2023-01-252022/23:SoU5 · p.4SoUHealth & social services
Increased resources
Increased resources for primary care's expanded rehabilitation mandate
What's at stake: The decision concerns whether primary care receives extra resources to handle its broader rehabilitation mandate, affecting both healthcare staff workloads and patients' access to rehabilitation close to home.
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 with proposals ensuring that primary-care resources increase in step with its expanded core mandate to offer rehabilitation, or whether no such task should be assigned now.
Yes Yes — the committee proposal
The committee rejects the motion, noting the government's assessment that including rehabilitation in primary care's core mandate carries no consequences for regions and municipalities, so a directed task on increased resources is not seen as necessary.
No No — the reservations
Reservation 4 (V, MP)
The dissenters argue that primary care's expanded core mandate to provide rehabilitation requires a corresponding increase in resources for cooperation between regions and municipalities to work, and want the government to return with proposals ensuring this.
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 4 by V, MP.
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 268–37Ja 251–54
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 | No 0/21/0/3 | match | confidence: high | explicit |
| S | No | Yes 93/0/0/14 | differs | confidence: high | derived |
| MP | No | No 0/16/0/2 | match | confidence: medium | not addressed |
| C | No | Yes 21/0/0/3 | differs | confidence: medium | derived |
| L | No | Yes 15/0/0/1 | differs | confidence: medium | derived |
| KD | No | Yes 17/0/0/2 | differsagainst own programme | confidence: medium | explicit |
| M | Yes | Yes 59/0/0/9 | match | confidence: low | not addressed |
| SD | No | Yes 63/0/0/10 | differs | confidence: medium | derived |
Committee proposal
The Riksdag rejects motion 2022/23:2 by Karin Rågsjö et al. (V) demand 3.
Original (Swedish)
Riksdagen avslår motion 2022/23:2 av Karin Rågsjö m.fl. (V) yrkande 3.
Riksdag decision: The Riksdag rejected the government's proposal on changed conditions when regions enter into agreements with private healthcare providers that also have insurance companies as clients. The government's proposal concerns amendments to the Health and Medical Services Act and means that the agreement must clarify how it is ensured that the private healthcare provider's other assignments do not have a negative impact on the care provided on behalf of the region. The Riksdag approved the proposal in the Health and Medical Services Act that rehabilitation should be included in primary care's core assignment. The Riksdag approved the proposal to amend the Patient Safety Act, which means that the Inspectorate for Care and Public Health (Ivo) shall be authorized to issue an order, that is to mandate, the healthcare provider who has not registered with Ivo's care register to do so. Such an order may be accompanied by a fine, that is a penalty. The amendments to the Patient Safety Act enter into force on 1 July 2023. The amendment to the Health and Medical Services Act enters into force on 1 January 2024.
Counter-proposals
- The counter-proposal wants to strengthen rules to prevent private care providers from concealing other clients and to prevent regions from contracting with care providers that simultaneously hold insurance company contracts. (V, MP) — Reservation 4
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 requires more resources for healthcare and to staff, and that redistribution from state to region and municipality increases.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan requires more resources for healthcare and to staff, and that redistribution from state to region and municipality increases. It also criticises that healthcare has been fragmented between levels and actors. An expanded core mandate with rehabilitation without corresponding resources contradicts this, which is why the plan supports the demand for increased resources.
Original (Swedish)
Planen kräver mer resurser till hälso- och sjukvården och till personalen, och att omfördelningen från stat till region och kommun ökar. Den kritiserar också att vården styckats upp mellan nivåer och aktörer. Ett utökat grunduppdrag med rehabilitering utan motsvarande resurser strider mot detta, varför planen stöder kravet på ökade resurser.
- more resources to healthcaredecisive»Därför vill Vänsterpartiet satsa mer resurser på hälso- och sjukvården och äldreomsorgen, samt satsa på personalen så att vi samtidigt får bort personalbristen och stärker personalens villkor och arbetsmiljö.« (2022 manifesto ↗)“For this reason the Left Party wants to invest more resources in healthcare and elderly care, and invest in staff so that we at the same time get rid of staff shortage and strengthen staff's conditions and workplace health.”
- increased state funds to regions»Omfördelningen från stat till region och kommun måste öka« (2022 manifesto ↗)“Redistribution from state to region and municipality must increase”
- right to rehabilitation»Du ska ha rätt till hjälp snabbt oavsett om du har brutit benet eller blivit utbränd.« (2022 manifesto ↗)“You should have the right to help quickly whether you have broken a bone or become burnt out.”
