2026-06-152025/26:SoU34 · p.8SoUHealth & social services

A national transition plan

A national transition plan for the co-occurring-conditions care reform

What's at stake: It concerns how legally secure and patient-safe the transition will be for people with harmful substance use or dependency as responsibility for care and treatment is reorganised between municipalities and regions.

Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.

What the vote decides

The question is whether the government should draw up a dedicated national transition plan, in dialogue with regions, municipalities, professions and user organisations, to steer the implementation, or whether the implementation support and preparation time already announced are sufficient.

Yes Yes — the committee proposal

The committee shares the government's assessment that preparation time is needed for implementation, but considers that the work must not be delayed further. It points out that the government has already announced 50 million kronor for agency assignments and other measures to support the principals, and that the National Board of Health and Welfare has been given a comprehensive assignment to support implementation of the reform. Against that background, a separate, parliament-mandated transition plan is not considered necessary, and the motion is rejected.

No No — the reservations

Reservation 7 (V)

The reservation (V) argues that the reform entails significant organizational changes for both regions and municipalities, and that in order to ensure a legally secure and patient-safe transition, the government should draw up a national transition plan for the implementation, developed in close dialogue with regions, municipalities, professional representatives and user organisations.

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 7 by V.

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
SNoYes 105/0/0/1departs from the planconfidence: lownot addressed
MPNoYes 18/0/0/0departs from the planconfidence: mediumnot addressed
CNoYes 24/0/0/0departs from the planconfidence: lownot addressed
LNoYes 16/0/0/0departs from the planconfidence: lownot addressed
KDNoYes 19/0/0/0departs from the planconfidence: mediumnot addressed
MYesYes 66/0/0/0follows the planconfidence: lownot addressed
SDNoYes 70/0/0/0departs from the planconfidence: lowderived

Committee proposal

Parliament rejects motion 2025/26:4181 by Karin Rågsjö et al. (V) request 1.

Original (Swedish)

Riksdagen avslår motion 2025/26:4181 av Karin Rågsjö m.fl. (V) yrkande 1.

Riksdag decision: Parliament approved, among other things, the government's proposal for coordinated care and support services. The proposal aims to achieve more uniform and coordinated care for persons with harmful use or addiction and other psychiatric conditions. The care shall be directed toward persons who have special needs for health and medical care services and social services for a longer period due to a mental functional impairment. 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 addiction so that it can be provided in a coordinated manner with other psychiatric care. Another change is that the term "substance abuse" is removed and replaced with use or alternatively harmful use and addiction in several statutes relating to health and medical care and social services. The legislative changes shall come 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 places the overall responsibility for welfare on the state and requires that care is equitable throughout the country.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan places the overall responsibility for welfare on the state and requires that care is equitable throughout the country. A national transition plan developed in dialogue with regions, municipalities, professions and user organisations responds to the plan's requirement that those who perform the work should have significantly increased influence over the activities. The counter-proposal's requirements are therefore in line with the plan.

Original (Swedish)

Planen lägger det övergripande ansvaret för välfärden på staten och kräver att vården är jämlik i hela landet. En nationell övergångsplan framtagen i dialog med regioner, kommuner, professioner och brukarorganisationer svarar mot planens krav på att de som utför arbetet ska ha ett kraftigt utökat inflytande över verksamheterna. Motförslagets krav ligger därför i linje med planen.

  • employees' influence in welfaredecisive»De anställda i välfärden bör också få ett kraftigt utökat inflytande över verksamheterna de arbetar i.« (2022 manifesto ↗)“Those employed in welfare should also have significantly increased influence over the activities they work in.”
  • equitable care throughout the country»Sjukvården måste vara jämlik, jämställd och tillgänglig, oavsett var i landet du bor och oavsett vem du är.« (2022 manifesto ↗)“Healthcare must be equitable, equal and accessible, regardless of where in the country you live and regardless of who you are.”
  • the state's responsibility for welfare»övergripande ansvaret för välfärden.« (party programme ↗)“overall responsibility for welfare.”
SSocialdemokraternaNoYesdeparts from the plannot addressed

The plan requires increased state responsibility and control over healthcare for national equity and good welfare regardless of where in the country one lives.

Plan documents: party programme

Reasoning and quotes

The plan requires increased state responsibility and control over healthcare for national equity and good welfare regardless of where in the country one lives. A national transition plan developed in dialogue with regions, municipalities and professions is a tool for legally secure and equitable change. However, the plan says nothing about transition plans as such.

Original (Swedish)

Planen kräver ökat statligt ansvar och kontroll över sjukvården för nationell likvärdighet och god välfärd oavsett var i landet man bor. En nationell övergångsplan framtagen i dialog med regioner, kommuner och professioner är ett verktyg för en rättssäker och likvärdig omställning. Planen säger dock inget om övergångsplaner som sådana.

  • state responsibility for equitable caredecisive»Ökat statligt ansvar och kontroll över sjukvården för nationell likvärdighet.« (party programme ↗)“Increased state responsibility and control over healthcare for national equity.”
  • equitable welfare»God service och välfärd till medborgarna oavsett var i landet de bor.« (party programme ↗)“Good service and welfare for citizens regardless of where in the country they live.”
  • ensured competence supply»God kompetensförsörjning inom skola, vård och omsorg.« (party programme ↗)“Good competence supply in schools, healthcare and 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.

