The main entrance of the Salo hospital, a part of Turku University Hospital (TYKS), in Salo, Southwest Finland, on 31 January 2024. Faced with substantial budget deficits and state-imposed adjustment requirements, Finland’s well-being services counties are widely rationalising their service networks. (Antti Aimo-Koivisto – Lehtikuva)

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SUBSTANTIAL budget deficit and austerity measures have created tensions in many well-being services counties in Finland, reports Helsingin Sanomat.

In Central Ostrobothnia, Minna Korkiakoski-Västi stepped down last week as the managing director of the well-being services county, citing lack of confidence in the elected leadership, namely the county council. Sari Innanen (Centre), the chairperson of the county council, was forced to step aside shortly thereafter after losing the confidence of her party, according to YLE.

Pohde, the well-being services county of North Ostrobothnia, announced last week it is launching large-scale consultative negotiations as part of a 90-million-euro cost-cutting programme.

The well-being services counties were created as part of the long-debated social and health care reform carried out by the previous government. The counties began their operations in early 2023, their primary duty being to organise social, health care and rescue services, and decide how to allocate the funding provided by the central government.

With the counties set to stick to economic austerity and cost savings that have provoked outrage among locals, their internal tensions have begun to surface.

The Central Finland well-being services county unveiled a new plan for its service network, revealing that health care centres would be shut down in a number of smaller municipalities.

Chairperson Jani Kokko (SPD) responded to the plan immediately, commending the plan as something he himself could have drawn up in a press release. The current financial and human resources, he argued, simply make it impossible to provide services in each corner of the county and force the county to make hard choices.

“Bemoaning won’t do you any good in this situation. That’s not a way to make investments or pay wages,” he said to Helsingin Sanomat on Saturday.

“I’m a rare opposition member in the sense that I’m not extending my hand to the government, calling for money. What I’d hope from the central government is that the deadline for closing the deficit be extended from two to three or four years.”

Kokko stated that the closure of small health care centres is unfortunate but outlined that the objective is to ensure all residents can access a well-equipped health care centre in 30 minutes. Slightly larger social and health care units, he gauged, are also more attractive employers for care professionals.

In North Ostrobothnia, the economic and productivity programme entails the closure of service units for the elderly and re-examination of some smaller health care centres. The programme is a state-imposed condition for running up debt to invest in developing the hospital system in Oulu.

Hanne-Leena Mattila (Centre), a councillor for Pohde, told Helsingin Sanomat that the county has the desire to reform itself and take advantage of its larger area. The cost savings demands, though, are too harsh.

“This isn’t enough time to produce good results. We haven’t been able to conduct impact assessments of the consequences of closing a health care centre in a particular area,” she said to the newspaper, adding that the digital and mobile services that are to replace in-person services are still on the drawing board.

“We recognise that Finland’s economic situation is difficult, but the counties have been given no opportunity to start operations. We can’t carry out any kind of development work when all our resources go into devising savings measures,” she retorted.

Heikki Vestman (NCP), the chairperson of the well-being services county council in Eastern Uusimaa, said the National Coalition was right to oppose the social and health care reform during the previous electoral term.

“My experiences as a county councillor have proved that. The reform was a mistake. It was expensive – it was only about reforming administration, not the services. The current economic difficulties are due to the social and health care model and funding law decided by the previous government,” he stated to the newspaper.

Helsingin Sanomat pointed out that parliamentary debates about the counties have been complicated by the fact that the reform was strongly opposed by two of the current ruling parties, the Finns Party and National Coalition. Opposition members who criticise the implementation of the reform are often met with remarks that they are in fact criticising their own party.

Aleksi Teivainen – HT

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