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Structures and reforms in Finnish health care system Assistant Director General Marina Erhola

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Structures and reforms in Finnish health care system Assistant Director General Marina Erhola. Public health services in Finland. Municipalities have legislative responsibility to arrange health care services for their residents in addition to basic education and social services

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Structures and reforms in Finnish health care systemAssistant Director General Marina Erhola

Marina Erhola / THL

public health services in finland
Public health services in Finland
  • Municipalities have legislative responsibility to arrange health care services for their residents
    • in addition to basic education and social services
  • 336 municipalities in 2011 (415 in 2008)
  • Population varies from 800 inhabitants to 560 000
    • the median being about 5 800
  • Municipalities can decide rather independently how services are provided and their scope
    • legislation gives only general outlines
  • Services are divided to primary health care and specialized health care
    • municipal specialized services are provided mainly by 20 municipal federations (Hospital Districts)

Marina Erhola / THL

historical perspective
Historicalperspective
  • Long tradition of strong municipal autonomy
  • Intense development of hospital sector in 1950s
  • Health centre –organisation developed in 1970s
  • National level steering of municipalities:
    • Before 1993: steering by funding and guidelines
    • After 1993: ”information steering”
    • Early 2000s trend of increasing ”programme steering”
    • Mid 2000s onwards: increasing steering by legislation and ”stick”

Marina Erhola / THL

challenges in terms of the service delivery system
Challenges in terms of the service delivery system
  • The service delivery system in social and health care has the support and appreciation of the public.
  • Challenges include:
    • to control the growing costs
    • to meet the increasing public demand for services
    • to ensure the supply of trained professionals
    • to efficiently steer and manage the service system
    • Increasing inequalities in health and inequalities in access to services.

Marina Erhola / THL

parliament elections 17 4 2011
Parliament elections 17.4.2011
  • Current government headed by Centre party in coalition with National coalition party, Green Party and Swedish peoples party
  • Parliament seats for four largest parties:
    • National coalition party 50 44
    • Social democratic party 45 42
    • True Finns party 539
    • Centre party 5135
  • Result leads to major change in government
    • Implies change for example to EU policy and tax policy
    • Implications to health care system?

Marina Erhola / THL

conclusions
Finnish health and social service system is under a phase of intense reform

Larger shoulders for organizational responsibility

Integration of social services and health services

Integration of primary care and specialised care

Increasing co-operation between municipal and private sector

Streamlining of financing system for health services

THL is central actor in this process

research, information steering, evaluation and implementation support

Conclusions

Marina Erhola / THL

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