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Law drafting continues for the regional government, health and social services reform. The proposals for the Freedom of Choice Act and the Act on the Financing of the Counties that are under consideration in Parliament will be amended as required by the statement of the Constitutional Law Committee of Parliament. Parliament will decide how the regional government, health and social services reform will proceed in the autumn term 2018. The aim is that the responsibility for organising health and social services would be transferred to the new counties on 1 January 2021, while freedom of choice would come into force in stages.

What will everyday life be like for you after the regional government, health and social services reform?

Building our everyday future

Securing future services for everyday life in Finland

The regional government, health and social services reform is all about securing future services for ordinary everyday life, a life that is of a good standard and takes equality issues fully into account. The reform is being carried out to ensure that everyone, including our children and their children, can have high-quality public services on an equal basis throughout the country. The reform will also improve people’s opportunities to participate. Residents of the counties will be able to make their voice heard more easily than before in matters affecting their own lives, their loved ones, everyday life and the environment.

 

The reform is scheduled to enter into force on 1 January 2021.

How will you be able to have a say on matters in your county? And why would it be worth doing so?

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The regional government reform will bring a further level of democracy, increasing the power in your hands. Have your say in the future of your county by voting in the county elections!

You can have your say on who in your county will make decisions on employment services, environmental matters, health and social services, land use planning, transport infrastructure and agricultural development, among other matters. Decisions concerning your area which were previously made by regional offices of state or joint municipal authorities (ELY Centres, Regional State Administrative Agencies, TE Offices) will now be made directly by those selected for the job by you and the other residents in your area. Make a difference to your county’s future right from the start!

County councils will have great responsibility and power concerning the development of the area and the organisation of services. By voting, you can help determine the matters that will be promoted by your county. You can also stand as a candidate in the election. Either way, help create the county you want to live in!

  • The county council elected will outline the strategy and future of your county, and will take responsibility for economic planning. Right now is the time to lay the foundation of your future county.
  • The county council will make decisions for the county as a whole, reaching across municipal boundaries. If you want to make a difference to the future of your entire county and your own municipality within it, make sure you vote – you may, of course, decided to stand as a candidate.
  • You can vote for the candidates of your county if you are at least 18 years old and a citizen of Finland, or a citizen of the EU, Iceland or Norway living in Finland, or if you are from outside the EU but have lived in Finland for at least two years. The size of each county council will vary according to the number of residents: the smallest counties will have a minimum of 59 councillors and the largest a minimum of 99 councillors.

The reform will also increase other direct opportunities to have a say

You can make your voice heard by voting in the county elections, and also through youth councils, older people’s councils, disability councils, client panels, county initiatives and county referendums. In each bilingual county there will be a language minority committee (Finnish or Swedish), and in the county of Lapland a Saami language minority committee.

What will everyday life be like for you as an ordinary resident of the county?

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Your county makes at least these three promises to you as a resident:

  • The level of democracy in decisions regarding your area will increase, and you will have a greater opportunity to make your views heard in matters concerning to you and your county.
  • Important publicly funded services will continue to be provided and available to you.
  • Future generations, too, will continue to have access to high-quality public services on an equal basis.

After the regional government, health and social services reform, most things will go on just like they did before: children will go to school, public transport will run as normal, people will go to work and pursue their hobbies, health centres will serve people… Life will go on as usual. However, there will be some new things as well. People will have more opportunities to have a say in the development of their area and in events locally, through county elections, resident panels and the right of initiative. Youth councils, older people’s councils and disabled people’s councils will also seek to improve matters in the area where you live.

Health and social services will be the responsibility of the county instead of the municipality. In practice, this will mean that services are available as comprehensively as possible to everyone: children, young people, adults and older people. The participation of private companies and organisations in the production of health and wellbeing services will bring increased freedom of choice.

Counties will also aim to secure the economic success of their area and to promote business growth and employment. Services for jobseekers and companies will be under one roof in the counties, under the title ‘growth services’, which will focus on improving employment and business competitiveness in the area.

Digital services are also increasing. This means that personal online appointments with experts in various fields are now possible even in more remote areas. These could include doctor’s consultations, employment advice, family support services and business services. Many services will also be on four wheels and go where the clients are.

Decisions regarding your environment, nature and the utilisation of natural resources will be made closer to you, as a resident of the area. The opportunities for you to actively participate will increase.

