Healthcare | The ministry sees no obstacles to access to treatment in two weeks – THL’s experts do not believe in the goal

Unhurried the treatment guarantee’s deadline will be tightened to two weeks in September. THL’s experts do not believe that the care guarantee will be implemented in every part of the country.

THL’s leading researcher and docent Liina-Kaisa Tynkkynen think that it is generally a good thing that the treatment guarantee is tightened, because primary care treatment has been a big problem in Finland. He still also sees big contradictions in it.

According to him, the welfare areas have different opportunities to realize access to treatment. In some areas, the care guarantee may already be implemented well, but there are also areas where implementing the care guarantee is more difficult.

“The differences between the regions are probably primarily related to issues of personnel availability,” Tynkkynen tells STT.

Ministry of Social Affairs and Health medical advisor I met Hämäläinen sees no obstacles to reaching the maximum two-week period specified by the treatment guarantee.

“At this stage, we are not aware of anything that would make the treatment guarantee unattainable. This has also not been known in the government program negotiations. The starting point is, of course, that when the law has been approved and is in force, it is realistic,” Hämäläinen tells STT.

According to Hämäläinen, development activities are being carried out continuously and the Ministry of Social Affairs and Health is having discussions with the welfare regions about the care guarantee. From the ministry’s point of view, the situation will be challenging in some welfare areas and “all possible means will have to be used.”

Care guarantee according to Tynkkynen and Hämäläinen, the implementation requires the utilization of private service providers.

The Ministry of Social Affairs and Health directs welfare areas to use purchase services and service vouchers. The welfare area can offer the patient a service voucher with which treatment can be obtained privately, if the welfare area is unable to provide treatment within the scope of the treatment guarantee.

In addition, the new Kela compensation model has been included in the new government program, which Hämäläinen says will be utilized. The previous, left-led government emphasized public health care, and the current right-wing government emphasizes the need for private health care.

Tynkkynen sees contradictions in the government’s new Kela compensation model.

“What is the incentive for welfare areas to improve access to treatment if the sanctions are not significant and if it is known that people have the opportunity to apply for a private sector reception with Kela compensation? I think that there are contradictions in terms of the goals and the proposed means,” he says.

Hämäläinen reminds that when the law on the care guarantee was enacted, funding was allocated to welfare areas to enable the care guarantee. Allocation of funding remains the responsibility of the welfare area.

“If the welfare area does not otherwise reach the treatment access times required by the treatment guarantee, additional funding from the Kela compensation has been allocated for that,” says Hämäläinen.

According to Tynkkynen, in the end, the most important thing for everyone is that a person gets treatment. The model by which the treatment is implemented remains secondary.

“But I myself have always said that we should choose which path we want to take now. Do we want to invest in these areas of well-being? Then I think the contributions should be put there instead of supporting another type of service organization from the sidelines.”

THL’s leading expert Juha Koiviston according to the treatment guarantee will not be implemented by September.

“There are no signs that access to treatment will suddenly improve. Increasing the number of doctors can temporarily improve the situation and shorten queues, but recruitment takes time, and it may not be a sufficient solution in the long run. A more fundamental change in operating models is needed,” Koivisto commented to STT.

In Tynkkynen’s opinion, it is not enough that the effort is focused only on access to treatment.

“Of course, anything can actually happen, if you decide to do so. It is then about what else remains to be done if access to treatment is optimized. The bottleneck will move elsewhere, for example to specialized hospital care,” Tynkkynen says.

According to Tynkkynen, in addition to access to treatment, it is important to invest in the continuity of treatment.

“If the aim is to quickly solve one problem in order to implement the treatment guarantee, it may be that the person comes back after a while.”

Today in Finland, about four out of five people who applied for treatment received treatment from a nurse or doctor in two weeks. Kainuu and Keski-Uusimaa’s welfare regions have come closest to the daily care guarantee requirement on an annual basis. In Central Uusimaa, 96 percent of those who applied for treatment received treatment within 14 days this year.

This year, the furthest away from the 14-day requirement was in the welfare region of North Ostrobothnia, where only two out of three received treatment in two weeks. The information can be found in THL’s treatment admission report.

Access to treatment by regional administrative agency area takes longer in the avi region of Northern Finland. This year, two out of three have received treatment there in two weeks. Regional administrative agencies supervise welfare areas and the implementation of health care.

“As a civil servant, I do not take a position on how legislation should be made. As supervisory authorities, we monitor that the laws in force are followed,” commented Chief Health Inspector Harri Suhonen of the Regional Administrative Agency of Northern Finland to STT.

According to Suhonen, the welfare regions must define the means they use themselves, so that they can comply with the maximum times defined by the law.

The current one according to the law, the patient must be admitted to non-urgent treatment within three months. With the new treatment guarantee, the patient must see a doctor or other healthcare professional within 14 days.

The care guarantee applies to basic health care, student health care and mental health services. The period of the oral healthcare treatment guarantee changes from six months to three months.

It is written into the new government program that the government will ensure the implementation of the treatment guarantee in primary health care reception activities and oral health care. It is also recorded in the government program that the government aims to lighten the burden on the welfare areas and break up treatment queues in primary health care.