2024-05-162023/24:SoU21 · p.9SoUHealth & social services
Healthcare in sparsely populated areas
State responsibility for digital care technology in rural areas
What's at stake: Long distances and a sparse population make it harder to maintain good access to care, and essential technology such as broadband is missing in some areas. The decision affects how quickly residents of rural areas and islands gain access to functioning remote care.
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 state should take greater financial responsibility for investments in broadband, telephone coverage and remote-care technology in rural areas and on islands, or whether this should be handled within existing agreements and ongoing development work.
Yes Yes — the committee proposal
The committee rejects the motions for state responsibility for care technology in rural areas. It points to ongoing efforts - including the Good and Close Care 2024 and Increased Accessibility 2024 agreements, the project on close care from a rural perspective, and work on a national digital infrastructure for healthcare under a dedicated national coordinator - and considers that the Riksdag does not need to take any further initiative.
No No — the reservations
Reservation 11 (C, MP)
The reservation (C, MP) calls for the state to take greater financial responsibility for investments in broadband, telephone coverage and technical aids for remote care in rural areas and on islands. The reasoning is that such technology already exists and can bridge many of the difficulties caused by long distances and a dispersed population.
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 11 by C, MP.
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: LLiberalerna, MModeraterna, SDSverigedemokraterna
Ja 242–32Nej 109–165
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 0/0/19/5 | differs | confidence: high | explicit |
| S | No | Yes 93/0/0/13 | differs | confidence: medium | not addressed |
| MP | No | No 0/13/0/5 | match | confidence: medium | explicit |
| C | No | No 0/19/0/5 | match | confidence: high | explicit |
| L | No | Yes 12/0/0/4 | differsagainst own programme | confidence: high | explicit |
| KD | No | Yes 14/0/0/5 | differs | confidence: medium | not addressed |
| M | No | Yes 60/0/0/8 | differsagainst own programme | confidence: high | explicit |
| SD | No | Yes 61/0/0/11 | differsagainst own programme | confidence: high | explicit |
Committee proposal
The Riksdag rejects the motions 2023/24:2344 by Nooshi Dadgostar et al. (V) demand 11 and 2023/24:2457 by Muharrem Demirok et al. (C) demand 17.
Original (Swedish)
Riksdagen avslår motionerna 2023/24:2344 av Nooshi Dadgostar m.fl. (V) yrkande 11 och 2023/24:2457 av Muharrem Demirok m.fl. (C) yrkande 17.
Riksdag decision: The Riksdag rejected approximately 90 proposals in motions regarding skills supply, e-health and preparedness that were submitted during the general motion period in 2023. The motions dealt with, among other things, training of personnel in occupational health services, skills supply and qualifications, workplace environment, life science matters, healthcare in sparsely populated areas, and health and social care preparedness. The Riksdag referred to, among other things, ongoing work in the area.
Counter-proposals
- The counter-proposal wants the government to assign a suitable authority responsibility for training specialist doctors in occupational medicine and securing necessary financing. (C, MP) — Reservation 11
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 election manifesto states that the expansion of transport infrastructure and fibre is going far too slowly and that the state needs to take greater responsibility for it, and that welfare must exist everywhere.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto states that the expansion of transport infrastructure and fibre is going far too slowly and that the state needs to take greater responsibility for it, and that welfare must exist everywhere. The counter-proposal's requirement for greater state financial responsibility for broadband, telephone coverage and remote care technology in rural areas thus falls within the plan's commitment. The plan also requires that care must be accessible regardless of where in the country one lives.
Original (Swedish)
Valplattformen konstaterar att utbyggnaden av transportinfrastruktur och fiber går alldeles för sakta och att staten behöver ta ett större ansvar för den, och att välfärden ska finnas överallt. Motförslagets krav på ett större statligt ekonomiskt ansvar för bredband, telefontäckning och teknik för vård på distans i glesbygd faller därmed inom planens åtagande. Planen kräver också att vården ska vara tillgänglig oavsett var i landet man bor.