What will everyday life be like for you and your family?

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Your county will make at least these three promises to you and your family:

  • You will be able to choose health and social services suitable for your family on a more extensive basis.
  • Your entire family will receive the health and social services they need, with increased freedom of choice.
  • You will receive help and support for your family’s everyday life according to your family’s situation and needs. If you ask for help at the daycare centre, maternity and child health clinic, health and social services centre, or school, you will be directed to the right place.

After the regional government, health and social services reform, your everyday life might be something like this: your children go to daycare and school just like they would now, visits to the maternity and child health clinic continue in the same fashion, and hobbies also continue as before. Your home municipality manages daycare centres, schools and many sports and culture services. What’s new is that the services and support for different life situations are brought closer to the everyday lives of children, young people and families, for example in daycare centres and schools. This way, the municipality and county cooperate across borders, for the good of families.

What if my family runs into sudden adversities, illness or financial difficulties?

The regional government, health and social services reform is intended to strengthen safety networks and make services for families more readily available, as they will be provided by larger operators and in more effective ways. Services will continue to be available for those who need them, but there will be more freedom of choice, as publicly funded services will be provided not only by public operators but also be private and third-sector operators. The services will be knitted together into a network which ensures that the need for support is recognised in time and families can receive the help they need when they need it. The services will continue to cover the entire country as equally as possible, no matter where you live.

If everyday life is to continue as before, why should I care about the reform?

Families with children have a direct connection with the future, and the lives of their children and of future generations will be affected by the choices we make today. The regional government, health and social services reform is being carried out to ensure that future generations can have access to high-quality public services on an equal basis throughout the country, and at reasonable cost. The future of your children should be reason enough for you to be interested in the improved opportunities for you to have your say. Find out more about the county elections.

What will everyday life be like for you as you grow older?

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Your county will make at least these three promises to you as an older person:

  • With the aid of versatile home services you will be able to enjoy a good everyday life in your own home for as long as possible.
  • Health and social services centres will be there to serve you just as before, and the emergency number to call will still be 112.
  • You will have better opportunities to have a say about the services provided in your area, through, for example, the older people’s council, county elections and public consultations.

Pensioners, most of whom are active and healthy, will be able to continue their lives unchanged even after the reform. Your municipality will remain in charge of your everyday environment and sports and culture services. When you grow older or your circumstances so require, you can turn to the county’s versatile home care services, which allow everyone to lead a good life at home for as long as possible. If you are alone, you can also find support from various organisations offering activities you may like to engage in.

Healthcare and medical care, home care services and housing services for older people are among the most significant cornerstones of the reform. The objective is that, as the population ages, society will still be able to offer high-quality public services to everyone around the country on an equal and more diverse basis, regardless of where they live. One of the most significant objectives of the reform is to ensure that everyone can have a dignified and good life when they grow old.

What will everyday life be like for you as a student?

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Your county will make at least these three promises to you as a pupil, student or other young person:

  • You will receive the health and social services you need in a smart way, according to your life situation and needs.
    • There will be more digital public services and these will go with you wherever you are, at all times.
    • When you complete your studies and look for a job, you will have access to a wide range of employment, career and skills development services.

After the regional government, health and social services reform, studies, school attendance and student life will continue just as before. Your current home municipality and other familiar education providers will continue to be responsible for education provision, from preschool up to vocational studies. Neither will the reform change the status or operation of higher education institutions. The reform will not change the funding of your studies either.

Student care services will be available to you no matter where you live in Finland. As a student in upper secondary school or vocational education, your county will provide any healthcare or dental care services you need. If you study at a university or university of applied sciences, the student healthcare services will be available through the Finnish Student Health Services (FSHS). If you are in urgent need of medical care, you will also be able to turn to a health and social services centre of your choice.

If everyday life is to continue as before, why should I care about the reform?

There is one crucial change that you should notice: you will be able to view the future with greater confidence; a future where society will be able to function successfully on the basis of tax revenues from the hard work of your generation. Thanks to the reform, the cost of the services needed to maintain the welfare state will have been kept in check. You and the generations after you, throughout the country, will have public services of the highest quality and of an equal standard, regardless of other factors. You will also have a better opportunity to have your say about decisions made in your region. Find out more about the youth councils and county elections.

What will everyday life be like for you as a jobseeker?

