Live broadcast | The fate of five hospitals is at stake in the working group's presentation: “Our population is getting older, our staff is getting older”

Hospitals and the working group that considered the fate of round-the-clock emergency services proposes a significant consolidation of the hospital and emergency room network and, among other things, a reduction in the number of central hospitals.

HS shows the press conference of the Ministry of Social Affairs and Health (STM) on the presentation of the working group as a live broadcast. It can be viewed in connection with this article from 10 o'clock.

The working group made up of experts gave its presentation on Thursday. The next step is political decision-making, which, based on previous experiences, can be predicted to be difficult, because the regions want to hold on to their own modern hospitals until the very end.

The government is supposed to present its proposal to the parliament during this year. The official preparation of the proposal has started in the ministries.

The working group would not abolish the hospitals, but their “service profile will change”.

The key reason for making the hospital and emergency room network more compact is the ever-worsening shortage of skilled personnel. Another reason is that the hospital network has not followed the demographic development of the regions. The population is concentrated in growth centers and the need for services changes as Finland ages and the number of births and children decreases.

The regions themselves have not made decisions about hospitals and emergency rooms on their own initiative, but they have strictly adhered to specialized hospital care. According to the working group, this could have “endangered and weakened” among other things basic health care, i.e. health centers.

Due to the difficulty of regional decisions, the division of labor in hospitals should be regulated by law, the working group suggests.

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The operations of five hospitals may be reduced.

Work group suggests a step-by-step progression. In the first phase, from the beginning of 2026, the number of maternity hospitals would be reduced so that, with the exception of Uuttamaa, each welfare region would have only one maternity hospital. The number of maternity hospitals in Uusimaa would also decrease.

Now in Uusimaa, births are held at the Women's Clinic in Helsinki, Jorvi in ​​Espoo, and in addition to them in Lohja and Hyvinkää.

In the opinion of the working group, each welfare region, with the exception of Uuttaamaa, should have only one hospital, which would offer 24/7 emergency services, surgeries and intensive care. Round-the-clock surgery consumes a lot of resources, the working group states.

If the qualification is done on the basis of the proposal, it will especially concern the current round-the-clock operation of the five hospitals. The hospitals in question are located in areas with either a university hospital or a central hospital.

The report does not directly name these five hospitals, but they are Länsi-Pohja Hospital in Kemi, Oulaskankaa Hospital in Oulaiin, and Valkeakoski, Savonlinna and Salo hospitals. Their activity may be reduced.

Oulaskangas, Valkeakoski and Salo are located in the areas of university hospitals. Lapland's central hospital in Rovaniemi is in the same area as Länsi-Pohja, and Mikkeli's central hospital is in the same area as Savonlinna.

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There would be no round-the-clock surgeries, births or intensive care in acute hospitals.

Work group would also reduce night-time separate primary care emergency centers. The only reason for maintaining them would be long distances, which is mostly true in Lapland.

Ivalo and Kuusamo could thus continue night duty, the others, i.e. Iisalmi, Jämsä, Kouvola, Pietarsaari, Raahe, Raasepori and Varkaus, would be at stake. Forsa was also on the list, but the welfare area there already stopped the nighttime emergency at the turn of the year.

From From 2028, at the latest in 2030, the hospital network would become even more compact. It would be based on five university hospitals in Helsinki, Turku, Tampere, Kuopio and Oulu. In addition to them, there would be five to eight central hospitals in Finland that would have round-the-clock emergency services for specialties. There would be 10–13 such hospitals in total.

“The working group has thought about the number of hospitals from a purely medical point of view, but the placement of hospitals is more than just medicine,” said the director of the Päijät-Häme welfare area, who chaired the working group Petri Virolainen on Thursday at a news conference.

According to Virolainen, factors such as distance and language rights affect the ranking.

Other hospitals would be “acute hospitals”. Every welfare area would have such a 24/7 emergency hospital, if there wasn't already a university or central hospital there.

In acute hospitals, however, there would be no round-the-clock surgeries and therefore no births or intensive care.

There are still uncertainties in the number of central hospitals because, according to Virolainen, for example, the effects of digitalization on medical care are not fully known.

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“It is not possible to forcibly maintain services that lead to the deterioration of basic services.” – Petri Virolainen

Estonian justified the working group's presentations by, among other things, that Finland's current hospital network was largely built in the 1990s, after which Finland has changed a lot.

“Our population is constantly concentrating, our population is getting older, but our personnel is also getting older,” Virolainen said.

He says that currently the use of resources is not distributed sensibly. Some of the emergency centers are unreasonably congested, while in others the load is low.

According to the Estonian, pruning the hospital network can be done without reducing patient safety.

“It is possible to extend the distance and, in that sense, to somewhat weaken the accessibility without jeopardizing patient safety. It is in no one's interest to have a service nearby if it is of poor quality.”

According to Virolainen, an important principle has been that basic services come before special services.

“Each welfare area must be able to secure basic services. It cannot be done by forcibly maintaining services that lead to the deterioration of basic services.”

STM's head of department Anna Cantell-Forsbom according to him, the main driver in the working group's proposals is not cost savings, but the lack of skilled personnel.

Work group was not unanimous. The leaders of the welfare regions of South Karelia, Kanta-Häme, South Savo and Central Ostrobothnia left a common dissenting opinion. In their opinion, the numbers of hospitals presented as the goals of the report do not automatically lead to improved staff availability or financial savings.