New rules for long-term sick leave in Sweden

"We have been busy with transfers since October and have been able to cover most of the people in out area. We're talking about some 400 people," says Beatrice Berglund, head of a new office in Gothenburg set up by the Public Employment Service there to help those being transferred under the new scheme.

Stockholm has also chosen to open an office especially to help this group, while in the rest of Sweden people will have to approach the usual job centres. Different parts of Sweden might chose different ways of achieving the change, but all those who have reached the limit of what sick leave can offer will now be offered an introduction back into working life by the Public Employment Service. 

First, every person is offered a face-to-face meeting with a representative from the Employment Service, to map their history of employment and illness and to plan their future. Many of those who now are reaching the limit for how long they can receive sickness benefit have long histories of ill health and often a weak connection to the labour market. 

"We want to find out what works, because even if you are ill there are often things that do work and things you can do. We want to focus on that. Many carry their own dreams of what they want to do, and we want to uncover those dreams. But that can take some time," says Beatrice Berglund.

The introduction to working life lasts three months. After that people can be included in a different labour market policy programme, they can be offered a supported job or, if the person is very ill, they could be offered a renewal of their sick leave. The Employment Service also enlists help from specialists like physiotherapists, psychologists and occupational therapists.

The transfer of people from the Social Insurance Agency to the Employment Service happens during an unusually difficult time for the labour market, especially in Western Sweden. 

"There is competition for vocational training places, but that can also be the case during an economic boom when companies are very busy," says Beatrice Berglund.

Uncertainty and debate

In all 54,000 people are affected by the new rules, and must be passed over to the Employment Service this year. Last autumn saw a heated debate which according to many observers has contributed to negative ratings for the governing coalition. There has been criticism of the way the proposed changes were brought forward resulting in confusion and uncertainty around what rules would apply. How ill do you have to be, for instance, to not have to accept a job offered to you? The criticism led to a softening of the rules. There will be less pressure on people to accept work offered them through job centres if taking up such jobs would create impossible consequences for them.

The level of compensation has also come in for criticism. According to the proposal people would transfer from sickness insurance to unemployment compensation as long as they were members of an unemployment benefit society. For a lot of people that would mean ending up considerably worse off, and for those without membership in an unemployment society the compensation would be far less than what they enjoy under their sickness insurance. 

There has also been fear that shifting responsibility for compensation from one authority to another will be messy because the two systems are incompatible. The government backtracked on this issue too. Only a few days before Christmas 2009 it announced that people coming off sickness insurance would be granted so-called activity support based on their sickness benefit. That should make things easier for the unemployment benefit societies, and people would get their compensation on time.

Minister for Social Security, Cristina Husmark Persson, has repeatedly found herself in rough weather. Time and again she has explained how the proposal has been about "building a bridge" between sick leave and work, but she has had to face tough criticism from many quarters. Media has described the uncertainty many people on long-term sick leave feel. They describe their illnesses and their fear of being forced into work they feel they are too ill to carry out.

Beatrice Berglund at the Gothenburg Employment Service confirms that many of those coming to her office to talk about the transfer from one authority to the other are worried. 

"That fear of course depends on how ill you are and in what way. There is also this idea which has spread that you have to be back at work from day three, but we will adjust to every individual person's needs," she says.