Transcript Structures and reforms in Finnish health care system

Structures and reforms in Finnish health care
system
Assistant Director General Marina Erhola
13.5.2011
Marina Erhola / THL
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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)
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Finland is different
EU country
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Historical perspective
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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”
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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.
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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:
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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?
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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
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