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Your county will make at least these three promises to you as a jobseeker:

  • You will get help and support at all stages of your working life, in finding a job, making career choices and developing skills.
  • Digital services will be further developed to complement existing services.
  • If you need more extensive support for finding a job, health and social services can be more flexibly combined with employment services.

The regional government, health and social services reform is a significant step forward in the provision of more effective employment services, as the current TE Services and the ELY Centres’ business services become the responsibility of the new counties. When your county organises services for companies and jobseekers, the aim will be to ensure that experience, skills and vacancies can be better matched up than before. As a jobseeker, you will continue to get help and support for finding a job or making career choices and for developing skills throughout the various stages of your career. Digital services will complement face-to-face services. The aim is to continue developing online services and be able to offer personal guidance online to jobseekers, for example. Your municipality will still be able to organise local services, such as workshop activities, and will remain in charge of vocational education.

As employment services are transferred to the counties alongside health and social services, even those who are termed the least employable will be able to get help and support more effectively for their individual needs and abilities, as well as rehabilitation, and the services will work in a more seamless way.

What will everyday life be like for you as the owner of a business?

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Your county will make at least these three promises to you as the owner of a business:

  • It will become easier to match up jobseekers and the needs of employers.
  • You will be able to obtain services and support for business establishment, development, growth and internationalisation.
  • As a resident of the county, you will have a greater opportunity to make your views heard regarding the development of your business environment.

Your everyday life as the owner of a business is unlikely to change dramatically after the reform. Many services and decisions that support the framework of entrepreneurship will remain the responsibility of your municipality, including land use planning, business location services, business advice services, energy issues and road maintenance.

However, the reform may bring new opportunities for developing the region’s vitality and economic base. With TE Services and the ELY Centres’ business services moving under the same roof, it will be easier to bring together the needs of the workforce and companies.

The reform aims to better respond to the rapid changes in the needs of companies and the labour market, and to find the best ways to increase the vitality of the area. Service provider companies will be increasingly included in the production of employment and growth services, creating new innovations and markets in the process. This will also open up new business opportunities for local businesses and increase the range of business services offered to suit the needs of local businesses: training, consultancy and development services. This means that your county will offer the support and services you need for founding, developing and internationalising your business. You can also access the Business Finland innovation funding and internationalisation services via your county.

Entrepreneurs and businesses often play an active role in the development of their local area. The scope for people, too, to participate in the development of their county will be broadened with the regional government, health and social services reform. Land use policies, transport infrastructure and many other structural matters will be decided upon by county councils, which are elected in county elections. The development of the area will also be affected by input from various advisory councils and client panels, and by the right of initiative. Increasing participation will also be good for businesses in the area.

Rural enterprises

Access to services in a single location will make life easier for rural enterprises too. The regional government reform will bring together the rural entrepreneur services now offered by the Centres for Economic Development, Transport and the Environment (ELY Centres), Regional State Administrative Agencies (AVI), joint municipal authorities and municipalities. It will be easier to do business with one single organisation.

The main thing is that you will still find help and support – including personal advice – just a reasonable distance away in all matters concerning your enterprise, including criteria for support payments, farm relief services and animal health issues. Your county will advise you in farm support payments and in matters concerning the development of agricultural holdings, including investment. Digital services are constantly being improved, also enabling virtual access to expert knowledge and assistance.

Many entrepreneurs and companies are active in developing their area. The regional government and health and social services reform will open up new venues for the residents to get involved in the development of the entire county. Decisions on land use policy, transport infrastructure and other strategic and structural matters will be made by elected county councils. Other means to make things happen include the right of initiative, various boards and councils, and client panels. Better opportunities for citizens’ participation is also in the interest of the companies and business.

What will everyday life be like for you as a person with a disability?

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Your county will make at least these three promises to you:

  • Your county will offer you all the health and social services you are entitled to by law even in the future.
  • Your right to self-determination will be stronger in health and social services. You will have more freedom to choose the service providers that best suit you.
  • Your rehabilitation services will be more effective.

The health and social services reform will safeguard equal access to services for persons with disabilities. The responsibility for organising services for persons with disabilities will be transferred from the municipalities to the counties. Persons with disabilities will have more freedom to choose their health and social services. The counties will be obligated to offer their clients guidance and advice in making choices and safeguard their language rights.

If you need many different kinds of services, you can get health and social services vouchers or a personal budget from your county. The services you can get with them will be defined in your client care plan, based on an assessment of your service needs. With a services voucher you can buy a specific service, such as housing services, home care or physiotherapy.

