2023-02-222022/23:SoU6 · p.3SoUHealth & social services
Sanction Fees
Penalty fees in pharmacy supervision
What's at stake: The National Audit Office has pointed out that limited powers to impose penalty fees hamper the supervisory authorities' work against pharmacies and drug wholesalers that break the rules, an issue that touches on patient safety and a well-functioning medicines market.
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 the government should now be tasked with expanding TLV's and the Medical Products Agency's powers to impose penalty fees in pharmacy and drug-trade supervision, or whether the matter should wait until ongoing inquiries are complete.
Yes Yes — the committee proposal
The committee welcomes the Audit Office's report but does not want to pre-empt ongoing work: since related proposals on information-sharing and the eHealth Agency's reporting duties are already being processed within the Government Offices, the committee rejects the motions calling for expanded penalty fees.
No No — the reservations
Reservation 4 (V, MP)
V and MP argue that TLV's limited ability to impose penalty fees hampers supervision and that the Medical Products Agency also needs expanded powers of this kind, and want the government to clearly act to strengthen this tool.
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 4 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 0/21/0/3 | follows the plan | confidence: medium | not addressed |
| S | No | Yes 91/0/1/15 | departs from the plan | confidence: medium | not addressed |
| MP | No | No 0/14/0/4 | follows the plan | confidence: medium | not addressed |
| C | No | Yes 20/0/0/4 | departs from the plan | confidence: low | not addressed |
| L | No | Yes 14/0/0/2 | departs from the plan | confidence: low | not addressed |
| KD | No | Yes 15/0/0/4 | departs from the plan | confidence: low | not addressed |
| M | Yes | Yes 58/0/0/10 | follows the plan | confidence: low | not addressed |
| SD | No | Yes 63/0/0/10 | departs from the plan | confidence: low | not addressed |
Broke with the party line
| SMarkus Kallifatides (S, Stockholms kommun) | Abstain — 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 motion 2022/23:2293 by Ulrika Westerlund (MP) claim 2.
Original (Swedish)
Riksdagen avslår motion 2022/23:2293 av Ulrika Westerlund (MP) yrkande 2.
Riksdag decision: The Riksdag has treated a letter from the Government. It concerns the National Audit Office's examination of the Medical Products Agency's supervision of community pharmacies and the wholesale trade in medicines. The report covers supervision by the Medical Products Agency, the Inspection Board for Health and Social Care (Ivo) and the Dental Care and Pharmaceuticals Benefits Board (TLV). The National Audit Office's conclusion is that the supervision that the state conducts over the pharmacy sector and trade in medicines is not effective. This can lead to both pharmacies and those who buy and sell medicines risking operating activities that do not meet the legal requirements. The consequence can then be that patient safety suffers and that costs to the state and regions become unnecessarily large. In the letter, the Government welcomes the examination and expresses support for several of the measures proposed by the National Audit Office. Among other things, the Government considers that there are reasons to consider whether rules should be introduced that prevent pharmacies from charging excessive prices on medicines that are not included in the pharmaceutical benefits but are subsidized by the state or regions and on special food for children. The Riksdag largely shares the Government's assessments and considers that it is central that supervision can be conducted effectively. With this, the Riksdag laid the letter to the papers, that is, closed the matter.
Counter-proposals
- The counter-proposal wants to give agencies expanded possibilities to impose sanction fees to improve oversight. (V, MP) — Reservation 4
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 asserts that privatizations of welfare open up for criminals to enrich themselves with tax funds and that companies are responsible for most economic crimes, and criticizes pharmacy privatization.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan asserts that privatizations of welfare open up for criminals to enrich themselves with tax funds and that companies are responsible for most economic crimes, and criticizes pharmacy privatization. Giving the Pharmaceutical Benefits Board and the Medical Products Agency effective sanction fees follows from this, even though the plan holds that the fundamental solution is to stop the profit hunt.
Original (Swedish)
Planen slår fast att privatiseringarna av välfärden öppnar för kriminella att sko sig på skattemedel och att företagen står för de flesta ekobrotten, samt kritiserar apoteksprivatiseringen. Att ge TLV och Läkemedelsverket verkningsfulla sanktionsavgifter följer av det, även om planen menar att den grundläggande lösningen är att vinstjakten stoppas.
