Report by THL: Many signs of the strengthening of health and social services – strict economic discipline marked the first two years of the wellbeing services counties
During their first two years of operation, the wellbeing services counties have undertaken a significant reform of their health and social services. However, the development of services is challenged by the pressure to adjust their finances,” explains THL’s extensive report.
The report prepared by nearly 100 researchers examines the reform which has been exceptional in scale. It describes what the health and social services reform has so far meant not only in terms of services but also steering, organisation and funding.
“The health and social services reform concerns a huge number of services ranging from preventing violence to child health clinics, care for the elderly and specialised medical care. A lot of excellent work has already been done in the wellbeing services counties, but a reform of this scale will inevitably take years, says Chief Researcher Liina-Kaisa Tynkkynen.
“One of the key conclusions in the report is that the significance of the health and social services reform cannot be examined as one large story. It must also be viewed as many small stories that take into account both the diversity of the wellbeing services counties and the diversity of services.”
Significant regional differences
According to the report, many health and social services have improved, but regional differences are significant.
For example, the availability of mental health services and the uniformity of the range of services have improved in many places. Substance abuse prevention work has also become established in the wellbeing services counties.
In addition, family services have been harmonised and the special competence needed by families with children has been strengthened at the basic level.
It also seems that the health and social services reform created good opportunities for service integration, i.e. the coordination of different services. In practice, for example, various multiprofessional teams are responsible for ensuring that the customer receives the services they need smoothly as a whole.
“The aim of the health and social services reform is to strengthen primary health care as well as the equality and integration of services. Good progress has already been made in these areas,” says Piia Aarnisalo, THL Director of Department.
Economic policy is emphasised in national steering
Three ministries are responsible for the national steering of wellbeing services counties: the Ministry of Finance, the Ministry of Social Affairs and Health and the Ministry of the Interior. According to the report, economic policy objectives have been strongly emphasised in steering.
“In wellbeing services counties, financial adjustment has so far decreased resources for developing services. If counties’ funding is not flexible, services may have to be weakened. There is a risk that trust in everyone receiving the care they need will decrease,” Tynkkynen says.
Although the wellbeing services counties are self-governing organisations, according to the report, their self-government seems thin. This is because the state is almost entirely responsible for the counties’ funding and the national steering of counties or even individual services is strong.
Development of the health and social services system requires broad political support
Occupational health care and Kela’s compensation system, for example, were excluded from the health and social services reform. According to the report, the examination of these issues is now topical. In addition, multi-channel funding should be reformed.
“Instead of creating service models that work according to different rules, such as Kela compensation for those aged 65 or over, alongside the basic health care provided by the wellbeing services counties, the counties’ capability to strengthen their basic services should be supported,” Tynkkynen says.
Effective health and social services are also part of the crisis resilience of society. The development of health and social services requires a long-term approach and a nationally uniform view of what the next stages and goals are.
“Well-being counties must be given the opportunity to succeed in their task. They need not only sufficient resources but also broad political support. To ensure this, we should start parliamentary work on the future of health and social services,” Tynkkynen says.
More information:
A crisis-resilient society requires healthy people supporting each other (article 28 Jan 2025)
Piia Aarnisalo
Director of Department
THL
Tel. +358 29 524 7048
[email protected]
Liina-Kaisa Tynkkynen
Chief Researcher
THL
Tel. +358 29 524 8517
[email protected]
