2026-06-152025/26:SoU34 · p.11SoUHealth & social services

Follow-up and evaluation of the reform

What's at stake: The decision affects how well it will be possible in practice to detect whether the reform delivers its intended effect for people with harmful substance use or dependency and other psychiatric conditions, or whether it instead crowds out other care or burdens municipalities and regions more than planned.

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 parliament should call on the government to carry out a special, thorough follow-up and evaluation of the reform's effects, accessibility, crowding-out effects and financing, or whether existing agency assignments and reports are sufficient to capture this.

Yes Yes — the committee proposal

The committee shares the government's assessment that the reform does not yet require additional, permanent financing, and takes the view that the assignments and reporting requirements already directed at the National Board of Health and Welfare — including producing knowledge support and reporting by 31 August 2026 — provide sufficient insight into how the reform functions in practice. A separate parliamentary statement on follow-up and evaluation is therefore not considered necessary, and the motions are rejected.

No No — the reservations

Reservation 10 (S, V, C, MP)

The reservation (S, V, C, MP) argues that the government should follow up the reform very closely, given concerns about securing resources, the absence of a national support structure and tight timeframes. The follow-up should examine whether the intended effects are achieved, whether services become more coordinated and accessible, whether the reform causes crowding-out effects within psychiatry or social services, whether the division of responsibility works in practice, and whether financing matches the principals' actual costs, with a clear gender-equality and anti-discrimination perspective.

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

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

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

No Backing the counter-proposal: reservation 10 by S, V, C, MP.

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

What each plan points to — and how the party voted

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

PlanVoteConfidenceEvidence
Vown reservationNoNo 0/21/0/0follows the planconfidence: mediumnot addressed
Sown reservationNoNo 0/105/0/1follows the planconfidence: lownot addressed
MPown reservationNoNo 0/18/0/0follows the planconfidence: mediumnot addressed
Cown reservationNoNo 0/24/0/0follows the planconfidence: lownot addressed
LNoYes 16/0/0/0departs from the planconfidence: mediumnot addressed
KDNoYes 19/0/0/0departs from the planconfidence: mediumnot addressed
MNoYes 66/0/0/0departs from the planconfidence: lownot addressed
SDNoYes 70/0/0/0departs from the planconfidence: lowderived

Committee proposal

The Riksdag rejects the motions 2025/26:4155 by Fredrik Lundh Sammeli et al. (S) request 3, 2025/26:4158 by Christofer Bergenblock et al. (C) request 3, 2025/26:4177 by Nils Seye Larsen et al. (MP) request 6 and 2025/26:4181 by Karin Rågsjö et al. (V) request 3.

Original (Swedish)

Riksdagen avslår motionerna 2025/26:4155 av Fredrik Lundh Sammeli m.fl. (S) yrkande 3, 2025/26:4158 av Christofer Bergenblock m.fl. (C) yrkande 3, 2025/26:4177 av Nils Seye Larsen m.fl. (MP) yrkande 6 och 2025/26:4181 av Karin Rågsjö m.fl. (V) yrkande 3.

Riksdag decision: The Riksdag approved the Government's proposal regarding coordinated care and support operations, among other things. The proposal aims to achieve more uniform and coordinated care for persons with harmful use or dependency and other psychiatric conditions. The care shall be directed at persons who have special needs for healthcare and social services over a longer period due to a mental disability. The Government's proposal entails an expanded requirement for cooperation between municipalities and regions. The regions shall, among other things, organize care for persons with harmful use or dependency so that it can be provided in coordination with other psychiatric care. Another change is that the word "missbruk" (misuse) is removed and replaced with "bruk" (use) or "skadligt bruk och beroende" (harmful use and dependency) in several statutes concerning healthcare and social services. The legislative changes shall enter into force on 1 January 2028.

Counter-proposals

Plan vs actual vote

Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.

VVänsterpartietNoNofollows the plannot addressed

The plan requires that resources for health and medical care increase to cover needs and that care is equal and equitable regardless of where in the country you live.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan requires that resources for health and medical care increase to cover needs and that care is equal and equitable regardless of where in the country you live. Careful monitoring of whether resources, financing and division of responsibility are sufficient, with gender equality and non-discrimination perspectives, is a means to ensure exactly that. The counter-proposal's demands are therefore in line with the plan.

