Politicians – No Excuses for Healthcare Disaster

All the big political parties here have known for the last 20 to 30 years that the Finnish society will age like a barrel of fine cognac. Given that this was a clear and indisputable fact then, you would have thought that these clever people would have been well prepared!

There was more than enough time for them to have solved the challenges of an aging population, which are the following:

  1. An aging population and increasing need for healthcare services
  2. Older folk need a lot of care from nurses, doctors, and care-workers in public sector healthcare for the elderly. We know that there is a shortage of doctors and healthcare workers because of a shortage of training places, tough workloads, and relatively low salaries compared to our Nordic neighbors.
  3. Older folk need safe, small homes where they can find the care they need when they are unable to manage by themselves.As more people retire from the work force, they need to be replaced, but because fewer babies are born, we need to invite foreigners to work here.

So, what have our politicians been doing to make sure that all of the above four matters are dealt with properly?

Here are the answers with a few official statistics:

In 2020 it was reported that Finland will need around 30,000 more nurses, in addition 50,000 healthcare staff, by 2030 to meet the demands of an aging population. This was set out in parliamentary bill that proposed a minimum nursing quota for round-the-clock care for the elderly of 7 care-workers for 10 residents. According to Teppo Kröger, Professor of Social Policy, “Even in this decade, the need for recruitment is great. In the 2030s, the need for both services and staff will grow even faster, as large age group populations will then become clients of care services,” Kröger said.

A new Finnish health care system has been introduced by the last governments, but public primary health care has continued to suffer from a lack of medical doctors, and this shortage has gradually gotten worse.

A series of recent report comment on this last point which has been known for years:

During the last decades Finland has suffered from a lack of doctors amongst other health care professionals in primary health care. The reasons behind the problem are many. The small number of physicians tends to be seen as the main factor in public opinions and debate (Aaltonen & Ruskoaho, 2023), but things like the vastly debated renewal of Finnish health care and poorly conducted IT-solutions like launching an electronic record system called Apotti cannot be put aside.

These events are examples of administrative actions that have put a lot of pressure on the health care field. Due to the renewal of Finnish health care the responsibility of producing the services has been shifted from municipalities to broader health care regions causing big changes on the responsibilities, finance and administration (Valtioneuvosto, 2023).

Professionals in the Finnish health care have expressed dislike towards the renewal due to high hierarchy, incompetent leadership, increased workload, decreased safety of patients and prob- lems in salary payments (Kokko, 2017).

Apotti, on the other hand, has not only been expensive, but also not user friendly and has even caused doctors to resign from their jobs in primary health care in the busiest regions in Southern Finland where the system is in use (Kuokkanen, K. & Takala S., 2022).

The shortage is particularly acute in rural areas and in certain specialties, such as primary care and geriatrics. This means that patients may have to wait longer for appointments and may not be able to see their preferred doctor.

The Finnish government is surely aware of the problem and the new government claims to be taking a number of policies steps like increasing the number of training capacity for doctors and nurses, investing in new technologies to improve the efficiency and productivity , and offering financial incentives to doctors and nurses to work in rural areas and in certain specialties. Increasing training is years too late to improve numbers significantly in the next few years, the Apotti system is an expensive digital system that appears to reduce productivity, and financial incentives has led to the private sector profiting from blind government generosity as doctors and healthcare workers moving to the private sector, forcing the public sector, with fewer resources, to outsource these services at a higher cost.

However, the shortage is expected to continue for some time, and it is important to be aware the impact on patients is dramatic with less needed care and longer waiting times for life-saving surgery. Preventive care appears to be the lowest priority for former and present governments with “Own Doctor” policies that are always mentioned but seldom implemented.

Here are some recent headlines from the news at Yle, the national broadcaster, about these shortages:

  • “Nurse shortage eats away at ward beds” (Yle, July 2023)
  • “Finland faces public sector doctor shortage” (Yle, March 2023)
  • “Helsinki faces Finland’s worst-ever labour shortage” (Yle, February 2023)

Based on recent data, the annual average of doctors and healthcare workers has remained relatively stable between 2000 and 2023, with slight increases of nurses and midwives. However, Finland’s population has been aging during this time, which means that there is a growing demand for healthcare services.

In conclusion, it is quite clear that the present and past governments have not addressed the needs of the healthcare sector in Finland, and it appears that the present government is even less inclined to attack the challenges because they continue to talk about how the private sector healthcare companies can quickly alleviate these problems. However, they do not publish how this will be achieved with less money and they certainly do not invest heavily in new training of doctors, nurses and healthcare workers. Furthermore, their attitude to inviting foreigners to work in the sector is not furthered by the manifesto of the True Finns, their coalition xenophobic partners in government!

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