2026-06-152025/26:SoU34 · p.9SoUHealth & social services
Implementation reporting
A comprehensive implementation report for the co-occurring-conditions care reform
What's at stake: It concerns how transparent and predictable the implementation of the whole reform becomes for municipalities, regions and the people affected, when only part of the reform is presented at a time.
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 return to parliament with a comprehensive, time-tabled plan for the whole co-occurring-conditions care reform, including the parts not yet presented, or whether it is enough for the division of responsibility to be clarified step by step through the legislation now proposed.
Yes Yes — the committee proposal
The committee notes that regions' healthcare responsibility for people with harmful substance use or dependency is now clarified in law, which the committee regards as an important clarification to ensure that the needs of the group concerned are met, and it assumes that municipalities and regions will coordinate and make care and support available appropriately. Against that background, the committee sees no reason for parliament to take its own initiative on a comprehensive, time-tabled implementation report, and the motion is rejected.
No No — the reservations
Reservation 8 (MP)
The reservation (MP) argues that it is not enough for the government to now present a bill covering only part of the reform, and that the government should instead return to parliament with a comprehensive, time-tabled plan for the whole co-occurring-conditions care reform, including the parts that remain.
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 8 by MP.
Abstain The party marks a position of its own that is not one of the two final alternatives.
What each plan points to — and how the party voted
For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | Yes 20/1/0/0 | departs from the plan | confidence: low | not addressed |
| S | No | Yes 104/1/0/1 | departs from the plan | confidence: low | not addressed |
| MP | No | No 0/18/0/0 | follows the plan | confidence: medium | not addressed |
| C | No | Yes 24/0/0/0 | departs from the plan | confidence: low | derived |
| L | No | Yes 16/0/0/0 | departs from the plan | confidence: low | derived |
| KD | No | Yes 19/0/0/0 | departs from the plan | confidence: medium | not addressed |
| M | Yes | Yes 66/0/0/0 | follows the plan | confidence: low | not addressed |
| SD | No | Yes 70/0/0/0 | departs from the plan | confidence: low | not addressed |
Broke with the party line
| VGudrun Nordborg (V, Västerbottens län) | No — party line: Yes |
| SPeter Hultqvist (S, Dalarnas län) | No — party line: Yes |
MPs whose vote differs from their party's majority position in this division. Marked with a dark ring in the chamber view.
Committee proposal
Parliament rejects motion 2025/26:4177 by Nils Seye Larsen et al. (MP) request 3.
Original (Swedish)
Riksdagen avslår motion 2025/26:4177 av Nils Seye Larsen m.fl. (MP) yrkande 3.
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
- The counter-proposal wants legislation to clearly establish that regions have primary responsibility for treating harmful substance use and addiction. (MP) — Reservation 8
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 establishes that people caught in addiction shall have access to the care they need and that the state has the overarching responsibility for welfare.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan establishes that people caught in addiction shall have access to the care they need and that the state has the overarching responsibility for welfare. A comprehensive and time-bound plan for the whole reform, including the parts that remain, is a means for that responsibility to become real and care to be equitable throughout the country. The plan does however not make statements about reporting forms, so the conclusion is derived.
Original (Swedish)
Planen slår fast att människor som fastnat i missbruk ska ha tillgång till den vård de behöver och att staten har det övergripande ansvaret för välfärden. En samlad och tidsatt plan för hela reformen, inklusive de delar som återstår, är ett medel för att det ansvaret ska bli verkligt och vården jämlik i hela landet. Planen uttalar sig dock inte om redovisningsformer, varför slutsatsen härleds.
- care for people in addictiondecisive»Människor som fastnat i missbruk ska ha tillgång till den vård« (party programme ↗)“People caught in addiction shall have access to the care they”
- the state's responsibility for welfare»övergripande ansvaret för välfärden.« (party programme ↗)“overarching responsibility for welfare.”
- equitable healthcare 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 plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan requires increased state responsibility and control over healthcare for national equivalence and equal rights for all to good care.
