In the future, the so-called welfare areas, formerly called provinces, will be responsible for organizing social and health care.
15.6. 11:55 | Updated 14:33
Parliament adopted on Wednesday years of social and health care reform.
In previous terms of government, reforms have failed, as they have been judged unconstitutional. Now the basic solution of the presentation was approved in the Committee on Constitutional Affairs, who saw change in detail only.
It has been easy to fall off the carts from the long-awaited reform in public. This story tells you what the basics of the reform are about.
Read more: Parliament approved the SOTE reform by a vote of 105–77, the organization of health care will be transferred from municipalities to wider areas
Finland’s population is aging rapidly, and urbanization is reducing the number of people in many places. Access to social and health services is difficult or slow in parts of the country. The growing population is causing problems in the Helsinki metropolitan area.
Sanna Marinin (sd) According to the government’s program, the aim of the reform is, for example, to reduce inequalities in well-being and health, to improve the availability and accessibility of services, and to secure the supply of skilled labor.
In addition, the government wants to “ensure equal and high-quality social and health services for all Finns” and “respond to the challenges posed by social change and curb the rise in costs”.
Whether the forthcoming reform will achieve these goals is an example the opposition disagreed.
Read more: Sote reform leading to one hundred million non-recurring costs in the top – there will continue to be no incentives for efficiency in the regions
How are social and health services organized now?
At present, the organization of social and health care is the responsibility of the municipalities.
This simply means that when you visit a health center, for example, on duty or in a clinic with a child, the municipality has arranged this in some way.
The municipality has been able to set up the health center itself and pay the doctor’s salary itself. In some municipalities, the service may have been purchased from private companies. In this case, the municipality pays the company that has set up the health center and pays the doctor’s salary.
In many places, this is also done by a so-called group of municipalities or co-operation area, ie several municipalities in co-operation.
What will the reform change?
A completely new level of government will be established in Finland.
In the future, the so-called welfare areas, formerly called provinces, will be responsible for organizing social and health care. In addition to organizing social and health care, the municipalities will be provided with fire and rescue services.
There will be a total of 21 areas. In addition, the City of Helsinki will continue to organize its own social services and rescue services.
Funding for war and rescue will be transferred from municipalities to the state.
In the future, the elected regional councils will decide on the organization of war and rescue operations. The first regional elections are scheduled for early 2022. Before that, the interim administration of the regions would be operational.
How is the reform reflected in the municipalities?
For example, the reform will affect which matters remain to be decided by the newly elected municipal councils.
The statutory tasks of municipalities include, for example, early childhood education, pre-primary and basic education, libraries, general cultural activities, so-called general activities and technical activities.
The employer of about 173,000 employees changes. In addition to social and health services and fire and rescue services, study care curators and psychologists would be transferred to the service of welfare areas.
The impact on municipal finances is large, as more than half of municipal costs have been spent on social and health services and rescue services. On the other hand, municipalities also lose the revenue from these.
Use the calculator below to see how the reform will affect the economy in your municipality.
Read more: Municipalities are facing a historic change: How the end of the war will affect the economy, property and tasks
Read more: Municipal finances will turmoil in the coming years: See on the counter how tax revenues and government funding will change in your municipality
Which reform has been criticized?
Opposition parties, the Coalition Party, the Basic Finns, the Christian Democrats and the Movement Now, left the issue of reform in May. In their view, the reform will not improve access to care or help curb rising health care costs.
The opposition has also been concerned about how the model will affect the economy of municipalities and cities. For example, a Member of Parliament Anna-Kaisa Ikonen (Kok) said in Parliament that with the government’s sote model, there would be a “silent funeral of municipalities” ahead.
Before the municipal elections, there was a lot of discussion about how the regions get money to organize services. For example, the Business Delegation has criticized in its report that the government’s proposal could lead to cost inefficiency.
The government’s solution to this has been a provincial tax, which, although it has had constitutional problems so far, and which has also been the subject of controversy within the government. The opposition opposes this: it believes the government is running out of war in a hurry to the finish line.
Read more: Opposition and health business interest groups disappointed with committee report, Orpo appeals to Greens: ‘Impact on big cities very bad’
Read more: Coalition accuses war of “silent funeral of municipalities”, SDP’s Lindén found 45 errors in opposition interlocutory
Read more: Eva’s report: Without freedom of choice, social reform will not improve services
Read more: Controversy over provincial tax tears government: How new tax would divide Finns into winners and losers
What changes were made at the last minute?
Earlier in the spring, the Committee on Constitutional Affairs considered that the basic solution to the reform was in accordance with the Constitution. However, it required changes to a few details. Last week, the Sote Committee presented a modified, final version of the proposal.
The extent to which municipalities are allowed to outsource their services to private companies and how outsourcing already done can be canceled has been particularly much debated.
For example, the committee did not set a percentage limit for outsourcing, but would limit it only in cases specifically mentioned by law. Counseling could also be outsourced.
Of the current outsourcing, only the contract of Länsi-Pohja Hospital would be canceled.
In addition, the committee proposed, for example, that the regulation on the so-called official doctor’s requirement be amended and that the provision securing the municipality’s financial self-government be supplemented.
Read more: Committee approves SOTE reform: No upper limit for outsourcing, councils can also be outsourced – Parliament to vote next week
What happens next?
In the autumn of 2021, the interim administration of the new welfare areas will begin. Regional elections are scheduled for early 2022 at the earliest.
The laws come into force in stages. Some will enter into force as early as 1 July and some on 1 March 2022, when the new regional councils take office. The last part will enter into force on 1 January 2023. The proposal would also include transitional periods.
Ultimately, responsibility for social and health care and rescue will be transferred to the regions in 2023.
Update 23.6. at 2:32 p.m .: Originally on June 15. published story updated throughout after the parliament approved the reform on June 23.