2023-03-222022/23:SoU22 · p.12SoUHealth & social services
Healthcare within elderly care
Healthcare within elderly care: access to doctors and nurses
What's at stake: The issue concerns older people living in assisted living or receiving home healthcare and their access to medical expertise and doctors, and how responsibility should be divided between municipality and region.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
Parliament decides whether the government should immediately legislate for guaranteed access to nurses and doctors in elderly care, or whether the matter should await ongoing inquiries and work already announced.
Yes Yes — the committee proposal
The committee rejects the motions. It points to the fact that questions about medical expertise in elderly care are already being addressed through proposals from a review of the pandemic's consequences and an inquiry on an elder-care law, as well as an announced inquiry on doctors in municipal care and a medically responsible physician, and intends to monitor these issues rather than have parliament act now.
No No — the reservations
Reservation 23 (C)
The reservation (C) calls for nurses and assistant nurses to be given greater responsibility and authority to care for older people in assisted living, for every elderly home to be guaranteed round-the-clock access to a designated nurse and doctors, and for a law requiring municipalities to have cooperation agreements with the region on medical care for people in assisted living and home healthcare, plus access to a medically responsible physician in every municipality.
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 23 by C.
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: KDKristdemokraterna, LLiberalerna, MModeraterna
Ja 155–21Nej 64–112
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 | Abstain 0/0/21/3 | differs | confidence: medium | not addressed |
| S | No | Abstain 0/0/93/14 | differs | confidence: high | explicit |
| MP | No | Abstain 0/0/16/2 | differs | confidence: medium | not addressed |
| C | No | No 0/21/0/3 | match | confidence: medium | explicit |
| L | No | Yes 14/0/0/2 | differsagainst own programme | confidence: high | explicit |
| KD | No | Yes 17/0/0/2 | differsagainst own programme | confidence: high | explicit |
| M | No | Yes 60/0/0/8 | differsagainst own programme | confidence: high | explicit |
| SD | No | Yes 64/0/0/9 | differs | confidence: medium | not addressed |
Committee proposal
The Riksdag rejects the motions 2022/23:85 by Karin Rågsjö et al. (V) demands 2, 11 and 14, 2022/23:93 by Ann-Sofie Lifvenhage (M), 2022/23:313 by Markus Wiechel (SD) demands 1-3 and 2022/23:901 by Christofer Bergenblock et al. (C) demands 2-5.
Original (Swedish)
Riksdagen avslår motionerna 2022/23:85 av Karin Rågsjö m.fl. (V) yrkandena 2, 11 och 14, 2022/23:93 av Ann-Sofie Lifvenhage (M), 2022/23:313 av Markus Wiechel (SD) yrkandena 1-3 och 2022/23:901 av Christofer Bergenblock m.fl. (C) yrkandena 2-5.
Riksdag decision: The Riksdag rejected approximately 90 proposals in motions submitted during the general motion period 2022, primarily citing ongoing work. The proposals in the motions concerned, among other things, the rights of the elderly, the organisation and financing of elderly care, staff continuity and conditions, language requirements for staff in elderly care, and nutrition and meals for the elderly.
Counter-proposals
- The counter-proposal wants the government to establish explicit legal basis for denying home care to people temporarily residing in the municipality during crisis management. (C) — Reservation 23
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 demands more resources for elderly care, that the staffing shortage be addressed and that care be provided based on need regardless of housing arrangement, which directly supports the demand for permanent nursing staff around the clock and physician access in special housing.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan demands more resources for elderly care, that the staffing shortage be addressed and that care be provided based on need regardless of housing arrangement, which directly supports the demand for permanent nursing staff around the clock and physician access in special housing. Giving nurses and nursing assistants greater responsibility responds to the plan's demand for greatly expanded influence for employees in welfare. The plan does not specifically mention cooperation agreements, so the conclusion is derived.
Original (Swedish)
Planen kräver mer resurser till äldreomsorgen, att personalbristen åtgärdas och att vård ges efter behov oavsett boendeform, vilket direkt bär kravet på fast sjuksköterska dygnet runt och läkartillgång i särskilt boende. Att ge sjuksköterskor och undersköterskor större ansvar svarar mot planens krav på kraftigt utökat inflytande för de anställda i välfärden. Planen talar dock inte om just samverkansöverenskommelser, så slutsatsen är härledd.
