2025 Report by the Minister of Social Affairs on the Implementation of the National Long-Term Development Strategy "Estonia 2035"
Session: The 15th Riigikogu, 6th Session, Plenary Sitting
Date: 2025-10-08 18:42
Total Speeches: 67
Membership: 15
Agenda Duration: 1h 47m
AI Summaries: 67/67 Speeches (100.0%)
Analysis: Structured Analysis
Politicians Speaking Time
Politicians
Analysis
Summary
Minister of Social Affairs Karmen Joller presented a report to the Riigikogu on the implementation of the state's long-term development strategy "Eesti 2035" in the fields of health and welfare. The Minister emphasized the need to integrate these sectors, highlighting that although life expectancy is on the rise (especially for women, at 83.4 years), people are living longer in poor health, and health inequality based on education and regional affiliation is significant (up to 12 years). The biggest concerns in the health sector are rising obesity, high alcohol consumption, the spread of e-cigarettes among young people, and a decline in childhood vaccination coverage (83.3% for the measles, mumps, and rubella vaccine). The Minister also pointed out the increasing frequency of mental health problems. Regarding healthcare financing, Joller noted that the Health Insurance Fund's (Tervisekassa) budget deficit has decreased as a result of internal efficiency improvements and better collection of social tax, but the system needs stability to implement lasting changes.
In the welfare sector, the focus was on the decline in the birth rate, which in 2024 was the lowest in the last 100 years. Positive developments noted included the slow reduction in the absolute poverty rate and the impact of the care reform on easing the burden of care. Future plans prioritize the reorganization of the hospital network, the integration of the social and healthcare systems, improving the quality of primary healthcare, and developing digital solutions (including the establishment of the SKAIS2 system). During the debate, opposition politicians sharply criticized the government's inaction in supporting the birth rate, as well as the Health Insurance Fund's high administrative costs and alleged wastefulness at a time when waiting lists for treatment are long. The Minister defended the Health Insurance Fund's development activities and emphasized that healthcare problems are structural and related to a shortage of specialists, rather than being solely about money.
Decisions Made 1
No decisions were made
Most Active Speaker
The most active speaker was Anastassia Kovalenko-Kõlvart (Centre Party, left), who, on behalf of the faction, delivered a highly detailed and scathing criticism concerning the amounts spent on the Health Insurance Fund’s administrative costs, advertising expenditures, and management consulting, accusing the ministry and the government of squandering funds during the healthcare crisis.
Aseesimees Toomas Kivimägi
AI Summary
Deputy Speaker Toomas Kivimägi announced the conclusion of the proceedings on the first agenda item and gave the floor to Minister of Social Affairs Karmen Joller, who will present a report of up to 30 minutes on the implementation of the state's long-term development strategy "Eesti 2035," which will be followed by questions and faction negotiations.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller, who is responsible for the health and welfare sectors, provided the Riigikogu (Parliament) with a comprehensive overview of the situation in 2024. She highlighted key concerns such as the healthcare funding crisis, the population’s increasing morbidity (obesity, alcohol use, mental health issues), and the low birth rate. At the same time, she stressed the importance of measures aimed at better integrating systems, continuing the care reform, and improving lifestyles, all necessary to ensure people live longer, healthier lives and to reduce inequality.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller thanked the audience, acknowledged their keen interest, and then gave the floor to Kalle Grünthal to ask questions.
Kalle Grünthal
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Kalle Grünthal is criticizing the ministry’s refusal to allow hospitals to order their own medicines, arguing that this maintains a monopoly. He claims this system enables family doctors to receive kickbacks and bonuses—such as foreign trips—for the indiscriminate prescription of drugs, via contracts signed with pharmaceutical manufacturers and wholesalers. This issue, he notes, has been known as a problem for 25 years.
Aseesimees Arvo Aller
AI Summary
Acting as moderator, Deputy Chairman Arvo Aller gave the floor to the next speaker with the short, decisive phrase, "Your time!", thereby signaling the start of their presentation or speech.
