International evaluation: Counties as the organisers of health and social services is a good solution
Finland has a good health and social services system but it can and should be enhanced and developed. Municipalities are too small and scattered to organise equal health and social services cost-effectively. Compiling the organisational responsibility to counties in the health and social services reform is a good solution. The integration of health and social services enhances cost-management, customer-orientedness and quality.
This is the international assessment panel’s evaluation of the Finnish health and social services system and the health and social services reform. In the spring of 2016, the Ministry of Social Affairs and Health asked the known European assessor, European Observatory on Health Systems and Policies, to organise a pre-evaluation of Finland’s health and social services reform. The panel consisted of recognised experts from WHO, OECD and European universities.
According to the assessment panel, the fundamental solutions of the health and social services reform are functional. However, the implementation has a decisive role. Know-how and resources have to be directed to the counties' organisational competence and strategic organisation of services, procurement and information systems. The implementation of the reform demands development of information systems and instrumentation. Strong state guidance for organising and evaluating certain services is needed for the ICT solutions.
Well developed and implemented freedom of choice may improve incentives and quality. The assessment panel considers phased augmentation wise. Creating a compensation model for producers with the freedom of choice and their guidance is a difficult task, so solutions should be developed as more experience is gained. Freedom of choice demands good reference data for the end users of the services.
In the assessment panel’s view, the producers should have an adequate amount of independent discretionary power to develop their operation and services. Avoiding price skimming and competition neutrality are important issues. The assessment panel also reminds of Finland's strong and successful national health work that must not be cast aside in the reform.
Under-Secretary of State Tuomas Pöysti, tel. +358 (0)2951 63012
Director Liisa-Maria Voipio-Pulkki, tel. +358 (0)2951 63382
Medical Councellor Taina Mäntyranta, tel. +358 (0)2951 63692