- better coordination between levels»Vården och omsorgen har styckats upp, mellan nivåer och aktörer, människor bollas runt i en stor administrativ apparat« (2022 manifesto ↗)“Healthcare and care have been fragmented, between levels and actors, people are passed around in a large administrative apparatus”
The plan's decisive commitment is to increase resources for welfare and the state's contributions to municipalities and regions, since new tasks otherwise undermine quality.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan's decisive commitment is to increase resources for welfare and the state's contributions to municipalities and regions, since new tasks otherwise undermine quality. An expanded basic mandate with rehabilitation therefore requires corresponding resources for cooperation to function and care to be equivalent throughout the country. The plan sees welfare investments as investments, not costs.
Original (Swedish)
Planens avgörande åtagande är att öka resurserna till välfärden och statens bidrag till kommuner och regioner, eftersom nya uppdrag annars urholkar kvaliteten. Ett utökat grunduppdrag med rehabilitering kräver därför motsvarande resurser för att samverkan ska fungera och vården vara likvärdig i hela landet. Planen ser välfärdssatsningar som investeringar, inte kostnader.
- increased resources for welfaredecisive»Öka resurserna till välfärden i hela landet. Vi vill fortsätta öka statens bidrag till kommuner och regioner.« (2022 manifesto ↗)“Increase resources for welfare throughout the country. We want to continue increasing the state's contributions to municipalities and regions.”
- equivalent 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 equivalent access to school, healthcare and care.”
- welfare as investment»Satsningar på välfärden ska därför ses som investeringar i mänskliga resurser« (party programme ↗)“Investments in welfare should therefore be seen as investments in human resources”
- the money must reach the operation»Villkor ska ställas så att pengarna till välfärden verkligen går till dess medarbetare« (2022 manifesto ↗)“Conditions must be set so that money for welfare actually goes to its employees”
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 invest in primary care and strengthen resources for care and nursing, and the party programme establishes that demographic development requires increased coordination between forms of care and that society should actively support rehabilitation.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto wants to invest in primary care and strengthen resources for care and nursing, and the party programme establishes that demographic development requires increased coordination between forms of care and that society should actively support rehabilitation. An expanded rehabilitation mandate without corresponding resources undermines this ambition. The plan therefore supports the requirement for increased resources.
Original (Swedish)
Valmanifestet vill satsa på primärvården och stärka resurserna till vård och omsorg, och partiprogrammet slår fast att den demografiska utvecklingen kräver ökad samordning mellan vårdformer och att samhället aktivt ska stödja rehabilitering. Ett utökat rehabiliteringsuppdrag utan motsvarande resurser urholkar den ambitionen. Planen stöder därför kravet på ökade resurser.
- investment in primary caredecisive»satsa på primärvården och öka tillgången till vård för psykisk ohälsa.« (2022 manifesto ↗)“invest in primary care and increase access to care for mental ill-health.”
- strengthened resources for care»förbättra vård och omsorg för äldre och stärka resurserna till hemsjukvården.« (2022 manifesto ↗)“improve care and nursing for the elderly and strengthen resources for home care.”
- rehabilitation as social responsibility»genom åtgärder för rehabilitering och utbildning.« (party programme ↗)“through measures for rehabilitation and education.”
- coordination between forms of care»Den demografiska utvecklingen ställer nya krav på vården« (party programme ↗)“Demographic development places new demands on care”
The plan wants to improve rehabilitation and strengthen cooperation between municipal and regional health and medical care, and promises better state support to regions adapted to their conditions.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan wants to improve rehabilitation and strengthen cooperation between municipal and regional health and medical care, and promises better state support to regions adapted to their conditions. The plan also holds firm that new commitments should not harm municipalities' finances. An expanded core responsibility with rehabilitation should therefore according to the plan be followed by corresponding resources, which is what the counter-proposal demands.
Original (Swedish)
Planen vill förbättra rehabiliteringen och stärka samverkan mellan kommunal och regional hälso- och sjukvård, och den utlovar bättre statligt stöd till regionerna anpassat efter deras förutsättningar. Planen håller också fast vid att nya åtaganden inte ska drabba kommunernas ekonomi. Ett utökat grunduppdrag med rehabilitering bör därför enligt planen följas av motsvarande resurser, vilket är vad motförslaget kräver.