- more resources and staffdecisive»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 the staff shortage and strengthen staff conditions and working environment.”
- care based on need»Vård och omsorg måste ges efter behov oavsett om du bor på ett särskilt boende eller har insatser av hemtjänsten.« (2022 manifesto ↗)“Care and services must be provided based on people's needs regardless of whether you live in special housing or have services from home care.”
- employees' influence»De anställda i välfärden bör också få ett kraftigt utökat inflytande över verksamheterna de arbetar i.« (2022 manifesto ↗)“Employees in welfare should also get greatly expanded influence over the activities they work in.”
- upgraded care sector»Sverige behöver rusta upp hela vårdsektorn för att kunna klara de mer normala skiftningarna i vårdbehov men också för att kunna växla upp kapaciteten i kristider.« (2022 manifesto ↗)“Sweden needs to upgrade the entire care sector to be able to handle more normal shifts in care needs but also to be able to scale up capacity in times of crisis.”
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 requires a new elderly care act that ensures equally good care throughout the country and access to nurses around the clock, which is precisely what the counter-proposal asks for.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto explicitly requires a new elderly care act that ensures equally good care throughout the country and access to nurses around the clock, which is precisely what the counter-proposal asks for. The plan also wants more to be trained and employed in elderly care and specialist training for nurses and nursing assistants to be supported, which supports the requirements for expanded medical responsibility and delegation. The programme's requirement for equal access to care throughout the country supports the requirement for doctor cooperation in all municipalities.
Original (Swedish)
Valmanifestet kräver uttryckligen en ny äldreomsorgslag som säkerställer lika bra omsorg i hela landet och tillgång till sjuksköterskor dygnet runt, vilket är precis vad motförslaget begär. Planen vill dessutom att fler utbildas och anställs i äldreomsorgen och att specialistutbildningar för sjuksköterskor och undersköterskor stöds, vilket bär kraven på utökat medicinskt ansvar och delegation. Programmets krav på likvärdig tillgång till vård i hela landet stöder kravet på läkarsamverkan i alla kommuner.
- sjuksköterskor dygnet runtdecisive»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.”
- stärkt medicinsk kompetens»Vi vill se ett språklyft för barnomsorgen och mer stöd till specialistutbildningar i vården, exempelvis för sjuksköterskor och undersköterskor.« (2022 manifesto ↗)“We want to see a language boost for childcare and more support for specialist training in healthcare, for example for nurses and nursing assistants.”
- fler anställda i äldreomsorgen»Fler ska utbildas och anställas inom äldreomsorgen och tillsynen av personalens arbetsmiljö ska förbättras.« (2022 manifesto ↗)“More shall be trained and employed within elderly care and supervision of staff working conditions shall be improved.”
- likvärdig vård i hela landet»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 school, healthcare and care.”
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 wants nurses and other licensed professional categories to take increased responsibility for their patients and that care has sufficient and trained personnel, and foresees increased coordination between primary care and elderly care.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme wants nurses and other licensed professional categories to take increased responsibility for their patients and that care has sufficient and trained personnel, and foresees increased coordination between primary care and elderly care. The election manifesto wants to strengthen care and services for the elderly and resources for home healthcare. The counter-proposal's requirement for delegation, permanent nursing and physician cooperation for particularly care housing is therefore in line with the plan.
Original (Swedish)
Partiprogrammet vill att sjuksköterskor och andra legitimerade yrkeskategorier får ta ökat ansvar för sina patienter och att omsorgen har tillräcklig och utbildad personal, samt förutser en ökad samordning mellan primärvård och äldreomsorg. Valmanifestet vill stärka vård och omsorg för äldre och hemsjukvårdens resurser. Motförslagets krav på delegation, fast sjuksköterska och läkarsamverkan för särskilt boende ligger därmed i linje med planen.