Kalle Grünthal
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Kalle Grünthal posed a sharp question, asking whether the opposing side is finally ready to relinquish its current monopolistic position.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller categorically rejects the ridiculous accusations concerning illegal contracts between general practitioners and pharmaceutical companies. She stressed that prescriptions are issued based strictly on medical indications and that pharmaceutical companies have no control whatsoever over prescription data. Furthermore, she confirmed that while there are few wholesale drug distributors, the situation does not constitute a pure monopoly. She also promised to announce within the week how they plan to proceed with the draft legislation concerning hospital drug procurement, a bill that hospitals themselves are reportedly not very keen on.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller called Madis Kallas to the podium, thereby giving him the floor.
Madis Kallas
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Madis Kallas, noting the complexity of the minister's portfolio, focused on the deepening health issues facing young people, specifically early vaping and mental health concerns linked to social media and artificial intelligence, asking the minister for additional resources and projects to analyze and tackle these two areas.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller, who considers the role of a minister overseeing two sectors to be extremely interesting and educational, focused on improving the mental health of young people. She detailed the creation of a stepped assistance model, which allows people to receive initial help and guidance before needing to consult a psychiatrist or family doctor. The implementation of this system involves training family nurses on mental health topics, integrating lower-level counselors into primary care centers and local governments (KOVs), and stressing that, alongside education and expanding the circle of specialists, a healthy lifestyle—including exercise, sleep, and avoiding blue screens and vaping—is critically important for maintaining mental health.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller invited the next speaker, Aleksandr Tšaplõgin, to the podium.
Aleksandr Tšaplõgin
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Aleksandr Tšaplõgin drew attention to the critically long medical waiting lists (half a year and longer) and directly asked the minister what the financial requirement is to eliminate them, and whether the government has any hope of finding that sum.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller emphasized that the long waiting lists in healthcare are caused both by the shortage of doctors and nurses, whose training takes years, and by people's excessively high expectations of seeing a specialist immediately, which is impossible in a solidarity-based system. Therefore, the solution lies in better organizing the system and expanding e-consultations to ensure that assistance is timely, based on the patient's actual need, rather than the length of the queue.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller and Reili Rand were invited to speak.
Reili Rand
Profiling Sotsiaaldemokraatliku Erakonna fraktsioonAI Summary
Reili Rand expresses deep disappointment over the minister’s most important speech of the year, as the critical topic of the lowest birth rate in a hundred years was addressed too superficially. She also criticizes the government for its lack of concrete steps, asking when, instead of merely citing analyses and rejecting opposition bills, they will actually start taking real action to support family well-being and the birth rate.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller defended the government’s actions regarding social and natality issues, emphasizing the importance of these topics and outlining a series of concrete measures based on recent analysis. These measures include enabling the use of second-pillar pension assets for a housing down payment, abolishing the tax bulge, and raising subsistence benefits. Furthermore, she proposed considering expanding the circle of parental benefit recipients and placing family policy under the State Chancellery to ensure its integration across all policy fields.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller gave the floor to Mart Maastik.
Mart Maastik
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Mart Maastik sharply criticized the dangerously long waiting times for medical specialists, citing a case where the extended wait resulted in a patient's death. He then questioned the minister as to why it is possible to gain immediate access to the very same doctor by paying, suggesting that the issue lies not in a shortage of resources, but in the organization of the system, which requires fundamental change.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller confirms that she plans to enhance the healthcare system, focusing on ensuring timely specialist medical care—in urgent cases, the patient must receive immediate assistance. She explains the role of private medicine, which typically offers faster service for a fee when dealing with simpler illnesses, while complex and expensive treatment cases remain the responsibility of the state system, and promises to analyze which sectors should receive investment to improve the accessibility of services.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller passed the floor to Riina Solman, inviting her to the podium.
Riina Solman
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Riina Solman acknowledges the minister's competence in the field of healthcare, but she focuses on the low birth rate. She simultaneously criticizes the unfair media attack against mothers with many children and asks why the estimated 11 million euros—which is left over in healthcare and child benefits due to the declining birth rate—is not directed toward supporting families and children already in the next fiscal year, given that this money belongs to the domain of families and children anyway.
Sotsiaalminister Karmen Joller
AI Summary
Social Minister Karmen Joller explains that the so-called surplus money currently under discussion actually originates from the family benefits budget. This is because the number of children is lower, resulting in a smaller calculated expenditure. Although she supports the proposal to use this money to boost the birth rate, securing its funding is complicated and requires not only the consensus of the political parties but also the approval of finance experts.
