In anticipation of the Government’s long-awaited comprehensive social welfare and health care reform, we published our vision of the reform towards the end of 2019.
We stressed the special status of HUS in respect of specialist medical care, both for Uusimaa and for Finland at large. For instance, we have nationwide responsibility for the most demanding specialist services such as organ transplantations and rare children’s diseases. Also, nearly half of all medical specialists in Finland are trained jointly by HUS and the University of Helsinki.
We proposed that HUS should have responsibility, enshrined in law, for providing specialist medical care in Uusimaa and should similarly have statutory special nationwide responsibilities, including training and research.
In February, there was a discussion about the social welfare and health care reform vis-à-vis Uusimaa organized by Krista Kiuru, Minister of Family Affairs and Social Services, at the House of the Estates in Helsinki. The design proposing four autonomous areas in Uusimaa and separate status for the City of Helsinki was being circulated for comment at the time. On that occasion, our CEO Juha Tuominen pointed to the expected major growth in population and hence in service needs in Uusimaa and the resourcing challenges that this would bring.
Draft legislation with unsustainable funding model
On June 15, 2020, the Government published its proposal for draft legislation for the social welfare and health care reform. In our view, the attainment of the goals of the social welfare and health care reform was important but the proposed funding model was completely unsustainable.
The HUS Executive Board published its opinion on the draft legislation on September 3, stating that the legislation as proposed would mean slashing services in Uusimaa. The HUS Executive Board remarked that the funding model, if implemented, would undermine the concept of equality in specialist medical care and would dismantle the system of specialist medical care in all of Finland.
HUS alone would suffer a cut of more than EUR 100 million per year under the funding model proposed by the Government. This would mean a permanent loss of about 1,500 person years at HUS.We voiced our concerns to Members of Parliament for Uusimaa at a social welfare and health care reform briefing on October 12, where the Chair of the Executive Board, the CEO and a number of key experts in the administration answered the MPs’ question.
We continued to criticize the reform as proposed later in October, drawing attention to the problems in the funding model in op-ed pieces in the media. We stressed that the funding model was based on artificial, theoretical coefficients which were intended to describe service needs in social welfare and health care but which were divorced from reality.
Other university hospital districts joined the criticism
The other university hospital districts in Finland joined our criticism of the social welfare and health care reform in a joint statement released in November. This statement emphasized in particular that no funding was allocated to research and teaching at university hospitals in the social welfare and health care reform legislation package. University hospitals spend one tenth of their budget on research and teaching, but the central government compensates for only half of this.
The directors of the university hospital districts declared it untenable to allow research and teaching in this field to decline in our country. They insisted that the forthcoming social welfare and health care legislation must allocate funding in full for both research and teaching.