2024-05-162023/24:SoU21 · p.4SoUHealth & social services
Hired personnel in healthcare
Reliance on agency staff (hyrpersonal) in healthcare
What's at stake: Heavy reliance on staffing agencies drives up costs for the regions and risks undermining stable, continuous care staffing with permanent employees, which can in turn affect the quality of care patients receive.
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 Riksdag should direct demands at the government to counter regions' reliance on costly agency healthcare staff and support coordinated procurement, or whether the issue should be handled within the ongoing work on staffing supply.
Yes Yes — the committee proposal
The committee rejects the motion for measures against reliance on agency staff. It points to the broader work on healthcare staffing supply, including the National Council for Healthcare Competence Supply's assignment to draw up a national plan, and considers that the Riksdag should not pre-empt that work.
No No — the reservations
Reservation 6 (S, MP)
The reservation (S, MP) calls for the government to closely monitor developments regarding the regions' reliance on agency staff - particularly the region-wide joint procurement of agency staff that Region Västra Götaland began in 2022 - and to take action so that healthcare becomes independent of agency staff and achieves stable staffing with its own employees.
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 6 by S, MP.
Abstain The party marks a position of its own that is not one of the two final alternatives.
The decision would have held
Explicit commitments that contradicted the vote: KDKristdemokraterna, VVänsterpartiet
Ja 186–106Ja 153–139
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 19/0/0/5 | differsagainst own programme | confidence: high | explicit |
| S | No | No 1/92/0/13 | match | confidence: medium | derived |
| MP | No | No 0/13/0/5 | match | confidence: medium | not addressed |
| C | Yes | Yes 19/0/0/5 | match | confidence: low | not addressed |
| L | No | Yes 12/0/0/4 | differs | confidence: medium | not addressed |
| KD | No | Yes 14/0/0/5 | differsagainst own programme | confidence: high | explicit |
| M | Yes | Yes 60/0/0/8 | match | confidence: medium | not addressed |
| SD | No | Yes 60/0/0/12 | differs | confidence: medium | not addressed |
Broke with the party line
| SLawen Redar (S, Stockholms kommun) | Yes — party line: No |
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 motion 2023/24:2617 by Fredrik Lundh Sammeli et al. (S) demand 21.
Original (Swedish)
Riksdagen avslår motion 2023/24:2617 av Fredrik Lundh Sammeli m.fl. (S) yrkande 21.
Riksdag decision: The Riksdag rejected approximately 90 proposals in motions regarding skills supply, e-health and preparedness that were submitted during the general motion period in 2023. The motions dealt with, among other things, training of personnel in occupational health services, skills supply and qualifications, workplace environment, life science matters, healthcare in sparsely populated areas, and health and social care preparedness. The Riksdag referred to, among other things, ongoing work in the area.
Counter-proposals
- The counter-proposal wants to secure adequate coordination and long-term financing of training for occupational physicians and nurses. (S, MP) — Reservation 6
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 identifies temporary staffing jobs as a source of insecurity in the labour market and wants there to be no profit-driven actors in healthcare and care services at all.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan identifies temporary staffing jobs as a source of insecurity in the labour market and wants there to be no profit-driven actors in healthcare and care services at all. The counter-proposal's requirement that healthcare should become independent of hired personnel and instead have its own permanent staffing is exactly the direction the plan indicates. The plan also wants to invest in staff to eliminate staff shortages.
Original (Swedish)
Planen pekar ut bemanningsjobb som en källa till otrygghet på arbetsmarknaden och vill att vinstdrivande aktörer överhuvudtaget inte ska finnas i vård och omsorg. Motförslagets krav att vården ska bli oberoende av hyrpersonal och i stället ha egen, varaktig bemanning är precis den riktning planen anger. Planen vill dessutom satsa på personalen för att bygga bort personalbristen.
- away with insecure employmentdecisive»Otryggheten skapas genom tillfälliga anställningar, sms-jobb, gig-jobb, deltidsjobb och bemanningsjobb.« (2022 manifesto ↗)“Insecurity is created through temporary employment, SMS jobs, gig jobs, part-time jobs and temporary staffing.”
- no profits in welfare»se några aktörer som är där för att göra vinster i välfärden.« (party programme ↗)“see some actors that are there to make profits in welfare.”
- own staff and permanent staffing»satsa på personalen så att vi samtidigt får bort personalbristen och stärker personalens villkor och arbetsmiljö« (2022 manifesto ↗)“invest in staff so that we simultaneously eliminate staff shortages and strengthen staff conditions and work environment”
- society's responsibility for welfare jobs»Vi vill att samhället tar ett större ansvar för att arbetsplatserna i« (party programme ↗)“We want society to take greater responsibility for workplaces in”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
The election manifesto wants welfare to come first with more full-time permanent positions and places a state responsibility for ensuring competence.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto wants welfare to come first with more full-time permanent positions and places a state responsibility for ensuring competence. The counter-proposal's requirement that care should become independent of hired personnel and instead have sustainable staffing with own employees is precisely that direction. Moreover, the plan opposes tax money going to corporate profits instead of care and personnel.