- stop welfare crimedecisive»Privatiseringarna av välfärden öppnar upp för kriminella att sko sig på skattemedel.« (2022 manifesto ↗)“Privatizations of welfare open up for criminals to enrich themselves with tax funds.”
- companies are responsible for economic crimes»Det är företagen som överlägset står för de flesta« (party programme ↗)“It is companies that overwhelmingly are responsible for most”
- criticism of pharmacy privatization»Privatiseringar har lett till dyrare elpris, att apoteken flyttar från landsbygd till städer och från fattiga till rika områden« (2022 manifesto ↗)“Privatizations have led to higher electricity prices, pharmacies moving from rural areas to cities and from poor to rich areas”
- control is not enough»Välfärdsbrott bekämpas inte bäst genom ytterligare tandlös kontroll.« (2022 manifesto ↗)“Welfare crime is not best combated through further toothless control.”
The plan demands that oversight be stepped up to guarantee quality and that society reacts clearly against breaches of regulations.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan demands that oversight be stepped up to guarantee quality and that society reacts clearly against breaches of regulations. Extended sanction fees for the Medical Products Agency and the Swedish Medicines Agency are such a tool and are in line with welfare crime being stopped. The plan also demands national regulations for activities financed with tax money.
Original (Swedish)
Planen kräver att tillsynen växlas upp för att garantera kvaliteten och att samhället reagerar tydligt mot regelöverträdelser. Utvidgade sanktionsavgifter för TLV och Läkemedelsverket är ett sådant verktyg och ligger i linje med att välfärdsbrottslighet ska stoppas. Planen kräver också nationella regelverk för verksamhet som finansieras med skattemedel.
- stronger oversightdecisive»Tillsynen av sjukvården ska växlas upp för att garantera kvaliteten.« (2022 manifesto ↗)“Oversight of healthcare shall be stepped up to guarantee quality.”
- clear response to regulatory breaches»Samhället måste reagera tydligt mot brott och regelöverträdelser.« (party programme ↗)“Society must react clearly against crime and breaches of regulations.”
- against welfare crime»Skattefusk, välfärdsbrottslighet och penningtvätt ska stoppas.« (2022 manifesto ↗)“Tax fraud, welfare crime and money laundering shall be stopped.”
- national regulations»För all verksamhet som drivs på uppdrag av det offentliga och finansieras med skattemedel ska det finnas nationellt fastställda regelverk.« (party programme ↗)“For all activities conducted on assignment from the public and financed with tax money there shall be nationally established regulations.”
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 party programme requires that all publicly financed activity be under the supervision of an authority that ultimately can stop activity that does not meet the standard, and that tax funds be used for what they are intended.
Plan documents: party programme
Reasoning and quotes
The party programme requires that all publicly financed activity be under the supervision of an authority that ultimately can stop activity that does not meet the standard, and that tax funds be used for what they are intended. Expanded administrative penalties for TLV and the Medical Products Agency are a tool for such effective supervision in the medicines field. The plan therefore supports the counter-proposal.
Original (Swedish)
Partiprogrammet kräver att all offentligt finansierad verksamhet står under tillsyn av en myndighet som ytterst kan stoppa verksamhet som inte håller måttet, och att skattemedel används till det de är avsedda för. Utvidgade sanktionsavgifter för TLV och Läkemedelsverket är ett verktyg för en sådan effektiv tillsyn på läkemedelsområdet. Planen stöder därför motförslaget.
- supervision with real sanctionsdecisive»All verksamhet ska vara underställd tillsyn av en offentlig myndighet som ytterst« (party programme ↗)“All activity shall be subject to supervision by a public authority that ultimately”
- tax funds for intended purposes»Det som är viktigt är kvaliteten på välfärden, att skattemedel används till den« (party programme ↗)“What is important is the quality of welfare, that tax funds are used for what”
- safe patient care»En av grundprinciperna i vården är att ingen« (party programme ↗)“One of the basic principles in care is that no”
The plan does not address sanction fees, but its line for publicly financed activities with private providers is strengthened supervision of activities and their owners and that what the public finances must maintain the same good quality for all.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan does not address sanction fees, but its line for publicly financed activities with private providers is strengthened supervision of activities and their owners and that what the public finances must maintain the same good quality for all. It also wants to tighten regulations against improprieties. Derived from this, the plan supports the demand to strengthen the supervisory authorities' sanction powers.
