Frequently asked questions about the regional government, health and social services reform
We have gathered the most frequently asked questions here.
You can browse the questions by subject or fill in your question directly in the field below.
Health and social services reform
Health and social services are services the state (central government) finances through tax revenue. They include, among others,
- outpatient services (which usually means health centre appointments and, for example, preventive services provided by maternity and child health clinics)
- hospital services
- oral health services
- mental health and substance abuse services
- child protection
- services for people with disabilities
- housing services to older people
- home care
The regional government, health and social services reform will give the public administration in Finland a clear three-tier structure: state, counties and municipalities. The aim is to modernise administration and services to respond better to client needs and to make the administration function cost-effectively. The objective of the regional government reform is to coordinate regional state administration and county government and to create an appropriate division of responsibilities between the regional state administration, the counties and the municipalities.
The objective of the health and social services reform is to improve the availability of health and social services and reduce disparities in citizens’ wellbeing and health. The reform aims at giving everyone equal opportunities to choose and use services and at creating services that would have a better impact on people. The reform also aims at curbing costs.
The reform is due to come into force on 1 January 2020.
Resources, such as personnel, premises and funding, can be used more effectively when health and social services are organised by 18 counties instead of the current municipalities and joint municipal authorities. Bridging the sustainability gap also requires a smooth integration of primary and specialised health and social services. This means in practice that clients receive the services they need in a smooth manner and without unnecessary intermediaries. These changes will help to reduce institutional care and reinforce preventive work, which in turn will postpone older persons' need for services. Counties will be larger and stronger operators than municipalities, enabling a better division of responsibilities and more efficient use of new service forms.
Significant savings will be made when health and social services in future utilise digital services more widely that today. In addition, interoperable information systems will guarantee that information flows well between different operators. Central government steering must be strong enough to spread good practices and to allocate funding and models in the right way to right places in order to implement the services.
Freedom of choice
Yes, they can. Patients can, for example, choose their health centre. They can also use private health services and receive reimbursement for the costs from Kela, the Social Insurance Institution of Finland. Patients can also choose a specialised medical care unit located in Finland. They can even seek medical care abroad. In social services, however, the clients do not yet have the same freedom of choice based on legislation, although they can choose some services using the current service voucher.
More information on choosing a care facility at present:
It means clients’ right to choose a suitable service provider, service entity and professional to provide them with health and social services. These rights to choose are to be expanded as of 1 January 2020. The draft bill for the Act on Clients’ Freedom of Choice in Healthcare and Social Welfare (Freedom of Choice Act) proposes that publicly funded health and social services could in future be provided by public, private and third-sector operators, such as organisations and foundations. Client charges will be the same for the same service, irrespective of service provider. Clients would have more freedom to choose the service providers that best suit them.
- This would mean that clients can sign up with the health and social services centre and dental clinic (oral health services unit) of their choice. The service provider would have to be approved by the county and the national licensing and supervisory authority.
- Clients could even get health and social services vouchers or a personal budget to get the health and social services defined in their client care plan.
- When using services provided by the county, clients could also choose which unincorporated county enterprise and which of its service entities to use. The service entity could be a social services clinic or a hospital, for example. Services provided by counties include social services and specialised medical care and some other health services.
- Clients can choose the professional they wish to see if it is possible and appropriate.
- Clients can seek medical care in another EU or EEA country already under existing provisions.
The aim is to improve the availability and quality of services and to encourage counties and service providers to work in the most efficient and effective way. This ensures that clients will get help for their matter or problem faster than today. Clients will have faster access to a nurse, physician, social worker or to other services. Clients will also have more freedom to choose where to get services and which services to use. The goal is that clients have better opportunities to have a say in decisions that concern them and their care and treatment. It is believed that the quality and cost-effectiveness of health and social services will improve when there is competition for clients among service providers.
Cost-effectiveness means the comparison of the relative costs of services and the effects of those services on people’s health, wellbeing and functional capacity. The cost-effectiveness of a treatment is the higher the more health benefits it generates with the available resources.
Partial optimisation means that an operator aims to ensure its own benefits without taking into consideration what would be best for the whole system. In healthcare and social welfare, partial optimisation can mean that the choices that benefit one operator can increase the total costs of the whole service system. Partial optimisation can also have negative effects on people’s health and functional capacity.