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The changing structure of Finnish social and health care and the challenges supervision is facing

This text discusses the challenges faced by supervision in the changing structure of social and health care in Finland, with a focus on the ongoing health and social care reform (SOTE). It explores the role of Valvira, the National Supervisory Authority for Welfare and Health, in overseeing healthcare and social service providers and ensuring safe and adequate access to healthcare services. The text also explains the stepwise progress of the SOTE reform and the future responsibilities of SOTE-districts in providing welfare and healthcare services.

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The changing structure of Finnish social and health care and the challenges supervision is facing

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  1. The changing structure of Finnish social and health care and the challenges supervision is facing EPSO-conference 30.9.2015 Helsinki Marja-Liisa Partanen, Director General The National SupervisoryAuthority forWelfare and Health (Valvira)

  2. Health and Welfare: Government Agencies and Institutes • Ministry of Social Affairs and Health (MSAH) • National Institute for Health and Welfare (THL) • Finnish Medicines Agency (Fimea) • Radiation and Nuclear Safety Authority (STUK) • Finnish Institute of Occupational Health (TTL) • National Supervisory Authority for Welfare and • Health (Valvira) • Regional State Administrative Agencies • Social Insurance Institution of Finland (Kela) Marja-Liisa Partanen, EPSO 30.9.2015

  3. Central Government SteeringMechanisms for Health and Welfare services • •National and EU legislation • • Other binding and non-binding regulation • • Policy documents, strategic programs • • Recommendations, national guidelines (evidence-based practice, evidence-informed policy) • • Economic steering (equalization payments,ear-marked grants and bonuses, sanctions) • • Research and development • • Supervision (reactive, systematic, guiding) Marja-Liisa Partanen, EPSO 30.9.2015

  4. Valvira – Purpose and role • Purpose • Supervise and provide guidance to • healthcare and social service providers • alcohol administration authorities • environmental health bodies • regional supervisory authorities • Provide licencing activities for social and healthcare • Role • Protect living environment that promotes health and welfare and access to social and healthcare services that are both safe and adequate. • Valvira is an expertorganisation committed to best practice. Marja-Liisa Partanen, EPSO 30.9.2015

  5. Marja-Liisa Partanen Director General Organisationalchart Communications Supervision and guidance secretariat Knowledge Director Development Manager Executive Assistant Administration Ritva Kujala Administrative Director Alcohol and Environ-mental Health Healthcare legal rights and technology Healthcare supervision Private sector licencing and social welfare supervision Core processes Promotion of legal protection and high quality in healthcare Promotion of legal protection and high quality in social welfare Management of health risks in the living environment Katariina Rautalahti Director JussiHolmalahtiDirector Tarja Holi Director Esa Koukkari Director Prevention of alcohol-related harm Number of personnel 180 Marja-Liisa Partanen, EPSO 30.9.2015

  6. Relevant primary legislation Alcohol Act Tobacco Act Gene Technology Act Food Act Adoption Act Biobank Act Act on the Electronic Processing of Client Data in Social and Health Care Act on Medical Devices • Health Care Act • Primary Healthcare Act • Act of Specialised Medical Care • Mental Health Act • Act on the Status and Rights of Patients • Act on Health Care Professionals • Social Care Act • Act on Social Care Professionals (1.3.2016) • Act on the Status and Rights of Social Care Customers • Private Health Care Act • Private Social Services Act • Health Protection Act Marja-Liisa Partanen, EPSO 30.9.2015

  7. Health Care Service • Districts in Finland • 320 Municipalities • 20 HospitalDistricts • 5 UniversityHospitalDistricts Marja-Liisa Partanen, EPSO 30.9.2015

  8. Health Care Services in Finland • The majority of Finnish health care services are organized and provided by the municipal healthcare system. • Specialist care is provided by hospital districts. • The Finnish system is more decentralized and mixed in its funding than in other European countries. Marja-Liisa Partanen, EPSO 30.9.2015

  9. Main targets of the ongoing health and social care reform (SOTE) • Main targets are: • Integration of social and health care services leading into improved cooperation between primary and secondary health care as well as welfare services. • Empowerment of primary care services and service chains by shifting organizing responsibility to larger and more resourceful entities (SOTE-districts). • SOTE-districts may self-provide regional services or contract with private or third sector providers. • Part of demanding specialized medical care may be centralized under the direction of Ministry. Marja-Liisa Partanen, EPSO 30.9.2015

  10. Stepwise progress of SOTE Marja-Liisa Partanen, EPSO 30.9.2015

  11. Future SOTE-districts • Maximum of 19 autonomous districts will be responsible for providing welfare and healthcare services. • SOTE-districts will be managed by elected councils. • Local government and/or central government funding models are currently under exploration. Marja-Liisa Partanen, EPSO 30.9.2015

  12. Valvira in the SOTE-reform • Participates in Ministry’s work in outlining the reform principles and drafting new legislation • Supervision/guidance • Participates in implementation of new legislation • Prepares solutions/guidance for integrated self-monitoring system for the whole country • Prepares proactive and risk-based supervision models • Prepares continuous monitoring systems for supervision together with THL • Prepares for quick complementary actions/revisions • to ensure patient safety - if needed Marja-Liisa Partanen, EPSO 30.9.2015

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