Minister Rehula: Freedom of choice to improve primary health and social services

On 21 December, the Government published a bill concerning the customer's freedom of choice with regard to social and health services, as well as the changes made to the Government's draft proposal on the health, social services and regional government reform after it has been circulated for comments. The legislative package concerning provision of health and social services will go to Parliament in early 2017, when the bill on freedom of choice in social and health services is circulated for comments.

"The health, social services and regional government reform has taken a step forward once again. The Government has a common view on the package concerning provision of social and health services, and the legislative package is in this respect ready to be given to Parliament. The related drafting of legislation on the customer's freedom of choice in social and health services has also progressed, and its circulation for comments can begin in early 2017," states Minister of Family Affairs and Social Services Juha Rehula.

"We are building a model for Finland on the wide-ranging freedom of choice for customers, which will strengthen and expand primary social and health services and in which a strong public provider will curb the rise of costs. Timely access to care and early prevention of problems will be based on people's needs and will be cost-effective," Minister Rehula says.

According to the minister, the improvement of primary level services is a large operational change. "In practice, this will mean that specialist consultation will be transferred to social and health centres. Social and health centres will bear responsibility for providing treatment and services to customers, as well as for covering related costs, which will mean that they will have no incentive to send customers to unnecessary services or tests," Minister Rehula states.

"The public sector must be licked into shape to ensure that it is sufficiently strong also in the future. Many will continue to rely on their safe and familiar local social and health station even under the new model," Minister Rehula says.

Information flow to be a point of focus

Minister Rehula emphasises the importance of information flow and the functionality of social and health care information systems especially with regard to future freedom of choice.

"Without well-functioning information systems and a quality management system that can be compared, a freedom of choice system cannot be implemented and customers will continue to be pushed around. With regard to the interoperability of information systems and information flow, it is essential that the Counties Act includes a service obligation for regional service centres. The ICT service centre must maintain and provide use of electronic patient information systems for all institutions and companies that provide social and health services. In this way, also small service providers will be able to utilise the ICT systems used generally in the county, which will ensure lighter investment pressure and the smooth flow of information," Minister Rehula explains.

"In the future, more and more of the services provided by health centres can be provided at home thanks to digitalisation. This change will be facilitates when the now drafted legislation enters into force," Minister Rehula says.

"Increased freedom of choice will also facilitate well-functioning service chains. In addition to information flow, the possibility for personal budgeting and customer guidance guarantee their realisation," Minister Rehula underlines.

Public gatekeeper curbs the rise of costs

Minister Rehula notes that despite expanding freedom of choice the core of social and health services will remain in the public sector. In the future, emergency treatment, intensive care and demanding specialised medical care services will be produced by public service providers. A strong service provider, the county, will see to it that the public services provided are cost-effective and of high quality regardless of whether the provider is from the public, private or third sector.

The minister notes that even if the costs of services added to the scope of freedom of choice were to initially grow, the overall result is the deciding factor. "A public sector service provider acts as a 'gatekeeper', who is able to curb costs and manage the entire process. The overall objective has for quite some time been to transfer focus from expensive specialist services to primary level services. Service provision and the contribution of professionals will increase in the future at the primary care level, which should, in the long-term, materialise as lower social and health service costs," Minister Rehula sums up.

The legislative package for the provision of health and social services is due to enter into force on 1 January 2019. According to the bill, extensive freedom of choice for basic level services will be implemented on 1 January 2021.

This is an English translation of press release which was published on 21th December.

Further information:

Special adviser to the Minister of Family Affairs and Social Services Hanna-Maija Kause, tel. +358 50 566 7949