2025-03-192024/25:SoU21 · p.7SoUHealth & social services
Palliative care in elderly care
National responsibility for palliative care in elderly care
What's at stake: Many older people in elderly care have palliative care needs, and the quality and availability of such care can currently vary between regions and municipalities. The question is whether the state should take clearer national responsibility so that everyone, regardless of where they live or their diagnosis, has access to knowledge-based, person-centred palliative care at the end of life.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The motion called for the government to review how national responsibility for palliative care in elderly care could be introduced so that care becomes equally available regardless of where a person lives, while the committee held that an ongoing government inquiry into strengthened medical competence in municipal health care already covers the issue and that no separate initiative was needed.
Yes Yes — the committee proposal
The committee notes that an ongoing government inquiry into strengthened medical competence in municipal health care already proposes measures to clarify the procedures for admission to palliative care in agreements between regions and municipalities, and prefers to await the government's continued processing of the matter rather than have parliament take its own initiative.
No No — the reservations
Reservation 8 (SD)
The reserving party (SD) stresses that palliative care should relieve suffering and promote quality of life for the terminally ill by taking physical, psychological, social, and existential needs into account and supporting relatives, and that such care should be available to everyone regardless of where they live or their diagnosis. The party wants the government to review how national responsibility for palliative care could be introduced, with tools and knowledge support that make it possible to integrate person-centred palliative care into elderly care.
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 SD.
Abstain The party marks a position of its own that is not one of the two final alternatives.
The decision would have held
Explicit commitments that contradicted the vote: KDKristdemokraterna
Ja 242–63Ja 225–80
Counterfactual: the parties above are moved to the position their own documents explicitly point at, carrying their whole contingent present. Every other party keeps its real figures, including dissenters and absentees.
How the AI parties would have voted
For each party: what its own plan – election manifesto and party programme – argues for in this case, next to how the party actually voted. The AI can only answer Yes or No; a party can also abstain.
| AI | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | Yes 21/0/0/3 | differs | confidence: high | not addressed |
| S | No | Yes 93/0/0/13 | differs | confidence: high | not addressed |
| MP | No | Yes 16/0/0/2 | differs | confidence: high | not addressed |
| C | No | Yes 20/0/0/4 | differs | confidence: medium | not addressed |
| L | No | Yes 15/0/0/1 | differs | confidence: medium | derived |
| KD | No | Yes 17/0/0/2 | differsagainst own programme | confidence: high | explicit |
| M | No | Yes 59/0/0/9 | differs | confidence: medium | not addressed |
| SD | No | No 0/62/0/10 | match | confidence: medium | not addressed |
Committee proposal
The Riksdag rejects motion 2024/25:1365 by Carina Ståhl Herrstedt et al. (Sweden Democrats) demand 10.
Original (Swedish)
Riksdagen avslår motion 2024/25:1365 av Carina Ståhl Herrstedt m.fl. (SD) yrkande 10.
Riksdag decision: The Riksdag said no to approximately 60 proposals on elderly care in motions from the general motion period of 2024. The proposals concern, among other things, the organization and function of elderly care, health and medical care in elderly care, and elderly care personnel. The Riksdag refers, among other things, to ongoing work in the area.
Counter-proposals
- The counter-proposal wants to increase gender equality in elderly care through measures for more equivalent treatment and support services. (SD) — 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 demands equitable and accessible care regardless of where in the country you live, that care is provided according to need, and that resources for health and medical care increase to meet needs.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan demands equitable and accessible care regardless of where in the country you live, that care is provided according to need, and that resources for health and medical care increase to meet needs. The counter-proposal's demand for national responsibility and knowledge support for palliative care in elderly care is an application of exactly this. Palliative care is not explicitly mentioned, so the position is derived.