- increased responsibility for licensed staffdecisive»sjukgymnaster och andra legitimerade yrkeskategorier får möjlighet att ta ökat ansvar för sina« (party programme ↗)“physiotherapists and other licensed professional categories get the opportunity to take increased responsibility for their”
- strengthened elderly care and home healthcare»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.”
- sufficient and trained personnel»tillräcklig och utbildad personal. De anhöriga ska« (party programme ↗)“sufficient and trained personnel. Relatives shall”
- coordination between care forms»och kommer att tvinga fram en ökad samordning« (party programme ↗)“and will be forced to drive increased coordination”
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 wants to give everyone the right to a fixed doctor contact and explicitly highlights increased cooperation between municipal and regional healthcare, which is the core of the counter-proposal's requirement for fixed doctors and cooperation agreements for residents in special housing.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto wants to give everyone the right to a fixed doctor contact and explicitly highlights increased cooperation between municipal and regional healthcare, which is the core of the counter-proposal's requirement for fixed doctors and cooperation agreements for residents in special housing. The plan also wants to strengthen nursing assistants' and nurses' professional roles through right to skills development and recruit more nurses. The requirement's detailed design is lacking in the plan, but the direction is the same.
Original (Swedish)
Valmanifestet vill ge alla rätt till en fast läkarkontakt och lyfter uttryckligen ökat samarbete mellan kommunal och regional hälso- och sjukvård, vilket är kärnan i motförslagets krav om fasta läkare och samverkansöverenskommelser för boende i särskilt boende. Planen vill också stärka undersköterskors och sjuksköterskors yrkesroll genom rätt till kompetensutveckling och rekrytera fler sjuksköterskor. Kravens detaljutformning saknas i planen, men riktningen är densamma.
- right to fixed doctor contactdecisive»Vi vill ge alla rätt till en fast läkarkontakt.« (2022 manifesto ↗)“We want to give everyone the right to a fixed doctor contact.”
- cooperation municipality and region»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 space billion and increased cooperation between municipal and regional healthcare we increase the opportunities to reach the goal of 90% occupancy at our hospitals.”
- strengthened professional role in care»Vi vill ge alla undersköterskor och sjuksköterskor rätt till kompetensutveckling.« (2022 manifesto ↗)“We want to give all nursing assistants and nurses the right to skills development.”
- more nurses»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 exam bonus and providing wages during specialist studies.”
The election manifesto explicitly wants to remove the ban on municipalities employing doctors in elder care and give those with home care their own team of care personnel, and the party programme wants to strengthen primary healthcare's role.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto explicitly wants to remove the ban on municipalities employing doctors in elder care and give those with home care their own team of care personnel, and the party programme wants to strengthen primary healthcare's role. The counter-proposal's requirement for a permanent nurse and permanent doctors in special housing as well as cooperation with the region on medical care is the same thing in substance: secured medical expertise around the elderly. The plan therefore supports the requirement.
Original (Swedish)
Valmanifestet vill uttryckligen ta bort förbudet för kommuner att anställa läkare i äldreomsorgen och ge den som har hemtjänst ett eget team av omvårdnadspersonal, och partiprogrammet vill stärka primärvårdens roll. Motförslagets krav på fast sjuksköterska och fasta läkare i särskilt boende samt samverkan med regionen om läkarvård är samma sak i sak: säkrad medicinsk kompetens kring den äldre. Planen bär därför kravet.
- doctors in elder caredecisive»För att öka tryggheten vill vi ta bort förbudet för kommuner att anställa läkare i äldreomsorgen.« (2022 manifesto ↗)“To increase safety, we want to remove the ban on municipalities employing doctors in elder care.”
- permanent staff around the elderly»Vi vill att du som har hemtjänst ska ha ett eget team av omvårdnadspersonal så att du slipper möta nya ansikten varje dag.« (2022 manifesto ↗)“We want those who have home care to have their own team of care personnel so that you avoid meeting new faces every day.”
- strengthened primary healthcare for the elderly»Primärvårdens roll i sjukvårdssystemet ska stärkas.« (party programme ↗)“Primary healthcare's role in the healthcare system shall be strengthened.”
