The reform of 24-hour services creates regional units and reinforces collaboration between healthcare and 24-hour social services
The Government proposes that the system of 24-hour services in healthcare and social welfare is reformed. The aim is to create larger units for the provision of specialised medical care. Some examinations, procedures and treatments would be centralised at the national and regional levels. The reform would secure equal access to services, sufficient skills in the units providing care as well as client and patient safety. It would also curb cost increases and improve access to urgent care. The reform will be implemented as part of the health, social services and regional government reform. The intention is to implement the reform gradually in 2017–2019.
The broadest selection of 24-hour specialised services would be available in 12 units providing extensive 24-hour services. Five of these units would be university hospitals that even provide highly specialised medical care. Each of the 12 units would provide services around the clock in at least ten specialist fields and in social services. This ensures that the units have multidisciplinary skills as well as preparedness for special situations.
Other central hospitals would continue as 24-hour services with a narrower selection of primary healthcare, specialised medical care and 24-hour social services. They would provide 24-hour services in the specialist fields in most demand. Each of the five catchment areas would agree on a detailed division of duties with their central hospitals, taking into account availability of services, distances between 24-hour service units as well as implementation of the population’s linguistic rights. All units providing 24-hour services must have the necessary resources and skills.
Emergency reception services, organised as local services in health centres, would be reinforced. According to the proposal, emergency reception services would be available as local services in the local health centre also in the evenings and at weekends.
It is also proposed that 24-hour social services would be available in both the units providing extensive 24-hour services and the central hospitals with a narrower selection of 24-hour services. The Government also proposes to reinforce the obligation to organise psychosocial support. Mental health and substance abuse services around the clock would be organised as part of 24-hour services in both healthcare and social welfare.
Clients’ need for social services would be assessed in both non-urgent and urgent cases. The aim is that contacting social services and referring clients to them would become a regular practice in healthcare. The proposed legislation also aims to ease the workload in 24-hour services by ensuring that non-urgent cases are as much as possible treated during office hours.
Particularly intensive social services could be centralised nationally or regionally as part of either healthcare services or other services. This would ensure client safety and the quality of services. According to the proposal the municipalities would still have a variety of alternative ways to develop 24-hour social services based on local needs, good practices and collaboration between municipalities.
The proposed legislation would also clarify the content of emergency medical services and the duties of the emergency medical service units. Collaboration between the emergency medical services, emergency medical service unit and 24-hour social services in the region will be reinforced, and regional guidelines will be harmonised.
The Government submitted a proposal on the reform to Parliament on Thursday, 27 October 2016. The intention is that the new acts would enter into force on 1 January 2017. The transition period of the decrees issued under the act would be 1–3 years. The division of duties between hospitals providing 24-hours services, the centralisation of surgeries as well as the launching of the joint 24-hour services in healthcare and social welfare would, nevertheless, take place on 1 January 2018 at the latest.
The special permits concerning childbirth services and 24-hour services in primary healthcare, granted under provisions in force before the now proposed act enters into force, will be valid until the expiry date mentioned in the permit. The Ministry of Social Affairs and Health has today granted on application three fixed-term special permits concerning childbirth services: the permits for the central hospitals in Kainuu and Mikkeli are valid until the end of 2020 and the permit for the central hospital in Länsi-Pohja until the end of 2018.
Anne Koskela, Ministerial Counsellor for Legal Affairs, tel. +358 2951 63384
Liisa-Maria Voipio-Pulkki, Director, tel. +358 2951 63382 (structural reform)
Timo Keistinen, Ministerial Counsellor for Health/Medical Affairs, tel. +358 2951 63385 (specialised medical care)
Virva Juurikkala, Senior Specialist, tel. +358 2951 63204 (24-hour social services)
Lasse Ilkka, Senior Specialist, tel. +358 2951 63995 (emergency medical services)
Anne Nordblad, Ministerial Counsellor for Health/Medical Affairs, +358 2951 63387 (oral health services)