Original (Swedish)
Planen kräver en jämlik och tillgänglig vård oavsett var i landet man bor, att vård och omsorg ges efter behov och att resurserna till hälso- och sjukvården ökar för att täcka behoven. Motförslagets krav på ett nationellt ansvar och kunskapsstöd för palliativ vård i äldreomsorgen är en tillämpning av just detta. Palliativ vård nämns inte uttryckligen, varför ställningstagandet härleds.
- equitable care throughout the countrydecisive»Sjukvården måste vara jämlik, jämställd och tillgänglig, oavsett var i landet du bor och oavsett vem du är.« (2022 manifesto ↗)“Healthcare must be equitable, gender-equal and accessible, regardless of where in the country you live and regardless of who you are.”
- care according to need in elderly care»Vård och omsorg måste ges efter behov oavsett om du bor på ett särskilt boende eller har insatser av hemtjänsten.« (2022 manifesto ↗)“Care must be provided according to need regardless of whether you live in special housing or receive home help services.”
- increased care resources»Resurserna till hälso- och sjukvården måste öka för att täcka behoven« (party programme ↗)“Resources for health and medical care must increase to meet needs”
- security in support»Alla ska känna sig trygga i att det finns stöd att få när vi behöver det.« (party programme ↗)“Everyone should feel safe knowing that support is available when we need it.”
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's bearing commitment is a new elderly care law that ensures equally good care throughout the country and access to nurses around the clock, and that welfare shall be there when someone is between life and death.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto's bearing commitment is a new elderly care law that ensures equally good care throughout the country and access to nurses around the clock, and that welfare shall be there when someone is between life and death. A national responsibility for palliative care, accessible regardless of residence and diagnosis, is the same kind of demand for equivalence. Palliative care is not explicitly mentioned, so the stance is derived.
Original (Swedish)
Valmanifestets bärande åtagande är en ny äldreomsorgslag som säkerställer lika bra omsorg i hela landet och tillgång till sjuksköterskor dygnet runt, och att välfärden ska finnas där när någon svävar mellan liv och död. Ett nationellt ansvar för palliativ vård, tillgänglig oavsett bostadsort och diagnos, är samma slags krav på likvärdighet. Palliativ vård nämns inte uttryckligen, varför ställningstagandet härleds.
- equivalent care throughout the countrydecisive»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 to have a new elderly care law that ensures everyone receives equally good care throughout the country and access to nurses around the clock.”
- welfare in life's most difficult moments»I de största och svåraste ögonblicken ska välfärden finnas där – när ett barn föds, när någon blir sjuk, kanske svävar mellan liv och död, när vi behöver extra stöd på ålderns höst eller när vi trampat snett i livet.« (2022 manifesto ↗)“In the greatest and most difficult moments welfare shall be there – when a child is born, when someone becomes ill, perhaps hovering between life and death, when we need extra support in old age or when we have stumbled in life.”
- equivalent care regardless of residence»Alla invånare i hela landet ska ha likvärdig tillgång till skola, vård och omsorg.« (party programme ↗)“All residents throughout the country shall have equivalent access to education, care and services.”
- safe old age»Det ska vara tryggt att åldras i Sverige.« (2022 manifesto ↗)“It shall be safe to grow old in Sweden.”
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 party programme wants to see developed end-of-life care with good nursing care and adequate pain relief, in an environment that is also good for relatives, and that care is distributed according to need.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme wants to see developed end-of-life care with good nursing care and adequate pain relief, in an environment that is also good for relatives, and that care is distributed according to need. The election manifesto promises good care regardless of where in the country you live and improved care for the elderly. A national responsibility with knowledge support for palliative care in elderly care follows from these commitments.
Original (Swedish)
Partiprogrammet vill se en utvecklad vård i livets slutskede med god omvårdnad och tillräcklig smärtlindring, i en miljö som är bra även för de anhöriga, och att vården fördelas efter behov. Valmanifestet lovar bra vård oavsett var i landet man bor och förbättrad omsorg för äldre. Ett nationellt ansvar med kunskapsstöd för palliativ vård i äldreomsorgen följer av dessa åtaganden.
