Improvements to services and effectiveness of health centres
The client services and effectiveness of health centres will improve. The action plan An Effective Health Centre launched by the Minister of Health and Social Services, Paula Risikko, presents approaches to improving the practices, administration, management and structures of municipal health centres. Health care education and research will also be developed. The methods will be introduced at health centres in stages over the years 2009–2010. The implementation of the pragmatic action plan can according to Minister Risikko be started immediately, since it has been built on a strong foundation. The initial stages will be supported by existing project funding, but in order to make the entire health care system more effective we need additional funding.
“According to the Government Programme we have to strengthen our primary health care system. There has been a long-standing consensus on what the problems faced by our health care are. Until now we have been building a sustainable foundation. The work is structured by the framework law to reform local government structures, the national development plan (KASTE) for social and health care services, the Policy Programme for Health Promotion, the government bill for a new Health Care Act, and the forthcoming act on social welfare and health care administration. The action plan seeks to find new concrete approaches to problems, even to difficult problems, in our primary health care together with professional organisations and stakeholders,” the Minister stated on 30 September when the action plan was published.
New methods to facilitate access to care
The proposed new practices would alter the division of duties and responsibilities in health centres. In terms of pay, the reform of the division of duties between doctors and nurses will be supported by local agreements. Family doctor services are ensured for those in need of them.
Nurses’ and physiotherapists’ consultation at health centres will increase. Their consultation is suited for instance for the care of acute patients, control visits to persons suffering from chronic diseases, assessment of the need for rehabilitation or of functional capacity, and ‘low threshold’ consultation for patients with mental health or substance abuse problems and for young people.
The planned reform regarding additional training in primary health care for physicians will, in the long term, increase the attraction of municipal health centres as workplaces. In the future, the physicians with this training would be employed, instead of by municipalities, directly by a primary health care unit, and work under supervision of experienced doctors. In practice the reform means that every hospital district in Finland will have a ‘training health centre’. At present, there are such health centres for instance in Turku and Pori.
New practices will help to improve service
The selection of methods included in the action plan support the aim of the bill for a new Health Care Act to intensify the cooperation between primary health care and specialised medical care. According to the bill, patients do not need to visit a health centre to obtain a referral to a specialist, as they do at present, but specialists’ consultation will also be available at health centres. Possibilities of information technology will be made use in client service. Examples of that are telephone and video consultations and the electronic patient portal.
The care of acute and emergency patients in the health centres of joint municipal boards, i.e. areas of a broad population base, will become more efficient when emergency units functioning without appointment are established. Emergency service in the evenings will be organised as a joint function of the municipalities concerned.
Preventive health care will be made more efficient, not only at maternity and child health clinics but also in health centre services. For instance home visits by maternity and child health clinic staff and home nursing staff will be increased. A counselling and service network will be established within social and health care to promote the wellbeing and health of older people.
Professionals in the pharmaceuticals field, such as the staff of pharmacies, will be involved more closely in particular in organising the pharmacotherapy of patients in home care. The introduction of electronic prescriptions enables, among others, a more extensive automated dose dispensing. In the best of cases, the dose would be brought to the patient’s home. The expertise of persons with special qualifications in pharmacotherapy assessment will be taken into account to a larger extent.
Alterations to administration, management and research
The Ministry of Social Affairs and Health supports together with the Association of Finnish Local and Regional Authorities the regional networking of primary health care units. This would help to coordinate the supply of services, such as emergency functions and daytime acute consultation, and intensify recruitment. Networking could also be utilised when concluding service agreements with specialised medical care.
Different alternatives for organising primary health care will be considered on the basis of opinions received on the bill for a new Health Care Act. In the same context, it will be examined how the models used in the other Nordic countries and OECD countries to organise primary health care and the work in primary health care are suited for the Finnish circumstances.
The research on primary health care will be reinforced. A system for the assessment of effectiveness and cost-effectiveness will be developed simultaneously. Models in which employees can combine research and work with patients will be launched in health centres.
The action plan is launched immediately
The implementation of the action plan for effective health centres begins immediately. The legislation basis needed in support of the measures will be reinforced when the new Health Care Act and the act on social welfare and health care administration, which is being drafted, will enter into force in 2010. The achievement of the objectives of the action plan will be monitored by the unit responsible for development of primary health care at the new National Institute for Health and Welfare (starting operation at the beginning of next year).
The Ministry of Social Affairs and Health together with relevant NGOs and stakeholders in the field are responsible for the implementation and evaluation of the action plan. The steering group chaired by Minister Risikko will decide on its objectives. The preparatory management group is chaired by Director-General Päivi Sillanaukee from the Ministry of Social Affairs and Health.
For further information contact:
Päivi Sillanaukee, Director-General, tel. (09) 160 73313, 040 5328249
Timo Aronkytö, Senior Medical Officer, tel. (09) 160 74178, 050 3121678