Aseesimees Arvo Aller
AI Summary
Deputy Speaker Arvo Aller and Helmen Kütt were called to the rostrum to begin their presentation.
Helmen Kütt
Profiling Sotsiaaldemokraatliku Erakonna fraktsioonAI Summary
Helmen Kütt highlighted the critical issues facing special welfare services, including service waiting lists stretching up to 53 months and low gross salaries averaging 1,200 euros. She then asked the minister what concrete steps would be taken to resolve the situation, stressing that the current state of affairs—where local governments are forced to sue the state—is not a sensible solution.
Sotsiaalminister Karmen Joller
AI Summary
Minister of Social Affairs Karmen Joller announces that the field of special care services will be brought into sharp focus next year to establish a long-term vision and resolve the issue of service suitability (especially concerning dementia and autism). She also emphasized that supporting informal caregivers is a crucial national priority to prevent them from leaving the labor market and experiencing health deterioration.
Aseesimees Arvo Aller
AI Summary
Deputy Speaker Arvo Aller gave the floor to Peeter Ernits.
Peeter Ernits
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Peeter Ernits reproaches the minister regarding the previous position held by his party's deputy chairman (the Minister of Finance), who argued that lowering the VAT on foodstuffs was unnecessary since Estonians are already overweight and should instead eat less. Ernits then asks ironically how this "guideline" has actually been implemented to improve public health and simultaneously avoid reducing the VAT.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller began by clarifying a previous statement, stressing that fruits and vegetables are already affordable. However, she declined to take a stance on the issue of VAT on groceries, explaining that it is a tax topic where she lacks expertise, and she trusts the experts in the tax domain.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller introduced the next speaker, Irja Lutsar, asking her to step up to the podium.
Irja Lutsar
Profiling Eesti 200 fraktsioonAI Summary
Irja Lutsar continued the discussion on screen time, highlighting Professor Tulviste’s study, which confirms the detrimental effect of smart devices on the language and speech development of children under five. She also asked the minister to state the Ministry of Social Affairs’ position regarding the pediatricians’ proposal to ban smart devices for children of a certain age.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller notes that the ministry does not have a position regarding the restriction of smart device usage, stressing that at home this is the responsibility of parents, not a matter for state intervention, while simultaneously welcoming screen-free initiatives by schools. She believes that although children must master technology to cope in the future world, it is the parents' duty to teach them boundaries and information assessment, as excessive use of social media and AI is one of the most complex challenges of modern parenting.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller invited Urmas Reinsalu to the rostrum to begin his presentation.
Urmas Reinsalu
Profiling Isamaa fraktsioonAI Summary
Urmas Reinsalu is questioning the minister regarding the needs-based child benefits system planned in the state budget strategy (RES), which is projected to bring the state 100 million euros in revenue starting from 2028, but requires taking away child benefits from people earning the average wage. He is demanding a detailed explanation concerning the content of the reform, those who will lose the benefit, and the date of its legal entry into force.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller stresses that the potential saving of 100 million euros, which would result from making benefits needs-based in the future, is only a very rough estimate, and there is no plan to withdraw existing benefits from anyone.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller prohibited the dialogue, steering the conversation back to the original question and emphasizing that the present moment was not suitable for discussion.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller emphasized that the current coalition has no plans to reduce or abolish benefits, but the SKAIS2 system currently under development will make the structuring of benefits more flexible starting in 2028 and will allow them to be adjusted according to predefined parameters.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller thanked those involved for the preceding discussion and then gave the floor to Andres Metsoja, requesting that he pose the next question.
Andres Metsoja
Profiling Isamaa fraktsioonAI Summary
Andres Metsoja notes that although the social sector is moving towards need-based support, physical activity remains an integral part of human physiology and mental health. He expresses concern that despite the construction of new sports facilities, young people are absent from sports events, suggesting that promoting physical activity would be a crucial and cheaper preventative measure compared to the later expensive treatment of mental health issues.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller stressed that while Estonia has successful initiatives promoting physical activity, such as the "Liikuma kutsuv kool" (School that Invites Movement) program, and sharing these experiences is crucial, the primary responsibility for shaping children's exercise habits rests first and foremost with the parents. She advised them to lead by example and engage in physical activities together with their children.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller granted the floor to Aleksei Yevgrafov, inviting him to the podium to deliver his presentation.
