The collage shows pictures of the party leaders and short quotes from the party's regional election platforms. Riikka Purra: Nurses back to Finland. Antti Lindtman: The self-help model should be introduced. Antti Kaikkonen: a health center system for the elderly. Minja Koskela: working hours should be reduced to 30 hours a week. Prime Minister Petteri Orpo: leave no stone unturned to ensure sufficient personnel.
We went through the parties' solutions to the problems caused by the shortage of nurses, the economic hardship of the regions and the aging population.
In just over two months, regional elections will be held, and those running for office are certainly not afraid of challenges.
Difficult solutions are expected in a situation where welfare areas are struggling with financial difficulties and austerity pressures.
Finland is also rapidly becoming grey. Services should be arranged for the increasing number of elderly people in welfare areas, while there is a shortage of nurses and doctors.
Finnish media company Yle reviewed the solutions offered by the parliamentary parties to the key problems of social welfare.
Not all parties have yet published their final election manifestos, so the article discusses the social and health care policies presented by the parties in other contexts. Some parties have published separate proposals for reforming social and health care in addition to their election manifestos.
In the big picture, the parties agree on a surprising number of issues, says Liina-Kaisa Tynkkynen, a leading researcher at the Finnish Institute for Health and Welfare, who has reviewed the parties' social and health care openings.
The similarity is explained by the fact that the parties have little concrete information. Many proposals are more about wishes about how things should be than how the wishes would be implemented in practice.
Tynkkynen takes the personal physician model, for example, which has clearly become a buzzword in these elections.
The parties repeatedly claim to want a personal physician model, but there is little concrete information in the manifestos about how the personal physician model should be implemented and, for example, where a sufficient number of doctors would be found to implement the model.
The parties' solutions and proposals were as follows:
Finland’s welfare regions that started their work in a difficult economic situation have had to lay off staff and close branches, but even this does not seem to be enough.
According to the law, the welfare regions should cover their accumulated deficits by 2026, but a significant part of the welfare regions are unable to make savings at that pace.
The opposition parties are demanding more time for the welfare regions to balance out. For example, according to the Greens, the government is forcing the welfare regions to make major cuts on an unreasonable schedule, which is jeopardizing services.
The opposition's demands received authoritative support last week, when the Economic Policy Review Council also recommended additional time.
The government has considered giving additional time to the regions as a wrong signal to regions, some of which have been able to make significant savings. Prime Minister Petteri Orpo and Riikka Purra have rejected the additional time. The Christian Democrats would not give additional time either.
However, the RKP's position on the matter is vacillating. According to the RKP, the perspectives of the Economic Policy Review Council must be "carefully assessed".
Mika Kortelainen, a professor of health economics at the University of Turku and a research professor at the Finnish Institute for Health and Welfare, who is familiar with social welfare financing issues, understands the arguments for and against the extension.
The situation highlights the so-called "soft budget constraint problem", which was warned about when the social welfare reform was being prepared.
In this model, there is a risk that welfare regions will be provided with funding on too loose a basis, so staying strict is justified in that sense, Kortelainen says.
The election programmes also hint at the regions' right to tax as a response to economic concerns. The Left Alliance and the Greens support the so-called regional tax. (See below: Vihr. – The Greens, Vas. – The Left Alliance).
According to the parties, the regional tax would strengthen the autonomy of welfare regions. Other parties reject the regional tax. According to the National Coalition Party's election program, a provincial tax would not solve the financing problems, but would raise the tax rate and lead to a more significant differentiation of taxation and service levels in different parts of the country than is currently the case.
According to Kortelainen, the introduction of a provincial tax would not directly lead to an increase in the tax rate. Among economists, the system's good side is considered to be the incentive, as welfare regions would have financial responsibility and the opportunity to lower or raise the level of taxation.
Everyone recognizes that the problem with the current financing model is that it lacks incentive. The parties disagree on how to respond to this problem, Kortelainen says.
The government's proposal to reform the model is currently being submitted for comment.
The parties' policies reiterate the hope that the focus of care will be shifted to prevention. It is hoped that this will curb costs and improve treatment outcomes.