With a personal budget you can get the services recorded in an official decision and your client care plan and to which you are entitled by law. You will be able to plan yourself – or together with your family or a close friend – in more detail the content of the services you can get with your personal budget. You will be able choose your service providers. You could use the personal budget to get housing services or day activities, for example.

You will be responsible for covering the costs of any services you get which are not provided as public services or to which you are not entitled by law.

Rehabilitation services are being developed as part of the health and social services reform
Persons with disabilities can get support for their functional capacity and work ability. This will improve their wellbeing, help them cope with everyday life and live at home and make it easier for them to study and work and be active in different kinds of communities. In the future, the counties will be responsible for the rehabilitation services package available in the region.

There will be a new act on services for persons with disabilities, replacing the existing Act on Services and Assistance for the Disabled and the Act on Special Care for People with Intellectual Disabilities. The proposed act is scheduled to be submitted as a legislative proposal to Parliament in autumn 2018. The act is due to enter into force in 2020.

The new act on services for persons with disabilities will safeguard sufficient, high-quality services even in the future and reinforce the possibilities of persons with disabilities and their families to influence their services. The reform will preserve the current rights to services, such as support for housing, personal assistance and transport services.

What is the regional government, health and social services reform?

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Important details to know about the counties’ new duties, decision-making and services.


This section includes information on what the new counties will do and how decision-making will be carried out in practice in the counties. These have been provided on in the Government’s legislative proposal. New legislation is currently being reviewed by Parliament, and the Parliament will make decisions on them in autumn 2018. The reform is due to enter into force on 1 January 2021.

Read more

Duties of the counties will be visible in the everyday life of residents

+ Wellbeing and health Read more

The first priority of the reform is to ensure that high-quality health and social services are available to everyone on an equal basis, regardless of where they live. Your county will be responsible for organising the services, which will be provided by public, private or third-sector operators.

This means that in many cases you will be free to choose the provider of the health or social services you need, as long as the provider is approved by the county. The client charges will be the same whether you receive the service from a public, private or third-sector operator. You will also be able to choose which of the county’s units you visit when you need, for example, a maternity and child health clinic or a social centre.

The municipalities, the county and the private operators in the area will cooperate closely. This is to ensure that residents have quicker access to doctors and other services, waiting times are reduced and service chains are combined smoothly.

Local services will still play a significant role in your area. For example, you will be able to continue using maternity clinic services as before, and occupational health services will also continue unchanged. The increased amount of digital services will make your everyday life more flexible. For instance, you will be able to make appointments and ask for advice online, or make a virtual appointment with a remote doctor. The maternity clinic will carry out family work at home if necessary, and home services will be available to assist older people with their everyday lives. In sparsely populated areas, services will be brought close to those who need them using mobile units, such as vaccination buses or dental care buses.

If you need urgent care, you can go to the nearest out-of-hours service, just like today, and in the event of an emergency, the emergency number 112 is there to help. The primary and specialised emergency care services of the central hospitals will continue to provide the most commonly needed emergency care services, but the most demanding treatments will only be available in the 12 designated hospitals with extensive emergency services. Most of us will  need such services only rarely, perhaps once in a lifetime. In social services, out-of-hours crisis care will also be available.

Of course, people need much more than just healthcare services to ensure their overall wellbeing. Exercise, hobbies and arts and culture services are also a significant part of wellbeing, and these will remain the responsibility of your home municipality. Peer support and the service offered by various organisations can also help improve your general wellbeing. Many of the local decisions concerning the attractiveness of your living environment, the built-up area and the natural surroundings are still made in your home municipality. However, the creation of the counties now means you can have a stronger and more direct say on the development of your area, in questions related to the environment and nature, land use planning or the cultural environment.

Health and social services of the county:

  • health and social services centre services
  • hospital services
  • dental care
  • mental health and substance abuse services
  • maternity and child health clinics
  • adult social work
  • child welfare services
  • disability services
  • housing services for older people
  • home care
  • rehabilitation

+ Environment Read more

Decisions on environmental matters are of considerable and growing importance for the wellbeing and future of individuals, businesses, society and the entire world. After the regional government reform, many environmental matters and questions related to economic activity and transport will be transferred to the new county government, elected by the residents of the county. You will have more opportunities to have a say on the development of your living environment, whether as a voter or active participant, or by submitting initiatives.

