Counties and municipalities promoting good health and welfare
Municipalities and counties come together to promote the well-being and good health of their inhabitants. Municipalities and counties have their own tasks in promoting the welfare and good health of their inhabitants.
Municipalities will also be in charge of promoting the inhabitants' welfare and good health after the health and social services reform. It is important that municipal decision-makers understand how to promote the welfare of residents in the everyday environment.
The task of counties is to support municipalities and provide them with expertise to support their work of promoting welfare and good health. Counties are also in charge of ensuring the regional promotion of welfare and good health, health and social services and the provision of promotional and preventive services.
In order to coordinate the services promoting welfare and good health provided by counties, municipalities and organisations, and to implement cooperation, clear structures across administrative branches are required.
Sharing good practices
In connection with the health and social services reform, it is important to share good practices and policies everywhere in Finland. Good practices and functional cooperation models are spread in ten projects. You can read about them here.
Municipalities solve many issues affecting residents’ welfare
Municipalities make decisions on many tasks and activities which are crucial for residents' welfare, inclusion, employment and ability to function. Issues affecting residents’ welfare and health include early childhood education and further education, the opportunities to exercise, catering and cultural services, housing, zoning and traffic arrangements. Decisions on the management of these issues and many other issues are made by the municipality.
Municipalities may contribute to the vitality of the region and mitigate the increase in social and health care expenditure by promoting the welfare of residents in a systematic and active manner. This will be successful as the municipal decision-makers involve various administrative branches, organisations and residents in order to find good solutions and to make the necessary changes. There are plenty of examples of good methods of operation. The authorities in charge of land use may plan local environments in conjunction with residents to inspire them to maintain their health and to keep them safe. Municipal youth or sports services may diversify recreational activities in cooperation with organisations. Municipal education services may provide digital training for different population groups, for instance in libraries. Municipalities may also decide on providing and supporting meals which are consistent with nutritional recommendations.
In order to implement the practice of promoting welfare and good health, municipalities require the following:
- permanent cross-administrative collaboration and implementation structures (working group on welfare and coordination of health promotion),
- management practices across administrative branches and accountability,
- commitment to welfare objectives in municipal planning,
- up-to-date information on the health and welfare of the population and the factors influencing them,
- effective health promotion practices, and
- professional expertise in prevention work and sufficient numbers of personnel.
Municipal tasks in the promotion of good health and welfare
Municipal tasks for the promotion of good health and welfare are not new. A welfare report is in active use, and the cross-administrative cooperation structures for promoting welfare are part of municipal management in most municipalities. They will ensure long-term and systematic work for promoting the welfare of the inhabitants of these municipalities. Instead, attention should be paid to the implementation of a preliminary estimate of impacts in several municipalities.
The statutory municipal tasks of promoting welfare and good health include the following:
- monitoring residents' health and welfare as well as factors affecting them by population group
- annual reports on the health and welfare of the inhabitants of municipalities and on the measures taken submitted to the council
- preparation of a welfare report for the council for every term of office of the local council
- setting objectives and actions to promote welfare and health based on local conditions and needs
- implementation of the preliminary estimate on the effects of the decisions
- designation of the parties responsible for the promotion of welfare and good health
- co-operation with the county and the other parties operating in the municipality (organisations included).
Counties promoting welfare and good health
The task of counties is to support municipalities and to ensure the tasks of promoting welfare and good health regionally. In addition, counties must ensure that they also contribute to these goals in their own activities.
Welfare and health promotion tasks for counties:
- drafting a county strategy taking into account the promotion of welfare among the inhabitants,
- compiling a regional welfare report in conjunction with the municipalities in the region,
- setting goals in their planning process for ensuring that the organisation and production of social and health care services promotes welfare and health, and defining measures and responsible parties supporting these goals,
- assessing in advance and taking into account the impact of decisions on the welfare and health of different population groups,
- providing expert support for municipalities in the promotion of welfare, good health and safety and in preventive substance abuse work, and
- organising preventive services.
The expertise of counties supports municipalities
Counties provide expert support to the municipalities for the promotion of social welfare and health and for preventive substance abuse work. Examples of support provided by the county to the municipalities include the following:
- county social and health care expert services, such as the support and training related to drafting the report on welfare and the preliminary estimate,
- production of information on welfare and health for municipalities and support for their interpretation,
- expert support for preventive substance abuse work and security,
- coordination and support for the prevention of violence and accidents, and
- support for the implementation of national programmes and policies.
Cooperation partnership with organisations
In the promotion of health and welfare, organisations will serve as important partners for the public administration.
The promotion of welfare and health will remain the responsibility of municipalities. In addition, counties must ensure the promotion of health and welfare in the framework of the tasks assigned to them. From the perspective of social and health sector organisations, this is a significant change.