MPMiljöpartietNoYesdeparts from the plannot addressed

The counter-proposal wants to develop a national transition plan in dialogue with regions, municipalities, professions and user organizations for a legally sound and care-safe transformation.

Plan documents: party programme

Reasoning and quotes

The counter-proposal wants to develop a national transition plan in dialogue with regions, municipalities, professions and user organizations for a legally sound and care-safe transformation. The plan requires increased collaboration between actors, points to major differences between regions and establishes that staff needs appropriate resources and working conditions. An orderly transition plan is a reasonable expression of these commitments.

Original (Swedish)

Motförslaget vill ta fram en nationell övergångsplan i dialog med regioner, kommuner, professioner och brukarorganisationer för en rättssäker och patientsäker omställning. Planen kräver ökad samverkan mellan aktörer, pekar på stora skillnader mellan regioner och slår fast att personalen behöver rätt resurser och arbetsvillkor. En ordnad övergångsplan är ett rimligt uttryck för dessa åtaganden.

  • collaboration between authoritiesdecisive»Vi vill se ökad samverkan mellan olika aktörer för att uppnå en god folkhälsa, då vården i« (party programme ↗)“We want to see increased collaboration between different actors to achieve good public health, as healthcare in”
  • equitable care between regions»otillräcklig och ojämnt fördelad, med stora skillnader mellan regioner och olika grupper i« (party programme ↗)“insufficient and unevenly distributed, with major differences between regions and different groups in”
  • staff's conditions»Vårdens personal behöver rätt resurser, arbetsvillkor« (party programme ↗)“Healthcare staff needs appropriate resources, working conditions”
  • integrated addiction care»En effektiv narkotikapolitik måste kombinera förebyggande arbete med skademinimering« (party programme ↗)“Effective drug policy must combine preventive work with harm reduction”

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.

CCenterpartietNoYesdeparts from the plannot addressed

The plan builds welfare on increased cooperation between municipal and regional health and medical services and on everyone having influence over their own lives even in welfare services.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan builds welfare on increased cooperation between municipal and regional health and medical services and on everyone having influence over their own lives even in welfare services. A national transition plan created in dialogue with regions, municipalities, professions and user organizations is an application of that, and supports the requirement for equivalent welfare throughout the country. However, the plan does not directly address implementation forms.

Original (Swedish)

Planen bygger välfärden på ökat samarbete mellan kommunal och regional hälso- och sjukvård och på att alla ska ha inflytande över sina egna liv även i välfärdstjänsterna. En nationell övergångsplan framtagen i dialog med regioner, kommuner, professioner och brukarorganisationer är en tillämpning av det, och stöder kravet på likvärdig välfärd i hela landet. Planen behandlar dock inte genomförandeformer direkt.

  • cooperation between municipality and regiondecisive»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 care billion and increased cooperation between municipal and regional health and medical services, we increase the chances of reaching the goal of 90% occupancy in our hospitals.”
  • user influence»Alla ska ha inflytande över sina egna liv också när det gäller välfärdstjänster.« (party programme ↗)“Everyone should have influence over their own lives even when it comes to welfare services.”
  • equivalent welfare»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 equivalent and reliable welfare regardless of where they live, and public service shall be there when needed.”
  • cooperation and responsibility»Vi värderar samarbete, ansvarstagande och resultat framför politiskt spel.« (2022 manifesto ↗)“We value cooperation, responsibility and results over political maneuvering.”

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.

LLiberalernaNoYesdeparts from the plannot addressed

The plan demands expanded national coordination and governance of healthcare and equivalent quality regardless of residence place, which speaks for a collective plan when responsibility moves between principals.

Plan documents: party programme

Reasoning and quotes

The plan demands expanded national coordination and governance of healthcare and equivalent quality regardless of residence place, which speaks for a collective plan when responsibility moves between principals. It also wants that user participation is facilitated, which answers the demand for dialogue with user organizations. The plan says however nothing about transition plans as a tool.

Original (Swedish)

Planen kräver utökad nationell samordning och styrning av vården och likvärdig kvalitet oavsett bostadsort, vilket talar för en samlad plan när ansvaret flyttas mellan huvudmän. Den vill också att brukarmedverkan underlättas, vilket svarar mot kravet på dialog med brukarorganisationer. Planen säger dock ingenting om övergångsplaner som verktyg.

  • national coordinationdecisive»Det behövs en utökad nationell samordning och styrning.« (party programme ↗)“There is a need for expanded national coordination and governance.”
  • user participation»Brukarmedverkan i kvalitetsarbetet ska underlättas, och meddelarfriheten för privat personal garanteras i lag.« (party programme ↗)“User participation in quality work shall be facilitated, and speaking freedom for private staff shall be guaranteed in law.”
  • equivalent welfare»Oavsett bostadsort har individer rätt att få likvärdig kvalitet på vården, omsorgen, socialtjänsten och andra välfärdstjänster.« (party programme ↗)“Regardless of residence place individuals have right to receive equivalent quality on healthcare, care, social services and other welfare services.”
  • cooperation around substance abuse»En nära samverkan mellan socialtjänst, hälso- och sjukvård och rättsväsende är viktig för att personer som hamnat i missbruk ska erbjudas hjälp.« (party programme ↗)“Close cooperation between social services, health and medical care and the justice system is important so that people who have ended up in substance abuse shall be offered help.”