- state responsibility for competence provision»Staten ska ta ett större ansvar för sjukvårdens strategiska planering, placering av högspecialiserad vård, beredskap och långsiktig kompetensförsörjning.« (2022 manifesto ↗)“The state shall take greater responsibility for healthcare's strategic planning, placement of highly specialized care, readiness and long-term competence provision.”
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 promises increased medical competence within elder care, regular medical contact with a named doctor and continuous skills development for staff in elderly care and home help.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto promises increased medical competence within elder care, regular medical contact with a named doctor and continuous skills development for staff in elderly care and home help. The party programme demands that care and support are accessible and based on a holistic view of the individual. The counter-proposal's demands for permanent nurses and doctors, cooperation agreements and a medical responsible doctor directly respond to this.
Original (Swedish)
Valmanifestet utfäster ökad medicinsk kompetens inom äldreomsorgen, fast läkarkontakt med namngiven läkare och kontinuerlig kompetensutveckling för personal på äldreboenden och i hemtjänst. Partiprogrammet kräver att vård och omsorg är tillgänglig och utgår från en helhetssyn på den enskilde. Motförslagets krav på fasta sjuksköterskor och läkare, samverkansöverenskommelser och medicinskt ansvarig läkare svarar direkt mot detta.
- medical competence in elder caredecisive»Ökad medicinsk kompetens inom äldreomsorgen.« (2022 manifesto ↗)“Increased medical competence within elder care.”
- permanent medical contact»Inför fast läkarkontakt med en namngiven läkare« (2022 manifesto ↗)“Introduce permanent medical contact with a named doctor”
- skills development for staff»Säkerställ att personal inom hemtjänst och äldreboenden har möjlighet till kontinuerlig kompetensutveckling.« (2022 manifesto ↗)“Ensure that staff in home care and elderly care have access to continuous skills development.”
- accessible care and support»service, vård och omsorg ska vara tillgänglig« (party programme ↗)“service, care and support shall be accessible”
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 states that medical expertise and continuity must be strengthened within elderly care and that the patient-responsible doctor contact shall be the hub of elderly care.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto states that medical expertise and continuity must be strengthened within elderly care and that the patient-responsible doctor contact shall be the hub of elderly care. The counter-proposal's demand for a permanent nurse 24 hours a day, permanent doctors and cooperation over doctor care is precisely this in practical form. The plan therefore supports the demand.
Original (Swedish)
Valmanifestet slår fast att den medicinska kompetensen och kontinuiteten måste stärkas inom äldreomsorgen och att den patientansvariga läkarkontakten ska vara navet i äldres sjukvård. Motförslagets krav på fast sjuksköterska dygnet runt, fasta läkare och samverkan om läkarvård är just detta i praktisk form. Planen stöder därför kravet.
- strengthened medical expertisedecisive»Den medicinska kompetensen och kontinuiteten måste stärkas inom äldreomsorgen.« (2022 manifesto ↗)“Medical expertise and continuity must be strengthened within elderly care.”
- fixed doctor contact for elderly»Se till att den patientansvariga läkarkontakten ska utgöra navet i äldres sjukvård« (2022 manifesto ↗)“Ensure that the patient-responsible doctor contact shall be the hub of elderly care”
- staff continuity»får regelbunden vård och omsorg av personal de känner igen« (2022 manifesto ↗)“receive regular care and support from staff they recognize”
- lessons from the pandemic»Coronakommissionens slutsatser om att äldreomsorgen inte stod förberedd och rustad att möta samhällsspridningen i pandemin måste leda till förändring.« (2022 manifesto ↗)“The Corona Commission's conclusions that elderly care was not prepared and equipped to meet community spread in the pandemic must lead to change.”
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 plan requires a new elderly care act that strengthens the legal basis for good living conditions and establishes that national quality requirements in healthcare and care shall not be undermined.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan requires a new elderly care act that strengthens the legal basis for good living conditions and establishes that national quality requirements in healthcare and care shall not be undermined. The counter-proposal's requirement for dedicated nurses around the clock, dedicated doctors, medically responsible doctor and cooperation agreements are precisely such quality requirements. The plan's investment in primary care with patient-responsible doctor and fast track for elderly points in the same direction.
