According to the doctors' advocate, the deadline for access to treatment in public health care is practically scrapped. At the same time, the government increases Kela compensations for private care.
Doctors In the opinion of the trustee Lääkäriliito, extending the treatment guarantee for primary care from two weeks to three months practically means canceling the treatment guarantee.
The union criticized that Petteri Orpon At the same time, the (kok) government will add 500 million euros to Kela compensation for private care in the years 2024–2027. The state's financial contribution is EUR 335 million.
The union considers that this means a complete change in the role of the private sector in Finnish health care.
In recent years, public health services have been outsourced to private health companies, so that the responsibility remains with the public, but the services are produced by the private sector.
Now let's go even further than this. Private services are directly supported at the same time as public services are cut.
Director of the policy branch of the Medical Association Jukka Mattila says that there has been no open public discussion about this change of direction.
Previous Sanna Marini The government led by (sd) tightened the care guarantee from three months to two weeks. The reform came into effect in September 2023, and now Orpo's government is returning it to three months.
It means that in primary health care, it may take a maximum of three months from the time the patient is contacted and the assessment of the need for treatment to admission to treatment.
Due to the extension of the care guarantee, the government will reduce the funding of welfare areas by 132 million euros per year.
Mattila says that savings in the treatment guarantee cannot be made in practice other than through staff reductions and layoffs, which means a weakening of services and longer queues. The 132 million euros in question are the personnel costs of about a thousand doctors per year.
“Well-being areas have pretty quickly gotten to a good situation with two weeks of treatment, and now it would be scrapped in this way. I hope that doesn't happen,” says Mattila.
In the welfare areas, operational models have been changed to meet the two-week deadline, digital services have been developed and additional workforce has also been recruited. The medical association's understanding is that the focus has been on the development of operations and not on increasing the number of vacancies.
To the same in almost all welfare areas, savings are made by cutting back on basic services, i.e. by closing small health centers.
According to Mattila, the extension of the care guarantee, the growing Kela reimbursements and the elimination of local services are a combination where citizens may be unsure about whether there will soon be any more public basic healthcare services in Finland.
According to Mattila, professionals in the field, such as doctors, have also been waiting for the promised strengthening of basic healthcare. Now the actions show everything else that erodes confidence in the system.
“Political decision-makers and leaders of welfare regions should say something reasonably clever about this,” says Mattila.
Government increased Kela compensations, i.e. the compensation paid for a private doctor's visit, already at the beginning of this year and justified it by helping the public side in breaking up treatment queues.
A new Kela compensation model is coming, which the government presented to stakeholders in April.
In the new model, the focus is on general practitioner visits. For the specialist's fee, you would only get Kela compensation with a referral from a general practitioner, but the exception would be visits to the gynecologist and ophthalmologist no more than twice a year. You would get compensation for them without a referral.
The direct appointments of the oral hygienist and physiotherapist would be replaced no more than twice a year without a referral. Fertilization treatments would also receive Kela compensation, as the government had previously announced.
In the years 2025–2027, about 155 million euros will be spent on the new Kela compensation model, i.e. more than saved by the care guarantee. In addition to the 500 million euro increase, the amount also takes into account the previous funding of around 90 million euro reserved for the current Kela compensations.
Lääkäriliitto hoped to experiment with the in-house doctor model as the Kela compensation model, but it did not materialize. In the model, practicing private doctors would work in welfare areas taking responsibility for the agreed population.
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