Responsibility for the diversity of the natural environment, the broad land use strategy, transport, waterways and marine management, and the cultural environment in your area will be largely in the hands of your county. The county will promote sustainable development, a low-carbon society, energy and material efficiency, climate objectives and the circular economy. Your county will also cooperate closely with the National Supervisory Authority (Luova) in environmental matters.

The county’s duties include management of waterways and marine areas in a way that ensures the condition of rivers, lakes, groundwater and the Baltic Sea is good and that waterways and the Baltic Sea remain uncontaminated. Your county will also ensure that the transport and land use plans support the sustainable development of the area. In addition, counties that include coastal areas will cooperate closely with each other in matters related to the use of the sea and will coordinate the needs of fishing, tourism, transport and the area’s businesses and residents. Financial support for waterway protection and waterway repairs will be transferred to the counties.

The counties will promote the protection and sustainable use of natural diversity. They will negotiate with the landowners on founding voluntary nature conservation areas and will seek to ensure that ecological values are taken into consideration in the planning of land and water uses. Counties will collect information on natural habitats and the plant and animal species in their area. They will also produce information on the environment, promote environmental responsibility among their residents and corporate environmental management work, and will organise environmental education.

Transport and mobility are essential to a well-functioning living environment. Your county will play a significant role in this as well, maintaining the main roads in the area and determining its policy towards these, ensuring the condition of the infrastructure for residents and businesses. The street networks and urban environments will remain the responsibility of the municipalities.

Your living environment, land use planning, and construction will remain for the most part in the hands of your municipality. If you wish to build an extension to your house, for example, the instructions are the same as before: apply for a building permit from your municipality. The counties will be responsible for broader policy matters and for the county land use plan.

A good and safe living environment is the foundation for all wellbeing and a solid base on which to build a dynamic and prospering county. A good environment will create the conditions for entrepreneurship, food production and sustainable use of natural resources.

The county’s environmental duties:
* county planning and county land use planning
* promoting municipal land use planning
* waterways and marine management
* marine area planning
* promoting environmental protection
* managing cultural environments
* producing environmental information

The county’s transport duties:
* functioning of the transport system
* traffic safety
* road and traffic conditions
* regional road management
* land use cooperation
* producing information on the operating environment for national transport system planning
* duties concerning discretionary government transfers for private roads and mobility guidance

+ Employment Read more

One of the objectives of the regional government reform is that jobseekers can find work and companies can find employees more quickly. This is why the public employment and business services are being reformed as well. The duties of the TE Offices and the ELY Centres will in future be the responsibility of the counties. Therefore, your county will organise business services and jobseeker services.

You will be able to get help and support for finding a job, making career choices and developing your skills, throughout your working life. Digital services will complement the face-to-face services. Finland has many sparsely populated areas and there are long distances between population centres, which makes it important to continue developing online services and to be able to offer personal guidance online to jobseekers. Your municipality will still be able to organise local services, such as workshop activities.

With the employment services and health and social services being brought under the same roof in the new counties, residents will be able to receive more seamless support for their individual needs and abilities, as well as rehabilitation for working life. Counties will cooperate closely with companies, organisations and municipalities in the promotion of employment. Through combining the competences of various operators, it will be possible to provide more versatile, client-oriented services for jobseekers and for businesses.

Read more at tem.fi/en

+ Businesses and entrepreneurship Read more

The conditions for engaging in business activities and for entrepreneurship  will be significantly improved throughout the country when services supporting labour availability are brought together with other services that support business competitiveness and growth.

The ELY Centres’ business services and the duties of the TE Offices are to be transferred to the counties. The objective is to respond faster and more flexibly to the needs of companies and to the changes in the employment market.

In the future, counties will be able to better adjust their services to the needs of their area. Service needs vary between counties as a result of the differences in population structure, occupational composition and employment characteristics. The counties will be able to provide a more customised  service for their clients. If you run, or plan to run, a business, you will have access to services and support for founding, developing, expanding and internationalising your company. These services will be increasingly provided by private companies, which will go through a tendering process organised by your county. This will encourage innovation and new business locally.

You will also be able to access the Business Finland innovation funding and internationalisation services via your county.

