THL: The development of social and health care should now focus on services and on building trust
In the development of social and health care, there is now a need to place greater emphasis on services and on improving their effectiveness, according to THL. This includes, among other things, defining the scope of services that publicly funded social and health care system should provide in general. So far, cost savings and public finance perspectives have been emphasised in the development and steering of the system.
THL has published ten proposals for developing the social and health care system during the next government term.
“Public finances will remain under pressure, and this is also reflected in social and health care. Within the economic constraints, it should still be possible to develop the content of services – that is, which services provide the greatest health benefits and how broadly the public sector offers different services,” says Deputy Director General Piia Aarnisalo.
Aarnisalo emphasises that defining the service selection involves value choices that belong to politicians. The prioritisation of services and care cannot be based solely on the assessments and decisions of social and health care professionals.
“Decision-making requires research-based evidence on the effectiveness of services. During the next government term, it will be important to develop expertise and indicators for assessing the cost-effectiveness of services and care.”
THL proposes establishing a strong national body in Finland that, in line with politically defined principles, can determine which social and health care services should be included in the publicly funded service selection.
“For this purpose, a completely new body could be established or, alternatively, existing ones could be strengthened,” says Aarnisalo.
A well-functioning social and health care system strengthens societal trust
Based on population surveys, Finns’ trust in social and health care has declined in the 2020s.
Although the quality of services and client experience have not deteriorated, the decline in trust is a serious sign that the legitimacy of the system is weakening.
“The role of social and health care services in society is highly significant, and a lack of trust in the system can weaken people’s sense of inclusion and trust in society as a whole,” says Chief Researcher Liina-Kaisa Tynkkynen.
In Finland, a parliamentary group began its work in the spring with the task of reforming social and health care. THL considers that the group’s work should continue throughout the next government term.
“Parliamentary work is an opportunity to strengthen citizens’ trust. From the perspective of system legitimacy, it is essential that health and social services are developed jointly, over the long term and transparently,” says Tynkkynen.
The parliamentary group’s agenda includes several large-scale issues, such as reforming the financing model, national steering practices, possible questions related to regional structures, and defining the public service selection.
“It is difficult to make these choices before the overall direction of the system has been decided. Should the autonomy of the wellbeing services counties be strengthened, or should there be a move towards a national entity for social and health care and rescue services?” Tynkkynen notes.
“During the next government term, decision-makers must make a clear choice about the direction of the social and health care system.”
Further information:
THL’s government programme proposals 2027
Piia Aarnisalo
Deputy Director General
THL
tel. +358 29 524 7048
Liina-Kaisa Tynkkynen
Chief Researcher
THL
tel. +358 29 524 8517