In June 2023, the government commissioned a parliamentary committee of inquiry on responsibility for care to analyse and assess the advantages and disadvantages of a full or partial State mandate over healthcare. The committee’s findings were presented on 2 June 2025.
The parliamentary committee (with representatives from all parliamentary parties) has analyzed how a state mandatorship would affect health and medical care based on several aspects, such as equity, accessibility, effectiveness, supply of human resources, funding and capacity for innovation. The committee’s analyses identified conceivable advantages and disadvantages in both alternatives:
- the regions remaining the responsible authorities for health and medical care and provision, and
- in making state government the responsible authority for health and medical care.
The committee finds that a change in mandatorship could entail both risks and opportunities. The committee members (political parties) have diverging views of the expected advantages and disadvantages of state mandatorship for all health and medical care, and there is no broad parliamentary support for a comprehensive and fundamental reform.
The committee does not suggest a full state mandatorship and it also advises against partial state responsibility for some healthcare sectors, such as the hospital or primary care. But the committee has identified unjustifiable differences between and within regions with respect to access to certain care and treatment and sees a need for increased state government responsibility for certain parts of the health and medical care system. The committee proposes that state government should assume greater responsibility for a number of health and medical care areas, including:
- Greater responsibility for the supply of human resources in health and medical care
- In the short term, ensuring equal access to certain special pharmaceutical treatments
- Greater responsibility for vaccinations through the national vaccination programmes
- Enhanced responsibility for forensic psychiatric care
In addition, the committee proposes that the state governance of the regions’ health and medical care needs to be enhanced and improved. On the whole, state governance of health and medical care is fragmented today, with an immense number of policy signals issued. The regions must be given conditions for long-term planning, and their recipient capacity for state governance must be factored in. Accountability and control should be strengthened with the aim of safeguarding patient rights and guaranteeing that health and medical care legislation has a greater impact in practice. The committee proposes that targeted state subsidies should only be used in exceptional cases and that the national government take measures with regard to the regions to ensure increased regulatory compliance and improve the position of patients. The inquiry is now on referral until 31 October 2025.