A Ministry of Social Affairs and Health working group has proposed that Finland reduce its number of central hospitals from the current level of 15 to between five and eight.
The country's largest central hospitals currently provide citizens with extensive 24-hour emergency care as well as specialised healthcare services.
The working group's proposal does not call for the hospitals or wards to be closed, but suggests that their functions should change. In practice, this could mean some of the existing central hospitals reducing the healthcare services they offer or, for example, not provide the capacity to perform surgery around the clock.
While the task force's report suggests significant changes to the nation's network of central hospitals, it noted that the number of university hospitals should remain the same, at five.
Staff shortages and budget cuts
The health ministry tasked the working group with finding ways for Finland to continue to provide healthcare services as it faces a multitude of challenges in the sector, including severe staff shortages and budget cuts.
In addition, Finland's population is ageing rapidly and becoming further concentrated around the main urban areas.
This further adds to the complexity of providing social and healthcare services nationwide, but working group chair Petri Virolainen, welfare director with the Päijät-Häme region, noted that the lack of skilled labour is the sector's biggest problem.
This leaves many specialised units understaffed, he said.
"The tasks of a healthcare region must be carried out to a high standard, which is a guarantee of patient safety. But if there are no skilled staff members, there is no quality, effectiveness or patient safety," Virolainen said.
"It is in no one's interest to have a local service if it is of poor quality," he added.
The working group's proposed measures would save the state coffers about 100 million euros per year, effective from 2027, according to Anna Cantell-Forsbom of the health ministry.
Working group divided over proposal
The working group was made up of leaders from welfare regions, known as wellbeing services counties, as well as specialists from certain government ministries.
The proposal of reducing the number of central hospitals created a sharp division within the group, with four representatives from different welfare regions strongly opposing the suggestion.
They argued that the central hospitals are essential to each region, and the services they provide should not be curtailed.
The working group's proposal is set to become a hot political topic, with MPs likely to staunchly defend their own region's central hospital.
The report did not name the central hospitals which could be subject to the proposed changes.
Following the so-called 'sote' reform, Finland has 21 welfare regions — officially named wellbeing services counties — in addition to the city of Helsinki, which provides its own social and healthcare services.
Many of the regions face similar and overlapping challenges, such as reduced budgets and difficulties in recruiting staff. The problems are especially acute in rural areas, where the population is ageing and shrinking.
The working group's proposals, if passed into law, would begin coming into force from 2026, when the number of 24-hour primary care emergency departments and the number of maternity hospitals would be reduced.
Cutting back on the number of central hospitals would start in 2028, according to the working group's proposed timeline.
Users with an Yle ID can leave comments on our news stories. You can create your Yle ID via this link. Our guidelines on commenting and moderation are explained here.