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Government moves to raise eldercare staffing requirement soon

Spurred by care scandals, the cabinet is to hike the minimum nursing quota at old-age institutions to 0.7 per patient.

Lähihoitaja Bern Amar työssään auttamassa vanhusta, Attendo, Vantaa, 12.11.2018.
The debate over minimum staffing requirements has dragged on for years. Image: Jari Kovalainen / Yle

The centre-left government, sworn in a month ago, says it is moving quickly to improve care at old-age homes. As promised in its platform released in early June, the cabinet will ask Parliament to require such institutions to have a minimum of 0.7 caregivers per patient on hand around the clock.

Minister of Family Affairs and Social Services Krista Kiuru of the Social Democratic Party said this week that the Act on Care Services for Older People will be revised to this effect by the end of this year.

That follows a string of revelations earlier this year of neglect and shoddy care at privately run facilities, linked to patient deaths in some cases.

The debate over a 0.7 minimum staffing requirement has dragged on since at least 2012. Instead a looser requirement of one nurse for every two residents, i.e. a level of 0.5, was written into law.

The last government, led by Centre Party PM Juha Sipilä, then tried to lower the minimum to 0.4 as a cost-saving measure, but later abandoned the idea. The Centre is also part of the new government coalition.

Two-track legislative reform

The government is hoping for a broad reform of the Act on Care Services for Older People. However as a matter of expediency, it intends to first present an urgent bill this autumn that would simply raise the 0.5 caregiver level to 0.7.

Other revisions to the law would then be presented separately next spring. These may include a cross-governmental programme to support Finland's rapidly ageing population, new support benefits aimed at fending off memory disorders and the establishment of an ombudsman for senior affairs.

The first bill would stipulate precise rules for staff working hours and what kinds of care patients need.

"When this requirement becomes legislation, we have to define who is covered by the 0.7 rule and what duties are included," says Satu Karppanen, ministerial adviser at the Ministry of Social Affairs and Health, who is on the committee revising the law.

"That in turn requires that we have a commonly agreed national metric for care needs, so that everyone receives care on the same basis in enhanced service residences. This also must be written into law," she tells Yle.

According to Karppanen, the same metrics cannot be applied to seniors who are in home care or otherwise being cared for by relatives, so revisions of the law related to these cases will have to be postponed until spring.

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