Health and social services centre
The Government proposes to increase clients’ freedom of choice as part of the health, social ser-vices and regional government reform. The content of this site is based on the government pro-posal of 8 March 2018, which will be amended during parliamentary consideration. The content will be updated after decisions on the amendments have been made. Parliament will decide how the health, social services and regional government reform will move forward in the autumn term 2018. The aim is that the new counties would start on 1 January 2021, while freedom of choice would come into force in stages.
The aim is to expand freedom of choice so that clients have more freedom in selecting the health and social services centre of their choice, which may be public or private. Health and social services centres provide the services of nurses and physicians as well as counselling related to social services. The intention is to also provide medical specialist services in the health and social services centres. Clients can obtain services from a public or private health and social services centre.
What is a health and social services centre and what services are available there?
Health and social services centres offer their clients basic-level health and social services.
These include, for example:
- health counselling
- health checks
- appointments with general practitioners
- assessments of functional capacity and work ability
- guidance and advice given by social workers
- such medical specialist services that, according to the plans, are intended to be available at health and social services centres.
In future, services will also be given in different modes when mobile clinics and e-services become more common.
If clients need services that are not available at their health and social services centres, they will be referred to an unincorporated county enterprise. A client will be referred to a unit of an unincorporated county enterprise also in cases where the services require an official decision. Such a unit may consist of a social services clinic or a unit providing services for persons with disabilities. The health and social services centre may even refer the client to receive peer support from civil society organisations if there is no need for actual health and social services.
Clients can choose their health and social services centre
If the freedom of choice will expand in the way the Government has proposed, clients can themselves choose which health and social services centre they want to use. In practice, people will sign up as clients to the health and social services centre they have chosen. The choice would be made online or in writing. If a client does not make the choice, the county of residence would refer him or her to a care facility that is located conveniently.
If the client does not choose a health and social services centre themselves, he or she will initially be signed up as a client of the unincorporated county enterprise health and social services centre. The client will be notified of the public health and social services centre to which he or she has been assigned as a client on the basis of where he or she resides. The same client will also be notified that he or she has the right to immediately change the health and social services centre he or she is signed up with if he or she so wishes.
If county’s resident has not chosen a health and social service centre, the county must assign him or her permanently as a client of one, which is in the county’s area and is easiest for the client to access (public or private).
According to the Act on Freedom of Choice, clients could get social welfare guidance and advice at the health and social services centre. Additionally, the unincorporated county enterprise’s social welfare professionals, such as social workers, could when necessary be present at health and social services centres. They would offer social services and carry out service needs assessments at health and social services centres. This would mean that the client would not need to seek services from the unincorporated county enterprise service unit when needing social services.
If a client needs more broad-scoped services or their service requires a decision by an authority, which cannot be carried out in a health and social services centre, the client is directed to the unincorporated county enterprise. The unincorporated country enterprise’s unit can be for example a unit that provides services to the elderly or disabled.
The unincorporated country enterprise’s unit assesses the client’s service need and draw up a client plan. The client either receives services according to the plan directly from the unincorporated country enterprise’s unit or may be provided with a health and social services voucher or a personal budget. In this case, the client may select a private company or organisation to provide the service in accordance with the client plan.
If there is no need for actual health and social services, the client may be guided to peer support services provided by an organisation.
Services of professionals in specialised medical care
Health and social services centre would also offer the services of professionals in at least two different fields of specialised medical care. The county could decide which fields these are. In this case, the overall responsibility for the client’s care will remain with the general physician at the health and social services centre and there will be no gaps in the client’s care.
A referral by a general practitioner or medical specialist will still be needed for specialised medical care in the future. A referral by a physician at a health and social services centre may be processed electronically at an unincorporated county enterprise to note the client's need for care and guide the client to treatment corresponding to his or her need. For instance, this may be an examination or surgery performed in a hospital. The client may choose the place of treatment together with the referring physician.
Clients can change their health and social services centre every six months
Clients must online or in writing submit a notice indicating which health and social services centre they have chosen as their care facility. The home county of the client will be informed of the choice.
Pirjo Kainulainen, Ministerial Counsellor, Legal Affairs, Ministry of Social Affairs and Health, tel. + 358 295 163 092
Kirsi Varhila, Director-General, Ministry of Social Affairs and Health, tel. +358 295 163 338