THL: Equal and timely access to treatment is the foundation of social welfare and healthcare

Equal and timely access to primary health care must be ensured, the Finnish Institute for Health and Welfare (THL) states. In connection with its spending limits session on Tuesday, the Government announced that the treatment time guarantee for non-urgent care in primary health care would be loosened, and care would have to be provided within 3 months. Currently, the wait can be no longer than 14 days.

“If the government decision leads to long waiting times, many patients’ condition may deteriorate enough to have permanent or long-term effects on work ability and functional capacity. This is wrong in a humane sense, and will ultimately increase social spending,” says Mika Salminen, Director General of THL. 

According to the THL, loosening the maximum waiting times for access to care sends a strong signal from the Government to wellbeing services counties, allowing them to reduce their investments in the development of primary health care. In the worst-case scenario, the proposed changes could negate the earlier efforts to shift the focus from heavy services to primary care.  

“Excellent development is already being carried out in the wellbeing services counties. For example, access to primary health care has improved. Ensuring the continuity of care is also important. Different social welfare and healthcare services should fit together seamlessly. We hope that the counties will be able to continue their work in peace.” 

THL would like to issue a reminder that the most unprivileged and vulnerable citizens fall within the scope of the wellbeing services counties’ services. 

“The credibility of our service system from the perspective of both patients and employees requires Finland to improve healthcare that serves people in an equal manner.” 

Reducing the carer ratio may alleviate the shortage of care givers in home care 

In its spending limits session, the Government also decided to reduce the staffing ratio in round-the-clock nursing units for the elderly to 0.6 employees per client. Currently, the statutory ratio is 0.65, and it was scheduled to reach 0.7 at the beginning of 2028. Initially, the ratio was supposed to become 0.7 in December 2023, but the Government has already postponed its entry into force. 

According to THL, a decrease in the staffing ratio in round-the-clock nursing units for the elderly does not automatically lead to a deterioration in the quality of care. Quality can also be ensured through other measures, such as increasing end-of-life care competence and various mobile services. Loosening the ratio could make staffing more flexible.

“In the future, round-the-clock nursing units should better meet the clients’ needs. More personnel are needed, for example, in situations where the client receives end-of-life care or needs versatile rehabilitation,” says Sari Kehusmaa, Chief Specialist at THL.

The decrease in the carer ratio in round-the-clock nursing may also provide more opportunities to hire more carers in home care for the elderly, the need for which will increase considerably in the next few years.

THL estimates that the number of people in need of services for the elderly, such as home care, communal housing and round-the-clock care, will increase by 33,000 over the next four years. 
“First, the need for home care services will grow. The wellbeing services counties must be able to quickly provide significantly more home care services than now. This means increasing the number of personnel in home care,” says Kehusmaa. 

Increasing the VAT on confectionery is a step in the right direction

THL welcomes the fact that the spending limits session has considered possibilities of promoting health through taxation. 

“Increasing the VAT on confectionery is a step in the right direction. We hope that the tax model will later be extended to include not only other sugary products but also products with high saturated fat and salt content,” says Mikaela Grotenfelt-Enegren, Chief Physician at THL. 

In the broad, gradual tax model, products containing less sugar, saturated fat and salt would be significantly cheaper than similar products with higher contents. 

“This would encourage people to make healthier choices. The impacts of adjusting the VAT on confectionery should now be monitored and tax solutions should be developed further based on the results.” 

More information:

Statement: Treatment time guarantee (in Finnish)

Access to care in primary healthcare (in Finnish) 

Press release 8 February 2024: The number of units that meet the statutory staffing ratio in services for the elderly has continued to increase – the number of clients has remained stable (in Finnish)

Mika Salminen
Director General
THL
tel. +358 29 524 6001

Sari Kehusmaa
Chief Specialist
THL
tel. +358 29 524 7914

Mikaela Grotenfelt-Enegren
Chief Physician
THL
tel. +358 29 524 8418

emails are in the format: [email protected]