Original (Swedish)

Planen kräver att resurserna till hälso- och sjukvården ökar för att täcka behoven och att vården är jämlik och jämställd oavsett var i landet man bor. En noggrann uppföljning av om resurser, finansiering och ansvarsfördelning räcker, med jämställdhets- och antidiskrimineringsperspektiv, är ett medel för att säkra just det. Motförslagets krav ligger därför i linje med planen.

  • increased resources for caredecisive»Resurserna till hälso- och sjukvården måste öka för att täcka behoven« (party programme ↗)“Resources for health and medical care must increase to cover needs”
  • equal and equitable care»Sjukvården måste vara jämlik, jämställd och tillgänglig, oavsett var i landet du bor och oavsett vem du är.« (2022 manifesto ↗)“Healthcare must be equal, equitable and accessible, regardless of where in the country you live and regardless of who you are.”
  • investments in care and staff»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 ↗)“That is why the Left Party wants to invest more resources in health and medical care and elderly care, and invest in staff so that we at the same time reduce staff shortages and strengthen staff conditions and working environment.”
SSocialdemokraternaNoNofollows the plannot addressed

The plan requires ambitious measures against mental ill-health and equitable and gender-equal public health, and a welfare with long-term and sustainable financing.

Plan documents: party programme

Reasoning and quotes

The plan requires ambitious measures against mental ill-health and equitable and gender-equal public health, and a welfare with long-term and sustainable financing. Careful monitoring of crowding-out effects, responsibility division and financing, with a gender equality perspective, serves just these commitments. The plan does not address monitoring forms, however, so the conclusion is derived.

Original (Swedish)

Planen kräver ambitiösa insatser mot psykisk ohälsa och en jämlik och jämställd folkhälsa, samt en välfärd med långsiktig och hållbar finansiering. En noggrann uppföljning av undanträngningseffekter, ansvarsfördelning och finansiering, med jämställdhetsperspektiv, tjänar just dessa åtaganden. Planen behandlar dock inte uppföljningsformer, varför slutsatsen är härledd.

  • measures against mental ill-healthdecisive»Ambitiösa insatser mot psykisk ohälsa, särskilt bland barn och unga.« (party programme ↗)“Ambitious measures against mental ill-health, especially among children and young people.”
  • equitable public health»Jämlik och jämställd folkhälsa.« (party programme ↗)“Equal and gender-equal public health.”
  • sustainable welfare financing»En välfärd med långsiktig och hållbar finansiering.« (party programme ↗)“A welfare with long-term and sustainable financing.”
MPMiljöpartietNoNofollows the plannot addressed

The counter-proposal wants careful follow-up of whether the reform produces the intended effects, whether crowding-out occurs and whether funding is sufficient, with equality and anti-discrimination perspectives.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The counter-proposal wants careful follow-up of whether the reform produces the intended effects, whether crowding-out occurs and whether funding is sufficient, with equality and anti-discrimination perspectives. The plan establishes that access to support is unequally distributed between regions and groups and that care shall be based on science and proven experience. The plan's intersectional starting point also carries the requirement for an equality perspective.

Original (Swedish)

Motförslaget vill ha en noggrann uppföljning av om reformen ger avsedda effekter, om undanträngning uppstår och om finansieringen räcker, med jämställdhets- och antidiskrimineringsperspektiv. Planen slår fast att tillgången till stöd är ojämnt fördelad mellan regioner och grupper och att vården ska bygga på vetenskap och beprövad erfarenhet. Planens intersektionella utgångspunkt bär också kravet på jämställdhetsperspektiv.

  • unequal access shall be followed updecisive»otillräcklig och ojämnt fördelad, med stora skillnader mellan regioner och olika grupper i« (party programme ↗)“insufficient and unequally distributed, with large differences between regions and different groups in”
  • science and proven experience»sammanhållen beroendevård som bygger på vetenskap och beprövad erfarenhet, där« (party programme ↗)“coherent substance abuse care that is based on science and proven experience, where”
  • intersectional perspective»intersektionellt synsätt som innebär att olika sociala kategorier samverkar, interagerar« (party programme ↗)“intersectional perspective which means that different social categories interact, interact”
  • accessible care for mental ill-health»satsa på primärvården och öka tillgången till vård för psykisk ohälsa.« (2022 manifesto ↗)“invest in primary care and increase access to care for mental ill-health.”
CCenterpartietNoNofollows the plannot addressed

The plan requires equal and reliable welfare regardless of where you live, better support for mental illness and that equality permeates policy.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan requires equal and reliable welfare regardless of where you live, better support for mental illness and that equality permeates policy. Careful monitoring of whether the reform produces the intended effects, whether crowding-out occurs and whether financing is sufficient, with equality and anti-discrimination perspective, follows from these commitments. However, the plan says nothing about this specific reform's monitoring.