- state responsibility for fibre expansiondecisive»Utbyggnaden av transportinfrastruktur och fiber går alldeles för sakta, staten behöver gå in och ta ett större ansvar för utbyggnaden.« (2022 manifesto ↗)“The expansion of transport infrastructure and fibre is going far too slowly, the state needs to step in and take greater responsibility for the expansion.”
- 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.”
- welfare throughout the country»Välfärden måste vara till för alla och finnas överallt.« (2022 manifesto ↗)“Welfare must be available to everyone and exist everywhere.”
- welfare closer at hand in rural areas»Det behöver bli enklare att röra sig i« (party programme ↗)“It needs to become easier to access”
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 establishes that the state shall be present throughout the country and that welfare shall be secured even in small municipalities with weak population bases.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto establishes that the state shall be present throughout the country and that welfare shall be secured even in small municipalities with weak population bases. The party programme demands equal access to care for all residents throughout the country. The counter-proposal's demand for greater state economic responsibility for broadband and telehealth technology in sparsely populated areas is a means for precisely that equivalence.
Original (Swedish)
Valmanifestet slår fast att staten ska finnas närvarande i hela landet och att välfärden ska säkras även i små kommuner med svagt befolkningsunderlag. Partiprogrammet kräver likvärdig tillgång till vård för alla invånare i hela landet. Motförslagets krav på ett större statligt ekonomiskt ansvar för bredband och distansvårdsteknik i glesbygd är ett medel för just den likvärdigheten.
- state presence throughout the countrydecisive»Staten ska finnas närvarande i hela landet.« (2022 manifesto ↗)“The state shall be present throughout the country.”
- equal care throughout the country»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, care and services.”
- equalisation for service in sparsely populated areas»För att säkra välfärden i hela landet behöver vi se över skatteutjämningssystemet, så att det garanterar offentlig service av hög kvalitet i hela landet, även i små kommuner som kämpar med sitt befolkningsunderlag.« (2022 manifesto ↗)“To secure welfare throughout the country we need to review the tax equalisation system, so that it guarantees public services of high quality throughout the country, even in small municipalities struggling with their population base.”
- equal care throughout the country»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 wish to have a new care for the elderly act that ensures that everyone receives equally good care throughout the country and access to nurses around the clock.”
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 makes good quality postal and telecommunications across the country a societal responsibility and identifies expanded, fast broadband as crucial for rural areas.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme makes good quality postal and telecommunications across the country a societal responsibility and identifies expanded, fast broadband as crucial for rural areas. The election manifesto establishes the right to good care regardless of where in the country you live. The counter-proposal's demand for state economic responsibility for broadband, coverage and technology for remote care follows directly from these commitments.
Original (Swedish)
Partiprogrammet gör post och telekommunikation av god kvalitet i hela landet till ett samhällsansvar och pekar ut utbyggt, snabbt bredband som avgörande för landsbygden. Valmanifestet slår fast rätten till bra vård oavsett var i landet man bor. Motförslagets krav på statligt ekonomiskt ansvar för bredband, täckning och teknik för vård på distans följer direkt av dessa åtaganden.
- public service throughout the countrydecisive»ska vara till för Sveriges alla invånare och finnas tillgängliga över hela landet.« (party programme ↗)“shall be available for all Sweden's inhabitants and be accessible throughout the country.”
- expanded broadband in rural areas»vara lättillgängliga alternativ, genom bland annat utbyggt, snabbt bredband.« (party programme ↗)“be easily accessible alternatives, through among other things expanded, fast broadband.”
- equal care throughout the country»Du ska ha rätt till en bra vård, oavsett var i landet du bor.« (2022 manifesto ↗)“You shall have the right to good care, regardless of where in the country you live.”
- digital care services»Digitala tjänster inom vården ska utvecklas.« (party programme ↗)“Digital services within care shall be developed.”