Plan documents: party programme
Reasoning and quotes
The plan requires increased state responsibility and control over healthcare for national equivalence and equal rights for all to good care. A comprehensive and time-bound plan for the entire reform, rather than parts being presented one at a time, serves that equivalence. The plan does not, however, address reporting formats, so the conclusion is derived.
Original (Swedish)
Planen kräver ökat statligt ansvar och kontroll över sjukvården för nationell likvärdighet och lika rätt för alla till god vård. En samlad och tidsatt plan för hela reformen, i stället för att delar läggs fram åt gången, tjänar den likvärdigheten. Planen behandlar dock inte redovisningsformer, varför slutsatsen är härledd.
- state responsibility for equivalent caredecisive»Ökat statligt ansvar och kontroll över sjukvården för nationell likvärdighet.« (party programme ↗)“Increased state responsibility and control over healthcare for national equivalence.”
- equal right to care»Lika rätt för alla till god hälso- och sjukvård genom samhällets försorg.« (party programme ↗)“Equal rights for all to good health and medical care through public provision.”
- equivalent 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.”
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 counter-proposal wants to see a comprehensive and time-bound plan for the entire reform instead of parts being presented separately.
Plan documents: party programme
Reasoning and quotes
The counter-proposal wants to see a comprehensive and time-bound plan for the entire reform instead of parts being presented separately. The plan wants a coordinated dependency care service with regional lead responsibility and increased cooperation between actors, and points out that access to support today is unevenly distributed. A comprehensive implementation plan is a reasonable consequence of these commitments.
Original (Swedish)
Motförslaget vill se en samlad och tidsatt plan för hela reformen i stället för att delar läggs fram var för sig. Planen vill ha en sammanhållen beroendevård med regionalt huvudansvar och ökad samverkan mellan aktörer, och pekar på att tillgången till stöd i dag är ojämnt fördelad. En samlad genomförandeplan är en rimlig följd av dessa åtaganden.
- regional lead responsibilitydecisive»och tillgänglig vård. Miljöpartiet vill att regionerna får huvudansvaret för en« (party programme ↗)“and accessible care. The Green Party wants regions to have lead responsibility for”
- coordinated care chain»En effektiv narkotikapolitik måste kombinera förebyggande arbete med skademinimering« (party programme ↗)“An effective substance abuse policy must combine preventive work with harm reduction”
- increased cooperation»Vi vill se ökad samverkan mellan olika aktörer för att uppnå en god folkhälsa, då vården i« (party programme ↗)“We want to see increased cooperation between different actors to achieve good public health, as care in”
- equitable access to support»otillräcklig och ojämnt fördelad, med stora skillnader mellan regioner och olika grupper i« (party programme ↗)“insufficient and unevenly distributed, with large differences between regions and different groups in”
The plan establishes that better care requires long-term work and a variety of reforms, and that the Centre Party prioritizes long-term joint solutions over political manoeuvring.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan establishes that better care requires long-term work and a variety of reforms, and that the Centre Party prioritizes long-term joint solutions over political manoeuvring. A comprehensive and time-bound plan for the entire reform, including the parts that remain, follows from that stance and from the requirement for coordination between municipality and region. However, the plan says nothing about reporting forms.
Original (Swedish)
Planen slår fast att en bättre vård kräver långsiktigt arbete och en mängd olika reformer, och att Centerpartiet prioriterar långsiktiga gemensamma lösningar framför politiskt spel. En samlad och tidsatt plan för hela reformen, inklusive de delar som återstår, följer av den hållningen och av kravet på samordning mellan kommun och region. Planen säger dock inget om redovisningsformer.
- long-term reform work in caredecisive»För att lyckas med allt detta krävs långsiktigt arbete och en mängd olika reformer.« (2022 manifesto ↗)“To succeed with all this requires long-term work and a variety of reforms.”