Read more at tem.fi/en

+ Rural areas, food and natural resources Read more

Responsibility for rural development will be transferred to the counties, closer to clients. Agriculture, food production and rural development together cover a broad range of matters, including agricultural subsidies, food safety, animal health and wellbeing, veterinarian services, plant health, the fishing industry, natural sources of livelihood, water resources management and flood protection. Most of the duties of the ELY Centres, the Regional State Administrative Agencies and the municipalities will now be combined under one roof in your own county, in which decisions will made by the elected county council.

The counties will ensure that the conditions are in place for the active development of your area, and for entrepreneurship and food production, as well as the sustainable utilisation of natural resources. Responsibility for agricultural subsidy management and farm relief services will be transferred from the municipalities to counties. Cooperation between municipalities and counties will ensure that the services reach farmers and rural residents across the county on an equal basis and are provided in an effective manner. Most of the expert tasks related to the fishing industry and water resources management will also be transferred to the counties. In the case of waterways which cross county boundaries, the counties will cooperate closely to ensure that all of the duties are expertly managed. Securing the wellbeing of people, animals and the environment will be one of the most important duties of your county.

+ Safety Read more

Every resident has the right to a safe living environment, to emergency and other help, and to be able to cope in a crisis situation. This will, of course, still be the case after the regional government reform. Personal safety is typically related to whether emergency or other help is available when needed. Such services will be the responsibility of the county rescue departments. Access to these services and their availability in an accident or other situation will remain at or above the present level: a fire engine or ambulance will arrive at the scene at least as quickly as before. In an emergency, call 112 for help. Prehospital emergency medical services will continue to be a local service. These services will contribute to the assessment of the customer’s need for care and begin urgent treatment. Urgent medical care in the form of 24-hour primary healthcare and specialised medical care services will be available to everyone, as will emergency social services.

The regional government reform will not affect policing. The police will respond to a call in the same way as before.

Environmental safety and crisis preparedness are the job of your county. This means that your county decides how to respond to natural disasters, environmental disasters and other major and unforeseen situations. If, for instance, transport or communications links to a community are cut due to a major snowfall or an autumn storm, the county authorities will be responsible for the provision and management of the necessary rescue services.

Your county will also be responsible for ensuring that there is no danger to you or the environment from environmental toxins, environmental contamination or hazardous substances. The management of flood risks is also the task of the counties, which will work closely together across the different river systems, and collaboration with county rescue departments will be even closer than before.

The most important thing to remember, though, is that whatever the emergency, the number to call for help is the familiar 112.

What are the counties?

On the map, click on any county to see which municipalities are in that county.

After the reform is in place, there will be 18 counties, which are scheduled to begin their operations on 1 January 2021. The new counties will be autonomous regions.

 

FIND OUT MORE ABOUT YOUR COUNTY
Find out more about the progress of the reform in your county, read about local preparations, and participate in discussions. Click to go to your county’s website:

FAQ

+ What is the regional government, health and social services reform?

In the regional government reform, Finland’s current regions will cease to exist and will be replaced by 18 counties. Decision-making in the counties will be performed by county councils composed of councillors elected in county elections. The municipalities will remain, but some of their duties will be transferred to the counties. Most of the duties of the ELY Centres, TE Offices, Regional State Administrative Agencies and joint municipal authorities will also be transferred to the counties. The counties will not have the right to collect taxes; rather, their funding will come from central government and from client charges. The counties will be responsible for organising the health and social services for their respective areas, for ensuring the availability of the services and for ensuring freedom of choice in accordance with the Freedom of Choice Act.

+ When will the reform take place?

The exact time for the first county elections will be determined after Parliament has decided on legislation concerning the regional government, health and social services reform. In these elections, the residents of each county who are entitled to vote can elect the members (councillors) of their county council. The number of councillors will vary according to the size of the county, measured in terms of its population. The minimum number of county councillors will be 59  for the smallest counties, and  99 for the largest ones.

After election, the county councils and counties will get organised, and they will make decisions on the organisation of health and social services and the implementation of freedom of choice.

The regional government, health and social services reform will take effect on 1 January 2021, at which time the responsibility for organising health and social services will also be transferred to the counties. The freedom of choice will be expanded in stages.

+ Will the reform increase bureaucracy?

Quite the opposite! The main idea of the entire regional government, health and social services reform is to establish a system of administration in Finland that is modern, streamlined and cost-efficient, and which serves people in a client-oriented manner.

