Finnish municipalities to be obliged to upgrade child and youth preventive health careFor the most part Finland's decentralized system of social and health care is run by municipalities according to statutory regulations but also non-binding guidelines.
Such guidelines are used when it comes to preventive health services for children and young people provided at maternity and child health clinics, and the school and student health care system. These guidelines are to be strengthened according to a statute issued by the government at the end of May concerning maternity and child health clinics, school and student health care and preventive oral health care. The new measure will introduce statutory health examinations in maternity and child health clinics and in school and student health care.
The move could appear to be a speedy piece of policy maneuvering. Times of recession are often periods when the non-statutory aspects of services get cut. The decree on preventive child and youth health care is nevertheless fortuitous, according to MSAH Senior Officer Marjaana Pelkonen. "It's a complete coincidence that the decree is being done at this point, but if ever there was a need for it now's the time."
Pelkonen says that work on the decree was started before the onset of the current recession. It was prompted by the wide variation nationwide in the quality and availability of child and youth preventive health care.
"Another reason is that the adversity, care orders and the costs of child protection are increasing. The inadequacy of preventive services is seen in the increasing need for corrective services"
Changes to legislation on state subsidization of municipalities in the early 1990s, when Finland was also hit by recession, resulted in local authorities having a freer hand in arranging social and health services as they saw fit. Some municipalities reduced the preventive services and periodic check-ups in maternity and child health clinics and schools. The situation did not return to its former state during the subsequent period of economic boom.
"The rising pressure of costs could be curbed if the need for corrective services and measures can be reduced," says Marjanna Pelkonen. "This could succeed by making school and student health care more effective as a part of municipalities' multi professional service networks."
The aim of the new statute is to tackle social exclusion and to reduce the large health gaps existing in Finland. Maternity and child health clinics and school and student health care play a key role in this, because they extend to all children, youth and their parents from birth to the start of working life. Optimally, they can be used to deal with the problems facing families and children at an early stage.
Until now, municipalities have organized services according to legislation, but the content of these services has been subject to recommendations and guidelines. Once the new statute takes effect, municipalities will be obliged to arrange services accordingly.
The new measure takes effect in July this year. Municipalities will be given a transition period in which to reorganize their service content. The use of periodic health check-ups related to preventive health care for children and young people should be in place by the beginning of 2011.
The organization of services in line with the statute may require that local authorities rearrange their human resources, training and make staff increases. The costs of these will be covered by an adjustment to the state subsidy to municipalities at the beginning of next year.
"We have the experience, knowledge and methods for preventing children's and young people's problems, if only the children in need of help can be identified in time. We need to make use of this expertise," says Marjanna Pelkonen.