Aleksei Jevgrafov
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Aleksei Jevgrafov acknowledges the Finance Minister’s claim concerning the reduction of the Health Insurance Fund’s budget deficit, but critically questions the means by which this improvement in the financial situation was actually achieved.
Sotsiaalminister Karmen Joller
AI Summary
Minister of Social Affairs Karmen Joller explains that the improvement in healthcare funding stems primarily from better social tax collection and internal efficiency measures implemented by the Health Insurance Fund (Tervisekassa), such as cutting additional expenditures from the COVID era. The objective of these measures is to ensure that the current level of availability of medical services is maintained and that new innovative services and medicines can be adopted.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller Henn Põlluaas was called to the podium to deliver his report.
Henn Põlluaas
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Henn Põlluaas expresses indignation over the minister's claim that food prices in Estonia are cheap anyway, highlighting that food prices have risen by 57% since the start of the pandemic—the highest figure in Europe—and criticizes the government's indifferent attitude toward the difficulties faced by people who are barely making it from paycheck to paycheck.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller refuted the claims attributed to her (such as the recommendation to eat carrots or the assertion that food is cheap). She emphasized that the government is aware of the rising cost of living and is directing support measures specifically towards those in the most difficult situations, such as single pensioners and low-wage earners, by raising subsistence benefits, abolishing the tax hump, and continuing the indexation of pensions. She categorically denied accusations of indifference.
Aseesimees Arvo Aller
AI Summary
Deputy Speaker Arvo Aller gave the floor to Helle-Moonika Helme.
Helle-Moonika Helme
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
Helle-Moonika Helme expresses deep concern regarding the failure of the SKAIS1 and SKAIS2 information systems, into which tens of millions of euros have already been sunk, and demands clarification on how much additional funding is planned to be allocated to the non-functioning system and what guarantees exist for its eventual launch.
Sotsiaalminister Karmen Joller
AI Summary
Social Affairs Minister Karmen Joller confirmed that ensuring the functionality of the SKAIS system is critically important, as failure to continue its development would pose the risk of pensions not being paid out. To secure this certainty, foreign experts were hired, plans and contracts were reviewed in detail, and crisis mechanisms were established, costing approximately 17 million euros over the next four years. However, the speaker also stressed that the shift toward needs-based benefits is a political decision that can only be made by the government taking office in 2027.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller closed the Q&A session, opened the floor for debate among the factions, and first gave the floor to Eero Merilind, the representative of the Estonian Reform Party faction.
Eero Merilind
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Eero Merilind emphasized that investing in healthcare is an investment in the country's future, not an expense, because a healthy population is the foundation for the functioning of the Estonian state. He highlighted the current health inequalities (across education and region) and the lower life expectancy compared to the EU average. He provided an overview of recent progress, such as permanent funding for mental health services, the reduction of out-of-pocket costs, and the streamlining of the hospital network. Merilind confirmed that the government's goal, in line with the "Estonia 2035" vision, is to create a sustainable healthcare system and a fair welfare state where years lived in good health increase and no one feels abandoned by the state, promising to launch a gene-based breast cancer prevention program and further reorganize the hospital network in the coming years.
Aseesimees Arvo Aller
AI Summary
Riina Solman, representing the Isamaa faction, was called to the podium by Deputy Chairman Arvo Aller to deliver her address.
Riina Solman
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Riina Solman praises the Minister of Social Affairs' activities in the health sector but demands the creation of a national strategy for the often-invisible field of mental health, especially concerning young people transitioning into adulthood. Most critically, she emphasizes the severe drop in the birth rate (which is far below the replacement level), while acknowledging the recently completed birth rate analysis. Furthermore, she warns that ignoring population reproduction jeopardizes the objectives established in the preamble of the Constitution of the Republic of Estonia regarding the preservation of the Estonian language, culture, and nation.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller asked for three minutes of extra time.
