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Government sent back to the drawing board on health and social care reform

A major reform of health and social care by Finland's government has been rejected as unconstitutional by a parliamentary committee. The reform will now have to be changed substantially before it can proceed, further delaying a controversial transformation that has long been in the works.

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Image: Yle Uutisgrafiikka

Government will have to make big changes to a major health and social care reform programme, after a parliamentary committee condemned parts of it as incompatible with the constitution.

The central issue with the reform is a planned requirement that public sector providers of care services be formed into limited companies before they can win contracts, which the committee deemed incompatible with the Finnish constitution.

"The government's proposed model of freedom of choice does not guarantee universal equality in health and social care well enough," said the chair of parliament's constitutional law committee, Annika Lapintie, at a press conference on Thursday.

Lapintie said that experts questioned by her committee had been unanimous in their condemnation of the government's plans.

Unconstitutional

"The government's proposed requirement that [newly-created] provincial governments be forced to corporatise their health and social care services is therefore unconstitutional," said Lapintie.

The committee found that provincial governments must, according to the constitution, have the right to provide services themselves. The government's timetable was also condemned as unrealistic, with Lapintie noting that it could in the worst case possibly lead to a crisis in healthcare services.

The committee found that the proposal as it stands hands over big chunks of public sector services to private providers without meeting the constitutional requirements for the transfer of such functions.

Savings unlikely

The proposal for the creation of provincial governments, on the other hand, was found to be compatible with the constitution. The second biggest party in government, the National Coalition, has said that it will not allow the regional government law to proceed unless legislation on freedom of choice in healthcare is also passed.

Experts have slammed the government's proposals as failing to meet the stated aim of saving some three billion euros per year. Experts from VATT, the Institute for Economic Research under the Ministry of Finance, told Yle on Thursday that savings are unlikely under the reform.

Provincial governments are slated to commission the services and spend the money, but they have no incentive to keep costs down as they are not responsible for taxation and central government is likely to bail them out if they run out of cash, according to VATT researcher Janne Tukiainen.

Both Prime Minister Juha Sipilä, head of the Centre Party, and his National Coalition counterpart Petteri Orpo yesterday agreed that choice can be increased without forcing corporatisation of public health providers. That position represents a u-turn on the government's previous stance, under which forced corporatisation was necessary to implement the government's desired 'freedom of choice' agenda.

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