7.1.2016 1

Social welfare and healthcare reform15.12.2015

7.1.2016 2

Current situation: social welfare andhealthcare services in mainland Finland

Healthcare services

• Municipalities (localauthorities, 301 in total) are responsible for arranging health careservices

• Hospital districts (20 in total) are responsible for specialised medical care. A municipality has to be partof a hospital district to arrange specialised medicalcare.

• 5 specific catchmentareas are responsible for arranging highly-specialised medical care

Social welfare services

• Municipalities (localauthorities) are responsiblefor arranging social welfareservices

• Municipalities are membersin joint municipalauthorities of specialwelfare districts (15+2 in total) that arrangeservices for people with developmental disabilities.

7.1.2016 3

Hospital districts and special catchmentareas

7.1.2016 4

Why is the reform needed?

• The increasing need for services among the aging population, the changing variety of illnesses and wider possibilities for treatment along with greater expectations from the population create a pressure for costs to rise

• Slow economic growth and a high total tax rate when compared internationally are an impetus for finding new ways to curb rising costs.

• Inequalities among different areas and groups

7.1.2016 5

Government programme

• The aim of the social welfare and health carereform is to narrow disparities in health and welfare and manage costs

• The reform will be implemented with complete integration of services and by strengthening the carrying capacity of service arrangers

• The Government is strengthening the sustainability of public finances byimplementing structural changes– Social welfare and healthcare reform´s share EUR 3

billion by the end of 2029

7.1.2016 6

Solution for arranging the services

• There will be 18 autonomous areas, of which15 will organize healthcare and social welfare services in their area themselves

• Under the new legislation, the remaining three regions will provide the services with the support of one of the other autonomous areas

• Also some other duties will be under the responsibility of the autonomous regions

• Areas will be managed by elected councils• The existing division into regions will be used

as a basis for dividing the country into autonomous areas

7.1.2016 7

Financing

1. Central government funding

- Also further investigation on the autonomous areas’ own right to levy taxes

- The effects of these alternative solutions will be assessed and compared.

2. Simplifying the multichannel financing of healthcare and social welfare

• Budgetary framework for social welfare and healthcare services to ensure effectivegovernance

7.1.2016 8

Production of services

• Autonomous areas– produce their services

– can buy services from companies or organisations

– or increase the use of service vouchers

• Indicators for efficiency and quality of serviceswill be created

• As part of the reform, legislation on freedom of choice will be enacted, enabling customers to choose between public, private or third sector service providers

7.1.2016 9

Timetable

• 4/2016 Circulation of the new bill for comments

• 11/2016 The bill will be presented to the Parliament

• 7/2017 Enactment of the new legislation

• 2017 - 2018 Elections

• 1/2019 Responsibility for the organization of healthcare and social services will be transferred from joint municipal authorities and local authorities to the autonomous regions

7.1.2016 10

Thank You!