The election manifesto promises broadband, mobile telephony and mobile data throughout the country and that public service, including safe and nearby healthcare, shall exist regardless of where one lives.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto promises broadband, mobile telephony and mobile data throughout the country and that public service, including safe and nearby healthcare, shall exist regardless of where one lives. The counter-proposal's demand for government responsibility for broadband, telephone coverage and technology for remote healthcare in sparsely populated areas is exactly this commitment put into practice in healthcare. The plan also assumes that the regular doctor contact can be met both physically and digitally.
Original (Swedish)
Valmanifestet lovar bredband, mobiltelefoni och surf i hela landet och att offentlig service, inklusive en trygg och nära vård, ska finnas oavsett var man bor. Motförslagets krav på statligt ansvar för bredband, telefontäckning och teknik för distansvård i glesbygd är just detta åtagande omsatt i vården. Planen förutsätter dessutom att den fasta läkarkontakten ska kunna mötas både fysiskt och digitalt.
- broadband nationwidedecisive»Alla ska ha tillgång till bredband, mobiltelefoni och surf i hela landet. Vi vill fortsätta bygga ut bredbandet och stärka mobiltäckningen i hela landet, inklusive på tågen.« (2022 manifesto ↗)“Everyone shall have access to broadband, mobile telephony and mobile data throughout the country. We want to continue expanding broadband and strengthen mobile coverage throughout the country, including on trains.”
- equitable healthcare nationwide»Offentlig service ska vara nära och pålitlig i hela landet. Alla ska ha en trygg polisnärvaro, en likvärdig skola och en trygg och nära vård och omsorg — oavsett var de bor.« (2022 manifesto ↗)“Public service shall be close and reliable throughout the country. Everyone shall have safe police presence, equitable schools and safe and nearby healthcare and care — regardless of where they live.”
- care both physical and digital»Alla ska ha rätt till en fast läkarkontakt som man vet namnet på och som man kan möta både fysiskt och digitalt.« (2022 manifesto ↗)“Everyone has the right to a regular doctor contact whose name you know and whom you can meet both physically and digitally.”
- digitalization on equal terms»Digitalisering på lika villkor, oavsett var man bor, är en förutsättning för demokrati och möjliggör decentralisering.« (party programme ↗)“Digitalization on equal terms, regardless of where one lives, is a prerequisite for democracy and enables decentralization.”
The plan explicitly states that the state, if needed, shall co-finance the expansion of IT capacity outside cities and in sparsely populated areas, precisely to compensate for the high expansion costs there.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan explicitly states that the state, if needed, shall co-finance the expansion of IT capacity outside cities and in sparsely populated areas, precisely to compensate for the high expansion costs there. It also requires that all regions be assigned a digital accessibility that is at least as good as the physical. The counter-proposal's requirement for state financial responsibility for broadband and technology for remote care in sparsely populated areas is thus directly supported.
Original (Swedish)
Planen säger uttryckligen att staten vid behov ska medfinansiera utbyggnaden av IT-kapacitet utanför städer och i glesbygd, just för att kompensera för de höga utbyggnadskostnaderna där. Den kräver dessutom att alla regioner åläggs en digital tillgänglighet som är minst lika bra som den fysiska. Motförslagets krav på statligt ekonomiskt ansvar för bredband och teknik för vård på distans i glesbygd stöds därmed direkt.
- the state co-finances IT in sparsely populated areasdecisive»utbyggnadskostnader i dessa områden, ska staten vid behov medfinansiera denna utbyggnad.« (party programme ↗)“expansion costs in these areas, the state shall, if needed, co-finance this expansion.”
- digital care guarantee throughout the country»Vi vill se en digital valfrihetsreform och vårdgaranti där alla regioner ska åläggas att erbjuda en minst lika bra digital tillgänglighet som fysisk, där du utifrån din situation alltid ska välja hur du vill möta vården.« (2022 manifesto ↗)“We want to see a digital choice reform and care guarantee where all regions shall be required to offer at least as good digital accessibility as physical, where based on your situation you can always choose how you want to meet care.”
- equitable care regardless of place of residence»Vården ska vara jämlik.« (party programme ↗)“Care shall be equitable.”