Original (Swedish)
Planen kräver en ny äldreomsorgslag som stärker lagstödet för goda levnadsvillkor och slår fast att nationella kvalitetskrav i vård och omsorg inte får underskridas. Motförslagets krav på fast sjuksköterska dygnet runt, fasta läkare, medicinskt ansvarig läkare och samverkansöverenskommelser är just sådana kvalitetskrav. Planens satsning på primärvård med patientansvarig läkare och snabbspår för äldre pekar i samma riktning.
- stronger elderly care actdecisive»En ny äldreomsorgslag måste stärka lagstödet för goda levnadsvillkor då den nuvarande benämningen med skäliga levnadsvillkor inte duger.« (2022 manifesto ↗)“A new elderly care act must strengthen the legal basis for good living conditions as the current designation with reasonable living conditions is not sufficient.”
- national quality requirements»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality requirements within healthcare and care must exist and may not be undermined.”
- patient-responsible doctor»Satsningar på primärvården med större patientkontakt och samordning av en patientansvarig läkare kan avlasta akut- och specialistvården genom snabbare vård.« (2022 manifesto ↗)“Initiatives in primary care with greater patient contact and coordination by a patient-responsible doctor can relieve acute and specialist care through faster care.”
- better care for elderly»Inrätta snabbspår för äldre patienter för att minska belastningen på akuten.« (2022 manifesto ↗)“Establish fast tracks for elderly patients to reduce the burden on emergency 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.
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Sources and documents
- The committee report on riksdagen.se (2022/23:SoU22)
- Committee report full text (HA01SoU22)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:1289 — Riktlinjer om chefsutbildning för bättre äldreomsorg av Sanna Backeskog och Sanne Lennström (båda S)
- Motion 2022/23:1336 — Undernäring bland äldre av Mats Wiking (S)
- Motion 2022/23:1401 — Ofrivillig ensamhet och isolering av Marie-Louise Hänel Sandström (M)
- Motion 2022/23:1850 — Språkkrav för vissa jobb inom omsorgen av Sten Bergheden (M)
- Motion 2022/23:1852 — Äldres rätt att få välja sin mat av Sten Bergheden (M)
- Motion 2022/23:1854 — Avgifter i äldreomsorgen av Sten Bergheden (M)
- Motion 2022/23:1974 — Lagen om valfrihetssystem av Eva Lindh m.fl. (S)
- Motion 2022/23:2011 — Språkkrav inom vård och äldreomsorg av Johanna Rantsi (M)
- Motion 2022/23:2018 — Förlängd satsning på Äldreomsorgslyftet av Paula Holmqvist m.fl. (S)
- Motion 2022/23:2061 — Utgiftsområde 9 Hälsovård, sjukvård och social omsorg av Fredrik Lundh Sammeli m.fl. (S)
- Motion 2022/23:313 — Värdighet för äldre och en professionalisering av äldreomsorgen av Markus Wiechel (SD)
- Motion 2022/23:314 — Nationell äldreombudsman av Markus Wiechel (SD)
- Motion 2022/23:613 — Demokratisk kontroll över den kommunala välfärden av Markus Kallifatides (S)
- Motion 2022/23:67 — Krav på registerutdrag för arbete i hemtjänst och äldreomsorg av Ann-Sofie Lifvenhage (M)
- Motion 2022/23:696 — Äldreomsorgen av Niklas Sigvardsson m.fl. (S)
- Motion 2022/23:85 — En äldreomsorg för framtiden av Karin Rågsjö m.fl. (V)
- Motion 2022/23:856 — En stärkt folkhälsa från barndom till ålderdom av Anders W Jonsson m.fl. (C)
- Motion 2022/23:859 — Ekonomisk trygghet vid ålderdom av Martina Johansson m.fl. (C)
- Motion 2022/23:90 — Pilotprojekt - Seniorhälsa av Ann-Sofie Lifvenhage (M)
- Motion 2022/23:901 — En äldreomsorg med trygghet och valfrihet i hela landet av Christofer Bergenblock m.fl. (C)
Source: The Swedish Parliament