Government session on spending limits agrees on the future of hospital network

The Government reached an agreement on the future of the network of hospitals and urgent and emergency health services in its spending limits session. It decided that changes would be made to night-time emergency care services in primary healthcare and to specialised healthcare in certain hospitals. The aim is to balance public expenditure and respond to the shortage of healthcare personnel.

However, each wellbeing services county will continue to have a central hospital equipped to provide childbirth services and perform surgical procedures in a comprehensive manner. The Government decided not to go ahead with the proposal of the hospital network working group that was published earlier this year and that would transform some of the central hospitals into acute hospitals. 

Impact on night-time emergency care services in different areas

In line with the Government’s decision, the wellbeing services counties and HUS Group may, as of the beginning of 2026, maintain night-time emergency care services in primary healthcare in Ivalo and Kuusamo due to long distances and in Jakobstad and Raseborg to ensure the realisation of linguistic rights. In addition, night-time emergency care services in primary healthcare could be continued in Kemi and Savonlinna if the relevant wellbeing services counties so decide. The current practice concerning derogations will be discontinued. Night-time emergency care services will end in Iisalmi, Jämsä, Kouvola, Raahe and Varkaus on 31 December 2025 at the latest. All wellbeing services counties will be free to provide more urgent appointment services during evenings and weekends, because this can reduce backlogs in emergency care services at hospitals. 

Changes in specialised healthcare and hospitals

As from 1 January 2026, the hospitals located in Kemi, Oulainen, Salo, Savolinna and Valkeakoski may continue to perform outpatient surgeries, but they cannot perform more demanding procedures that require 24-hour preparedness and operating theatres. Thus, if the wellbeing services so decide, these hospitals may continue to have a wide range of outpatient clinic activities in different specialties (such as a maternity outpatient clinic) along with inpatient care in conservative specialties and the emergency care services required by it (e.g. internal medicine and its subspecialties, neurology, dermatology, psychiatry, cardiology, oncology, respiratory medicine). Kemi will stop providing childbirth services when the special permit granted to it will cease on 31 December 2025. HUS Group will decide on the service range, emergency care services and childbirth services in its hospitals in Uusimaa. The wellbeing services counties may maintain the emergency care services required by hospital wards in their different hospitals.

Performance and procurement of procedures and surgeries

In future, certain procedures under light anaesthesia (e.g. psychiatric electroconvulsive therapy under light anaesthesia, cardioversion, a certain dental treatment under anaesthesia) may be performed by any healthcare unit which has sufficient skills and expertise and which can ensure patient safety. The wellbeing services counties may also procure these procedures from private service providers.

In addition, day and short-stay surgery may be procured from private service providers. In future, the wellbeing services counties belonging to the same collaborative area for healthcare and social welfare will agree on the principles of procurement in their cooperation agreement.
Further provisions on the above-mentioned procedures and surgeries will be laid down by decree. This possibility will be available as soon as the relevant decree has entered into force. The aim is for the decree to enter to into force in early 2025.

Demanding surgery that requires 24-hour preparedness and operating theatres may be procured from private service providers only if the service provider’s hospital is in the immediate vicinity of a university or central hospital and if it has an inseparable operational connection with them. Therefore, it will continue to be possible to make use of the services of the Coxa Hospital for Joint Replacement and the Heart Hospital, for example.

Economic impact on wellbeing services counties

Changes concerning hospitals and urgent and emergency health services will produce a saving of EUR 26.3 million in the finances of the wellbeing services counties from 2026 onwards. In addition, the economic impact of the wellbeing services counties’ own decisions on the network of hospitals and urgent and emergency health services will become clear in the ex-post control of county funding.

The Government will continue the joint preparations and dialogue with the wellbeing services counties as to how to further develop the division of responsibilities and cooperation in specialised healthcare and how to respond to the shortage of personnel. The aim is to ensure a well-functioning division of responsibilities between the university hospitals at the national level and between the university and central hospitals at the regional level. New forms of working across the boundaries of the counties and collaborative areas will be sought through cooperation, with the aim of curbing the costs of the wellbeing services counties by EUR 25 million a year from 2026 onwards.

Inquiries

Nuutti Hyttinen, Special Adviser to Minister of Social Affairs and Health Kaisa Juuso, tel. +358 295 163 073
Sirkku Pikkujämsä, Senior Ministerial Adviser for Medical Affairs, Ministry of Social Affairs and Health, tel. +358 295 163 014