yes — the committee proposal
The committee agrees that it is important for care providers to inform and involve individuals and relatives when care injuries and malpractice occur, but notes that fairly extensive support already exists in legislation and in the National Board of Health and Welfare's guidance, knowledge support, training, and handbooks, and therefore rejects the motions calling for further measures.
No No — the reservations
Reservation 2 (V, MP)
The reservation holds that individuals' and relatives' right to be involved, receive feedback, and describe their experience is in practice insufficient, and wants the National Board of Health and Welfare given expanded authority to set binding requirements that relatives be given the chance to describe their experience and that individuals and relatives be informed and involved when serious care injuries and malpractice occur, together with guidance from the Board on how this should be done.
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 2 by 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.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | No 0/19/0/5 | follows the plan | confidence: medium | not addressed |
| S | No | Yes 92/0/0/15 | departs from the plan | confidence: medium | not addressed |
| MP | No | No 0/16/0/2 | follows the plan | confidence: medium | not addressed |
| C | No | Abstain 0/0/20/4 | departs from the plan | confidence: medium | not addressed |
| L | No | Yes 12/0/0/4 | departs from the plan | confidence: medium | derived |
| KD | No | Yes 17/0/0/2 | departs from the plan | confidence: medium | derived |
| M | No | Yes 58/0/0/10 | departs from the plan | confidence: low | not addressed |
| SD | No | Yes 60/0/0/12 | departs from the plan | confidence: medium | derived |
Committee proposal
The Riksdag rejects the motions 2023/24:183 by Christofer Bergenblock et al. (C) item 2 and 2023/24:221 by Ulrika Westerlund et al. (MP) items 1-3.
Original (Swedish)
Riksdagen avslår motionerna 2023/24:183 av Christofer Bergenblock m.fl. (C) yrkande 2 och 2023/24:221 av Ulrika Westerlund m.fl. (MP) yrkandena 1-3.
Riksdag decision: The National Audit Office has reviewed whether the state's measures within the framework of the provisions on lex Maria and lex Sarah are effective in preventing care damage and shortcomings in care and elderly care. The National Audit Office's conclusion is that the state's measures should be strengthened and they present several recommendations in their audit report. The government has in a written statement presented its assessment of the observations and recommendations that the National Audit Office presents in the report and largely agrees with the problem description. However, the government makes a different assessment of which measures should be taken and presents several measures that have already been taken to strengthen national governance and to increase the quality of elderly care and to prevent shortcomings. Furthermore, the government believes that there is already sufficient support, for example through the Board of Health and Welfare's guidance, to inform and involve individuals in cases of care damage and shortcomings. The Riksdag decided to file the written statement with the records, that is, to close the case.
Counter-proposals
- The counter-proposal wants the government to develop a national action plan for increased quality in elderly care. (V, MP) — Reservation 2
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 describes how care has been fragmented so that it becomes a struggle for the individual and relatives to get the right care, and how relatives are forced to bear an increasing burden.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan describes how care has been fragmented so that it becomes a struggle for the individual and relatives to get the right care, and how relatives are forced to bear an increasing burden. The plan also requires democratization of public activity with increased influence for users and citizens. Binding requirements that individuals and next of kin are informed and made involved in serious medical injuries follow from this. The plan says nothing about the committee's reasons that existing guidelines already suffice.
Original (Swedish)
Planen beskriver hur vården styckats upp så att det blir en kamp för den enskilde och anhöriga att få rätt vård, och hur anhöriga tvingas bära ett växande ansvar. Planen kräver dessutom en demokratisering av den offentliga verksamheten med ökat inflytande för brukare och medborgare. Bindande krav på att enskilda och närstående informeras och görs delaktiga vid allvarliga vårdskador följer av detta. Planen säger inget om utskottets skäl att befintliga vägledningar redan räcker.
- individual's position in caredecisive»Vården och omsorgen har styckats upp, mellan nivåer och aktörer, människor bollas runt i en stor administrativ apparat och det är ofta en kamp för den enskilde och dess anhöriga att få rätt tillgång till vård.« (2022 manifesto ↗)“Care and welfare have been fragmented, between levels and actors, people are bounced around in a large administrative apparatus, and it is often a struggle for the individual and their relatives to get proper access to care.”
