New structure

The reform will shift the responsibility for organising health and social services and rescue services from the local government level (municipalities) to the regional government level (counties).

Healthcare and social welfare structures will be reformed to ensure the equal availability of services throughout Finland.

Finland’s population is ageing and will need more services than previously. At the same time, the birth rate is declining and the dependency ratio is changing. Finland will need a health and social services structure that will be able to respond to these changes.

At present, municipalities are responsible for organising healthcare and social welfare services either alone or by forming joint municipal authorities. In addition to the public sector, services are available from various private companies. Furthermore, the third sector healthcare and social welfare organisations in Finland play a major role in the provision of services that supplement public services. Organisations provide both free of charge and paid services.

Studies indicate that larger organisers of healthcare and social welfare are better able to secure the equal availability of services as well as efficient operations and administration.

Counties

The health and social services reform will see the responsibility for organising healthcare, social welfare and rescue services shift from municipalities to larger autonomous regions, that is, counties.

Initially, the funding of the counties, which will now be established, will principally be based on central government funding. The funding system for health and social services will be reformed and be based on needs-based standardised criteria. The right of counties to levy taxes will be examined in a parliamentary process.

The residents of counties will have the right to vote in county elections, where representatives will be elected to the county’s highest decision-making body, the county council. Provisions on the administration of counties will be laid down in an act (Counties Act).

Responsibilities

The responsibility for organising health and social services and rescue services will be transferred from local governments to counties. Municipalities will remain responsible for the wellbeing of residents and the promotion of health.

The public sector will remain the organiser and primary provider of services. Private sector actors and the third sector will supplement public health and social services.

The role of the third sector in the promotion of health and wellbeing will be strengthened, and its ability to provide services will be guaranteed.

In order to secure special-level services, five collaborative areas will be established in accordance with the regional division of university hospitals. These areas will be based on current catchment areas. The opportunity to use health and social services across regional borders will be retained.

The coordination of information systems, ICT preparation and other funding for health and social services development will be secured during the transition period.

Special arrangements for Uusimaa

Over one and a half million people live in the Region of Uusimaa. This accounts for one fifth of Finland’s residents. For this reason, the administrative structure of Uusimaa was examined separately from the other regions.

Special arrangements were considered for the Region of Uusimaa, the Greater Helsinki area or Helsinki so that the special characteristics of the whole area could be taken into account in the new health and social services structure.

In autumn 2019, the alternatives were examined in close cooperation with the municipalities in the region and with HUS (Helsinki and Uusimaa Hospital District).

A model based on five self-governing districts was proposed as the basis for further preparation. According to the proposal, the responsibility for organising health and social services would be assumed by four self-governing districts and the City of Helsinki.

Inquiries:

Kari Hakari, Director, Ministry of Social Affairs and Health, tel. + 358 295 163 585