Are there constitutional problem areas in the health and social services draft proposals?

The draft proposals for the social and health services and regional government reform were circulated for comment on 31 August. Under-Secretary of State Tuomas Pöysti talks about the key content of the draft proposals, whether there are any constitutional problem areas, what will happen to the personnel and what the schedule for submitting comments is.

Link to the video interview: https://youtu.be/hNKiz5kHET0

Transcript of the interview

What is the main content of the draft proposals?

“The circulated legislative package consists of a total of 27 different acts for establishing the new autonomous counties in Finland. Responsibilities from about four hundred different municipal or central government organisations will be transferred to them. A big change in the system is the transfer of responsibility for organising health and social services and their public production from municipalities or joint municipal authorities to eighteen autonomous counties. 

From the citizen’s point of view, the new rather strict regulations on reconciling the services, i.e. integration of service, are important. Legislation will secure the right of users to receive services that combine expertise from various professionals at the right time, i.e. integrated services. As organisers and funders, counties will also have special obligations to ensure that service providers implement this integration, or the possibility for clients to receive coordinated services, in practice.”

Are there any constitutional problem areas in the legislative package?

“The approach in the drafts circulated for comment is based on two statements made by the Constitutional Law Committee at the end of the previous parliamentary term. We are not expecting any considerable problem areas in this regard. However, we are building a whole new county government and a whole new way of organising and providing health and social services, so we will definitely see new questions regarding the interpretation of the Constitution.

Most of the debate will possibly be due to issues regarding democracy in the separation of organisers and providers. In principle, organisers have a strong role in steering production in the draft legislation, but it is possible that, in practice, providers will be strong. And this is a question we will also have to evaluate from the point of view of the Constitution.

Another big question concerns the equality of inhabitants. The counties will be different from each other in terms of resources and carrying capacity and the big question is therefore whether the proposed arrangement will safeguard citizens’ equal access to high-quality health and social services.”

What will happen to the personnel?

“About 220,000 municipal and partly also central government employees will be transferred to another employer. They will in effect become employees of the new counties or counties’ service utilities and companies that belong to county corporations. This will be carried out as a transfer of business, so to say. The employees will be transferred to the new organisations and their old employment terms and conditions will be preserved. The biggest issue for the personnel is that they are themselves the most important factor in this operational reform. In other words, multi-professional cooperation is now expected even more, and specialists in social matters and health matters will be collaborating to find solutions to clients’ problems. This is perhaps the biggest change from the personnel’s point of view in the long term.” 

What is the schedule for the comments?

“We have requested that the comments for the draft proposals be submitted to the Ministry by 16.15 on 9 November. When we finalise the government proposal, we can only take into consideration the comments that were submitted by this deadline. The intention is to submit the government proposal towards the end of the autumn plenary session or at the very beginning of the spring plenary session in order to allow Parliament to consider the content of the legislative package in spring 2017 and the legislation to enter into force at the beginning of July 2017.

It is very important that the comments are submitted preferably in good time and not left until after the deadline. This way we can ensure that all necessary points of view can really be considered when we finalise the legislative proposals and their arguments.”

Further information

• Instructions for submitting a comment on the draft proposals on the health and social services and regional government reform (YouTube)
• All health and social service providers will soon have to register (press release 31 August 2016, in Finnish)
• Draft proposals on the health and social services and regional government reform circulated for comment (press release 31 August 2016)

Video: Kimmo Vainikainen