- burden on relatives»När vården inte räcker till tvingas anhöriga, särskilt kvinnor, att ta ett allt större ansvar.« (2022 manifesto ↗)“When care is not sufficient, relatives, especially women, are forced to take on increasing responsibility.”
- democratize welfare»En demokratisering av den offentliga verksamheten« (party programme ↗)“A democratization of public activity”
- user influence»kan kompletteras med anställdas, boendes och brukares frivilliga« (party programme ↗)“can be complemented with employees', residents' and users' voluntary”
The plan wants to increase oversight of healthcare to guarantee quality and requires that citizens can scrutinize tax-financed activities and demand accountability.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan wants to increase oversight of healthcare to guarantee quality and requires that citizens can scrutinize tax-financed activities and demand accountability. Binding requirements that individuals and relatives be informed and made participating in serious healthcare injuries align with these commitments. The committee's reasons that existing guidelines suffice are not addressed by the plan.
Original (Swedish)
Planen vill växla upp tillsynen av sjukvården för att garantera kvaliteten och kräver att medborgare kan granska skattefinansierad verksamhet och utkräva ansvar. Bindande krav på att enskilda och närstående informeras och görs delaktiga vid allvarliga vårdskador ligger i linje med dessa åtaganden. Utskottets skäl att befintliga vägledningar räcker berörs inte av planen.
- strengthened oversight of caredecisive»Tillsynen av sjukvården ska växlas upp för att garantera kvaliteten.« (2022 manifesto ↗)“Oversight of healthcare shall be increased to guarantee quality.”
- transparency and accountability»granska den och utkräva politiskt ansvar« (party programme ↗)“scrutinize it and demand political accountability”
- openness in all care»Offentlighetsprincipen ska gälla även privat vård och omsorg.« (2022 manifesto ↗)“The transparency principle shall apply also to private care and services.”
- participation for the individual»Vi socialdemokrater vill att alla ska ha lika förutsättningar och lika möjlighet till delaktighet« (party programme ↗)“We Social Democrats want all to have equal preconditions and equal opportunity for participation”
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 wants to strengthen patient rights, establishes that no patient shall be harmed and takes a position for user influence and transparency regardless of governance form.
Plan documents: party programme
Reasoning and quotes
The plan wants to strengthen patient rights, establishes that no patient shall be harmed and takes a position for user influence and transparency regardless of governance form. Binding requirements that individuals and next of kin be informed, involved and be able to describe their experience in cases of serious healthcare damage and malpractice are in line with this. The plan says nothing about whether existing guidelines are sufficient.
Original (Swedish)
Planen vill stärka patientens rättigheter, slår fast att ingen patient ska komma till skada och tar ställning för brukarinflytande och insyn oavsett driftsform. Bindande krav på att enskilda och närstående informeras, görs delaktiga och får beskriva sin upplevelse vid allvarliga vårdskador och missförhållanden ligger i linje med detta. Planen säger däremot inget om huruvida befintliga vägledningar räcker.
- stronger patient rightsdecisive»Vi vill stärka patientens rättigheter« (party programme ↗)“We want to strengthen patient rights”
- no patient shall be harmed»patient ska komma till skada. Sjukvårdens utförare« (party programme ↗)“patient shall be harmed. Healthcare providers”
- user influence and transparency»tar även ställning för brukarinflytande och insyn« (party programme ↗)“also takes a position for user influence and transparency”
- participation in care»Patientens självbestämmande och delaktighet är en« (party programme ↗)“Patient autonomy and participation is a”
The plan requires healthcare and social services that put patients and users at the centre and that society's actors adopt the individual's perspective, which bears the requirement that individuals and next of kin are informed and made party to serious healthcare injuries.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan requires healthcare and social services that put patients and users at the centre and that society's actors adopt the individual's perspective, which bears the requirement that individuals and next of kin are informed and made party to serious healthcare injuries. The plan also establishes that the individual shall have influence over their own life in welfare services. The demand to reduce administration in healthcare pulls in another direction but does not undermine patient perspective.
Original (Swedish)
Planen kräver en vård och omsorg som sätter patienter och brukare i centrum och att samhällets aktörer intar individens perspektiv, vilket bär kravet att enskilda och närstående informeras och görs delaktiga vid allvarliga vårdskador. Planen slår också fast att den enskilde ska ha inflytande över sitt eget liv i välfärdstjänster. Kravet på minskad administration i vården drar åt andra hållet men rubbar inte patientperspektivet.
