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Union slams government’s healthcare reform

Finland's much-trailed reform of social and healthcare services is supposed to increase competition among service providers, but that competition has caused concerns among some in the industry. One trade union says that private sector operators will have an in-built advantage when tendering for contracts.

JHL:n osaavaa voimaaa -juliste
Image: Yle

That's the charge from one healthcare workers' union, which says the government is looking to run down public healthcare providers.

The sector is heading for a big shakeup. After an upcoming reform, municipalities will no longer have responsibility for health or social care--that will pass to regional bodies which will commission services from public and private providers.

The JHL union, though, has spotted a problem. According to the government's plan announced in April, these bodies will have to commission a minimum share of services from private or third-sector outfits.

Competition neutrality

That's clearly a disadvantage for the public sector, says the JHL's Marjo Katajisto, as public providers will be run down and private outfits boosted.

“There was a principle in government whereby there should be neutrality in competition, so that every service provider has the same starting point,” said Katajisto. “But if there’s a minimum requirement, so that within every province there should be a minimum amount of private sector provision, then that runs counter to the principle of neutral competition.”

The Ministry of Social Affairs and Health denies any compulsion in their plans. It's a target, not a requirement, says project leader Tuomas Pöysti, and it may bring a new dynamic to healthcare.

Regional variation

“The markets are very different in different provinces, and for that reason the percentages will be different for example in Uusimaa compared to other provinces,” said Pöysti. “The percentage shares will vary between a few percent and 30 percent.”

Sparsely-populated rural areas, in other words, will have a lower target for private provision than the bigger provinces in the urban south.

The proposals are due to go out for consultation in the summer.