Wellbeing services counties are finding financial balance, but the progress of structural reforms varies
The wellbeing services counties have achieved a better balance in their finances and found new ways of securing their services in a difficult situation, explains the annual assessment of the Finnish Institute for Health and Welfare (THL) on the organisation of healthcare and social welfare services.
Although financial development has improved in several counties, especially in ones with declining populations, the situation remains challenging and only a few counties will be able to cover their deficit by the end of 2026. Service network reforms are progressing at different rates, and decision-making on the implementation of the reforms is slow in many places.
"The wellbeing services counties have done a great deal of work to balance their finances and secure their services. Now we need courage in operations and decision-making to continue the structural reforms, as well, so that the changes can carry us far into the future," says Piia Aarnisalo, Director of Department at THL.
In 2025, the wellbeing services counties have reformed their service networks by centralising physical service points to larger units and municipal centres and by expanding their offering of digital services. Significant progress has also been made in the introduction of uniform customer and patient information systems in several counties where the starting point was fairly fragmented.
The wellbeing services counties have also continued to reform their services through national development projects. In many counties, progress has been made in harmonising evidence-based practices and introducing practices that have been found effective into fundamental everyday work.
"Wellbeing services counties have many good practices that should now be spread across regional and organisational boundaries. It is important that the development work continues over the long term and that its results become a part of the service system," says Anu Niemi, Service System Director at THL.
The ageing population and regional segregation increase pressure on services
The population of Finland is ageing rapidly and concentrates in the central cities of the regions. The number of over 85-year-olds will almost double by 2040. This development increases the service needs of older people and challenges the service structures of sparsely populated areas, in particular.
Home care coverage has decreased and the share of 24-hour care has remained high, which conflicts with the objectives of supporting older people's living at home. According to THL, the service reform requires that the focus is genuinely shifted to solutions that are offered at customers' homes and everyday environments.
"A reform of the service structure is essential in order to respond sustainably to the growing service needs of older people. We now need solutions that support everyday living and providing early support in all counties," says Chief Specialist Nina Knape.
The personnel situation has improved in several counties, and the use of temporary agency workers has been reduced. Despite the positive developments, there is still a shortage of many professional groups: especially doctors and psychologists, but also social workers in some places. The retirement rate of personnel increases the pressure to safeguard services, which requires proactive personnel planning in the counties and investments in the current employees' wellbeing at work.
A sustainable service system requires strengthening preventive and low-threshold services
According to an assessment by THL, the availability of early support in services for children, young people and families is still insufficient in many counties, which is reflected in the high usage rates of expensive remedial services.
The structures for welfare and health promotion in cooperation with municipalities and organisations have been mostly put in place in many counties, which provides a good basis for strengthening preventive work.
"In terms of the sustainability of the service system, it is essential that welfare and health promotion be strengthened as a part of the reform of services and service structures. It requires cooperation at all levels – in municipalities, wellbeing services counties and nationwide," Knape states.
Enquiries
Nina Knape
Chief Specialist
THL
tel. +358 29 524 7683 | [email protected]
Anu Niemi
Service System Director
THL
tel. +358 29 524 7296 | [email protected]
Piia Aarnisalo
Director of Department
THL
tel. +358 29 524 7048 | [email protected]