Original (Swedish)
Valmanifestet vill att välfärden ska gå före med fler heltider i fasta jobb och lägger ett statligt ansvar för kompetensförsörjningen. Motförslagets krav att vården ska bli oberoende av inhyrd personal och i stället ha varaktig bemanning med egna medarbetare är just den inriktningen. Planen vänder sig dessutom mot att skattepengar går till bolagsvinster i stället för till vård och personal.
- full-time and permanent positions in welfaredecisive»Vi vill att välfärden ska gå före och att fler ska kunna arbeta heltid i fasta jobb.« (2022 manifesto ↗)“We want welfare to come first and that more shall be able to work full-time in permanent positions.”
- state responsibility for ensuring competence»Staten har ett ansvar för att säkra kompetensförsörjningen, inte minst i välfärden.« (2022 manifesto ↗)“The state has a responsibility to secure the supply of competence, not least in welfare.”
- tax money to care, not profits»Skattepengar delas ut till riskkapitalbolagens aktieägare, istället för att användas till skolböcker, fler anställda och bättre vård och omsorg.« (2022 manifesto ↗)“Tax money is distributed to venture capital companies' shareholders, instead of being used for textbooks, more employees and better care and services.”
- better working conditions in welfare»Arbetsvillkoren i välfärden måste spegla hur centrala jobben är för att samhället ska fungera.« (2022 manifesto ↗)“Working conditions in welfare must reflect how central these jobs are for society to function.”
The party programme asserts that welfare activities shall not be handled like any market and that commercially oriented actors should be removed in favor of activity focused on quality.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme asserts that welfare activities shall not be handled like any market and that commercially oriented actors should be removed in favor of activity focused on quality. A dependence on staffing companies is precisely such market logic that drives costs. The counter-proposal's demands for stable in-house staffing are therefore supported by the plan, which also wants to raise salaries and secure the working environment so care can retain its personnel.
Original (Swedish)
Partiprogrammet slår fast att välfärdens verksamheter inte får hanteras som vilken marknad som helst och att kommersiellt inriktade aktörer bör bort till förmån för verksamhet med kvalitet i fokus. Ett beroende av bemanningsföretag är just en sådan marknadslogik som driver kostnader. Motförslagets krav på stabil egen bemanning stöds därför av planen, som också vill höja löner och säkra arbetsmiljön så att vården kan behålla sin personal.
- welfare is not a marketdecisive»Välfärdens verksamheter får inte hanteras som vilken marknad som helst.« (party programme ↗)“Welfare activities shall not be handled like any market.”
- retain in-house care personnel»höja lönerna och säkra en god arbetsmiljö i vården« (2022 manifesto ↗)“raise salaries and secure a good working environment in care”
- stable staffing»Personaltätheten måste hålla tillräcklig nivå så att« (party programme ↗)“Personnel density must maintain sufficient level so that”
- requirements in procurement»Vid offentliga upphandlingar ska« (party programme ↗)“In public procurement, shall”
The plan's response to staffing problems in care is recruitment, competence development and better working conditions, not making care independent of private staffing companies.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan's response to staffing problems in care is recruitment, competence development and better working conditions, not making care independent of private staffing companies. The party programme states a market economy free from command-economy directives and the election manifesto defends freedom of choice and many providers in care and nursing. The requirement to phase out hired staff in favour of only own employees therefore lacks support in the plan.
Original (Swedish)
Planens svar på vårdens bemanningsproblem är rekrytering, kompetensutveckling och bättre arbetsvillkor, inte att göra vården oberoende av privata bemanningsföretag. Partiprogrammet slår fast en marknadsekonomi fri från planekonomiska pekpinnar och valmanifestet försvarar valfrihet och många utförare i vård och omsorg. Kravet på att fasa ut hyrpersonalen till förmån för enbart egna medarbetare saknar därför stöd i planen.
- freedom of choice in care and nursingdecisive»Vi vill försvara valfriheten inom vård och omsorg och bedriva verksamheten nära vårdtagarna.« (2022 manifesto ↗)“We want to defend freedom of choice in care and nursing and conduct the activity close to those receiving care.”
- recruitment ahead of staffing stop»Vi vill rekrytera fler sjuksköterskor genom att införa en examenspremie och ge lön under specialiststudietiden.« (2022 manifesto ↗)“We want to recruit more nurses by introducing an examination premium and providing salary during specialist studies.”
