Date: Apr 24th, 2017
Motion: THB that over time the social and health care overhaul will succeed
Role: Chair (opp.)
I have mused on the social and health care overhaul in Finland a little, and christened it ”Sahco”. I have been disappointed with what the earlier one and present regime have accomplished (= little, or nothing), so I think it’s time I presented you with an alternative vision about the reform that we ”have to” do, or are to do, at any rate. Let us first run through the basics.
The way that I understand the Sahco reform drive is that pressures from both doctors and patients have forced politicians to declare that the present state of health care, and to a lesser extent, social care, is inadequate, which has prompted a trend towards centralisation. There is also the financial question, or the seesaw between smaller units and the state, as to who will foot the bill. As far as I can see, on the human level the reform is informed by
- patients’ desire for quality treatments
- patients’ desire to be able to jump queues and get quick fixes and
- doctors’ desire to have the most amount of colleagues and the best kind of equipment available
At present, there are several models and key numbers that rival each other:
- Municipalities will shed off the responsibility for health affairs
- There are 19 legacy provinces in the country
- However, only 18 provinces are taken into account
- There should be 12 hospitals with full service on a 24/7 duty
- 1 extra hospital with full service on a 24/7 duty is being required by the Swedish-speaking, who want to have a hospital of their own due to their special, evident lingual needs.
- Maternity wards at hospitals where fewer than 1,000 babies are born annually will be shut down
- Specialised health care, (whatever that means), will be divided between 5 administrative and regional units
Even so, I think that the controversy is pointless, as it seems that the changes would be minimal compared to the amount of debate that has been maximal. To redeem the volume of ink that has so far been spent on the issue, I propose that the following, more drastic model be put into action to implement the reform.
- People need major operations fairly seldom in their lives. Most people are operated once, twice or thrice in their lives. As the need is fairly rare and the biggest concentration of expertise is based in the capital city Helsinki, I would have all operations of a major magnitude (by-pass operations, cancer removals, plastic surgery, hip replacements) performed in Helsinki. Helsinki has the best hospitals, the best doctors and the best nurses. And everyone who needs a surgery of the big sort can afford to have the operation in Helsinki, even with additional costs from accommodation, travel, eating out and so on.
- Giving birth is the only major operation that many people go through in life that can’t be classified as an accident, defect, disease, emergency, injury or illness but which requires a hospital. I would apply the same kind of thinking here as before. As labour is part of one’s life likely only once, twice or thrice, I would place maternity wards at only three hospitals within the country. To serve Northern, Central and Southern Finland equally, I would place baby-delivery services in Rovaniemi, Jyväskylä and Helsinki. They would allow any pregnant Finn, but more logically people would choose the one that they would consider the nearest. As an aside, Kuopio, which is a town with a university hospital, could be regarded as an alternative to Jyväskylä, as it may have a more central location within Central Finland. The country would be divided up geographically with diagonal northwest-southeast lines into three sectors.
- All minor medical procedures (dental care, injuries, vaccinations etc.) would be carried out at health centres around the country as usual. Services could be offered by corporate or communal players. Politicians could set the bar of state-sponsored services at the desired percentage.
The enclosed image depicts the model that I favour. It could be considered the ”3 + 1” model. I hope that this bolder, more radical and drastic model will gather support, once people realise that they need medical services, but that they do not need them as frequently and as near to them as they think they do.
Arvio: Edellisellä viikolla katsoin, että opposition muut jäsenet voisivat tehdä erinäisiä muita asioita, jos sihteeri keskittyisi lääkäreihin, kun tästä nimenomaisesta aloitteesta puhutaan. Tässä nyt sitten opposition puheenjohtaja esittää vaihtoehtoisen mallin. Nimenomaan hän tekee sen, koska väittelyssä ”järein” aines sopii ensin puhuvalle.