2024-06-182023/24:SoU16 · p.2SoUHealth & social services

National Screening Programmes

National coordination of disease screening programmes

What's at stake: The outcome affects how quickly and equally diseases such as cervical cancer can be detected and prevented nationwide, and whether everyone affected by vaccination and screening is reached within a given 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 parliament should initiate a more centrally directed, nationally coordinated screening effort, for example against cervical cancer, or whether it should remain up to each region to decide if and when to start a screening programme.

Yes Yes — the committee proposal

The committee notes that the National Board of Health and Welfare already has a mandate to produce recommendations for national coordination of screening and equal care, but considers that it should remain up to each region to decide if and when to start a screening programme, and therefore sees no reason for parliament to take any initiative.

No No — the reservations

Reservation 5 (V, MP)

The government should look into eradicating cervical cancer through a coordinated national effort within a few years, so that everyone affected is reached by vaccination and screening, and should review the age limits of screening programmes so they are updated and do not miss affected groups.

Summarised from the committee report. Party labels in the summary come from the report, not from the vote.

VSMPCLKDMSD
YesNoAbstainAbsent

What do the votes mean here?

Yes The committee proposal: rejecting the motions (keeping things as they are).

No Backing the counter-proposal: reservation 5 by V, 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.

PlanVoteConfidenceEvidence
Vown reservationNoNo 0/20/0/4follows the planconfidence: mediumderived
SNoAbstain 0/0/93/13departs from the planconfidence: mediumderived
MPown reservationNoNo 0/15/0/3follows the planconfidence: mediumderived
CNoYes 20/1/0/3departs from the planconfidence: mediumderived
LNoYes 13/0/0/3departs from the planconfidence: mediumderived
KDNoYes 16/0/0/3departs from the planconfidence: mediumderived
MNoYes 60/0/0/8departs from the planconfidence: mediumderived
SDNoAbstain 0/0/63/9departs from the planconfidence: mediumderived

Broke with the party line

CAlireza Akhondi (C, Stockholms 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 the motions 2023/24:2063 by Carina Ståhl Herrstedt et al. (SD) amendments 1-3 and 5, 2023/24:2304 by Ann-Sofie Lifvenhage (M), 2023/24:2617 by Fredrik Lundh Sammeli et al. (S) amendment 45 and 2023/24:2705 by Ulrika Westerlund et al. (MP) amendment 3.

Original (Swedish)

Riksdagen avslår motionerna 2023/24:2063 av Carina Ståhl Herrstedt m.fl. (SD) yrkandena 1-3 och 5, 2023/24:2304 av Ann-Sofie Lifvenhage (M), 2023/24:2617 av Fredrik Lundh Sammeli m.fl. (S) yrkande 45 och 2023/24:2705 av Ulrika Westerlund m.fl. (MP) yrkande 3.

Riksdag decision: Parliament rejected approximately 140 proposals in motions concerning priorities in health and healthcare from the 2023 general motion period. The motions concerned, for example, priorities, assisted reproduction, donation and virginity testing. Parliament refers, among other things, to work already being undertaken in the areas that the motions address.

Counter-proposals

Plan vs actual vote

Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.

VVänsterpartietNoNofollows the planderived

The plan requires that healthcare is equitable, equal and accessible regardless of where in the country you live, and that the state takes greater responsibility for equal conditions even if the main responsibility remains with the regions.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan requires that healthcare is equitable, equal and accessible regardless of where in the country you live, and that the state takes greater responsibility for equal conditions even if the main responsibility remains with the regions. It also wants healthcare to be seen as part of public health work and prioritized according to need and evidence. A coordinated national approach to HPV vaccination and screening, with updated age limits, follows from these commitments.

Original (Swedish)

Planen kräver att sjukvården är jämlik, jämställd och tillgänglig oavsett var i landet man bor, och att staten tar ett större ansvar för lika förutsättningar även om huvudmannaskapet ligger kvar hos regionerna. Den vill också att vården ses som en del av folkhälsoarbetet och prioriteras utifrån behov och evidens. Ett samlat nationellt grepp om HPV-vaccination och screening, med uppdaterade åldersgränser, följer av dessa åtaganden.