- developed end-of-life caredecisive»Vi vill se en utvecklad vård i livets slutskede med god omvårdnad och tillräcklig smärtlindring« (party programme ↗)“We want to see developed end-of-life care with good nursing care and adequate pain relief”
- equitable care regardless of residence»Du ska ha rätt till en bra vård, oavsett var i landet du bor.« (2022 manifesto ↗)“You have the right to good care, regardless of where in the country you live.”
- strengthened elderly care and home care»förbättra vård och omsorg för äldre och stärka resurserna till hemsjukvården.« (2022 manifesto ↗)“improve care for the elderly and strengthen resources for home care.”
- care according to need»Vården ska hålla god kvalitet, vara tillgänglig, fördelas efter behov och vara solidariskt finansierad.« (party programme ↗)“Care should be of good quality, be accessible, be distributed according to need and be financed in a solidaristic manner.”
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 commits to lifting the quality of healthcare and elderly care, and the party programme to all getting a secure old age with dignity and equivalent care regardless of where in the country one lives.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto commits to lifting the quality of healthcare and elderly care, and the party programme to all getting a secure old age with dignity and equivalent care regardless of where in the country one lives. A review making person-centred palliative care available regardless of residence and diagnosis aligns with this. The plan does not however want to move responsibility for care from regions to the state, which makes support for national main administration weaker.
Original (Swedish)
Valmanifestet åtar sig att kvaliteten i sjukvården och äldreomsorgen ska lyftas, och partiprogrammet att alla ska få en trygg ålderdom med värdighet och en likvärdig vård oavsett var i landet man bor. En översyn som gör personcentrerad palliativ vård tillgänglig oavsett bostadsort och diagnos ligger i linje med detta. Planen vill däremot inte flytta vårdansvaret från regionerna till staten, vilket gör stödet för ett nationellt huvudmannaskap svagare.
- improved quality in elderly caredecisive»Kvaliteten i sjukvården och äldreomsorgen ska lyftas.« (2022 manifesto ↗)“Quality in healthcare and elderly care shall be lifted.”
- secure and dignified old age»Alla ska kunna få en trygg ålderdom med hög livskvalitet och värdighet.« (party programme ↗)“All shall be able to get a secure old age with high quality of life and dignity.”
- equivalent care throughout the country»Sjukvården bör ta hänsyn till att människor är olika och att förutsättningarna ser olika ut i olika delar av landet, men alla ska vara trygga med att få en likvärdig vård.« (party programme ↗)“Healthcare should take account of the fact that people are different and conditions look different in different parts of the country, but all shall be secure in getting equivalent care.”
- care responsibility stays with regions»Ansvaret för vården ska inte flyttas från regionerna till staten.« (2022 manifesto ↗)“Responsibility for care shall not be moved from regions to the state.”
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 establishes that the right to self-determination and influence also applies to patients at the end of life and that care shall be equitable regardless of place of residence.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan establishes that the right to self-determination and influence also applies to patients at the end of life and that care shall be equitable regardless of place of residence. That supports the counter-proposal's requirements for national responsibility and knowledge support so that person-centred palliative care can be provided in elderly care everywhere. The plan also wants the state to take greater responsibility for healthcare planning and for municipalities to be able to employ doctors in elderly care.
Original (Swedish)
Planen slår fast att rätten till självbestämmande och inflytande även gäller patienter i livets slutskede och att vården ska vara jämlik oavsett bostadsort. Det bär motförslagets krav på ett nationellt ansvar och kunskapsstöd så att personcentrerad palliativ vård kan ges i äldreomsorgen överallt. Planen vill dessutom att staten tar ett större ansvar för sjukvårdens planering och att kommuner ska få anställa läkare i äldreomsorgen.
- self-determination at life's enddecisive»till självbestämmande och inflytande ska även gälla för patienter i livets slutskede.« (party programme ↗)“to self-determination and influence should also apply to patients at the end of life.”
