Based on a study by the Research Institute of the Finnish Economy published on 23 March, the very ambitious goals of the social welfare and healthcare reform are partly conflicting, and so are the means proposed for their implementation.
According to the study Social welfare and healthcare – more, better and cheaper? there has been hardly any discussion about the core elements for the success of the reform – performance management and incentive systems, and involvement of the social welfare and healthcare staff in the reform. The aims to reduce differences in health status, improve the quality of services, and achieve cost savings conflict with each other, unless the reform succeeds in considerably improving the cost-efficiency of these services. Higher cost-efficiency requires that the various actors in the regions responsible for organising the social welfare and healthcare services act in a way that the common goal can be achieved. Without new kinds of performance management and incentive systems it is unlikely that the goals will be reached. Performance indicators and the related incentives guide the activities in healthcare services as well, but poor indicators may induce distortions in behaviour and lead to manipulation of indicators. It is quite difficult to create a functioning performance management and incentive system because the research information is scattered and there are challenges relating to performance evaluation.
Based on an inquiry among social welfare and healthcare professionals conducted in February 2016 in connection with the research, the private and public sectors should not be seen as strict opposites of each other, regardless of the freedom of choice and competition. In the replies to the inquiry it was hoped that the good elements of the present social welfare and healthcare system will not be lost in the reform and that the professionals in these sectors will have up-to-date and accurate information on its progress.
The purpose of the study was to analyse the goals and means of the social welfare and healthcare reform from various perspectives. Information was collected from international and domestic research literature, through international cooperation and an extensive inquiry among the producers of social welfare and healthcare services, and by analysing the comments given by local governments.
The study was conducted by Antti Kauhanen, Annu Kotiranta, Martti Kulvik, Jukka Lassila, Sirpa Maijanen, Marja Tähtinen and Tarmo Valkonen from the Research Institute of the Finnish Economy. The research was part of the implementation of the Government plan for analysis, assessment and research for 2014.
Report (pdf, in Finnish)
Further information on the Government’s analysis, assessment and research activities
Inquiries: Tarmo Valkonen, Research Advisor, Research Institute of the Finnish Economy ETLA, tel. +358 50 329 6014 and Sari Löytökorpi, Project Manager, Prime Minister’s Office, Government’s analysis, assessment and research activities, tel. +358 295 160 187
English translation of the press release published on 23 March 2016