  • equitable and equal caredecisive»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.”
  • state responsibility for equity»Lösningen är inte att förstatliga sjukvården men för att säkerställa en jämlik vård i Sverige måste staten ta ett större ansvar för att skapa lika förutsättningar.« (2022 manifesto ↗)“The solution is not to nationalize healthcare but to ensure equitable healthcare in Sweden the state must take greater responsibility for creating equal conditions.”
  • preventive public health work»Vården behöver ses som en del i det bredare arbetet med folkhälsa.« (party programme ↗)“Healthcare needs to be seen as part of the broader work with public health.”
  • evidence and needs-based prioritization»evidens och prioriteras utifrån behov.« (party programme ↗)“evidence and prioritized according to need.”
SSocialdemokraternaNoAbstaindeparts from the planderived

The plan is based on the state guaranteeing that care is equivalent throughout the country and that no one shall need to worry about getting care in time, with a statutory care guarantee and increased oversight as tools.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan is based on the state guaranteeing that care is equivalent throughout the country and that no one shall need to worry about getting care in time, with a statutory care guarantee and increased oversight as tools. A unified national initiative on HPV vaccination and screening, including updated age limits, is an application of this same commitment. The plan does not explicitly address screening programmes, hence deduced coverage.

Original (Swedish)

Planen bygger på att staten ska garantera att vården är likvärdig i hela landet och att ingen ska behöva oroa sig för att få vård i tid, med lagstadgad vårdgaranti och uppväxlad tillsyn som verktyg. Ett samlat nationellt grepp om HPV-vaccination och screening, inklusive uppdaterade åldersgränser, är en tillämpning av samma åtagande. Planen nämner inte screeningprogram uttryckligen, därav härledd täckning.

  • state-guaranteed care in timedecisive»Ingen ska behöva känna oro över att få vård i tid. Om en region inte uppfyller vårdgarantin enligt lagen ska vård erbjudas i en annan region.« (2022 manifesto ↗)“No one shall need to worry about getting care in time. If a region does not meet the care guarantee according to the law, care shall be offered in another region.”
  • 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 equivalent access to school, care and elder care.”
  • national governance of quality»Tillsynen av sjukvården ska växlas upp för att garantera kvaliteten.« (2022 manifesto ↗)“Oversight of healthcare shall be increased to guarantee quality.”

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.

MPMiljöpartietNoNofollows the planderived

The programme wants to see a national public health programme with long-term efforts on disease prevention measures and states that equivalent care regardless of gender should be a given.

Plan documents: party programme · 2022 manifesto

Reasoning and quotes

The programme wants to see a national public health programme with long-term efforts on disease prevention measures and states that equivalent care regardless of gender should be a given. The election manifesto furthermore promises good care regardless of where in the country you live. A coordinated national initiative to reach everyone with vaccination and screening for HPV and cervical cancer is such a preventive and equality-driven measure, which is why the plan supports the counter-proposal's demand.

Original (Swedish)

Programmet vill se ett nationellt folkhälsoprogram med långsiktiga satsningar på sjukdomsförebyggande insatser och slår fast att likvärdig vård oberoende av kön borde vara en självklarhet. Valmanifestet lovar dessutom bra vård oavsett var i landet man bor. Ett samlat nationellt grepp för att nå alla med vaccination och screening mot HPV och livmoderhalscancer är en sådan förebyggande och jämlikhetsdrivande insats, varför planen stöder motförslagets krav.

  • national public health programmedecisive»Vi vill därför se ett nationellt folkhälsoprogram och stödja kommuner och landsting i deras hälsofrämjande arbete.« (party programme ↗)“We therefore want to see a national public health programme and support municipalities and county councils in their health promotion work.”
  • equal care regardless of gender»Likvärdig vård oberoende av kön och socioekonomiska faktorer borde vara en självklarhet.« (party programme ↗)“Equivalent care regardless of gender and socioeconomic factors should be a given.”
  • equal care nationwide»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.”
  • sexual and reproductive health»God sexualundervisning i skolan, tillgängliga ungdomsmottagningar och tillgång till preventivmedel ska säkra en god sexuell och reproduktiv hälsa.« (party programme ↗)“Good sex education in schools, accessible youth health clinics and access to contraceptives shall ensure good sexual and reproductive health.”
CCenterpartietNoYesdeparts from the planderived

The plan commits to national initiatives for women's health—a national research program on women's diseases and strengthened gender medicine expertise throughout the healthcare chain—and that healthcare should become more equal and equitable throughout the country.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan commits to national initiatives for women's health—a national research program on women's diseases and strengthened gender medicine expertise throughout the healthcare chain—and that healthcare should become more equal and equitable throughout the country. Screening programs are not mentioned, but a comprehensive national approach to reach everyone with vaccination and screening for HPV and cervical cancer follows from precisely these commitments and from the plan's preventive public health perspective. The fact that equitable care should apply regardless of region speaks against letting coverage depend on each region's own choice.