Riina Solman
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Riina Solman sharply criticizes the government’s priorities, alleging that funding for the social sector and support for families are being sidelined, while a "monster ministry" (the Ministry of Climate) was created, which wastes money on flooding forests. The speaker particularly emphasizes that the lack of state-provided health insurance for informal caregivers is criminal and prevents them from returning to the labor market. Furthermore, she expresses concern over the Health Insurance Fund’s (Tervisekassa) massive deficit and the costly and inadequate public procurement process used to find a new director, concluding her critique with the cutting of family benefits and the aggressive methods used to collect the car tax (specifically, the seizure of bank accounts).
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller gave a brief and specific signal that the speaker's time had begun.
Riina Solman
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Riina Solman concludes her address by wishing the minister strength in their work, while simultaneously expressing hope—and slight skepticism—that the measures and funds designated for children would actually be implemented and wouldn't simply remain a fairy tale.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller introduced the next speaker, Tanel Kiik, who represents the Social Democratic Party, and also expressed hope regarding the validity of his mandate.
Tanel Kiik
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Tanel Kiik requested three minutes of extra time, just in case, to continue his speech.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller briefly announced that he required three additional minutes to continue his presentation or address.
Tanel Kiik
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Tanel Kiik asserts that while the minister’s stated priorities concerning healthcare, the social sector, and family policy are correct, the government’s budget reveals that the true priorities are elsewhere. Critical areas (such as reducing medical waiting lists, special welfare services, and subsistence benefits) are either left without the necessary additional funding or receive only a minimal increase, while hundreds of millions of euros are found to support the wealthier population—a move that flies in the face of common sense.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller gave the floor to Anastassia Kovalenko-Kõlvart, the representative of the Estonian Centre Party faction, who requested and was granted three minutes of additional time for her presentation.
Anastassia Kovalenko-Kõlvart
Profiling Eesti Keskerakonna fraktsioonAI Summary
Anastassia Kovalenko-Kõlvart sharply criticizes the government's lack of priorities in tackling the healthcare crisis, pointing out that Estonia leads Europe in the number of people who are unable to access necessary medical care, even as patient fees have increased. Her speech, however, primarily focuses on the wild squandering by Tervisekassa (the Health Insurance Fund), where taxpayer money is unreasonably spent—nearly one and a half million euros annually—on advertising, expensive management consulting, training, and motivational events. Given that the salary fund has also grown and large performance bonuses are paid to board members, the speaker calls into question the necessity of Tervisekassa’s current independent structure and continues to demand accountability from the Minister of Social Affairs for the resulting chaos.
Aseesimees Arvo Aller
AI Summary
Deputy Speaker Arvo Aller granted Helle-Moonika Helme, representing the parliamentary group of the Estonian Conservative People's Party, an additional three minutes of extra time for her presentation.
Helle-Moonika Helme
Profiling Eesti Konservatiivse Rahvaerakonna fraktsioonAI Summary
Helle-Moonika Helme sharply criticizes the minister's inaction and bureaucratic approach to healthcare, arguing that the fine words "health and well-being" do not reflect the reality where people cannot quickly see a doctor. She points out that IT systems (such as SKAIS) needlessly consume millions and that the high VAT on foodstuffs prevents people from making healthy choices, demanding a humane and thorough overhaul of the entire system instead of mere cosmetic changes.
Aseesimees Arvo Aller
AI Summary
Deputy Chairman Arvo Aller thanked [the previous speaker/group] and then gave the floor to Stig Rästa, the representative of the Eesti 200 faction.
Stig Rästa
Profiling Fraktsiooni mittekuuluvad Riigikogu liikmedAI Summary
Stig Rästa emphasizes that a caring Estonia 2035 is not a distant future but the result of today's decisions, calling for the building of a just and compassionate state where humaneness and supporting those in need are considered more important than financial constraints, and where social sector workers and volunteers represent the country's true strength, because care is measured by attention, not by money.
Aseesimees Arvo Aller
AI Summary
Vice-Chairman Arvo Aller addressed Minister Karmen Joller with a question regarding her willingness to participate in the talks, but since the Minister refused, the speaker immediately terminated the negotiations and declared the second item on the agenda passed.