Things will change – with or without the social and health­care reform

The Finnish social and health care system is in the throes of a radical change. The ways in which social and health services are organized and produced will change according to the legislative changes stemming from the health and social services reform (the Sote reform) currently underway. If the legislative reform is not carried out at this point, the system will change regardless.

The population structure change currently underway in Finland, the increasing indebtedness of the state and municipalities, the availability of a competent labour force, the competition provided by private social and health care operators, and the increased interest in health insurance are all resulting in a change in the system. Public sector operators will have to compete for customers more effectively in both specialized and basic health care. In the field of occupational health care, private sector operators will expand their service offering to a solvent group of employed persons, which will increase the competition further.

The health and social services and regional government reform is a significant renewal process and an extensive reform project

All the operators to which the Sote and regional government reform applies are in a hurry to prepare themselves for the new system. When it is realized, the Sote and regional government reform will be the greatest change in Finland’s economic history. Municipal responsibility to organize social and health services, which has lasted over hundred years, will come to an end. The public sector health care system will become an entity managed by the Ministry of Social Affairs and Health, Ministry of Finance, and the Finnish Government. The regions will become part of state administration, and the regions will be responsible for the organization of social and health services. The current hospital districts will become state-owned companies, and they will provide social services and specialized and basic health care services. After 2020, customers will determine social and health care operators’ range and methods of operation. When the freedom of choice included in the Sote reform is realized, each operator will be provided with funding, for the part of the services the freedom of choice applies to, on the basis of customer enlistment. Thus, the importance of the resident and customer experience will be emphasized even more when deciding on the service provider.

It is time for radical thinking, but we must also ensure that those thoughts have a chance to be realized.”

On a Finnish scale, the Sote reform provides private sector operators with a great opportunity to extend their business operations. At the time of writing, it is still unclear what the final restrictions on the freedom of choice will be and which services will fall within the scope of the freedom of choice and how. What is clear, however, is that, on an annual level, the reform offers a several billion-euro business opportunity to the private sector. It is up to private sector operators how they can gain the most in this new competitive situation. Occupational health care and its customers will play a key role in the realization of the extension and growth of business operations.

Social and health services will undergo a reform no matter what

The change in the age structure of the population, the employment situation and the availability of the labour force, urbanization as a phenomenon, the increasing indebtedness of the state and municipalities, the service offering and the competition provided by private social and health care operators, and the increased interest in health insurance will, in any case, result in a change in the way social and health services are organized and produced. This change will take place, and it must be prepared for. If the Sote and regional government reform currently under preparation is not carried out, the next Finnish government will begin the preparation of a new Sote reform right away. How will the services be organized, produced, and financed? This problem particularly concerns citizens who are not covered by occupational health care. In addition, the aged population is increasing, which means that the increasing service needs in home and institutional care must also be responded to.

Reform requires radical thinking and a systematic way of implementing changes

As social and health services are currently being radically reformed in Finland, all operators should have the courage to start planning their own reform and how to implement it. Taking successful steps in a time of radical change requires a change in thinking, beliefs, attitudes, ways of organizing and producing services, and management. Now is the time for radical thinking, but it and its results must also be provided with the opportunity to be realized. Will the old way of thinking and acting leave enough room for the new, so that the reforms required by the radical change can be implemented? The radical changes in the social and health services must be examined comprehensively in both the public and private sector.

Current legislation, the increased interest in health insurance, and occupational health care services provide residents and customers with opportunities to select services and compare and select service providers from among a large group of public and private health care providers. What will make the future service organizers and producers competitive, and how can residents and customers still be offered the best social and health care services in the world in a sustainable way?