In the future, municipalities will continue to have the opportunity to provide grants to organisations in different sectors, provide organisations with facilities and refer municipal residents to activities within organisations, such as peer-to-peer support or voluntary activities. However, municipalities will no longer purchase health and social services from organisations. Instead, they may cooperate with health and social service organisations in promoting residents' welfare and health.
Cooperation between counties and organisations
For promoting residents' welfare and health, counties must cooperate with other public operators in the county as well as with private enterprises and public utility companies. To achieve this, it is important to take into account voluntary public utility activities or organisations and peer-to-peer support in the statutory strategies and the public service commitment of the county. The support provided by organisations can be part of the service and care chains, for instance for services intended for families with children, and for mental health and substance abuse services.
The county shall also ensure that residents are referred to get involved with the activities in the organisations. For example, associations train and guide municipal and county authorities in their sectors on matters related to availability and preparedness, and work together according to the plans made.
For instance, counties may ensure the use of the facilities they have rented or the use of the facilities of service providers for public utility activities by means of contractual arrangements. In addition, counties shall ensure that the representatives of organisations are involved in planning and coordinating the promotion of welfare and health.
Cooperation between municipalities, counties and organisations in joint interfaces
The promotion of people's welfare and health and the reduction of differences in their health requires close cooperation between municipalities, counties and organisations. For the implementation of cooperation, structures and jointly agreed operating models are required.
Regional cooperation structures
For implementing regional cooperation, network-type structures which are shared by various operators are required. For instance, counties may establish a county-wide Cooperation pool for promoting welfare and health or a similar entity to gather operators promoting welfare and health in order to define common policy goals, to agree on implementation and to implement monitoring activities.
A cooperation pool for promoting welfare and health is a collaboration network that gathers together the operators in the area. It is based on the voluntary actions of the operators and their willingness to cooperate. Its objective is to serve as a flexible and enabling collaboration platform. According to the needs of the area, the cooperation pool will take into account the multisectoral nature of the pool, the comprehensive nature of the tasks determined in legislation, and the involvement of various population groups, including linguistic and cultural groups. Residents, representatives of municipalities and organisations, and other local and regional operators may participate in the activities. Various structures for cooperation with organisations are being established in counties.
Implementation of services in the joint interface
Joint interfaces include activities and task entities for which municipalities or counties are responsible, but which can only be implemented in a resident-oriented and customer-oriented manner if municipalities, counties and organisations have common objectives. Examples of joint interface services include services for children, adolescents and families, services related to the management of employment, integration services, services for the elderly, the sports service chain as well as cultural welfare services. Functions in the joint interface also include the coordination of multisectoral services such as the Ohjaamo youth activities, and the coordination of involvement and voluntary activities,
In order to implement the services in the joint interface, counties, municipalities and organisations will jointly identify the main groups and services. In addition, the implementation of evaluation and monitoring, for instance as part of the regional welfare report work, will be jointly agreed on.
- Hyvinvoinnin ja terveyden edistämisen johtaminen-sivusto (THL)
- Opas kunnan hyvinvoinnin ja terveyden edistämistyötä johtaville (THL)
- Järjestöjen asema sote- ja maakuntauudistuksessa Faktalehti
- Kunnat hyvinvoinnin ja terveyden edistäjinä sote-uudistuksessa (Faktalehti 2/2017)
- Liikuntapalveluketjuja on vahvistettava sote- ja maakuntauudistuksessa (kannanotto 24.2.2017)
- Ravitsemuksella rakennetaan hyvinvointia ja elinvoimaa kuntiin ja maakuntiin (kannanotto 12.12.2017)
- Hyvinvoinnin ja terveyden maantiede kunnittain 8/2017, Timo Aro (pdf)
- Tartuntatautien torjunta ja sote- ja maakuntauudistus
- Tapaturmien ja onnettomuuksien ehkäisy maakunnissa ja kunnissa
- Tulevaisuuden maakunta edistää turvallisuutta yhteistyössä kunnan kanssa
- Tunnista, turvaa ja toimi - Lähisuhdeväkivallan ehkäisy on maakunnan ja kunnan tehtävä
- Maakunnan tehtävät ehkäisevässä päihdetyössä – Tiedä ja toimi
- Työterveyshuoltopalvelujen tuottaminen
- Selvitys kärkihankkeen tulosten integroimiseksi maakunta- ja soteuudistukseen (Edistetään terveyttä ja hyvinvointia sekä vähennetään eriarvoisuutta, loppuraportti)
Heli Hätönen, Ministerial Adviser, Ministry of Social Affairs and Health, tel. 0295 163 112, [email protected]
Sarita Friman, Senior Specialist, Ministry of Social Affairs and Health, tel. 0295 163 349, [email protected]
Director Taru Koivisto, Ministry of Social Affairs and Health, tel. 0295 163 323, [email protected]