Original (Swedish)

Planen åtar sig nationella insatser för kvinnors hälsa — ett nationellt forskningsprogram om kvinnosjukdomar och stärkt genusmedicinsk kompetens i hela vårdkedjan — och att sjukvården ska bli mer jämställd och likvärdig i hela landet. Screeningprogram nämns inte, men ett samlat nationellt grepp för att nå alla med vaccination och screening mot HPV och livmoderhalscancer följer av just dessa åtaganden och av planens förebyggande folkhälsoperspektiv. Att en jämlik vård ska gälla oavsett region talar mot att låta täckningen bero på varje regions eget val.

  • national initiative for women's diseasesdecisive»Vi vill inrätta ett nationellt forskningsprogram om kvinnosjukdomar och stärka den genusmedicinska kompetensen i hela vårdkedjan.« (2022 manifesto ↗)“We want to establish a national research program on women's diseases and strengthen gender medicine expertise throughout the healthcare chain.”
  • equal healthcare»Vi ska leda Sverige till en mer jämställd sjukvård.« (2022 manifesto ↗)“We shall lead Sweden toward a more equal healthcare system.”
  • equitable care throughout the country»Så kortar vi köerna och stärker likvärdigheten i hela landet.« (2022 manifesto ↗)“Thus we shorten queues and strengthen equity throughout the country.”
  • preventive public health work»En förutsättning för en hållbar välfärd är ett förebyggande förhållningssätt. Folkhälsoperspektivet måste genomsyra hela samhället för att ge resultat.« (party programme ↗)“A prerequisite for sustainable welfare is a preventive approach. The public health perspective must permeate all of society to produce results.”

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

LLiberalernaNoYesdeparts from the planderived

The plan wants the state to take greater responsibility for healthcare's strategic planning and that care be equal regardless of place of residence, which is precisely what a comprehensive national approach to HPV vaccination and screening entails.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The plan wants the state to take greater responsibility for healthcare's strategic planning and that care be equal regardless of place of residence, which is precisely what a comprehensive national approach to HPV vaccination and screening entails. The plan does not mention screening programs or cervical cancer, so the requirement is reached through derivation. The committee's reasons that regions themselves should decide directly meet the plan through the requirement for increased national control.

Original (Swedish)

Planen vill att staten tar ett större ansvar för sjukvårdens strategiska planering och att vården är jämlik oavsett bostadsort, vilket är just vad ett samlat nationellt grepp om HPV-vaccination och screening innebär. Planen nämner inte screeningprogram eller livmoderhalscancer, så kravet nås genom härledning. Utskottets skäl att regionerna själva ska avgöra möter planen direkt genom kravet på ökad nationell styrning.

  • national control of healthcaredecisive»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 specialized care, preparedness, and long-term competency supply.”
  • equal care»Vården ska vara jämlik.« (party programme ↗)“Care shall be equal.”
  • women's healthcare needs are prioritized»Jämställdhetsperspektivet ska utvecklas i hälso- och sjukvården.« (party programme ↗)“The gender equality perspective shall be developed in healthcare.”
  • children's healthcare needs»Barns och ungas särskilda behov ska beaktas i all hälso- och sjukvård.« (party programme ↗)“Children's and young people's special needs shall be considered in all healthcare.”

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

KDKristdemokraternaNoYesdeparts from the planderived

The election manifesto wants to abolish the regions' responsibility for healthcare and let the state take over with a joint organization, and introduce a national healthcare placement service that matches care needs against capacity throughout the country.

Plan documents: 2022 manifesto · party programme

Reasoning and quotes

The election manifesto wants to abolish the regions' responsibility for healthcare and let the state take over with a joint organization, and introduce a national healthcare placement service that matches care needs against capacity throughout the country. The party programme requires equal care for the entire population and that health-promoting work is stimulated. A coordinated national approach to HPV vaccination and screening, with updated age limits, follows from these commitments.

Original (Swedish)

Valmanifestet vill avskaffa regionernas ansvar för sjukvården och låta staten ta över med en gemensam organisation, samt införa en nationell vårdförmedling som matchar vårdbehov mot kapacitet i hela landet. Partiprogrammet kräver jämlik vård för hela befolkningen och att hälsofrämjande arbete stimuleras. Ett samlat nationellt grepp om HPV-vaccination och screening, med uppdaterade åldersgränser, följer av dessa åtaganden.

  • state responsibility for caredecisive»Låt staten ta över ansvaret för vården med en gemensam organisation i stället för 21 olika.« (2022 manifesto ↗)“Let the state take over responsibility for care with one joint organization instead of 21 different ones.”
  • national coordination of healthcare capacity»Inför en nationell vårdförmedling som matchar vårdbehovet med den vårdkapacitet som finns i hela landet« (2022 manifesto ↗)“Introduce a national healthcare placement service that matches care needs with the healthcare capacity that exists throughout the country”
  • equal care»Vården ska vara jämlik och tillgänglig för hela« (party programme ↗)“Care should be equal and accessible for all”
  • preventive health work»Hälsofrämjande arbete ska stimuleras.« (party programme ↗)“Health-promoting work should be stimulated.”