Cutting the costs of temporary labor also plays a major role in the parties' savings proposals.
The SDP would introduce a price cap system for temporary labor and limit the hiring of medical students at "unhealthily high salaries".
The RKP also proposes a kind of price cap model, in which welfare regions would join a national agreement on a "reasonable price level" for temporary physician services.
The regions are having difficulty getting doctors to health centers, nurses to nursing homes for the elderly, and social workers to child welfare. The shortage of personnel is expected to worsen as the population ages and almost a fifth of those working in the social welfare sector will retire within a decade.
The solutions offered by the parties are very similar. The aim is to make welfare areas more attractive employers and increase the level of education. A large number of parties are also looking to foreign labor.
For example, the National Coalition Party states that it is “ready to leave no stone unturned to ensure sufficient personnel”. This would also include recruiting from abroad.
The program of the Finns Party (formerly True Finns), which has a negative attitude towards immigration, also calls for nurses from abroad, but these would be Finnish returnees. The party would attract nurses back by improving working conditions and improving the general attractiveness of Finland.
During parliamentary question time on Thursday, Finnish Fundamental Rights Minister of Social Affairs and Health Kaisa Juuso admitted that Finland also needs foreign labor.
A proposal to attract Finnish nurses back to Finland is also included in the “health care reform package” presented by the Swedish People's Party of Finland (RKP).
The Party would introduce lighter taxation for returnees working in the healthcare sector. In addition, the party would like a fast lane for recognizing foreign healthcare qualifications. Filipino immigrants wave to the camera in a group photo in the airport arrivals hall.
THL’s Liina-Kaisa Tynkkynen will miss more concrete information from the parties regarding immigration.
If we want social welfare personnel here, how, for example, will their families be received and what methods will be used to attract these workers to Finland, Tynkkynen says.
In addition to immigration, the parties want relief from the labor shortage in social welfare students and retirees. The RKP and Liike Nyt would attract retired professionals to work with reduced taxation.
The Center Party would oblige medical students to complete their internships in the welfare areas. The Finns Party would also require medical students to work in the public sector for a fixed period after graduation.
Almost all parties promise to improve well-being at work in one way or another, which is hoped to attract new employees and make current employees stay in work longer.
The strongest offer for workers in welfare areas is being made by the Left Alliance, whose election program proposes reducing regular working hours to 30 hours a week with the same salary as a solution to the skills shortage.
The SDP's social and health care package, on the other hand, proposes, among other things, the introduction of cultural and sports benefits that support well-being at work in every region.
Several parties also talk about developing the content of work and better management.
Tynkkynen agrees with the parties that there is much to be done in terms of well-being at work in welfare regions.
Personnel policy in the social and health care sector is not the most modern, there are certainly many things there that can be genuinely improved.
The parties also have strong faith that the use of digitalization and artificial intelligence will ease the shortage of workers and improve the quality of services. Artificial intelligence would be helpful, for example, in patient registration, which would save working time for other things.
The problems of insufficient funding and staff shortages in welfare areas will be exacerbated in the coming years, largely because the number of elderly people who need a lot of services is increasing.
The number of people over 75 will increase by about 25 percent by 2030, but at the same time, the number of places for 24-hour assisted living in welfare areas is expected to remain almost the same.
According to the parties, the elderly must be taken care of, investment should be made in home care and 24-hour care should be available if necessary, but according to Tynkkynen from THL, the promises remain empty.
I don’t think any party is addressing the big question of what kind of care one can expect and to what extent relatives are expected to provide care. In practice, many people experience in their everyday lives how promises and reality do not match, for example, the criteria for 24-hour care have increased, but this reality is not reflected in the parties’ programs, Tynkkynen says.
Many parties would also invest in prevention in elderly services, for example by increasing counseling and various health checks.
The Center Party's program proposes a national elderly health center system similar to children's health centers. The Finns Party's program proposes that public health care would begin regular meetings with retirees as soon as they leave the scope of occupational health.
Tynkkynen believes that it would be more important to get public services in such a state that people can receive care if necessary, regardless of age.
Based on: Yle (in Finnish)
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