Original (Swedish)

Planen kräver likvärdig och pålitlig välfärd oavsett var man bor, bättre stöd vid psykisk ohälsa och att jämställdheten genomsyrar politiken. En noggrann uppföljning av om reformen ger avsedda effekter, om undanträngning uppstår och om finansieringen räcker, med jämställdhets- och antidiskrimineringsperspektiv, följer av dessa åtaganden. Planen säger dock inget om just denna reforms uppföljning.

  • equal welfaredecisive»Alla invånare ska ha tillgång till en likvärdig och pålitlig välfärd oavsett var de bor, och den offentliga servicen ska finnas där när man behöver den.« (2022 manifesto ↗)“All residents shall have access to equal and reliable welfare regardless of where they live, and public services shall be there when needed.”
  • better support for mental illness»Stödet för personer med psykisk ohälsa måste förbättras, inte minst för unga.« (2022 manifesto ↗)“Support for people with mental illness must be improved, especially for young people.”
  • equality perspective»Vi ska bygga ett jämställt Sverige med möjligheter och rättvisa för alla.« (2022 manifesto ↗)“We shall build an equal Sweden with opportunities and justice for all.”
  • combat discrimination»Vi bekämpar alla strukturer, formella och informella, som förtrycker eller diskriminerar människor.« (party programme ↗)“We combat all structures, formal and informal, that oppress or discriminate against people.”
LLiberalernaNoYesdeparts from the plannot addressed

The plan requires that care and treatment of physical and mental illnesses is provided on scientific grounds and that addiction care is scientifically based, which presupposes that effects are actually followed up.

Plan documents: party programme

Reasoning and quotes

The plan requires that care and treatment of physical and mental illnesses is provided on scientific grounds and that addiction care is scientifically based, which presupposes that effects are actually followed up. It also requires equivalent quality regardless of place of residence and that a gender equality perspective is integrated in all relevant public decisions. Careful follow-up of the reform with a gender equality perspective therefore follows from the plan.

Original (Swedish)

Planen kräver att vård och behandling av fysiska och psykiska sjukdomar ges på vetenskaplig grund och att missbruksvården är vetenskapligt grundad, vilket förutsätter att effekterna faktiskt följs upp. Den kräver också likvärdig kvalitet oavsett bostadsort och att ett jämställdhetsperspektiv integreras i alla relevanta offentliga beslut. En noggrann uppföljning av reformen med jämställdhetsperspektiv följer därmed av planen.

  • scientifically based caredecisive»Vård, behandling och rehabilitering av fysiska och psykiska sjukdomar ska ges på vetenskaplig grund.« (party programme ↗)“Care, treatment and rehabilitation of physical and mental illnesses shall be provided on scientific grounds.”
  • evidence-based addiction care»Missbruks- och beroendevården ska vara vetenskapligt grundad.« (party programme ↗)“Addiction and dependency care shall be scientifically based.”
  • gender equality perspective in decisions»Ett jämställdhetsperspektiv ska integreras i alla relevanta offentliga beslut.« (party programme ↗)“A gender equality perspective shall be integrated in all relevant public decisions.”
  • equivalent welfare»Oavsett bostadsort har individer rätt att få likvärdig kvalitet på vården, omsorgen, socialtjänsten och andra välfärdstjänster.« (party programme ↗)“Regardless of place of residence individuals have the right to receive equivalent quality in care, support, social services and other welfare services.”

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.

KDKristdemokraternaNoYesdeparts from the plannot addressed

The plan makes evaluation, cost follow-up and quality control central political tasks and requires that decisions be tested against their long-term consequences.

Plan documents: party programme

Reasoning and quotes

The plan makes evaluation, cost follow-up and quality control central political tasks and requires that decisions be tested against their long-term consequences. Careful monitoring of whether the reform produces intended effects, whether displacement occurs in psychiatry and whether financing is sufficient follows from that, as does the requirement for equitable and accessible care.