Original (Swedish)
Planen behandlar inte sanktionsavgifter, men dess linje för offentligt finansierad verksamhet med privata utförare är skärpt tillsyn av verksamheter och deras ägare och att det som det offentliga finansierar ska hålla samma goda kvalitet för alla. Den vill också skärpa regelverket mot oegentligheter. Härlett ur detta stöder planen kravet på att tillsynsmyndigheternas sanktionsmöjligheter stärks.
- strengthened supervision of providersdecisive»Vi vill bland annat se höga kvalitetskrav för fortsatt verksamhet och vinstutdelning, och vi vill skärpa tillsynen av skolor och deras ägare.« (2022 manifesto ↗)“We want to see, among other things, high quality requirements for continued operations and profit distribution, and we want to tighten supervision of schools and their owners.”
- tightened rules against improprieties»Vi vill inrätta en antikorruptionsmyndighet, skärpa regler mot korruption och införa ett lobbyregister.« (2022 manifesto ↗)“We want to establish an anti-corruption agency, tighten rules against corruption and introduce a lobbying register.”
- quality in publicly financed activities»Det som det offentliga finansierar ska vara likvärdigt för alla och med samma goda kvalitet till alla.« (party programme ↗)“What the public finances must be equivalent for all and with the same good quality for all.”
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 says nothing about sanction fees for TLV or the Medical Products Agency.
Plan documents: party programme
Reasoning and quotes
The plan says nothing about sanction fees for TLV or the Medical Products Agency. The closest lying principle is that supervision shall be conducted in state administration according to nationally established quality standards and that the market needs strong legislation because even private power can be abused. Based on this, the plan speaks for strengthening the supervisory authorities' tools, thus in the counter-proposal's direction.
Original (Swedish)
Planen säger inget om sanktionsavgifter för TLV eller Läkemedelsverket. Närmast liggande princip är att tillsynen ska ske i statlig regi utifrån nationellt fastställda kvalitetsnormer och att marknaden behöver stark lagstiftning eftersom även privat makt kan missbrukas. Utifrån detta talar planen för att tillsynsmyndigheternas verktyg stärks, alltså i motförslagets riktning.
- strong state supervisiondecisive»Tillsynen ska ske i statlig regi utifrån nationellt fastställda kvalitetsnormer.« (party programme ↗)“Supervision shall be conducted in state administration according to nationally established quality standards.”
- strong market rules»behövs en stark konkurrenslagstiftning och konsumentlagar som ger rätt till korrekt produktinformation.« (party programme ↗)“there is a need for strong competition law and consumer laws that give the right to correct product information.”
- private power can be abused»Även den privata makten kan missbrukas.« (party programme ↗)“Even private power can be abused.”
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 does not address sanction charges.
Plan documents: party programme
Reasoning and quotes
The plan does not address sanction charges. It does, however, establish that the state's role is to oversee that legislation and good ethics are upheld on the market, and that solidarity-financed healthcare should be fit for purpose and cost-effective with medications within a solidarity-financed system. Based on these principles, the plan supports strengthening the supervisory authorities' tools against regulatory breaches. The conclusion is derived.
Original (Swedish)
Planen behandlar inte sanktionsavgifter. Den slår dock fast att statens roll är att övervaka att lagstiftning och god etik upprätthålls på marknaden, och att den solidariskt finansierade vården ska vara ändamålsenlig och kostnadseffektiv med läkemedel i ett solidariskt system. Utifrån dessa principer stöder planen att tillsynsmyndigheternas verktyg mot regelbrott stärks. Slutsatsen är härledd.
- the state oversees the marketdecisive»Statens roll i näringspolitiken är att övervaka att lagstiftningen och en god etik upprätthålls på marknaden.« (party programme ↗)“The state's role in business policy is to oversee that legislation and good ethics are upheld on the market.”
- solidarity-financed drug financing»Läkemedel ska efter särskilt godkännande omfattas av ett solidariskt finansierat system.« (party programme ↗)“Medications shall, following special approval, be covered by a solidarity-financed system.”