- patient at the centredecisive»Sverige behöver en vård och omsorg som sätter patienter, brukare och medarbetare i centrum.« (2022 manifesto ↗)“Sweden needs healthcare and social services that put patients, users, and staff at the centre.”
- individual's perspective»Samhällets aktörer ska inta individens perspektiv.« (party programme ↗)“Actors in society shall adopt the individual's perspective.”
- participation in welfare»Alla ska ha inflytande över sina egna liv också när det gäller välfärdstjänster.« (party programme ↗)“Everyone shall have influence over their own lives also when it comes to welfare services.”
- reduced administration»Den administrativa bördan inom vården måste minska« (2022 manifesto ↗)“The administrative burden in healthcare must be reduced”
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 overarching commitment is a power shift in healthcare towards patients and that the individual's opportunities to assert their rights against authorities increase.
Plan documents: party programme
Reasoning and quotes
The plan's overarching commitment is a power shift in healthcare towards patients and that the individual's opportunities to assert their rights against authorities increase. That oversight occurs in state administration based on nationally established quality standards provides support for binding requirements that individuals and relatives are informed and involved when serious healthcare damage occurs. The plan also wants support for relatives who care for close ones to improve.
Original (Swedish)
Planens bärande krav är en maktförskjutning i vården till patienterna och att den enskildes möjligheter att hävda sina rättigheter gentemot myndigheterna ökar. Att tillsynen ska ske i statlig regi utifrån nationellt fastställda kvalitetsnormer ger stöd för bindande krav på att enskilda och närstående informeras och görs delaktiga vid allvarliga vårdskador. Planen vill också att stödet till anhöriga förbättras.
- power shift to the patientdecisive»Det behövs en maktförskjutning inom hälso- och sjukvården till patienterna.« (party programme ↗)“There is a need for a power shift within healthcare towards patients.”
- state oversight with quality standards»Tillsynen ska ske i statlig regi utifrån nationellt fastställda kvalitetsnormer.« (party programme ↗)“Oversight shall occur in state administration based on nationally established quality standards.”
- strengthened position for individuals»Den enskildes möjligheter att hävda sina rättigheter gentemot myndigheterna måste öka.« (party programme ↗)“The individual's opportunities to assert their rights against authorities must increase.”
- better support for relatives»Stödet till anhöriga som tar hand om sina nära behöver förbättras.« (party programme ↗)“Support for relatives who care for their close ones needs to improve.”
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 there are dignity guarantees in care and health services that concretely relate to the activity and that care recipients and relatives know what demands can be made, which speaks for binding requirements for information and involvement in cases of care damage.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan requires that there are dignity guarantees in care and health services that concretely relate to the activity and that care recipients and relatives know what demands can be made, which speaks for binding requirements for information and involvement in cases of care damage. The patient's right to information and ability to influence care is a stated commitment, and relatives' contributions shall be utilized and made visible. Patient safety shall be ensured with national standards.
Original (Swedish)
Planen kräver att det finns värdighetsgarantier inom vård och omsorg som konkret anknyter till verksamheten och att vårdtagare och anhöriga vet vilka krav som kan ställas, vilket talar för bindande krav på information och delaktighet vid vårdskador. Patientens rätt till information och möjlighet att påverka vården är ett uttalat åtagande, och anhörigas insatser ska tas tillvara och synliggöras. Patientsäkerheten ska tryggas med nationella standarder.
- dignity guarantees with concrete demandsdecisive»Därför ska det finnas värdighetsgarantier inom vård och omsorg« (party programme ↗)“Therefore there shall be dignity guarantees in care and health services”
- the patient's right to information»Att som patient få tillgång till information, kunna påverka vård« (party programme ↗)“That as a patient you have access to information, can influence care”
- relatives shall be made visible»Anhörigas vårdinsatser är en ovärderlig tillgång« (party programme ↗)“Relatives' care contributions are an invaluable asset”
- national standards for patient safety»Trygg patientsäkerheten med nationella standarder och tekniska specifikationer för all digital vårdinformation.« (2022 manifesto ↗)“Ensure patient safety with national standards and technical specifications for all digital health information.”
