Coronavirus Why does Finland’s medical care capacity threaten to be exceeded with smaller numbers of patients than in many other countries?

In Finland was already warned in October severely of the end of health care carrying capacity, although the wave of infection caused by the omicron transformation was not yet known. Now the government has begun preparations for the introduction of a state of emergency law to secure health care operations.

The number of hospital patients in many European countries has risen to multiple levels during a pandemic. Why does Finland’s hospital capacity threaten to be exceeded with much smaller numbers of patients than are treated in Europe in many countries per capita?

There are few hospital and intensive care places in Finland, according to a social and health policy researcher Liina-Kaisa Tynkkynen From the University of Tampere.

The same is confirmed by the Assistant Professor of Health and Production Economics Paulus Torkki From the University of Helsinki.

“The number of special care beds in Finland has been reduced to a very small level,” he says.

Over here there have been good reasons in normal times. In both Finland and the other Nordic countries, efforts have been made to transfer patients to outpatient care where possible.

Many cancers and many other common ailments are treated so that the patient comes to the outpatient clinic, receives the necessary treatments and goes home overnight.

Tynkkynen estimates that the number of hospital beds has halved in recent decades.

Hospital stays are generally more expensive than outpatient care, so money is saved. Treatment is also centralized. For example, regional hospitals have been abandoned. The system has therefore been resolutely streamlined.

Finland spends much less public money on health care than the Nordic countries, which are often used as a benchmark. Finland also spends a smaller share of GDP and less euros per capita than most Western European countries.

In normal times the system has worked well, Tork said. He has been involved in the development of sote functions and related research for the past 20 years.

“It has been stated that Finnish healthcare is able to achieve good results with fewer resources. It has been a virtue, ”says Tynkkynen.

The pandemic brought out the flip side of virtue.

“There is very little waste in the system, many functions have been streamlined to the last point. There is also a clear under-resourcing in primary health care, ”says Tynkkynen.

“When the need for care or new tasks suddenly increase, they immediately have to reduce operations elsewhere.”

According to Tork, behind the crisis talk that started with the modest number of patients this autumn is how much or how little pandemic patients are accepted to take away from others.

As a bottleneck however, they are not hospital beds or facilities, but a lack of staff. Healthcare is a very labor-intensive sector.

The pandemic has put particular pressure on intensive care, mainly because it requires a particularly large number of caregivers per patient and a lot of special expertise from caregivers. The shortage of intensive care has been encountered in several other countries as well.

For such a specialized area, the difficulty is how much staff can be trained for tasks where there is no need for them in normal times.

During the omicron wave, however, the need for intensive care has so far increased slightly in Finland as well as in Great Britain and Denmark, which are estimated to be a couple of weeks ahead of the omicron wave.

However, the need for other hospital care has increased sharply with infections. The situation is exacerbated by the fact that there has already been a shortage of skilled professionals in the sector.

A stub has conducted research with his team on health care management during a pandemic. It has shown that staff have been used creatively during the pandemic. For example, it has been possible to transfer staff from the cultural service to telephone services and close nurseries to, for example, the care of the elderly.

Even omicroneal people have to survive by moving care professionals. At the worst, we have to cut down on almost everything else. However, the treatment of the corona cannot go beyond everything, as some of the old diseases are even more dangerous than the corona, Torkki points out.

The Standby Act also allows for the assignment of private actors and their employees to new positions. However, the obligation to work is a very politically challenging regulation, Tynkkynen estimates.

A stub and Torkki agree that Finland was not prepared for this situation either in its crisis preparedness.

Health care contingency plans have been made for short-term emergencies that require special arrangements for perhaps a week. In contrast, a years-long pandemic is not anticipated. There are lessons to be learned from this.

“We have to assess whether the system has been pulled too tight,” says Torkki.

In addition to the non-existent precaution, it is noteworthy that the situation was not improved during the pandemic before the onset of the microwave.

In the coming weeks In addition, staff shortages are a key issue for the future of the SOTE system, Tynkkynen says.

Nursing professionals have moved to other fields. In addition to pay, Tynkkynen thinks it would be important to pay attention to working conditions. He warns that not enough care has been taken of the nursing staff.

“Stretching for years with physical and mental strain, poor leadership and a climate that doesn’t even get you properly compensated can affect the industry’s attractiveness.”