Ledare: Vinst i välfärden hot mot sammanhållningen

2013-04-16
LEDARE

Det finns ett glapp mellan väljare och partiledningarna i frågan om vinster i välfärden. Svenskar är betydligt mer negativa till vinstuttag i privat vård, skola och omsorg som drivs med skattemedel än den politik som bedrivs. Trots detta försvarar både Socialdemokraternas och Miljöpartiets ledningar envist rätten för företag att ta ut vinster från välfärden.

Novus opinionsundersökning i somras visade att bara 12 procent av samtliga väljare ansåg att vinstuttag överhuvudtaget ska vara tillåtet. I början av detta år gjorde Novus, på uppdrag av tankesmedjan Katalys, en ny undersökning och nu anser endast åtta procent att det ska vara ett fritt vinstuttag. 41 procent vill förbjuda vinsterna helt eller anser att all vinst ska återinvesteras i verksamheten. 25 procent, anser att vinstuttag i storleksordningen av 1 procent utöver statslåneräntan är den bästa lösningen.

Tidningen Fokus beskrev härom veckan (nr 13-14, 2013) hur starka lobbyorganisationer som t.ex. Vårdföretagarna och Svenskt Näringsliv satsat hårt på lobbyverksamhet för att bagatellisera t.ex. Caremaskandalen och för att få politiker att ”förstå” behovet av vinstuttag. Vårdföretagarna beslutade på sin årsstämma 2012 att intensifiera politikerbesöken. De har lagt ner stor energi på att skrämma socialdemokratiska ledare på alla nivåer för att ett stopp för vinsterna skulle leda till att många människor som arbetar i de kommersiella verksamheterna skulle förlora sina jobb och att verksamheter skulle läggas ner. S-kongressen beslutade, efter en kompromiss mellan partiledningen och vinstkritiska gräsrötter, att Näringslivets vinstintresse inte ska få styra välfärden. Konkret fastslog kongressen att kommunerna ska ha avgörande inflytande vid start av friskolor och att kommuner och landsting själva ska avgöra om de vill privatisera välfärden. S vill också införa bemanningskrav och att verksamheter ska kunna läggas ut enbart på icke-vinstdrivande aktörer. Det mest nyskapande var kanske att S lyfter fram icke-vinstdrivande alternativ. Vad partiet inte har insett är att kommersialiseringen av välfärden är ett systemskifte som på sikt undergräver den gemensamma välfärdens fortbestånd. Svenskt Näringsliv och andra privatiseringsivrare vill att välfärden i framtiden inte bara ska drivas av privata företag, de vill också att en mindre del ska finansieras av skatter och en större av privata avgifter.

Miljöpartiets ledare har förstås också utsatts för omfattande lobbyverksamhet för att de inte ska låta politiken ta den väg som majoriteten av deras väljare vill. På partiets kommun- och landstingsdagar i höstas låg en tidning från Vårdförtagarna ”Framtidens vård” i deltagarmappen från partiet. Vårdföretagarna skickade också hem tidningen till alla landstingspolitiker. Åsa Romson pryder omslaget och innehållet förmedlar en bild av att Miljöpartiet delar den syn på välfärd som Vårdföretagarna står för. En rad miljöpartistiska landstingspolitiker intervjuas och alla beklagar debatten om vinster i välfärden. De säger mycket klokt förstås men ingen lyfter fram kommersialiseringen av välfärden som ett problem. Men enligt en undersökning i Dagens Samhälle 3/4 -13 står en stor majoritet av MP:s kommunalpolitiker närmare de röda vinstmotståndarna än de blåa vinstförespråkarna. Detta är också MP:s officiella uppfattning, i varje fall enligt kongressbeslutet 2012, där det heter: ”Att MP ska verka för att aktiebolag som driver skolor ska ange i sin bolagsordning att verksamhetens syfte inte är att ge vinst till fördelning mellan aktieägarna, detta för att överskott i verksamheten som huvudregel ska återinvesteras och att de vinstutdelningar som sker ska bli transparenta och lätta för tillsynsmyndigheter att granska.”

Beslutet fokuserade på skolan men skulle vara vägledande för hela välfärdsområdet. Något snarlikt står nu i Miljöpartiets sjukvårdspolitiska program. Vad beslutet egentligen innebär är dock inte glasklart. Betyder det som det står i texten till den antagna att-satsen ovan ”... måste reglera verksamhetens syfte i bolagsordningen och där ange att detta syfte är ett annat än att dela ut vinst till aktieägarna.” Det kan tolkas som att man inte alls får ha något syfte att dela ut vinst, vilket skulle betyda att vanliga aktiebolag, som enligt aktiebolagslagen syftar till ekonomisk vinst för ägarna, inte tillåts inom välfärden. Så skriver också Gunvor G Ericson, gruppledare för MP i riksdagen och ledamot i socialförsäkringsutskottet, i Dagens Arena den 23 augusti 2012. Men längre ner i texten skriver hon att ”Beslutet går i korthet ut på att skolor som bedrivs i aktiebolagsform ska ha ett annat huvudsyfte än att generera vinst.” Utifrån det förstår man att vinstsyftet mycket väl kan finnas kvar, bara det finns andra syften också. Och med den tolkningen innebär det ingen förändring. Det ansåg också Kunskapsskolans vice vd Mikaela Valtersson direkt efter MP kongressen. Den tolkningen stärks av att det i de sammanfattande punkterna i MP:s sjukvårdspolitiska program ”Vi vill att aktiebolag som utför vårdverksamhet anger vård och omsorg som syfte i sin bolagsordning.” Ett bolag ska förstås ange vad de sysslar med. Det har ingenting med begränsat vinstsyfte att göra.