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 explicitly prioritizes care close to people outside major cities and the party programme places on the state responsibility for maintaining a long-term high investment level in electronic communication channels.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto explicitly prioritizes care close to people outside major cities and the party programme places on the state responsibility for maintaining a long-term high investment level in electronic communication channels. Everyone regardless of residence should have access to society's fundamental rights. The counter-proposal's requirements for state responsibility for broadband and technology for remote care in sparsely populated areas therefore align with the plan.
Original (Swedish)
Valmanifestet prioriterar uttryckligen vård nära människor utanför storstäderna och principprogrammet lägger på staten ett ansvar för att investeringsnivån i elektroniska kommunikationskanaler hålls långsiktigt hög. Alla ska oavsett bostadsort få del av samhällets grundläggande rättigheter. Motförslagets krav på statligt ansvar för bredband och teknik för vård på distans i glesbygd ligger därmed i linje med planen.
- care nearby across the countrydecisive»Fler vårdcentraler på landsbygden och enklare för enskilda läkare att starta egen verksamhet - så att vården finns nära till hands.« (2022 manifesto ↗)“More healthcare centres in rural areas and easier for individual doctors to start their own practice - so that care is close at hand.”
- state infrastructure responsibility»investeringsnivån i kommunikationssystemens infrastruktur såsom vägar, järnvägar och elektroniska« (party programme ↗)“the investment level in communications systems infrastructure such as roads, railways and electronic”
- rights regardless of residence»Alla människor ska oavsett bostadsort kunna få del av« (party programme ↗)“All people should regardless of residence be able to have access to”
- digital healthcare information»Trygg patientsäkerheten med nationella standarder och tekniska specifikationer för all digital vårdinformation.« (2022 manifesto ↗)“Ensure patient safety with national standards and technical specifications for all digital healthcare information.”
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 classify broadband as national infrastructure and prioritize accordingly, explicitly on the grounds that everyone should be able to connect to a healthcare center.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto wants to classify broadband as national infrastructure and prioritize accordingly, explicitly on the grounds that everyone should be able to connect to a healthcare center. That is precisely what the counter-proposal requires state responsibility for in sparsely populated areas. The plan also establishes that welfare should function regardless of where in the country you live.
Original (Swedish)
Valmanifestet vill klassa bredband som nationell infrastruktur och prioritera därefter, uttryckligen med motiveringen att alla ska kunna koppla upp sig mot en vårdcentral. Det är precis det motförslaget kräver statligt ansvar för i glesbygd. Planen slår dessutom fast att välfärden ska fungera oavsett var i landet man bor.
- broadband as national infrastructuredecisive»Klassa bredband som nationell infrastruktur och prioritera därefter« (2022 manifesto ↗)“Classify broadband as national infrastructure and prioritize accordingly”
- connection to healthcare center»Bredband måste finnas så att alla har samma möjligheter att koppla upp sig mot en vårdcentral eller att jobba hemifrån.« (2022 manifesto ↗)“Broadband must exist so that everyone has the same opportunities to connect to a healthcare center or to work from home.”
- equivalent welfare throughout country»Du ska kunna känna dig trygg med att välfärden fungerar oavsett var i landet du bor.« (2022 manifesto ↗)“You should be able to feel confident that welfare functions regardless of where in the country you live.”
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 explicitly commits to investment in broadband and telephone expansion throughout the country and states with concern that rural areas are lagging behind in broadband expansion and mobile coverage.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan explicitly commits to investment in broadband and telephone expansion throughout the country and states with concern that rural areas are lagging behind in broadband expansion and mobile coverage. It also requires that care is available even in sparsely populated regions and that a national patient record system is introduced. The counter-proposal's requirements for state responsibility for broadband, coverage and technology for remote healthcare in rural areas thus lie within the plan's commitments.