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 requires well-developed cooperation between providers and that user influence is encouraged.

Plan documents: party programme

Reasoning and quotes

The plan requires well-developed cooperation between providers and that user influence is encouraged. A national transition plan developed in dialogue with regions, municipalities, professions and user organizations is a direct expression of this and serves the plan's requirement for equitable care. The stewardship principle further requires that decision consequences be considered in a future perspective.

Original (Swedish)

Planen kräver väl utvecklad samverkan mellan huvudmän och att brukarnas inflytande uppmuntras. En nationell övergångsplan framtagen i dialog med regioner, kommuner, professioner och brukarorganisationer är ett direkt uttryck för det, och tjänar planens krav på en jämlik vård. Förvaltarskapsprincipen kräver dessutom att besluts konsekvenser beaktas i ett framtidsperspektiv.

  • cooperation between providersdecisive»Samverkan mellan olika huvudmän ska vara väl utvecklad.« (party programme ↗)“Cooperation between different providers shall be well-developed.”
  • user influence»Äldres inflytande i form av patient-, pensionärs- eller brukarföreningar ska uppmuntras.« (party programme ↗)“Elderly people's influence in the form of patient, pensioner or user associations shall be encouraged.”
  • equitable care»Vården ska vara jämlik och tillgänglig för hela befolkningen.« (party programme ↗)“Care shall be equitable and accessible to the entire population.”
  • 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”

flags: citat_migrerat

The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.

MModeraternaYesYesfollows the plannot addressed

The plan is based on a step-by-step reform method and on prioritising what must be done now and what can wait; it also sees queues and delays in healthcare as a failure.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan is based on a step-by-step reform method and on prioritising what must be done now and what can wait; it also sees queues and delays in healthcare as a failure. A special national transition plan before the reform continues merely postpones the reform without adding care. The plan says nothing about transition plans, which is why certainty is low.

Original (Swedish)

Planen bygger på en stegvis reformmetod och på att prioritera vad som måste göras nu och vad som får vänta; den ser också köer och dröjsmål i välfärden som ett misslyckande. En särskild nationell övergångsplan innan genomförandet fortsätter skjuter reformen framåt utan att tillföra vård. Planen säger inget om övergångsplaner, varför säkerheten är låg.

  • prioritisation and decisive actiondecisive»Vi vet vad som måste göras – och vad som får vänta.« (2022 manifesto ↗)“We know what must be done – and what can wait.”
  • step-by-step reformism»Moderaterna tror på en stegvis samhällsutveckling« (party programme ↗)“The Moderate Party believes in step-by-step societal development”
  • delays in healthcare are a failure»Köer till välfärdstjänster är ett misslyckande« (party programme ↗)“Queues for healthcare services are a failure”
SDSverigedemokraternaNoYesdeparts from the planderived

The plan requires new structures for improved cooperation between authorities and actors and a national strategy in the health field, which speaks for a national transition plan when responsibility changes for both regions and municipalities.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan requires new structures for improved cooperation between authorities and actors and a national strategy in the health field, which speaks for a national transition plan when responsibility changes for both regions and municipalities. The plan also wants to review the organization of healthcare and establishes that care should be equal and good throughout the country. A plan developed in dialogue with the principal managers therefore lies in line with the plan.

Original (Swedish)

Planen kräver nya strukturer för förbättrat samarbete mellan myndigheter och aktörer och en nationell strategi på hälsoområdet, vilket talar för en nationell övergångsplan när ansvaret förändras för både regioner och kommuner. Planen vill också se över sjukvårdens organisation och slår fast att vården ska vara jämn och god i hela landet. En plan framtagen i dialog med huvudmännen ligger därmed i linje med planen.

  • cooperation structuresdecisive»Det behöver skapas nya strukturer för ett förbättrat samarbete mellan departement, myndigheter och andra relevanta aktörer.« (2022 manifesto ↗)“New structures need to be created for improved cooperation between departments, authorities and other relevant actors.”
  • national strategy»Ta fram en nationell strategi för det fortsatta arbetet med psykisk hälsa« (2022 manifesto ↗)“Develop a national strategy for continued work on mental health”
  • review of healthcare organization»Se över sjukvårdens organisation« (2022 manifesto ↗)“Review the organization of healthcare”
  • equal care throughout the country»Sverigedemokraterna ser till hela Sveriges bästa och anser det därför vara av yttersta vikt att det skapas en jämn och god vård över hela landet så att inte regionala obalanser uppstår.« (party programme ↗)“The Sweden Democrats look to all of Sweden's benefit and therefore consider it of utmost importance that equal and good care is created throughout the country so that regional imbalances do not arise.”

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