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Finland's social welfare and health care reform – Yle’s guide to the basic principles

The Finnish Parliament will soon be asked to decide on a government-proposed bill seeking sweeping reform of its social and health care system. Yle has compiled a simple list of the basic concepts included in the reform bill.

Sairaanhoitajat siirtävät potilasta sairaalan käytävällä.
Image: Vesa Moilanen / Lehtikuva

Sote region

When Finns talk about social and health care, they often resort to using an acronym of sorts from the Finnish words ‘sosiaali’ and ‘terveys’, or ‘sote’. The reform bill proposes implementing a new structure of five large social welfare and health care regions that assume responsibility for arranging equal provision of social welfare and health care services in all parts of the country. The five new ‘Sote regions’ would also be responsible for monitoring the quality, amount and effectiveness of such services.

19 areas of responsibility

The responsibility for service provision will then lie with 19 different areas at most. These 19 groupings of local governments will provide the entire chain of social welfare and health care, from doctors taking care of patients to homecare workers caring for the elderly and social workers responsible for child welfare. How Finland’s 317 municipalities will be distributed among the 19 areas of responsibility has not yet been decided.

Service provision plan

Each ‘Sote region’ will then draw up a region-specific service provision plan with the municipalities and joint authorities in its areas of responsibility. The plan will define how the social welfare and health care services will be carried out. The service provision plans will also determine the quality and level of services and how the availability of and access to the services will be ensured.

Who will foot the bill?

Municipal residents will continue to pay municipal taxes as they have in the past, and municipalities will also receive state funding. Half of the municipal funds will then be transferred to the Sote region, who will then distribute the money to the 19 areas of responsibility that provide the services.

Goal of the reform

The key objective of the government’s proposed reform is to create overseeing regions larger than municipalities responsible for the provision of social welfare and health care services in Finland, so only one administrative body would be in charge of a larger area. The underlying principle is that if an older person falls and breaks their hip, they will have an operation in hospital and then transfer smoothly to a health centre in-patient facility for follow-up care, and from there again home for rehabilitation. In this way, the entire care chain, from specialist doctors to local health care centre to home care would be under the jurisdiction of one region, hopefully avoiding unnecessary bouncing around and confusion.

According to the government, the reform seeks to mitigate the rising costs of Finland’s social welfare and health care services to guarantee that its aging population will continue to receive all of the services it needs in the future.

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