Original (Swedish)

Planen gör utvärdering, kostnadsuppföljning och kvalitetskontroll till centrala politiska uppgifter och kräver att beslut prövas mot sina långsiktiga konsekvenser. En noggrann uppföljning av om reformen ger avsedda effekter, om undanträngning uppstår i psykiatrin och om finansieringen räcker följer av det, liksom av kravet på jämlik och tillgänglig vård.

  • follow-up as a political taskdecisive»kostnadsuppföljning och kvalitetskontroll är därför viktiga politiska uppgifter.« (party programme ↗)“cost follow-up and quality control are therefore important political tasks.”
  • equitable and accessible care»Vården ska vara jämlik och tillgänglig för hela befolkningen.« (party programme ↗)“Care shall be equitable and accessible to the entire population.”
  • accessible psychiatric care»snabb och tillgänglig kompetens för barn och ungdom med psykisk ohälsa.« (party programme ↗)“fast and accessible expertise for children and young people with mental illness.”
  • consequences shall be considered»Alla politiska beslut bör fattas i enlighet med förvaltarskapsprincipen, vilket innebär att« (party programme ↗)“All political decisions should be made in accordance with the stewardship principle, which means that”

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.

MModeraternaNoYesdeparts from the plannot addressed

The plan says nothing about monitoring of this specific reform.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The plan says nothing about monitoring of this specific reform. It rests instead on reforms being based on research and proven experience, and on the party constantly evaluating and reconsidering what has been implemented, and it promises that welfare shall function regardless of where in the country one lives. That argues for careful monitoring of effects and potential displacement. The support is derived and uncertain.

Original (Swedish)

Planen säger inget om uppföljningen av just den här reformen. Den vilar däremot på att reformer ska luta sig mot forskning och beprövad erfarenhet och att partiet ständigt ska utvärdera och ompröva det som genomförts, och den lovar att välfärden ska fungera oavsett var i landet man bor. Det talar för en noggrann uppföljning av effekter och undanträngning. Stödet är härlett och osäkert.

  • ständig utvärdering av reformerdecisive»beredskap för att utvärdera, ompröva, förändra och förbättra« (party programme ↗)“readiness to evaluate, reconsider, change and improve”
  • likvärdig välfärd i hela landet»Du ska kunna känna dig trygg med att välfärden fungerar oavsett var i landet du bor.« (2022 manifesto ↗)“You should be able to feel safe that welfare functions regardless of where in the country you live.”

flags: citat_blockerat

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.

SDSverigedemokraternaNoYesdeparts from the planderived

The plan requires clear results for every public investment and wants to strengthen resources to psychiatry, which speaks for careful follow-up of whether the reform achieves its intended effect and whether funding is sufficient.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan requires clear results for every public investment and wants to strengthen resources to psychiatry, which speaks for careful follow-up of whether the reform achieves its intended effect and whether funding is sufficient. The plan's demand for full compensation to municipalities supports follow-up of costs. The part about gender equality perspective lies however further from the plan, which favors formal rather than outcome-driven equality.

Original (Swedish)

Planen kräver tydliga resultat för varje offentlig satsning och vill stärka resurserna till psykiatrin, vilket talar för en noggrann uppföljning av om reformen får avsedd effekt och om finansieringen räcker. Planens krav på full kompensation till kommunerna stöder uppföljningen av kostnaderna. Delen om jämställdhetsperspektiv ligger dock längre från planen, som förordar formell snarare än utfallsstyrd jämställdhet.

  • results follow-updecisive»Begära tydliga resultat för varje offentlig satsning« (2022 manifesto ↗)“Demand clear results for every public investment”
  • resources for psychiatry»Stärka resurserna till psykiatrin« (2022 manifesto ↗)“Strengthen resources to psychiatry”
  • full municipal cost coverage»Staten bör aldrig fatta beslut om nya kostnadsdrivande åtaganden för kommunerna utan att fullt ut kompensera dem för kostnaderna.« (party programme ↗)“The state should never make decisions about new cost-driving commitments for municipalities without fully compensating them for the costs.”
  • formal equality»Riktig jämställdhet nås inte genom att vidta politiska åtgärder för att på gruppnivå skapa samma utfall mellan män och kvinnor, utan genom att ta krafttag mot samhällsfenomen som begränsar den enskilde.« (2022 manifesto ↗)“True equality is not achieved by taking political action to create the same outcome at group level between men and women, but by taking action against social phenomena that restrict the individual.”

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

Documents under consideration

Source: The Swedish Parliament