Why are the structures of emergency medical care and specialised medical care reformed?

The structures of emergency medical care and specialised medical care are reformed. The objective of the reforms is to ensure that clients of social welfare and health care services have access to equal and safe services and to guarantee that the units providing the services and care are competent enough.

Director of the Health Services Group Liisa-Maria Voipio-Pulkki from the Ministry of Social Affairs and Health talks in more detail about why the structures are being reformed. She also talks about everything that the reform involves, how local services will be secured and whether patient safety has been ensured.

Link to the video interview: https://youtu.be/zuNy9sHYBmw

Lisää aiheesta:

• The emergency medical care reform would link social welfare and health care services closer together – proposal sent for comments (in Finnish)
• Emergency medical care and specialised medical care (alueuudistus.fi) (article in Finnish)

Transcript of the interview

Why are the structures of emergency medical care and specialised medical care reformed?

“These reforms have actually been planned since the beginning of this century. In the long term, there are two reasons. First of all, Finland’s hospital network was largely built in the 1960s and 1970s and it has become outdated in many ways. The population has increasingly moved to large population centres, but we also have to maintain urgent medical care services in areas that are less densely populated. We are used to health centres being open at night. In reality, apart from a few exceptions, the number of night-time visits made to emergency medical care at health centres is rather small. As a result, people who have fallen seriously ill or who have been severely injured do not always end up in the appropriate place of care straight away and, on the other hand, staff is not always used in the best possible way. ”

What does the extensive reform of emergency medical care and specialised health care include?

“We will try to centralise night-time emergency medical care and, on the other hand, concentrate treatment for people who have fallen seriously ill or who have been severely injured in places where it is possible to organise their care safely and efficiently around the clock. That is why we will reinforce the resources of 12 hospitals that provide a very extensive selection of emergency medical care and, on the other hand, investigate the status of the other central hospitals rather carefully. In cooperation with the catchment areas for highly specialised medical care, we will look into what 24-hour emergency medical care it is worthwhile and necessary for the central hospitals to provide. In addition to this, it is possible to continue 24-hour emergency medical care in primary health care or acute care in those health centres and smaller hospitals in which it is necessary for the population if the catchment areas so request. Additionally, this reform includes significant measures to improve the availability of social welfare and emergency social services. And finally, I need to mention urgent appointments in health centres in the evenings and at weekends. They are provided specifically to direct the population and to offer them good urgent appointment services so that they would not need to go to the joint emergency services and queue there for long times.”

How will local services be secured when social welfare and health care services are gathered to larger units?

“In addition to increasing the possibilities for these health centres to provide urgent appointments, attention will also be paid to prehospital care. Prehospital care is operations in which very demanding procedures can be carried out. It can also assess the need for treatment. It is really important that we investigate carefully where the demand and need for prehospital care is biggest, but we will also safeguard it in areas where it is needed occasionally. This also concerns those many social welfare institutions, sheltered housing units and for instance in-patient wards at health centres that we do not intend to leave without emergency physician’s services and in which prehospital care can be given at the location when necessary.”

Has patient safety been ensured now that journey times to hospitals are becoming longer?

“In fact, journey times to hospitals will not become substantially longer. If we look at the population as a whole, according to this model, nearly everyone will be able to reach 24-hour emergency medical care in less than the two hours set as the national goal. For 80% of the population, the journey time will be less than one hour. I would really emphasise that the need for night-time emergency medical care is low at primary level, but when we talk about more serious situations, it is people from prehospital care that go and assess the situation on the basis of the call to the emergency centre and take care of the patient during the transport."

Interview and video: Kimmo Vainikainen