Why should the government's supervision of social welfare and health care be strengthened?

To be successful, social welfare and health care reform requires clearer steering by the government. Above all, it requires joint responsibility by all the actors involved. This is the view of the rapporteurs appointed by the Ministry of Social Affairs and Health. While people's wellbeing and health need to be improved we should, at the same time, be conscious of the limits of public finance available. Tuomas Pöysti, the project manager for the social welfare and health care reform and regional administrative reform, tells in a video interview why government's supervision of social welfare and health care should be strengthened.

Link to the video interview:
https://www.youtube.com/watch?v=iT0-cGd7a-o

Text version of the interview

Why should the government's supervision of social welfare and health care be strengthened?

"Government's supervision is one of the means to strengthen equality in access to services. With the government in control, it is also possible to support practical work by organising the services effectively and cost-efficiently. In this way, we will have as well organised services as possible for all. At the same time, we can ensure that the resources will be sufficient for those who need them most."

How is the supervision of the strengthening of social welfare and health care going to take place?

"In the strengthening of the social welfare and health care supervision, it is now essential to define the issues that the government intends to place under its control. The recently completed work by the rapporteurs is a very important and very good subject for a debate. It contains ideas similar to those that have come up in the official preparation at the ministry. That is, the government's control should focus on so-called big picture, strategic aims, resource questions, sufficiency of resources and their just distribution and cost-effectiveness. Here you have the main essence of government's supervision."

Considering the resources and costs, what is the main concern of the rapporteurs who have pondered over the control of social welfare and health care?

"One important concern of the rapporteurs is related to the support of professionals working in practical areas. This applies especially in health care but also in social welfare where, in both areas, identity development is under way. Now we easily interpret resource issues only from the viewpoints of current needs of an individual client and the rights of this kind of client at that particular moment. In this, the rapporteurs brought up the desire by both professions for resource discussions to be linked to a wider social development. The rapporteurs also were after this kind of social responsibility, meaning that the wider social welfare and health benefits of resource targeting should be taken into account when prioritising. In the similar way, we need to consider the longer term development of an individual; that is, we must figure out how effective the measures we are taking are."

What do we expect of the management in the social welfare and health care reform?

"In the social welfare and health care reform, there are many expectations on management. During the preparation of the reform, it has been noticed that management is one of the important ways by which savings could be created and equality could be improved. The rapporteurs added a very important and interesting viewpoint to this, namely giving hope. A strong feeling about the desirability to give the staff hope and faith to the future became evident both through the rapporteurs and the data they had gathered in their interviews and questionnaires. And this can also free human capital and resources for the development of activities."

The reform applies both to health care and social welfare. Can we consider the same steering model for social welfare?

"This was something that the rapporteurs also considered. They came to a conclusion that this would actually be the same control model.  
This means that for example management by knowledge would take place both in social welfare as well as in health care, and for this reason the structures of research and development should be put together. This is why the rapporteurs exchanged thoughts for example about joining the centres of expertise in the social field to the university hospitals' structure currently linked to their catchment area so that they would form an equal development unit in that entity. This is an interesting idea. Another viewpoint, brought up especially from the perspective of social services, is the defence of weaker members of society, which is related to a more general definition of responsibility during times of scarce resources. This applies both to the individual's and society's systemic responsibility. This is quite an important debate in fact."

Interview and video: Kimmo Vainikainen