- long-term joint solutions»Vi prioriterar långsiktiga, gemensamma lösningar med partier från både vänster och höger.« (2022 manifesto ↗)“We prioritize long-term joint solutions with parties from both left and right.”
- coordination between 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 location improvement and increased cooperation between municipal and regional healthcare, we increase the possibilities of reaching the target of 90% bed occupancy in our hospitals.”
- equal 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 inhabitants shall have access to equal and reliable welfare regardless of where they live, and public services shall be available where needed.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan wants the Swedish drug policy to be investigated in its entirety and requires expanded national coordination and direction and close cooperation between social services, healthcare, and the justice system.
Plan documents: party programme
Reasoning and quotes
The plan wants the Swedish drug policy to be investigated in its entirety and requires expanded national coordination and direction and close cooperation between social services, healthcare, and the justice system. Presenting a comprehensive and time-bound plan for the entire reform instead of parts at a time responds to that holistic view. However, the plan does not take a position on the reporting form as such.
Original (Swedish)
Planen vill att den svenska narkotikapolitiken utreds i sin helhet och kräver utökad nationell samordning och styrning samt nära samverkan mellan socialtjänst, vård och rättsväsende. Att lägga fram en samlad och tidsatt plan för hela reformen i stället för delar i taget svarar mot den helhetssynen. Planen tar dock inte ställning till redovisningsformen som sådan.
- comprehensive drug policydecisive»Mot bakgrund av Sveriges höga narkotikadödlighet och problem med gängbrottslighet vill Liberalerna dock att den svenska narkotikapolitiken utreds i sin helhet.« (party programme ↗)“Against the background of Sweden's high drug mortality and problems with gang crime, the Liberals want the Swedish drug policy to be investigated in its entirety.”
- national coordination»Det behövs en utökad nationell samordning och styrning.« (party programme ↗)“Expanded national coordination and direction is needed.”
- cooperation on 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, healthcare, and the justice system is important so that people who have fallen into substance abuse are offered help.”
- zero vision for drug deaths»Det övergripande målet ska vara en nollvision mot drogrelaterat lidande och drogrelaterade dödsfall.« (party programme ↗)“The overarching goal should be a zero vision for drug-related suffering and drug-related deaths.”
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 stewardship principle requires that the consequences of decisions be considered in a future perspective, and the plan makes follow-up and quality control a political task.
Plan documents: party programme
Reasoning and quotes
The stewardship principle requires that the consequences of decisions be considered in a future perspective, and the plan makes follow-up and quality control a political task. A comprehensive and time-limited plan for the entire reform, including the parts that remain, is precisely such long-term management and facilitates the cooperation between principal authorities that the plan requires for appropriate care.
Original (Swedish)
Förvaltarskapsprincipen kräver att beslutens konsekvenser beaktas i ett framtidsperspektiv, och planen gör uppföljning och kvalitetskontroll till en politisk uppgift. En samlad och tidsatt plan för hela reformen, inklusive de delar som återstår, är just en sådan långsiktig hantering och underlättar den samverkan mellan huvudmän som planen kräver för en ändamålsenlig vård.
- consequences in a future perspectivedecisive»Alla politiska beslut bör fattas i enlighet med förvaltarskapsprincipen, vilket innebär att« (party programme ↗)“All political decisions should be taken in accordance with the stewardship principle, which means that”
- follow-up as a political task»kostnadsuppföljning och kvalitetskontroll är därför viktiga politiska uppgifter.« (party programme ↗)“cost follow-up and quality control are therefore important political tasks.”
- cooperation between principal authorities»Samverkan mellan olika huvudmän ska vara väl utvecklad.« (party programme ↗)“Cooperation between different principal authorities shall be well developed.”
- appropriate care»Den solidariskt finansierade hälso- och sjukvården ska vara ändamålsenlig och« (party programme ↗)“The solidarity-financed health and medical care shall be appropriate and”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan's reform method is explicitly staged, where new progress is added to old, and it is built on prioritising what must be done now and what can wait.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan's reform method is explicitly staged, where new progress is added to old, and it is built on prioritising what must be done now and what can wait. A demand that the entire reform shall be laid out in a comprehensive and timed plan before parts are carried through goes against that method. The plan says nothing on implementation reporting, hence confidence is low.