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.

MModeraternaNoYesdeparts from the planderived

The plan prioritises cancer care explicitly, wants to improve the conditions for earlier diagnoses through structured working methods and risk profiling and points out that regional differences in quality and waiting times are a problem.

Plan documents: 2022 manifesto

Reasoning and quotes

The plan prioritises cancer care explicitly, wants to improve the conditions for earlier diagnoses through structured working methods and risk profiling and points out that regional differences in quality and waiting times are a problem. A comprehensive national approach to reach everyone with vaccination and screening against HPV and cervical cancer is in line with these commitments and with the plan's particular prioritisation of women's diseases. Screening programmes as an instrument are not mentioned, so the stance is derived.

Original (Swedish)

Planen prioriterar cancervården uttryckligen, vill förbättra förutsättningarna för tidigare diagnoser genom strukturerade arbetssätt och riskprofilering och pekar på att regionala skillnader i kvalitet och väntetider är ett problem. Ett samlat nationellt grepp för att nå alla med vaccination och screening mot HPV och livmoderhalscancer ligger i linje med dessa åtaganden och med planens särskilda prioritering av kvinnors sjukdomar. Screeningprogram som instrument nämns inte, så ställningstagandet är härlett.

  • prioritised cancer caredecisive»Prioritera cancervården och fördubbla stödet till barncancervården, som ska ges särskilt riktade resurser varje år« (2022 manifesto ↗)“Prioritise cancer care and double support for paediatric cancer care, which shall receive specially targeted resources each year”
  • earlier diagnosis»Förbättra möjligheterna att ställa tidigare diagnoser, bland annat med hjälp av digitala beslutsstöd och strukturerade arbetssätt med till exempel riskprofilering« (2022 manifesto ↗)“Improve the opportunities to make earlier diagnoses, among other things with the help of digital decision support and structured working methods such as risk profiling”
  • women's diseases prioritised»Stärka forskningen gällande sjukdomar som drabbar kvinnor« (2022 manifesto ↗)“Strengthen research regarding diseases affecting women”
  • level out regional differences»Det finns också stora regionala skillnader i kvalitet och väntetider.« (2022 manifesto ↗)“There are also major regional differences in quality and waiting times.”

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.

SDSverigedemokraternaNoAbstaindeparts from the planderived

The plan requires a new unified healthcare system and wants the state to take over greater responsibility to a greater extent, precisely because regional fragmentation creates unequal care.

Plan documents: 2022 manifesto

Reasoning and quotes

The plan requires a new unified healthcare system and wants the state to take over greater responsibility to a greater extent, precisely because regional fragmentation creates unequal care. A coordinated national approach to screening and vaccination against HPV and cervical cancer is an application of this line, and the plan additionally wants patients not to be reached by care first at an advanced stage of disease. The plan therefore supports the requirement.

Original (Swedish)

Planen kräver en ny sammanhållen sjukvård och vill att staten i större utsträckning tar över huvudansvaret, just för att den regionala splittringen ger ojämlik vård. Ett samlat nationellt grepp om screening och vaccination mot HPV och livmoderhalscancer är en tillämpning av den linjen, och planen vill dessutom att patienter inte ska nås av vården först i ett förvärrat sjukdomsstadium. Planen stöder därför kravet.

  • unified national healthcaredecisive»För att åstadkomma det krävs en ny sammanhållen sjukvård i Sverige.« (2022 manifesto ↗)“To achieve this, a new unified healthcare system in Sweden is required.”
  • state main responsibility for healthcare»Sverigedemokraterna vill också se över hur staten i större utsträckning kan ta över huvudansvaret för sjukvården, med utgångspunkt i framgångsrika exempel i Norge och Danmark.« (2022 manifesto ↗)“Sweden Democrats also want to look into how the state can to a greater extent take on the main responsibility for healthcare, based on successful examples in Norway and Denmark.”
  • early detection and accessibility»Bristerna leder till att patienter ofta får vård i ett senare och ofta förvärrat sjukdomsstadium än vad som hade varit möjligt med en mer tillgänglig vård.« (2022 manifesto ↗)“The shortcomings lead to patients often receiving care at a later and often more advanced stage of disease than would have been possible with more accessible care.”
  • equal care»Sverigedemokraterna vill verka för en jämställd vård där män och kvinnor behandlas lika.« (2022 manifesto ↗)“Sweden Democrats want to work for equal care where men and women are treated equally.”

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

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Sources and documents

Documents under consideration

Source: The Swedish Parliament