Over the past decade, healthcare has become fragmented, emergency services have been outsourced and the private sector has regrouped into a number of chains. According to the CEO of the Hospital District of Helsinki and Uusimaa, Aki Lindén, the reasons are to be found in a less tight grip by state management in healthcare that started in the 1990s.

"Previously there was very precise and centralised direction of where resources were to be used, and in that way a functional public healthcare centre system was created. The present state of affairs is the result of municipality-driven policies," says Lindén.

Among the medicine prescribed to improve the situation has been a reform in municipal governance which, it is hoped, would further define and centralise services. Lindén says that a much more focused reaction is needed.

"Under no conditions can we in healthcare await municipal governance reforms. The strongly growing private sector, which is heavily owned by international capital investors, is taking healthcare in Finland in its own direction. If we await reforms for the next 3-5 years, then Finland's public healthcare system will be lost," argues Aki Lindén.

According to Lindén, the gap between the goals set out in law for public healthcare and the reality being seen has become too wide. Not everyone can afford private services and so inequalities in care are growing at an increasing pace.