- equitable care regardless of place of residence»Vården ska vara jämlik. Var och en har rätt till god vård och omsorg oavsett bakgrund, kön, ålder,« (party programme ↗)“Care shall be equitable. Everyone has the right to good care and services regardless of background, gender, age,”
- greater state responsibility for healthcare»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 specialised care, preparedness and long-term skills supply.”
- medical expertise in elderly care»För att öka tryggheten vill vi ta bort förbudet för kommuner att anställa läkare i äldreomsorgen.« (2022 manifesto ↗)“To increase security, we want to remove the ban on municipalities employing doctors in elderly 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.
The plan demands a dignified death with good care at the end of life and a holistic view aimed at advanced care and pain relief, with staff aware of existential questions.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan demands a dignified death with good care at the end of life and a holistic view aimed at advanced care and pain relief, with staff aware of existential questions. The election manifesto moreover promises increased medical expertise in elderly care. Introducing national responsibility and knowledge support for person-centred palliative care in elderly care is therefore the plan's own line.
Original (Swedish)
Planen kräver en värdig död med god vård i livets slutskede och en helhetssyn som syftar till avancerad omvårdnad och smärtlindring, med personal som är medveten om existentiella frågor. Valmanifestet lovar dessutom ökad medicinsk kompetens inom äldreomsorgen. Att införa ett nationellt ansvar och kunskapsstöd för personcentrerad palliativ vård i äldreomsorgen är därmed planens egen linje.
- good care at the end of lifedecisive»istället krävs en helhetssyn som syftar till en avancerad omvårdnad och smärtlindring« (party programme ↗)“instead requires a holistic view aimed at advanced care and pain relief”
- healthcare in the service of life»Sjukvården ska stå i livets tjänst.« (party programme ↗)“Healthcare shall be in the service of life.”
- existential needs are considered»fortbildning som leder till medvetenhet om existentiella frågor.« (party programme ↗)“further training that leads to awareness of existential questions.”
- medical expertise in elderly care»Ökad medicinsk kompetens inom äldreomsorgen.« (2022 manifesto ↗)“Increased medical expertise in elderly 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 plan establishes that medical expertise and continuity must be strengthened in elderly care and that the patient-responsible doctor contact should be the hub in elderly health care.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan establishes that medical expertise and continuity must be strengthened in elderly care and that the patient-responsible doctor contact should be the hub in elderly health care. It also requires equivalent care of high quality regardless of where in the country one lives. A review of national responsibility and knowledge support for palliative care in elderly care follows from these commitments, although palliative care is not specifically mentioned.
Original (Swedish)
Planen slår fast att den medicinska kompetensen och kontinuiteten måste stärkas inom äldreomsorgen och att den patientansvariga läkarkontakten ska vara navet i äldres sjukvård. Den kräver också likvärdig vård av hög kvalitet oavsett var i landet man bor. En översyn av ett nationellt ansvar och kunskapsstöd för palliativ vård i äldreomsorgen följer av dessa åtaganden, även om palliativ vård inte nämns särskilt.
- strengthened medical expertisedecisive»Den medicinska kompetensen och kontinuiteten måste stärkas inom äldreomsorgen.« (2022 manifesto ↗)“Medical expertise and continuity must be strengthened in elderly care.”
- doctor contact as hub»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 in elderly health care”
- equivalent care throughout country»Alla har rätt till likvärdig vård – som kan ges i rätt tid och håller hög kvalitet.« (2022 manifesto ↗)“Everyone has the right to equivalent care - which can be provided in the right time and maintains high quality.”
- dignified old age»Äldre har en självklar rätt till en trygg och värdig ålderdom« (party programme ↗)“Elderly have a self-evident right to a secure and dignified old age”
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.
The party programme states that everyone should be able to age with dignity, that older people must not die alone and that national quality standards in care must exist and not be undercut.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme states that everyone should be able to age with dignity, that older people must not die alone and that national quality standards in care must exist and not be undercut. National responsibility and knowledge support for palliative care in elderly care is one way to realise this, and aligns with the plan's desire to review how the state can take greater overall responsibility for care. Palliative care is not explicitly mentioned in the documents.