- many actors in care»Genom att uppmuntra många olika aktörer inom vården kan också vården utvecklas för att möta lokala och individuella behov.« (party programme ↗)“By encouraging many different actors within care, care can also be developed to meet local and individual needs.”
flags: citat_blockerat
The plan's answer to staffing problems in care is permanent own staff: a national drive for more staffed care beds and conditions that make shortage professions dream jobs.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan's answer to staffing problems in care is permanent own staff: a national drive for more staffed care beds and conditions that make shortage professions dream jobs. The counter-proposal's requirement for stable, permanent staffing with own employees instead of dependent on hired personnel is in line with this. The plan, however, does not take position on the role of staffing companies as such, so the coverage is derived.
Original (Swedish)
Planens svar på bemanningsproblemen i vården är fast egen personal: en nationell kraftsamling för fler bemannade vårdplatser och villkor som gör bristyrken till drömjobb. Motförslagets krav på en stabil, varaktig bemanning med egna medarbetare i stället för beroende av inhyrd personal ligger i linje med detta. Planen tar dock inte ställning till bemanningsföretagens roll som sådan, varför täckningen är härledd.
- more staffed care bedsdecisive»Vi vill därför nästa mandatperiod se en nationell kraftsamling för fler bemannade vårdplatser i hela landet så att du som patient kan få vård snabbare.« (2022 manifesto ↗)“We therefore want to see a national drive during the next term for more staffed care beds across the country so that you as a patient can receive care faster.”
- own employees with good conditions»För att klara det måste de som arbetar inom vården mötas av goda arbetsvillkor, fler kollegor och bra löneutveckling.« (2022 manifesto ↗)“To achieve this, those working in care must be met with good working conditions, more colleagues and good wage development.”
- attractive care professions»Bristyrken ska bli drömjobb.« (2022 manifesto ↗)“Shortage professions shall become dream jobs.”
- diversity of care providers»Vårdval och etableringsfrihet ska råda i hela landet för den som lever upp till kvalitetskraven.« (party programme ↗)“Care choice and establishment freedom shall prevail throughout the country for those meeting quality requirements.”
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 states that the need for expensive hired staff should decrease and that conditions in care shortage occupations should improve, which is exactly what the counter-proposal requires.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto explicitly states that the need for expensive hired staff should decrease and that conditions in care shortage occupations should improve, which is exactly what the counter-proposal requires. The plan also wants to consolidate stewardship with the state instead of 21 regions, which directly addresses regions competing for staff. Healthcare should according to the party programme be cost-effective.
Original (Swedish)
Valmanifestet slår uttryckligen fast att behovet av dyr inhyrd personal ska minska och att villkoren i vårdens bristyrken ska förbättras, vilket är exakt vad motförslaget kräver. Planen vill dessutom samla huvudmannaskapet hos staten i stället för 21 regioner, vilket direkt adresserar att regionerna konkurrerar om personal. Vården ska enligt principprogrammet vara kostnadseffektiv.
- reduce expensive hired staffdecisive»Utbilda mer personal för sjukvården. Förbättrade villkor i vårdens bristyrken och minska behovet av dyr inhyrd personal.« (2022 manifesto ↗)“Educate more staff for healthcare. Improved conditions in care shortage occupations and reduce the need for expensive hired staff.”
- state stewardship of healthcare»Avskaffa regionernas ansvar för sjukvården. Låt staten ta över ansvaret för vården med en gemensam organisation i stället för 21 olika.« (2022 manifesto ↗)“Abolish the regions' responsibility for healthcare. Let the state take over responsibility for care with a single organization instead of 21 different.”
- cost-effective care»hälso- och sjukvården ska vara ändamålsenlig och kostnadseffektiv, säker för patienterna« (party programme ↗)“healthcare should be purposeful and cost-effective, safe for patients”
The stance rests on the quoted commitment in the party's own documents; the actual vote deviated. Click the quote to verify it in the document.
The party programme makes diversity of providers and freedom of choice into supporting principles in welfare and warns against centrally controlled uniform solutions.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme makes diversity of providers and freedom of choice into supporting principles in welfare and warns against centrally controlled uniform solutions. Making health and medical care independent of staffing companies means an actor group is excluded, which goes against that line. The plan's answer to the staffing problem is instead to strengthen care's own staff and get more hands in care.
Original (Swedish)
Idéprogrammet gör mångfald av utförare och valfrihet till bärande principer i välfärden och varnar för centralstyrda enhetslösningar. Att göra hälso- och sjukvården oberoende av bemanningsföretag innebär att en aktörsgrupp styrs bort, vilket går emot den linjen. Planens svar på bemanningsproblemet är i stället att stärka vårdens egna medarbetare och få fler händer i vården.
