Healthcare reform in Finland from 2020

Healthcare reform in Finland has been delayed until 2020 due to practical problems in altering many systems.

As a result of recent discussions, the Finnish government has decided to continue the health, social services and regional government reform but delay the changes until 1 January 2020, instead of 2019.

Legislative proposals under consideration in Parliament will be amended. New laws on patient freedom of choice, will be worked out in 2018. The Organising Health and Social Services and the Counties Act, that are currently under consideration in Parliament, will be amended in parliamentary committees to meet the changes required by the delay.

The legislative proposals on health, social services and regional government reform will not be changed in any other respect. The Counties Act, the Act on Organising Health and Social Services, and the Act on Freedom of Choice will be considered in Parliament in 2018.

The Constitutional Law Committee found no fundamental problems with the key elements of the health and social services reform relating to freedom of choice and the organisation and financing of services by the counties. There were also no serious problems with regard to the means of implementing freedom of choice, including health and social services centres, oral health services units, health and social services vouchers and personal budgets. But the Constitutional Law Committee proposes several justified changes to them. Trials and pilot projects relating to freedom of choice will be advanced.

The delays and minor changes are to ensure decision-making and the attainment of the three-billion-euro savings target set for the health and social services reform.

A cornerstone of the plan is to balance public finances and boost the economy after a decade of stagnation, including cutting €3bn off healthcare cost in the 10 years up to 2029 as Finland struggles with an ageing population.

A parliamentary committee found that some of the government’s proposal to boost competition between public and private service providers breached Finland’s constitution, and that implementing the changes by January 2019 was unrealistic.

The reform will establish 18 new counties and shift responsibility for the provision of services to new health care regions, from more than 300 local governments at present.