Juha Ristamäki
Reducing welfare areas and cooperation areas must be on the table, writes Juha Ristamäki.
The growth of SOTE expenses is not under control. PEKKA KARHUNEN/KL
The preparation of next year’s state budget is in full swing. The entire government will meet on the 3rd-4th of the fall budget row. September
From the point of view of the national economy, the most critical spending item is social and health services. About a third of next year’s budget, more than 26 billion, will be spent on welfare areas’ expenses, and even that is not enough.
In the current year, the welfare regions will make a deficit of approximately 1.5 billion euros, and next year does not look much better.
At the end of the election period, according to estimates, the welfare areas will have a debt of around four billion euros. At the same time, social security expenditures can be estimated to have increased by around six billion euros.
The shoe is off.
During the budget crisis, different parties traditionally bring out their problems and their need for money, so that the government would still react to them and give more money. Of course, in terms of schedule, this is also due to the fact that entities prepare their own budgets.
On Thursday, Marina Erhola, the director of Pirkanmaa’s welfare area, opened the box of sorrows, who in an interview with Yle stated that the number of welfare areas should be reduced by half. Erhola would drop the number of 21 regions to twelve.
Pirkanmaa’s welfare area is the largest in Finland and one of the most deficit-producing. In the current year, it will have a deficit of at least EUR 70 million.
The second bomb of Wednesday came from the Hus group, which is Finland’s largest producer of specialized medical care. Hus plans to initiate extensive change negotiations for the entire staff.
The reduction need is a maximum of approximately 990 person-years of work. According to Hus, the group’s financial adjustment need for next year is around 140 million euros.
In the welfare areas of Uusimaa, with the same logic, large cooperation negotiations are ahead. If Hus’s situation is compared to the whole country, up to ten thousand social security employees may end their employment.
The welfare area of Vantaa and Kerava, on the other hand, is applying for additional money from the state for this year and next year of almost 150 million euros. Many other welfare regions with drastic deficits follow how Vantaa-Keravan is doing.
Welfare regions should save about 800 million euros from their expenses during the term of government. If you believe in the success of this, you must be strong in your faith.
It is clear that our social and health care system, which was reformed for 16 years, is still broken, at least in terms of financing.
At this rate, the next government will be left with such a heavy social security legacy that it will be in trouble with it. The aging population’s need for services is growing all the time, the personnel shortage is not disappearing anywhere, and at least no means have yet been proposed to deal with the cost pressure.
The SDP, the main architect of the current social welfare model, knows this very well, and on Thursday, it was suggested that we should start discussing the introduction of the provincial tax again. “Without the right to tax, social security areas are pretty much out of reach,” said Tytti Tuppurainen, chairman of SDP’s parliamentary group.
Tax reform is one thing that needs to be on the table. The second is the number of welfare areas, as Erholakin presented. There should be clearly fewer regions in order for them to be viable, especially if the regions will also have the right to tax.
What Erhola did not present, but could have thought, was that the number of social and healthcare cooperation areas also needs to be reviewed. Now there are five of them, three cooperation areas would probably be enough for Finland, especially if the number of welfare areas is reduced.
Larger areas built around university hospitals would be able to more effectively seek savings in specialized hospital care. This means, among other things, the centralization of more demanding surgeries and a critical review of the hospital network.
Bringing the costs of specialized medical care under control would also mean that there would be enough money for basic health care. After all, that was the goal of the entire social security reform, so that people would not end up in expensive specialized medical care.
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