Original (Swedish)
Planen åtar sig uttryckligen att satsa på utbyggnad av bredband och telefoni i hela landet och konstaterar med oro att landsbygden halkar efter i bredbandsutbyggnad och mobiltäckning. Den kräver också att vård finns tillgänglig även i glest befolkade regioner och att ett nationellt patientjournalsystem införs. Motförslagets krav på statligt ansvar för bredband, täckning och teknik för distansvård i glesbygd ligger därmed inom planens åtaganden.
- broadband throughout the countrydecisive»Satsa på utbyggnad av bredband och telefoni i hela landet« (2022 manifesto ↗)“Invest in broadband and telephone expansion throughout the country”
- rural digital lag»Sverigedemokraterna ser med oro på hur landsbygden halkar efter i bredbandsutbyggnaden, men även mobiltäckningen och postutdelningen är sämre i glesbygden.« (2022 manifesto ↗)“Sweden Democrats see with concern how rural areas are lagging behind in broadband expansion, but also mobile coverage and mail delivery are worse in remote areas.”
- care throughout the country»En viktig uppgift är att säkerställa att det finns akut- och förlossningsvård över hela landet, även i glest befolkade regioner samt att införa ett gemensamt nationellt patientjournalsystem.« (2022 manifesto ↗)“An important task is to ensure that acute and maternity care is available throughout the country, even in sparsely populated regions, as well as to introduce a common national patient record system.”
- policy for the whole country»Bedriva en politik för hela Sverige« (2022 manifesto ↗)“Conduct a policy for the whole of Sweden”
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.
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Sources and documents
- The committee report on riksdagen.se (2023/24:SoU21)
- Committee report full text (HB01SoU21)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2023/24:1002 — Rätt till tolk inom hälso- och sjukvården av Helén Pettersson och Åsa Karlsson (båda S)
- Motion 2023/24:1041 — Digital vård av Carina Ödebrink m.fl. (S)
- Motion 2023/24:1084 — Bemötande av våldsutsatta kvinnor av Azra Muranovic m.fl. (S)
- Motion 2023/24:1092 — Svenskar i utlandet av Markus Wiechel m.fl. (SD)
- Motion 2023/24:1127 — En sömlös vård av Helena Storckenfeldt och Lars Püss (båda M)
- Motion 2023/24:1172 — Integritetsskydd vid Ivo-anmälningar av Markus Wiechel (SD)
- Motion 2023/24:1191 — Internationellt kris- och hälsosamarbete av Markus Wiechel (SD)
- Motion 2023/24:1208 — Nationella beredskapslager av Ann-Christine Frohm Utterstedt och Eric Westroth (båda SD)
- Motion 2023/24:1239 — Delegationer i sjukvården av Martina Johansson (C)
- Motion 2023/24:128 — Betalningsansvar för outnyttjade tolktjänster av Eric Palmqvist (SD)
- Motion 2023/24:1348 — Begränsning av bemanningsföretagen i vården av Peder Björk m.fl. (S)
- Motion 2023/24:1393 — Gemensamt it-system i vården av Peter Ollén (M)
- Motion 2023/24:1538 — Marknadsföring av nätläkare av Johan Löfstrand m.fl. (S)
- Motion 2023/24:1584 — Legitimation eller skyddad yrkestitel för ortoptister av Ulrik Nilsson (M)
- Motion 2023/24:1682 — Anonymisering av sjukvårdspersonal i patientjournaler av Eric Westroth (SD)
- Motion 2023/24:1812 — Osteopati av Elisabeth Thand Ringqvist (C)
- Motion 2023/24:19 — Insyn i barns läkemedelslista av Ann-Christine From Utterstedt (SD)
- Motion 2023/24:1929 — En nationell digital infrastruktur för sjukvård och äldreomsorg av Gunilla Carlsson och Amalia Rud Pedersen (båda S)
- Motion 2023/24:2069 — En stärkt psykisk hälsa i hela landet av Carina Ståhl Herrstedt m.fl. (SD)
- Motion 2023/24:2072 — Folkhälsan i fokus av Carina Ståhl Herrstedt m.fl. (SD)
Source: The Swedish Parliament