How will openness as well as transparency in the use of taxpayers’ money be guaranteed in the public healthcare and social welfare companies?

The Government’s policy line is that public healthcare and social welfare services within the sphere of the customer’s freedom of choice should be corporatised. The reform will come into force on 1 January 2019.

Tuomas Pöysti, project leader of the healthcare, social welfare and regional government reform package, explains in a video interview how openness as well as transparency in the use of taxpayers’ money will be guaranteed in the public healthcare and social welfare companies, to which the Act on the Openness of Government Activities does not apply. In addition, he explains whether price alone will be decisive in the competitive tendering of services or whether quality will also be taken into account, how the position of personnel will be safeguarded, whether corporatisation will threaten public services, and when the Government proposal on the Act on Organising Healthcare and Social Welfare Services and the Counties Act will be completed.
 

Link to the video interview: https://youtu.be/wkjWWM1PpaI

Text version of the interview

When will the Government proposal on the Act on Organising Healthcare and Social Welfare Services and the Counties Act be completed?

“Minister Rehula has indicated that it should be completed no later than the summer. The target timetable is that the Government will finalise the substantive decisions in detail during May, so that in June we can publish drafts of the Government proposal in terms of the key statutes of the first stage of this reform.”

How will openness as well as transparency in the use of taxpayers’ money be guaranteed in the public healthcare and social welfare companies, to which the Act on the Openness of Government Activities does not apply?

“In connection with the preparation, we will also assess the need to update the Act on the Openness of Government Activities. Sweden has legislation in which the principle of public disclosure applies to a limited extent to municipal and county companies. We need to discuss this in Finland. We cannot necessarily assume that restrictions according to current legislation would be valid in the future. The Government policy lines state that, with respect to some key information, openness must exist so that, in general, it will be possible to register as a provider of freedom-of-choice services. This openness will also apply to private operators. The key factors affecting quality, effectiveness and price should be public, and in official preparation there has also been discussion about the fact that, in any case, at least the rules corresponding to those set internationally for the openness of stock market listed companies should be applied to the activities of the companies concerned.”

Will the counties be able to procure services? In the competitive tendering of services, will price alone be decisive or will quality also be taken into consideration?

“Moving from 297 municipalities to 18 counties also means that procurement expertise can also be pooled and developed much better than in the current system. There is every reason to believe and expect that the counties will operate as tendering parties much more professionally and more consistently than in the current situation. In that sense, we can safely expect that procurement expertise and tendering expertise will improve. There is a rapporteur report concerning freedom of choice. The rapporteurs, working under the leadership of Professor Mats Brommels, propose that the tendering criterion would be primarily quality, i.e. those tendering would compete on quality. No political decisions have yet been made on this, but the idea is that, as factors, quality as well as the success of care and service, i.e. effectiveness, would carry very great weight in competitive tendering processes.”

How will the position of personnel be safeguarded?

“Safeguarding the position of personnel must be considered in more detail, and to a large extent also in the model that utilises companies. The Government policy line is that personnel will be transferred in accordance with the principles of transfer of undertakings. Under consideration is follow-up legislation whereby this would be done in two stages. Firstly, in accordance with the principles of transfer of undertakings to the counties and, secondly, insofar as the counties during the transition period undertake the corporatisations required by this solution, a further transfer possibly based on special legislation in accordance with the principles of transfer of undertakings. We need personnel to commit strongly to substantive change. It is important, therefore, that in the change situation the fundamental position of personnel is safeguarded. For healthcare and social welfare personnel, the labour market situation is very good. The outlook for attrition via retirement means that support service personnel can also be quite confident when it comes to jobs.”

Will corporatisation threaten public services?

“Implemented sensibly, corporatisation will not threaten public services. The goal is to prescribe two levels of obligations to safeguard public services. In the new healthcare and social welfare model, organisers will have a general responsibility to ensure that quality, effective and integrated services based on people’s needs are available. In addition, we have considered the idea that county-wide service-provision obligations and public service obligations be prescribed for counties’ service-provision companies. Under the rules of EU competition law, these obligations must be clearly specified and applied to ensure that we will have, also in the future, an effectively operating and quality public sector available as an ultimate actor and as a genuinely good alternative to provide services to customers. In addition, in this context, we must come to a conclusion in Finland about what in fact is the fundamental duty of public authorities and public administration, and not only in relation to certain official decisions. It is also the intention to implement this safeguarding of public services in connection with this reform.”

Video and interview: Kimmo Vainikainen