- better state support to regionsdecisive»Vi vill skapa fler vårdplatser där det behövs med hjälp av en platsmiljard och bättre stöd till regionerna.« (2022 manifesto ↗)“We want to create more care places where needed with help from a place billion and better support to regions.”
- strengthened rehabilitation»Gör mer för att förebygga, motverka och rehabilitera stressrelaterad psykisk ohälsa. Vi vill göra sjukskrivningen mer flexibel och förbättra rehabiliteringen.« (2022 manifesto ↗)“Do more to prevent, counter and rehabilitate stress-related mental illness. We want to make sick leave more flexible and improve rehabilitation.”
- cooperation between region and municipality»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 place billion and increased cooperation between municipal and regional health and medical care we increase the possibilities to reach the goal of 90% occupancy at our hospitals.”
- new tasks shall be financed»Vi vill göra förskola och fritidsverksamhet tillgänglig för alla, utan att dessa kostnader drabbar kommunerna, för att underlätta integrationen, stärka jämställdheten och ge varje barn en bra start i livet.« (2022 manifesto ↗)“We want to make preschool and leisure activities accessible to all, without these costs affecting municipalities, to facilitate integration, strengthen gender equality and give every child a good start in life.”
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 to strengthen primary care's role and states that the care guarantee shall cover the entire care chain up to rehabilitation.
Plan documents: party programme
Reasoning and quotes
The plan wants to strengthen primary care's role and states that the care guarantee shall cover the entire care chain up to rehabilitation. It also requires that individuals regardless of residence receive equivalent quality and that local authorities' and regions' economic conditions be equalized. An expanded basic task with rehabilitative interventions without corresponding resources thus goes against the plan.
Original (Swedish)
Planen vill stärka primärvårdens roll och slår fast att vårdgarantin ska omfatta hela vårdkedjan ända till rehabilitering. Den kräver också att individer oavsett bostadsort får likvärdig kvalitet och att kommunernas och regionernas ekonomiska villkor utjämnas. Ett utökat grunduppdrag med rehabiliterande insatser utan motsvarande resurser går därför emot planen.
- stronger primary caredecisive»Primärvårdens roll i sjukvårdssystemet ska stärkas.« (party programme ↗)“Primary care's role in the healthcare system shall be strengthened.”
- rehabilitation in the care chain»Vårdgarantin ska omfatta hela vårdkedjan, från diagnostik och undersökningar till återbesök och rehabilitering.« (party programme ↗)“The care guarantee shall cover the entire care chain, from diagnosis and examinations to follow-up visits and rehabilitation.”
- equivalent healthcare throughout the country»Oavsett bostadsort har individer rätt att få likvärdig kvalitet på vården« (party programme ↗)“Regardless of residence, individuals have the right to receive equivalent quality healthcare”
- equalized economic conditions»De ekonomiska villkoren för kommuner och regioner behöver därför utjämnas« (party programme ↗)“The economic conditions for local authorities and regions therefore need to be equalized”
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 argues that an expanded core assignment with rehabilitative measures requires corresponding increased resources to regions and municipalities.
Plan documents: party programme
Reasoning and quotes
The counter-proposal argues that an expanded core assignment with rehabilitative measures requires corresponding increased resources to regions and municipalities. The party programme establishes that the financing principle must be respected when the state imposes new tasks on municipalities and that it is a state task to support municipalities that do not meet their statutory obligations. The plan also points to the links between social insurance, health care and rehabilitation, which require coordinated resources.
Original (Swedish)
Motförslaget menar att ett utökat grunduppdrag med rehabiliterande insatser kräver motsvarande ökade resurser till regioner och kommuner. Principprogrammet slår fast att finansieringsprincipen måste respekteras när staten ålägger kommunerna nya uppgifter och att det är en statlig uppgift att stödja kommuner som inte klarar sina lagstadgade skyldigheter. Planen pekar dessutom på sambanden mellan socialförsäkring, sjukvård och rehabilitering, vilket kräver samordnade resurser.
- the financing principledecisive»Finansieringsprincipen måste respekteras när staten ålägger kommunerna nya uppgifter.« (party programme ↗)“The financing principle must be respected when the state imposes new tasks on municipalities.”