The number of different administrative organisations will be radically reduced, as some 190 inter-municipal or other organisations will be replaced with 18 counties which will manage the duties of approximately 400 municipal or central government authorities. This means a giant leap towards a one-stop shop principle in a client-oriented service. Most of the duties of the ELY Centres, the TE Offices, the Regional State Administrative Agencies, the joint municipal authorities and the municipalities will be moved under the same county roof to ensure that clients receive the best services for their situation in a flexible manner. Gathering these duties together in one place will also bring greater efficiency, for example to employment services, as it will be possible to match the needs of companies with those of jobseekers more effectively.

+ What will happen to local services?

The county will have to ensure that important public services are available to everyone and are reasonably easily accessible. Local healthcare and social welfare services will be provided for the everyday lives of clients, and the availability of these services will be secured using new means, including online and mobile services. Social services are an example of local services produced at the client’s home, as a mobile service, or at a nearby unit. Such services can include home care, family work and child welfare services. Services and help at home will also be available for older people. The role of the municipality will remain significant for the everyday environment of its residents. The municipalities will remain responsible for organising matters such as early childhood education, school, exercise opportunities, food and culture services, land use planning, and traffic arrangements, which are all matters which affect people’s health and wellbeing.

+ How can I make a difference?

You can make your voice heard through voting in the county elections, but also through youth councils, older people’s councils, disabled people’s councils, client panels, county initiatives and county referendums. Decisions concerning your area which were previously made by regional offices of state or joint municipal authorities (ELY Centres, Regional State Administrative Agencies, TE Offices) will now be made directly by those elected to the job by you and the other residents in your area. All residents of the county as well as corporate entities and foundations operating in the area will be entitled to submit initiatives in matters related to the activities of the county.

+ Will I be able to receive services in my native language?

As a client, you will be entitled to services in Finnish or Swedish. Sometimes, there will be no common language. In these cases, an interpreter will have to be used, or the staff will otherwise need to ensure that the client understands how their matters are being dealt with.

Glossary of Health and Social Services

+ Health and social services centre

A health and social services centre – i.e. an HSS centre – is a place where you will receive the most common health services and advice on social services. You will go to a health and social services centre for reasons such as a prolonged cold or a sprained ankle.

In other words, HSS centres are similar to the current health centres in many respects. The services provided by HSS centres include medical check-ups, general practitioners’ surgeries, social services counselling, etc.

You can choose for yourself which health and social services centre to visit. An HSS centre may be operated by a private or a public body

+ Health and social services voucher

You may receive a voucher for certain health and social services once a physician, a social worker or some other professional has assessed the types of services that you will require. If you require cataract surgery or some other type of non-urgent surgery, for example, you may receive a services voucher for such surgery, allowing you to choose where the procedure will be performed. The purpose of a health and social services voucher is to ensure that you will receive treatment as soon as possible.

You may also use a services voucher for physiotherapy, home care or rehabilitation, to name but a few examples. When you are referred to physiotherapy, you will receive treatment matching the value of your services voucher from your chosen physiotherapist.

Health and social services vouchers will be granted by counties, and they will work in the same way as the service vouchers currently granted by local authorities. Moving forward, health and social services vouchers will replace municipal service vouchers, which will no longer be available.

+ Personal budget

If you require multiple services for an extended period of time, you may receive a personal budget for obtaining services. Typically, such budgets are available for services intended for elderly or disabled people.

You may be granted a personal budget once your service needs have been assessed by a physician, a social worker or some other professional. The types of services that you require will be included in your client care plan. After this, a certain amount of euros will be credited to your personal budget, which you can use to purchase services. However, you will not receive any money in your bank account; instead, your county will pay the service provider – which may be a business or a non-governmental organisation (NGO), etc. – directly for the services that you use.

You can decide for yourself where to purchase the services included in your client care plan. You will also have a say about the content of these services. This will ensure that you will receive services that meet your specific needs. By way of example, you can use your personal budget to cover housing services or a personal assistant.

+ County

Counties constitute a new intermediate level of self-government to be established between local and central government levels, with decision-makers to be elected in county elections. Moving forward, a total of 18 counties will assume responsibility for aspects such as health and social services for their respective residents. They are scheduled to start operations on 1 January 2020. The forthcoming counties will have more or less the same borders as the current regions.

View a list of the new counties and read more here.

View the Glossary of Health and Social Services. 

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