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 wants protection for the individual in relation to government agencies and municipalities to be practical and effective, not just fine words, and establishes that everyone has the right to equivalent care of high quality.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan wants protection for the individual in relation to government agencies and municipalities to be practical and effective, not just fine words, and establishes that everyone has the right to equivalent care of high quality. Strengthening the rights of individuals and next of kin to be informed and made involved in serious healthcare injuries is in line with that prioritization of the individual before the system. However, the plan does not address the supervisory authority's powers, which is why the conclusion is derived.
Original (Swedish)
Planen vill att skyddet för den enskilde i förhållande till myndigheter och kommuner ska vara praktiskt och effektivt, inte bara vackra ord, och slår fast att alla har rätt till likvärdig vård av hög kvalitet. Att stärka enskildas och närståendes rätt att informeras och göras delaktiga vid allvarliga vårdskador ligger i linje med den prioriteringen av individen framför systemet. Planen behandlar däremot inte tillsynsmyndighetens bemyndiganden, varför slutsatsen är härledd.
- the individual's standing against the systemsdecisive»Vi måste se till att det inte bara är vackra ord, utan att grundlagen också ger ett praktiskt och effektivt skydd för enskilda människor i relation till exempelvis en kommun eller en statlig myndighet.« (2022 manifesto ↗)“We must ensure that it is not just fine words, but that the constitution also provides practical and effective protection for individuals in relation to, for example, a municipality or a government agency.”
- the patient's right to quality»Alla har rätt till likvärdig vård – som kan ges i rätt tid och håller hög kvalitet.« (2022 manifesto ↗)“Everyone has the right to equivalent care - which can be provided at the right time and is of high quality.”
- quality and accessibility in healthcare»Svensk sjukvård ska präglas av kvalitet, tillgänglighet och« (party programme ↗)“Swedish healthcare shall be characterized by quality, accessibility and”
flags: citat_migrerat
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 counter-proposal wants to give the regulatory authority a mandate to impose binding requirements that individuals and their relatives are informed and involved when serious care injuries and irregularities occur.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The counter-proposal wants to give the regulatory authority a mandate to impose binding requirements that individuals and their relatives are informed and involved when serious care injuries and irregularities occur. The plan establishes that national quality requirements in care and nursing must exist and must not be undercut, and that legal support for good living conditions needs to be strengthened. Binding requirements in favour of the individual therefore follows from the plan.
Original (Swedish)
Motförslaget vill ge tillsynsmyndigheten mandat att ställa bindande krav på att enskilda och närstående informeras och görs delaktiga vid allvarliga vårdskador och missförhållanden. Planen slår fast att nationella kvalitetskrav inom vård och omsorg måste finnas och inte får underskridas, och att lagstödet för goda levnadsvillkor behöver stärkas. Bindande krav till den enskildes förmån följer därför av planen.
- binding national quality requirementsdecisive»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality requirements in care and nursing must exist and must not be undercut.”
- stronger legal support for the individual»En ny äldreomsorgslag måste stärka lagstödet för goda levnadsvillkor då den nuvarande benämningen med skäliga levnadsvillkor inte duger.« (2022 manifesto ↗)“A new care law must strengthen legal support for good living conditions since the current reference to reasonable living conditions is insufficient.”
- trust in the care provider»trygghet och tillit till vårdgivaren.« (party programme ↗)“security and trust in the care provider.”
- the role of relatives is recognized»Frivilligorganisationer som anhörigföreningar och andra volontärinsatser är viktiga« (party programme ↗)“Voluntary organisations such as relative associations and other volunteer efforts are important”
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.
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Sources and documents
- The committee report on riksdagen.se (2023/24:SoU5)
- Committee report full text (HB01SoU5)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2023/24:183 — med anledning av skr. 2022/23:141 Riksrevisionens rapport om lex Maria och lex Sarah av Christofer Bergenblock m.fl. (C)
- Motion 2023/24:221 — med anledning av skr. 2022/23:141 Riksrevisionens rapport om lex Maria och lex Sarah av Ulrika Westerlund m.fl. (MP)
- Regeringens skrivelse 2022/23:141 — Riksrevisionens rapport om lex Maria och lex Sarah
Source: The Swedish Parliament