Up until to now, municipalities have mainly been responsible for the provision of public healthcare services in Finland.
However, as of the start of the new year, healthcare services will be transferred to self-governing wellbeing services counties under the terms of a new healthcare, social welfare and rescue services reform. One of the aims of the reform is to curb costs.
The exception is the City of Helsinki, which will provide these services independently.
A provincial model has been used in seven regions, where municipal associations have pooled services for residents.
These groupings already have several years of experience in jointly operated social and healthcare services. Yle approached healthcare and social services managers in these areas to ask what what changes at the turn of the year are likely to look like.
1. Name changes
At the beginning of January, terms used to refer to the regional authorities in charge of healthcare, social and rescue services will be harmonized. Each of the 21 regional service providers will be termed a "hyvinvointialue" in Finnish, or "välfärdsområde" in Swedish. This translates as ”wellbeing service county” in English.
Municipal associations that currently supply services in some regions will also be renamed to reflect the change.
The exception is the capital region. The City of Helsinki will be responsible for its own services, but otherwise the province of Uusimaa is divided into four wellbeing services counties.
2. Adjustments to zones
With the start-up of the reform and elimination of municipal association services, some municipalities will be shifted to a different wellbeing services county.
For example, for the purpose of wellbeing services, Kronoby will move from the Central Ostrobothnia service region to the Ostrobothnia services county.
This change will affect several municipalities, some of which are currently in service associations and some of which have independently provided social and healthcare services to local residents.
3. More digital services likely
Based on the experience of services by municipal associations, the launch of wellbeing services counties is likely to increase the use of digital, home-delivered, and mobile services.
With the transition away from municipally-based service provision, some local facilities will be closed or trimmed back.
Under the municipal association scheme in Päijät-Hämee, non-statutory services, such as day activities for the elderly, were discontinued. Regional psychiatry outpatient clinics in Orimattila and Heinola were closed. At the same time, completely new service models were developed, providing more centralised services.
In the Kymenlaakso region, one primary healthcare bed unit was closed. At the same time, home nursing care was increased.
Shared services also brought greater flexibility. For example, residents have been able to make a dental appointment in a neighboring municipality if there were no available appointments in their own.
Managers in some areas also say that a larger team to drawn upon provided improved access to professional support.
4. Teething problems
Almost all municipal association managers managers a shortage of personnel as an issue in their region hindering the availability of services.
"Unfortunately, the wellbeing services reform does not eliminate or correct this challenge in itself," says Minna Korkiakoski-Västi, the director of Central Ostrobothnia's wellbeing services county.
In the future, the funding for wellbeing services will come from the state, not from the municipalities. This has led to some managers cite insufficient funding as a threat to the provision of services.
Funding is expected to be tight, and wellbeing services counties will be finalising service offerings for residents as soon as budgeting is confirmed.
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