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Will the social welfare and health care reform make it easier to get to a doctor?

Ministry of Social Affairs and Health
Publication date 13.11.2015 13.41
News item

The social welfare and health care (SOTE) reform involves the setting up of 18 autonomous areas, 15 of which will organise the social and healthcare services themselves. Three other autonomous areas will organise their healthcare and social welfare services with support from another autonomous area. Tuomas Pöysti, the Project Manager of the social welfare and health care reform, answers key questions about the social welfare and health care reform in a video interview.

Link to the video interview:

Text version of the interview

Will the basic services for people improve through the reform? Will it be easier to get to a doctor?

The goal of the social welfare and health care reform is to secure services of sufficient quality and to make them available on an equal basis under conditions of limited resources. The goal is to reinforce first line services - that is, new types of basic level services. This means that it will hopefully be easier to see a doctor in the future.

This basic level also means that in the first phase all central services would be available close to where people are.  Not only these present services of the basic level, but also, if consultations of a specialised level are needed, for example, whether the matter involves social work or specialist medical services, these could also be brought, according to the needs of the customer, to the front line as wholes.

All of this is the aim, but it naturally requires big operational change and in this we still need to work patiently. The reform that has now been decided on will only form the framework for this, but the work must be continued so that this can also be implemented in practice.

How will the hospital network be reformed? Will nearby 24-hour services come to end?

Nearby 24-hour services will not come to an end.

The starting point in this Government move will be that in the future, Finland would have 12 units for extensive 24-hour services: five university hospitals and seven other hospital units with extensive 24-hour services. Extensive 24-hour service means that all specialised fields are available 24 hours a day, every day of the year.

But then in the regions, closer to people, the present central hospitals will continue as 24-hour services with a narrower selection of services, and the call duties of health centres and related social emergency services will continue. The aim is to have 24-hour service available and accessible all over the country, but the system relies on these 12 units where all specialist fields are always available.

Can local authorities still affect the content of the upcoming reforms?

Local authorities can affect the content of the upcoming reform in many ways. After the Government set the political course of action, an extensive round of consultation will begin, which means that the whole will be sent to the local authorities for consultation. Municipalities can give their statements on it and the aim will be to take them into consideration.

In addition, these preparations will be made in broad cooperation with the Association of Finnish Local and Regional Authorities in such a way that the Association is involved, and the Association will pass on that the local authorities and the networks that they form are also involved in the drafting of this legislation, which will get a new boost from the political policy decisions, also making it possible to affect the content of future legislation.

It is most important to think how the new structures and goals will be implemented in the regions in practice. As the regional division is gradually visualised, regional work in which the local authorities will be involved as key players, will begin. I hope that local authorities will start thinking already in the regions, with both the health care district and the regional council, and with other regional players, about what customer-oriented integrated social and health services mean in that area and how they could be implemented.

How is the regional government reform linked with this reform?

The regional government reform is the second pillar of this reform, which is also aimed at the achievement of better societal goals and better productivity, more unambiguous administration, and the organisation of services. The aim of the regional administrative reform is that regional tasks of promotion and development in an area wider than a municipality, and other tasks, will be brought together in the autonomous areas in such a way that the autonomous areas will become transparent authorities that are close to the citizens and efficient.

The autonomous areas are being given all of the tasks of regional councils and consequently, the tasks of regions from the ELY Centres and those linked with the promotion of business activities extensively. Tasks of emergency services would also be transferred to the autonomous areas. Environmental health care is being evaluated as a whole to see if it is also connected to the tasks of the regions.

In general, all tasks that local authorities have been obliged by law to organize in collaboration with other local authorities, i.e. those that need to be arranged in an area that is wider than a single locality. These could form such a clear whole, and democracy would also improve when they are under the authority of a council chosen by the people in direct elections and organised according to the decision-making authority of the council. 

Interview: Katariina Vesikko

Video: Kimmo Vainikainen

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