- state support to municipalities»Det är en statlig uppgift att stödja kommuner som« (party programme ↗)“It is a state task to support municipalities that”
- coordinated rehabilitation resources»Det finns tydliga samband mellan kostnaderna för« (party programme ↗)“There are clear links between the costs for”
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 counter-proposal requires that new proposals be drawn up to ensure increased resources to regions and municipalities for the expanded core function.
Plan documents: 2022 manifesto
Reasoning and quotes
The counter-proposal requires that new proposals be drawn up to ensure increased resources to regions and municipalities for the expanded core function. The plan establishes that the major needs within the justice system, defence and welfare place great demands on prioritisations and that all new promises must be financed or fit within the budget surplus target. The plan wants to strengthen healthcare staff, but not through new unspecified resource requirements. The requirement is rejected.
Original (Swedish)
Motförslaget kräver att nya förslag tas fram som säkerställer ökade resurser till regioner och kommuner för det utökade grunduppdraget. Planen slår fast att de stora behoven inom rättsväsendet, försvaret och välfärden ställer stora krav på prioriteringar och att alla nya löften måste finansieras eller rymmas inom överskottsmålet. Planen vill stärka vårdens medarbetare, men inte genom nya ospecificerade resurskrav. Kravet avvisas.
- hard prioritisationsdecisive»De stora behoven inom rättsväsendet, försvaret och välfärden ställer stora krav på prioriteringar under åren som kommer.« (2022 manifesto ↗)“The major needs within the justice system, defence and welfare place great demands on prioritisations in the years to come.”
- financed reforms»Alla nya löften och reformer – som till exempel våra inkomstskattesänkningar – behöver finansieras eller rymmas inom överskottsmålet.« (2022 manifesto ↗)“All new promises and reforms – such as our income tax cuts – need to be financed or fit within the budget surplus target.”
- strengthened healthcare staff»Stärka vårdens medarbetare, bland annat genom att förbättra arbetsmiljön och möjligheterna till vidareutbildning – det behövs fler händer i vården som kan korta vårdköerna och avlasta personalen« (2022 manifesto ↗)“Strengthen healthcare staff, among other things by improving the working environment and opportunities for further training — more hands are needed in care to shorten waiting lists and relieve staff”
flags: citat_migrerat
The counter-proposal means that an expanded core mission with rehabilitative measures requires corresponding increased resources to regions and municipalities.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The counter-proposal means that an expanded core mission with rehabilitative measures requires corresponding increased resources to regions and municipalities. The plan explicitly requires more resources and increased focus on preventive work and early rehabilitation efforts, and that national quality requirements in care and support shall not be undermined. An expanded mission without resources risks doing just that.
Original (Swedish)
Motförslaget menar att ett utökat grunduppdrag med rehabiliterande insatser kräver motsvarande ökade resurser till regioner och kommuner. Planen kräver uttryckligen mer resurser och ökat fokus på förebyggande arbete och tidiga rehabiliteringsinsatser, och att nationella kvalitetskrav i vård och omsorg inte får underskridas. Ett utökat uppdrag utan resurser riskerar just det.
- resources for rehabilitationdecisive»Större fokus och mer resurser måste också läggas på förebyggande arbete samt tidiga rehabiliteringsinsatser.« (2022 manifesto ↗)“Greater focus and more resources must also be placed on preventive work and early rehabilitation efforts.”
- prioritized rehabilitation»Se ökat fokus och mer resurser på förebyggande arbete samt rehabilitering« (2022 manifesto ↗)“See increased focus and more resources on preventive work and rehabilitation.”
- strengthened primary care»Satsa på primärvården« (2022 manifesto ↗)“Invest in primary care.”
- national quality requirements»Nationella kvalitetskrav inom vård och omsorg måste finnas och får inte underskridas.« (party programme ↗)“National quality requirements in care and support must exist and shall not be undermined.”
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 (2022/23:SoU5)
- Committee report full text (HA01SoU5)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:2 — med anledning av prop. 2021/22:260 Ökad kontroll i hälso- och sjukvården av Karin Rågsjö m.fl. (V)
- Motion 2022/23:5 — med anledning av prop. 2021/22:260 Ökad kontroll i hälso- och sjukvården av Camilla Waltersson Grönvall m.fl. (M, SD, KD, L)
- Motion 2022/23:8 — med anledning av prop. 2021/22:260 Ökad kontroll i hälso- och sjukvården av Anders W Jonsson (C)
- Proposition 2021/22:260 — Ökad kontroll i hälso- och sjukvården
Source: The Swedish Parliament