Original (Swedish)
Partiprogrammet slår fast att alla ska kunna åldras med värdighet, att äldre inte får dö ensamma och att nationella kvalitetskrav inom vård och omsorg måste finnas och inte får underskridas. Ett nationellt ansvar och kunskapsstöd för palliativ vård i äldreomsorgen är ett sätt att förverkliga just detta, och ligger i linje med planens vilja att se över hur staten kan ta ett större huvudansvar för vården. Palliativ vård nämns inte uttryckligen i dokumenten.
- national quality standardsdecisive»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality standards in care must exist and must not be undercut.”
- no one should die alone»kan inte acceptera att äldre dör ensamma« (party programme ↗)“cannot accept that older people die alone”
- dignified ageing»Alla människor skall kunna åldras med värdighet.« (party programme ↗)“All people shall be able to age with dignity.”
- greater state responsibility for care»Sverigedemokraterna vill också se över hur staten i större utsträckning kan ta över huvudansvaret för sjukvården« (2022 manifesto ↗)“Sweden Democrats also want to review how the state to a greater extent can take overall responsibility for healthcare”
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Sources and documents
- The committee report on riksdagen.se (2024/25:SoU21)
- Committee report full text (HC01SoU21)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2024/25:1029 — Kvalitet i äldrevården av Kerstin Lundgren (C)
- Motion 2024/25:1364 — Folkhälsan i fokus av Carina Ståhl Herrstedt m.fl. (SD)
- Motion 2024/25:1365 — God vård och omsorg för äldre av Carina Ståhl Herrstedt m.fl. (SD)
- Motion 2024/25:1412 — Jämställdhet och diskriminering av Michael Rubbestad m.fl. (SD)
- Motion 2024/25:1527 — Skydds- och tvångsåtgärder inom vården och omsorgen för äldre personer av Peder Björk och Malin Larsson (båda S)
- Motion 2024/25:1635 — Språkkrav i välfärden av Lawen Redar (S)
- Motion 2024/25:183 — Förbättrade måltider för äldre i det offentliga av Catarina Deremar (C)
- Motion 2024/25:1851 — Lagen om valfrihetssystem (LOV) inom välfärdsområdet av Jessica Rodén och Petter Löberg (båda S)
- Motion 2024/25:2224 — Språkkrav inom vård och äldreomsorg av Johanna Rantsi (M)
- Motion 2024/25:2234 — Utdrag ur belastningsregister för personer som arbetar med äldre av Johanna Rantsi (M)
- Motion 2024/25:2358 — Svenska språket inom äldreomsorgen av Peter Hultqvist (S)
- Motion 2024/25:2392 — Kognitiva sjukdomar som leder till demens av Mats Sander (M)
- Motion 2024/25:2395 — Heltäckande registerutdrag för personal inom offentlig verksamhet av Caroline Högström (M)
- Motion 2024/25:2493 — Bemanning i verksamheter nära medborgarna av Gunilla Svantorp m.fl. (S)
- Motion 2024/25:2515 — Lagen om valfrihetssystem av Markus Kallifatides m.fl. (S)
- Motion 2024/25:2553 — Språktest för arbete i omsorg och äldreomsorg av Ann-Sofie Lifvenhage (M)
- Motion 2024/25:2675 — Möjlighet att anställa kommunala läkare av Ann-Sofie Lifvenhage (M)
- Motion 2024/25:2701 — Pilotprojekt - seniorhälsa av Ann-Sofie Lifvenhage (M)
- Motion 2024/25:2772 — Språkkrav för vissa jobb inom omsorgen av Sten Bergheden (M)
- Motion 2024/25:2774 — Äldres möjligheter att få bo kvar i sin hemkommun av Sten Bergheden (M)
Source: The Swedish Parliament