I förslaget till nytt partiprogram som Miljöpartiets partistyrelse nu lagt står det ”Alla utförare inom välfärden ska ha som främsta motiv att bedriva en högkvalitativ verksamhet, och drivas av ett socialt och samhälleligt engagemang. Syftet med verksamheten ska inte vara att dela ut vinst, vilket också ska framgå av stadgar eller bolagsordning. Eventuell vinst ska som huvudregel återinvesteras i verksamheten. Upplägg som innebär för hög skuldsättning, eller orimligt höga vinstuttag eller ränteutbetalningar, eventuellt också via så kallade skatteparadis, ska stoppas. Verksamheternas ekonomi ska redovisas öppet. Vi föredrar upphandlingar där aktörer konkurrerar om att erbjuda bästa kvalitet istället för lägsta pris.” Det är lika luddigt som tidigare beslut och många förslag till skapare skrivningar mot vinstsyftet och vinstuttag har lagts fram. I förslaget står också: ”Under senare år har människor fått ett ökat inflytande över välfärdstjänsterna genom olika slags valfrihetsreformer. Miljöpartiet har ingen ideologisk låsning kring huruvida välfärdstjänster ska drivas privat eller offentligt. Det är kvaliteten på välfärden som är viktig, inte driftsformen.” De s.k. valfrihetsreformernas konsekvenser problematiseras inte alls.

Skolverket har kommit fram till att den skolmarknad som uppstått lett till segregation och medverkat till elevernas sjunkande studieresultat. Vårdval har gynnat rika och friska på bekostnad av multisjuka och personer i socioekonomiskt svaga områden, där behoven är större. Det lönar sig bättre med motiverade elever och patienter som inte är så sjuka och då dras resurserna dit.

Att minska på personalens antal och löner ger högre vinster och det görs konsekvent. De kontroller som krävs för att verksamheterna inte helt ska utarmars, såsom Caremas Koppargården, kostar resurser som tillsammans med vinsterna skulle gjort mer nytta i verksamheten. Ett antal forskare har på senare tid beskrivit problemen och Maciej Zaremba levandegjorde systemskiftets konsekvenser i en serie i DN i februari-mars i år.

För att kunna hantera klimatkris, ekonomisk kris, mat- och energikris framöver krävs ett samhälle som hänger ihop. En gemensam välfärd som omfattar alla på lika villkor och som styrs i demokratiska former är ett fundamentalt kitt för ett samhälle som alla är delaktiga i och som därmed är socialt hållbart. Vi kommer inte att kunna hantera de utmaningar vi står inför om samhället är segregerat med djupa klyftor mellan olika grupper och folk söker privata lösningar istället för gemensamma.

På flera ställen i partiprogrammet talas om individen som ansvarstagande och aktiv i utformandet av samhället samt om att alla ska få vara den de är och om betydelsen av att få välja det man vill ha. Insikten om att vi som individer trivs och ger mest om vi får vara självbestämmande är fundamental för ett långsiktigt hållbart samhälle.

Miljöpartiet ville bryta upp de offentliga monopolen inom välfärden för att uppnå mångfald i pedagogik och vårdmetoder samt göra det möjligt för personal, brukare och föräldrar att själva driva verksamheten. Den kommersialisering vi nu har fått är något annat. De stora vinstdrivna koncernerna växer på bekostnad av ideella och små aktörer. Enligt Sektor3 – tankesmedjan för det civila samhället (Svd 16 dec 2012) pekar utvecklingen mot färre ägare bland Sveriges friskolor där de tio största bolagen i dag utbildar 40 procent av alla elever i fristående skolor. Inom äldrevården är trenden ännu starkare, där två stora bolag står för hela 50 procent av den privata äldreomsorgsmarknaden.

Kontrollsystemen växer i takt med likriktningen. I partiprogramsförlaget finns en del bra skrivningar till stöd för de idéburna verksamheterna. Men så länge partiet inte tar ställning mot kommersialiseringen av välfärden, dvs fullständigt tar avstånd från vinstsyftande företag inom välfärden, kommer man inte på allvar kunna uppnå varken mångfald i verksamheternas innehåll eller verklig makt för personal och brukare.

Häromdagen bildades Idéburna skolors riksförbund. De ska vara det naturliga språkröret för alla skolor som inte delar ut vinst till ägarna. Det är sådana organisationer som är Miljöpartiets självklara allierade, inte Vårdföretagarna. Frågan om vinster i välfärden kommer att bli het på Miljöpartiets kongress. Sektor3s undersökning via Demoskop visade att 18 procent föredrar att välja en icke-vinstdriven organisation, 11 procent ett företag med restriktioner på vinst och bara 3 procent föredrar att välja ett vinstdrivet företag. Hälften föredrar en offentlig aktör. Med det i ryggen finns det alla möjligheter för Miljöpartiets kongress att klargöra att ”inte vinstsyfte” hos välfärdsföretagen betyder att de inte får ha något vinstsyfte alls. Dessutom borde politiken tydligare inriktas på att främja den idéburna verksamheten. Socialdemokraternas steg framåt i frågan borgar för att det är möjligt att få genomslag för en sådan politik i verkligheten.

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Marléne Tamlin

Christer Sanne

Christer Sanne
Lotta Hedström

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I frihandelns goda namn

Klimatmålsinitiativet

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