- cost-effective care»Den solidariskt finansierade hälso- och sjukvården ska vara ändamålsenlig och kostnadseffektiv, säker för patienterna och baserad på kunskap och beprövad erfarenhet« (party programme ↗)“Solidarity-financed health and medical care shall be fit for purpose and cost-effective, safe for patients, and based on knowledge and proven experience”
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 says nothing about penalty fees for TLV or the Medical Products Agency.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan says nothing about penalty fees for TLV or the Medical Products Agency. The nearest principle is instead that companies' regulatory burden should decrease significantly and that it should be easy to do right, and that policy must prioritize large needs in the legal system, defense and welfare. Based on this the plan provides no support for now building a new penalty tool.
Original (Swedish)
Planen säger ingenting om sanktionsavgifter för TLV eller Läkemedelsverket. Den närmast liggande principen är i stället att företagens regelbörda ska minska kraftigt och att det ska vara lätt att göra rätt, samt att politiken måste prioritera de stora behoven i rättsväsende, försvar och välfärd. Utifrån det ger planen inget stöd för att nu bygga ut ett nytt sanktionsverktyg.
- reduced regulatory burdendecisive»Ta bort en tredjedel av företagens administrationskostnader och en tredjedel av regelkrånglet« (2022 manifesto ↗)“Remove a third of companies' administrative costs and a third of regulatory red tape”
- easy to do right»Där det är lätt att göra rätt – för att en tredjedel av regelkrånglet tagits bort.« (2022 manifesto ↗)“Where it is easy to do right – because a third of regulatory red tape has been removed.”
- political prioritization»Politiken har en viktig uppgift att prioritera och välja bort« (party programme ↗)“Politics has an important task to prioritize and reject”
- hard priorities»De stora behoven inom rättsväsendet, försvaret och välfärden ställer stora krav på prioriteringar under åren som kommer.« (2022 manifesto ↗)“Large needs within the legal system, defense and welfare place major demands on prioritization in the years to come.”
The plan does not address supervisory authorities' sanction fees, but establishes that fraud and systems that encourage fraud shall be countered and that accountability for shortcomings in the handling of public resources shall be strengthened.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan does not address supervisory authorities' sanction fees, but establishes that fraud and systems that encourage fraud shall be countered and that accountability for shortcomings in the handling of public resources shall be strengthened. Expanded sanction possibilities for TLV and the Medical Products Agency are an application of that principle in the pharmaceuticals field. The plan is silent on the committee's reasons that ongoing preparation should not be prejudged.
Original (Swedish)
Planen behandlar inte tillsynsmyndigheternas sanktionsavgifter, men slår fast att fusk och system som lockar till fusk ska motverkas och att ansvarsutkrävande vid brister i hanteringen av offentliga resurser ska stärkas. Utvidgade sanktionsmöjligheter för TLV och Läkemedelsverket är en tillämpning av den principen på läkemedelsområdet. Planen är tyst om utskottets skäl att pågående beredning inte bör föregripas.
- counter fraud and corruptiondecisive»Både fusk och sådana system som tenderar att locka till fusk och korruption ska motverkas.« (2022 manifesto ↗)“Both fraud and systems that tend to encourage fraud and corruption shall be countered.”
- strengthened accountability»Sverigedemokraterna vill stärka möjligheter för ansvarsutkrävande när hanteringen av de offentliga resurserna brister.« (2022 manifesto ↗)“Sweden Democrats want to strengthen possibilities for accountability when the handling of public resources is deficient.”
- tightened sanctions against fraud»Skärpa straffen för fusk inom välfärdssystemen« (2022 manifesto ↗)“Tighten penalties for fraud within welfare systems”
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 (2022/23:SoU6)
- Committee report full text (HA01SoU6)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:2287 — med anledning av skr. 2022/23:12 Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel av Karin Rågsjö m.fl. (V)
- Motion 2022/23:2292 — med anledning av skr. 2022/23:12 Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel av Anders W Jonsson m.fl. (C)
- Motion 2022/23:2293 — med anledning av skr. 2022/23:12 Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel av Ulrika Westerlund (MP)
- Regeringens skrivelse 2022/23:12 — Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel
Source: The Swedish Parliament