Original (Swedish)
Planens reformmetod är uttryckligen stegvis, där nya framsteg läggs till gamla, och den bygger på att prioritera vad som måste göras nu och vad som får vänta. Ett krav på att hela reformen ska läggas fram i en samlad och tidsatt plan innan delarna genomförs går emot den metoden. Planen säger inget om just genomföranderedovisning, varför säkerheten är låg.
- staged reformdecisive»Moderaterna tror på en stegvis samhällsutveckling« (party programme ↗)“The Moderates believe in staged societal development”
- prioritisation and determination»Vi vet vad som måste göras – och vad som får vänta.« (2022 manifesto ↗)“We know what must be done – and what can wait.”
- prioritise and choose to omit»Politiken har en viktig uppgift att prioritera och välja bort« (party programme ↗)“Policy has an important task to prioritise and choose to omit”
The plan does not address this particular reform's implementation plan, but it consistently requires that public investments be reported and followed up with clear results and citizen benefit.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan does not address this particular reform's implementation plan, but it consistently requires that public investments be reported and followed up with clear results and citizen benefit. A comprehensive and time-bound plan for the entire reform is the kind of follow-up the plan seeks. Sweden Democrats also want to review the organization of the health service as a whole rather than in isolated parts.
Original (Swedish)
Planen tar inte upp just denna reforms genomförandeplan, men den kräver genomgående att offentliga satsningar redovisas och följs upp med tydliga resultat och medborgarnytta. En samlad och tidsatt plan för hela reformen är den sortens uppföljning planen efterfrågar. Sverigedemokraterna vill också se över sjukvårdens organisation i sin helhet snarare än i lösryckta delar.
- resultatkrav på offentliga satsningardecisive»Begära tydliga resultat för varje offentlig satsning« (2022 manifesto ↗)“Demand clear results for every public investment”
- tydlig medborgarnytta»Sverigedemokraterna vill koncentrera de offentliga utgifterna till välfärdens hjärta och begära tydlig medborgarnytta för alla satsningar.« (2022 manifesto ↗)“Sweden Democrats want to concentrate public expenditures on the heart of welfare and demand clear citizen benefit for all investments.”
- stärkt ansvarsutkrävande»Sverigedemokraterna vill stärka möjligheter för ansvarsutkrävande när hanteringen av de offentliga resurserna brister.« (2022 manifesto ↗)“Sweden Democrats want to strengthen possibilities for accountability when the management of public resources fails.”
- sammanhållen sjukvård»Se över sjukvårdens organisation« (2022 manifesto ↗)“Review the organization of the health service”
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 (2025/26:SoU34)
- Committee report full text (HD01SoU34)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2025/26:4155 — med anledning av prop. 2025/26:251 En mer sammanhållen vård för personer med skadligt bruk eller beroende och andra psykiatriska tillstånd av Fredrik Lundh Sammeli m.fl. (S)
- Motion 2025/26:4158 — med anledning av prop. 2025/26:251 En mer sammanhållen vård för personer med skadligt bruk eller beroende och andra psykiatriska tillstånd av Christofer Bergenblock m.fl. (C)
- Motion 2025/26:4177 — med anledning av prop. 2025/26:251 En mer sammanhållen vård för personer med skadligt bruk eller beroende och andra psykiatriska tillstånd av Nils Seye Larsen m.fl. (MP)
- Motion 2025/26:4181 — med anledning av prop. 2025/26:251 En mer sammanhållen vård för personer med skadligt bruk eller beroende och andra psykiatriska tillstånd av Karin Rågsjö m.fl. (V)
- Proposition 2025/26:251 — En mer sammanhållen vård för personer med skadligt bruk eller beroende och andra psykiatriska tillstånd
Source: The Swedish Parliament