- diversity of providersdecisive»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.”
- more freedom of choice in welfare»vi behöva mer valfrihet, mångfald och innovationsförmåga,« (party programme ↗)“we need more freedom of choice, diversity and capacity for innovation,”
- strengthened care staff»Stärka vårdens medarbetare, bland annat genom att förbättra arbetsmiljön och möjligheterna till vidareutbildning« (2022 manifesto ↗)“Strengthen care's staff, among other things through improving the working environment and opportunities for further training”
The plan identifies expensive consultants as an example of public waste and demands that unnecessary spending be scaled back so funds go to the core of welfare.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan identifies expensive consultants as an example of public waste and demands that unnecessary spending be scaled back so funds go to the core of welfare. It also identifies gaps in healthcare's competence supply as a main problem and wants to review healthcare's organization. This speaks for the counter-proposal's demand for stable in-house staffing instead of dependence on hired personnel.
Original (Swedish)
Planen pekar ut dyra konsulter som ett exempel på offentligt slöseri och kräver att onödiga utgifter skalas bort så att medlen går till välfärdens kärna. Den identifierar också brister i sjukvårdens kompetensförsörjning som ett huvudproblem och vill se över vårdens organisation. Det talar för motförslagets krav på en stabil egen bemanning i stället för beroende av inhyrd personal.
- stop expensive consulting costsdecisive»dyra konsulter, utköp av personal och många andra märkliga satsningar« (2022 manifesto ↗)“expensive consultants, staff buyouts and many other strange investments”
- gaps in competence supply»Huvudproblemet handlar i betydande utsträckning om att styrningen via 21 olika regioner skapar otydlighet, målkonflikter, successivt ökande administration och brister i kompetensförsörjningen.« (2022 manifesto ↗)“The main problem largely concerns that governance through 21 different regions creates unclear lines, goal conflicts, gradually increasing administration and gaps in competence supply.”
- reduce public waste»Skala bort onödiga utgifter i det offentliga« (2022 manifesto ↗)“Scale back unnecessary public spending”
- reform healthcare organization»Se över sjukvårdens organisation« (2022 manifesto ↗)“Review healthcare's organization”
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:SoU21)
- Committee report full text (HB01SoU21)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2023/24:1002 — Rätt till tolk inom hälso- och sjukvården av Helén Pettersson och Åsa Karlsson (båda S)
- Motion 2023/24:1041 — Digital vård av Carina Ödebrink m.fl. (S)
- Motion 2023/24:1084 — Bemötande av våldsutsatta kvinnor av Azra Muranovic m.fl. (S)
- Motion 2023/24:1092 — Svenskar i utlandet av Markus Wiechel m.fl. (SD)
- Motion 2023/24:1127 — En sömlös vård av Helena Storckenfeldt och Lars Püss (båda M)
- Motion 2023/24:1172 — Integritetsskydd vid Ivo-anmälningar av Markus Wiechel (SD)
- Motion 2023/24:1191 — Internationellt kris- och hälsosamarbete av Markus Wiechel (SD)
- Motion 2023/24:1208 — Nationella beredskapslager av Ann-Christine Frohm Utterstedt och Eric Westroth (båda SD)
- Motion 2023/24:1239 — Delegationer i sjukvården av Martina Johansson (C)
- Motion 2023/24:128 — Betalningsansvar för outnyttjade tolktjänster av Eric Palmqvist (SD)
- Motion 2023/24:1348 — Begränsning av bemanningsföretagen i vården av Peder Björk m.fl. (S)
- Motion 2023/24:1393 — Gemensamt it-system i vården av Peter Ollén (M)
- Motion 2023/24:1538 — Marknadsföring av nätläkare av Johan Löfstrand m.fl. (S)
- Motion 2023/24:1584 — Legitimation eller skyddad yrkestitel för ortoptister av Ulrik Nilsson (M)
- Motion 2023/24:1682 — Anonymisering av sjukvårdspersonal i patientjournaler av Eric Westroth (SD)
- Motion 2023/24:1812 — Osteopati av Elisabeth Thand Ringqvist (C)
- Motion 2023/24:19 — Insyn i barns läkemedelslista av Ann-Christine From Utterstedt (SD)
- Motion 2023/24:1929 — En nationell digital infrastruktur för sjukvård och äldreomsorg av Gunilla Carlsson och Amalia Rud Pedersen (båda S)
- Motion 2023/24:2069 — En stärkt psykisk hälsa i hela landet av Carina Ståhl Herrstedt m.fl. (SD)
- Motion 2023/24:2072 — Folkhälsan i fokus av Carina Ståhl Herrstedt m.fl. (SD)
Source: The Swedish Parliament