Voters in Finland will cast their vote later this month in the country’s first regional elections that will revolutionize the way the Nordic nation provides health and social care.
County elections will be held on January 23, but early voting opens on Wednesday.
It is the result of the largest reform of the country’s public health system in decades and transfers responsibility for social, health and emergency services from 294 individual hard-to-manage municipalities, half of them with fewer than 6,000 inhabitants, to 21 new, more simplified regional authorities whose boards are directly elected.
Voting takes place in all parts of Finland except the capital Helsinki and the semi-autonomous islands of Åland.
The reforms are a flagship policy for Prime Minister Sanna Marin’s Social Democrat-led coalition, and mark the beginning of radical and difficult changes that have eluded previous governments: Former Prime Minister Juha Sipilä staked the entire legacy of his administration on the health system reform in Finland, but resigned in spring. 2019 when an agreement could not be reached.
Demographics are the main drivers of change
Finland currently spends around € 22 billion a year in healthcare, about 7% of GDP, which is right on the EU average according to the latest Eurostat figures).
But the problems facing today’s healthcare setup, as well as individual municipalities potentially making their own local policies, have more to do with changing demographics.
Finland has one of the oldest populations in Europe, and the proportion of people 65 and older is projected to rise from 22% today to 26% by 2030, and then to 29% by 2060.
This, together with the increasing age of new mothers and a low birth rate, creates a problem in which rural areas are left at a disadvantage in terms of health care provision: municipalities become too sparsely populated or too poor in taxes to adequately care for the local elderly. residents or even hire the right staff.
The new regional system aims to restore that balance in the future.
Reforms don’t pick up the pulse
While the provision of social and health care services and emergency rescue services affects everyone living in Finland, the upcoming elections have not exactly aroused much enthusiasm.
A recent poll suggests turnout could be less than 40% with the center-right National Coalition Party on track to win the highest percentage of votes; followed by the Sanna Marin Social Democrats and the right-wing Finnish Party.
“The main political gap is between the privatization and the public organization of these services,” Markku Jokisipilä, assistant professor at the Center for Parliamentary Studies at the University of Turku, told Euronews.
“These new regions have real power, the power to choose between public providers and then private providers. But how radical the changes will be or the decisions that these new councils make, that remains to be seen, ”he said.
In theory, a region dominated by the National Coalition Party could open many of its health services to private providers, while the region next door, run by left-wing parties, could provide everything from its own resources. However, Jokisipilä thinks that is not likely to happen in reality.
“There may be some differences between these 21 regions, but in the end the differences will not be so great, because all the big parties will have something to say about it. It’s about haggling. Anyone can say something and the more votes they get, the more they can say ”.
Candidates discuss their motivation to run for office
In the Uusimaa region of southern Finland, Karin Cederlöf is concerned about the possible low voter turnout.
He is running on the ballot for the Swedish People’s Party, one of the five parties in the ruling government coalition, and is currently also a member of the city council for Espoo, Finland’s second-largest city.
“Unfortunately, in recent weeks it has become quite apparent that there are many people who do not know what this election is about,” he told Euronews.
“For people who do not follow politics, I think it is difficult to visualize what is happening and what parts of the administration are moving from the municipalities to this new regional level.”
Cederlöf also notes that the differences in health care provision between municipalities can be quite stark, but newer and larger regions should be able to ensure that everyone receives the same level of service.
In the Central Finland region, Dr. Ville Väyrynen is running on the nomination of the National Coalition Party and, as a surgeon from a small municipality, he acknowledges that he has a unique view of the problems facing the healthcare system of the country.
“For a doctor to be in this kind of election, well, there’s no way I’m going to miss it. We are going to build a totally new healthcare system in Finland, ”he said.
While some high-ranking members of his party have spoken openly about how the new funding arrangements can be a disadvantage for big cities, such as Helsinki, Dr. Väyrynen believes that there are pros and cons for his part of the country, even as some services become more centralized.
“I think that in Jyväskylä [the main city in the area] we will benefit from this type of new system. Personally, I am from Muurame, which is a small town and I think we are going to suffer a bit, but if you think about the entire region, I think it is a great step forward ”.
In southern Finland, Sara Peltola is running on the green electoral list and says that cost savings for acquisitions will be a major benefit of the new system, to make budgets more efficient.
“This is one of the reasons why some municipalities have already been moving in that direction, pooling their resources, and the good experiences that have come out of these areas are the reason why the government now wants to accelerate their development”, argument.
Language rights and health care for immigrants
As Finland’s population ages and more immigration is needed to fill jobs, the question of how to provide medical and social care to people who do not speak Finnish as a first language also looms large.
This is related to language rights in Finland, where a Swedish-speaking minority of around 5% is constitutionally guaranteed to receive services in their mother tongue, which may not always be practical or affordable in different parts of the country.
Also in Lapland, the indigenous Sámi population of Finland are also guaranteed services in their own language, a real challenge in a vast wilderness area.
Karin Cederlöf believes that technology could be a good solution to all these problems, and that foreigners should also be able to access medical help in their own language.
“In practice, a solution could be to have more digital services and if a Swedish-speaking person wants to have services in Swedish, they could have an appointment with a Swedish-speaking doctor in another region,” he said.
Every weekday Uncovering Europe brings you a European story that goes beyond the headlines. Download the Euronews app to receive a daily alert for this and other breaking news notifications. Is available in Apple Y Android devices.
www.euronews.com
George is Digismak’s reported cum editor with 13 years of experience in Journalism