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Freedom of choice into force from 1 January 2019

The Government submitted to Parliament a proposal on an Act on Freedom of Choice on 9 May 2017. The Parliament will decide on the Act in autumn. The Act is scheduled to enter into force at the beginning of 2019 when counties start to organise public health and social services. 

Preparation and implementation of freedom of choice is progressing at different paces in different counties. Therefore the legislative proposal contains several transition periods.  In some counties freedom of choice would be extended already during 2017–2018 through pilot projects. From the beginning of 2019, all counties must take into use health and social services vouchers, personal budgeting and client’s right to choose a dental clinic.  Health and social services centres shall launch their activities and offer at least a limited range of services from1 July 2019 at the latest. By special permit counties could postpone the establishment of health and social services centres until the beginning of 2021.  Freedom of choice should be introduced in full in all counties by 1 January 2023.

2017–2018

  • In some counties freedom of choice would be extended already during 2017–2018 through pilot projects.  In those counties, piloting the activities of new health and social services centres would start   by 1 July 2018.
  • By 30 June 2018, all counties must decide on the requirements to be set for the dental clinic service providers.
  • The same deadline applies to counties’ decisions on their implementation plans regarding freedom of choice. The implementation plans shall include, among other matters, a timetable for and details on starting the activities in health and social services centres.
  • Counties have four alternatives when deciding on the date and scope for the establishment of health and social services centres. The centres can be launched by pilot projects mentioned above, by offering a more limited range of services first, by immediately offering a full range of services, or in special cases the county can apply for a special permit to start the activities later.
  • If a county considers they need more time for extending the freedom of choice, the county shall apply for a special permit by 30 September 2018.
  • Service providers offering their services at oral health services units are required to give notification of their service provision to the respective county by 1 September 2018.
  • From 1 November 2018, clients can register as clients of the oral health unit (dental clinic) of their choice.


1 January 2019

  • From the beginning of 2019, a client could choose a public or private oral health unit (dental clinic).
  • In the beginning of 2019, unincorporated county enterprises take into use health and social services vouchers and personal budgeting. Dental clinics can also grant .
  • Health and social services vouchers will be taken into use by health and social services centres when the centres start their work.
  • Service providers offering their services at health and social services centres are required to give notification of their service provision to the respective county by 31 January 2019.
  • Clients can choose their health and social services centres from 1 April 2019, at the latest.
  • The health and social services centres will start their work by 1 July 2019 unless the county has applied for a special permit.  Counties can decide whether the activities will start by offering a limited range of services or a full range of services.


1 January 2021

  • By special permit counties could postpone the establishment of health and social services centres until to the beginning of year 2021 by offering first a limited range of services. The full range of services must be in use by 1 January 2022 at the latest.  In such situations the county should take health and social services vouchers into use in their primary health and social services from the beginning of 2019.


1 January 2022

  • If a health and social services centre starts its work by offering first a limited range of services (from 1 July 2019 at the latest), including primary health care services and social service guidance, the full range of services must be in use by 1 January 2022 at the latest. This means that by that point of time the health and social services centres shall offer, for example, medical specialist services and short-term social services.


1 January 2023

  • If a health and social services centre starts its work in 2018 by a pilot project and by offering a limited range of services, the full range of services must be in use by the beginning of 2023.
  • This means that freedom of choice will be introduced in full in the whole country from the beginning of 2023.