Sweden’s stricter immigration rules collide with hospital staffing realities

As Sweden’s political leaders make their final appeals before Sunday’s general election, a growing unease is rippling through the country’s hospitals: the migration crackdown that has dominated recent policy may be undermining the very workforce the healthcare system depends on.

At the NU Hospital Group in the southern city of Trollhattan, nurse Johanna Bjorkman stood outside the cardiology unit’s operating rooms and pointed to the team around her. “I’m the only one born in Sweden here today. The rest are born abroad,” she said. “There wouldn’t have been any operations without them.”

The unit’s senior specialist, Dr. Davood Javid, reinforced the point: three of every four doctors in the cardiology department were trained overseas. Nationally, the Swedish Association of Local Authorities and Regions (SKR) reports that 37 percent of specialist doctors and 53 percent of nursing assistants were born outside the country.

That reliance has grown more visible as Sweden’s asylum and immigration rules have tightened dramatically since the 2015 refugee surge. Both center-left and center-right governments have pursued increasingly restrictive policies, and the current coalition—led by Prime Minister Ulf Kristersson with the support of the anti-immigration Sweden Democrats—has made the crackdown a centerpiece of its agenda.

Javid first came to Sweden from Iran in the 1980s. After decades in the country, he now feels a distinct shift in tone. “The tone has hardened in Sweden, and the debate has become highly polarised,” he said. That polarisation has touched his own family. His nephew’s two daughters—ages 21 and 24, who had lived in Sweden for eight years while studying to become nurses—were deported because they could not meet the income requirements for extended residence permits.

The case became a flashpoint in what Swedes now call “teenage deportations,” in which people who arrived as minors with their parents are sent back as adults for failing to satisfy income thresholds. Doctors and specialized nurses often earn enough to qualify under the stricter rules, but nursing assistants, elderly-care workers, and younger family members of healthcare personnel frequently do not.

Javid described the heartbreak and the wider cost of such decisions. “The individual loses out, the family is torn apart, and society pays the price for this,” he said. He also voiced frustration that the migration debate is so consumed with criminality, while ignoring what immigrants have contributed to Sweden’s welfare state.

His concerns are shared by hospital administrators. Bjorn Jarbur, director of NU Hospital Group, said at least one employee had left after their child was deported. Losing people with that kind of expertise is particularly damaging now, he explained, when the shortage of qualified staff is the true bottleneck. “Today, it’s not money that’s the limiting factor, it’s finding employees with the skills we need,” Jarbur said. “If we had been able to recruit more nurses, we would have been able to have more beds open.”

The stakes have become a major issue in the election campaign. Opinion polls consistently show that healthcare ranks at the top of voters’ concerns—above immigration, despite its prominence in political discourse.

Yet Sweden Democrats leader Jimmie Akesson rejects the idea that the healthcare squeeze should force a relaxation of immigration rules. “What people often forget in that discussion is that those who immigrate to Sweden also have needs when it comes to welfare, healthcare, and social care,” Akesson told reporters. “Statistically, they often have greater needs than those born in the country.”

But Tommy Moller, a political science professor at Stockholm University, said he has observed a notable shift ahead of this year’s vote. The public backlash over “teenage deportations” prompted the government to adjust course, he said—most notably in June, when authorities raised the age at which migrants’ children are considered adults from 18 to 21.

Moller also pointed to a broader opening in the debate. The Centre Party and Green Party are now actively arguing that Sweden needs more immigration, a position that was once politically fraught. “They are raising these issues,” Moller said. “It hasn’t really been opportune to do so before, because public opinion has been so critical of immigration.”

For Javid, the question is not just about policy mechanics but about what kind of society Sweden wants to be. Immigrants have long helped keep hospitals running, he stressed, and the nation risks turning away the very people who care for its sick and elderly. “We are all losing out when this happens,” he said.