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Gov't proposes broadening private health firms' abilities to perform non-urgent surgeries

The proposal is being met with surprise and worry by several opposition MPs.

Oulun yliopistollisen sairaalan avosairaala.
File photo. Image: Jaakko Mäntymaa / Yle

On Wednesday MPs are scheduled to discuss government's proposal to give private health care companies increased possibilities to carry out non-urgent operations, within the current health care districts.

The proposal would override previous provisions that aims to restrict many types of surgery to 12 central hospitals with a broad-range of services and an accident and emergency department.

Many opposition lawmakers, including Greens MP Outi Alanko-Kahiluoto, responded to the unexpected proposal with surprise and worry.

"Private hospitals and health care companies would receive the right to carry out operations, but [any] eventual complications would then be taken care of by the public health care sector," said Alanko-Kahiluoto, who has a seat on the parliamentary social and health care committe.

She said she is both surprised and worried, saying that if government's proposal is approved, it would come into force this spring.

The proposal is formulated in a way that it affects the current health care system, regardless of whether Sote (government's broad social and health care reforms proposal) is approved or not, according to Alanko-Kahiluoto. That reform aims to remove responsibility for healthcare from municipalities, passing it to new regional authorities, and expanding private provision of healthcare services.

Exception to freshly-written rule

The long-proposed Sote reforms include a stipulation that only 12 large, central hospitals offering 24-hour emergency services would be able to carry out surgeries which require operating rooms and anaesthetics. That decision was strongly criticised by the Swedish People's Party and politicians from the west-coast city of Vaasa, which was left without an accident and emergency department and provision of certain services.

Now, government has proposed an exception that would permit non-urgent surgeries to be performed at hospitals or health care centres without 24-hour emergency room services - but only at facilities which can respond to possible post-surgery complications.

If the new proposal goes through, administrators in Finland's health care districts will be able to purchase surgical services from private companies more broadly than they could before.

The proposal was drafted by officials at the Ministry of Social Affairs and Health, who made the assessment that private health care firms would receive "comprehensive opportunities" to offer surgical services - without increasing costs - in communities with 24 hour central hospital facilities.

Swedish People's Party MP Veronica Rehn-Kivi said there's a risk that a significant proportion of surgeries will be taken over by private health care firms.

"Then there may not be adequate resources on the public [health care] side anymore," she said.

Changes will save money, ministry says

The proposal states that public hospitals would make agreements with private health care companies regarding such support hospital services. In cases of eventual complications or problems, patients would have to be able to reach these support hospitals - equipped with intensive care facilities and adequate gear to perform on-call operations 24 hours a day.

The ministerial authors of the proposal said its benefits and aim is to use health care funding more effectively, saying that central hospitals would save money by not having to invest in new surgical equipment and facilities.

Government is also proposing two other law changes linked to health care reforms, specifically new customer fees within the social and health care system as well as adjustments to emergency care services.

Opposition MP Li Andersson from the Left Alliance party Tweeted on Monday that the law proposal is part of a well-known pattern, saying that government wants to open the health care market to private firms in as broad a manner as possible.

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