Finland is undertaking a major reform of its social and health care system to address issues like an aging population, regional disparities in access to services, and rising costs. The key points of the reform are establishing 18 new counties to organize services currently provided by municipalities, integrating social and health care, increasing choice of providers, and shifting responsibility for financing, oversight and delivery from municipalities to counties while strengthening the role of the central government. The reform aims to narrow health differences, enhance access to equitable services, and curb costs by 3 billion euros by 2030, but faces challenges in implementation and ensuring equality amid increased private provision.
Ageing: Fiscal implications and policy responses -- Mirko Lichetta, United Ki...OECD Governance
This presentation was made by Mirko Lichetta, United Kingdom, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Long-term care: Integrating health and social care - Albert Veraart, NetherlandsOECD Governance
This presentation was made by Albert Veraart, Netherlands, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Ageing: Fiscal implications and policy responses -- John Beard, World Health ...OECD Governance
This presentation was made by John Beard, WHO, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Chris Ham: introduction to the Health and Social Care Act and integrationThe King's Fund
Chris Ham, Chief Executive at The King’s Fund, gives an introduction to the Health and Social Care Act with a particular focus on integration. He explains what is meant by integration, looks at good practice case studies and outlines the duties of Monitor, the NHS Commissioning Board, clinical commissioning groups and health and wellbeing boards.
This presentation is compiled from several sources and summarizes the health care system in Europe. Some of the information could be outdated and readers are encouraged to follow recent updates as well.
Ageing: Fiscal implications and policy responses -- Mirko Lichetta, United Ki...OECD Governance
This presentation was made by Mirko Lichetta, United Kingdom, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Long-term care: Integrating health and social care - Albert Veraart, NetherlandsOECD Governance
This presentation was made by Albert Veraart, Netherlands, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Ageing: Fiscal implications and policy responses -- John Beard, World Health ...OECD Governance
This presentation was made by John Beard, WHO, at the 6th Meeting of the Joint OECD DELSA-GOV Network on Fiscal Sustainability of Health Systems, held at the OECD Conference Centre, Paris, on 18-19 September 2017
Chris Ham: introduction to the Health and Social Care Act and integrationThe King's Fund
Chris Ham, Chief Executive at The King’s Fund, gives an introduction to the Health and Social Care Act with a particular focus on integration. He explains what is meant by integration, looks at good practice case studies and outlines the duties of Monitor, the NHS Commissioning Board, clinical commissioning groups and health and wellbeing boards.
This presentation is compiled from several sources and summarizes the health care system in Europe. Some of the information could be outdated and readers are encouraged to follow recent updates as well.
Presentation by James Smith of the American Continental Group at the Sept. 30, 2013 83rd Texas Post-Legislative Conference hosted by One Voice Texas, United Way of Greater Houston and the Harris County Healthcare Alliance.
Presentation giving an overview of the Care Bill and the upcoming consultation. Presented on 2 May 2014 by Simon Medcalf, Deputy Director Social Care Policy and Legislation at the Department of Health at the Local-Central Government Discovery Day on the Impact of the Care Bill hosted by the Department for Communities and Local Government.
Health care in Turkey consists of a mix of public and private health services. Turkey has universal health care under its Universal Health Insurance (Genel Sağlık Sigortası) system. Under this system, all residents registered with the Social Security Institution (SGK) can receive medical treatment free of charge in hospitals contracted to the SGK
Peter Crampton on public health in New Zealandmhjbnz
Prof Peter Crampton (Dean and Head of Campus, University of Otago Wellington)
specialist in public health medicine, argues that public health is a social, political, economic and justice issue, not a medical one. After charting the course of change to our health system since the 30’s, he urges every citizen to articulate in all their relationships (personal, professional, civil), their commitment to public health as a right of citizenship. He also agues that the goal of the public health system is to reduce inequalities and produce just outcomes for all New Zealanders.
http://dosomething.org.nz
1.0. Introduction:
The Open Government Partnership (OGP) is a global initiative that aims at promoting transparency, empower citizens, fight corruption and encourage use of new technologies to improve governance. The OGP is overseen by a multi-stakeholder International Steering Committee comprised of Government and civil society representatives. One of the major benefits of OGP is to improve service delivery and make Governments more responsible and accountable to their citizens. Given the benefits of this initiative, Tanzania declared its intention to join OGP during the launching meeting. The decision to join OGP is an important step to complement the Government‟s ongoing efforts to strengthen good governance across all sectors. Good governance has been a critical element to enhance and sustain peace and stability, economic growth, social development and poverty reduction in Tanzania. It is on this basis, that the Government formulated the National Framework for Good Governance (NFGG) in 1999 as a guide to institute good governance in the country. The NFGG envisages a broad-based national partnership for development of good governance. Such a partnership includes Central and Local Governments, Private Sector, Faith-Based and Civil Society Organizations consistent with OGP principles. To spearhead good governance across the Government, several key and cross-cutting governance reforms are being implemented. These core reforms are; the Public Service Reform Program (PSRP), the Local Government Reform Program (LGRP), the Legal Sector Reform Program (LSRP), the Public Financial Management Reform Program (PFMRP) and the National Anti-corruption Strategy and Action Plan (NACSAP). In line with these reforms, sector specific programmes have been undertaken to improve service delivery through the implementation of Decentralization by Devolution (D-by-D). These programmes constitute the policy and strategic framework for enhancing accountability, transparency and integrity in the use of public resources in order to improve service delivery.
The Government has also established and continues to strengthen, empower and improve performance of institutions dealing with issues of good governance, integrity and combating corruption. These include the Ethics Secretariat the Prevention and Combating of Corruption Bureau and the Commission for Human Rights and Good Governance. Other accountability institutions include the Public Procurement Regulatory Authority, the National Audit Office and the Parliamentary Watchdog Committees. In addition to this, Tanzania has enacted laws that require leaders and senior public officials to disclose their incomes and assets to the Ethics Secretariat as a measure to instill integrity in public life.
http://www.opengovpartnership.org/countries/tanzania
Presentation by James Smith of the American Continental Group at the Sept. 30, 2013 83rd Texas Post-Legislative Conference hosted by One Voice Texas, United Way of Greater Houston and the Harris County Healthcare Alliance.
Presentation giving an overview of the Care Bill and the upcoming consultation. Presented on 2 May 2014 by Simon Medcalf, Deputy Director Social Care Policy and Legislation at the Department of Health at the Local-Central Government Discovery Day on the Impact of the Care Bill hosted by the Department for Communities and Local Government.
Health care in Turkey consists of a mix of public and private health services. Turkey has universal health care under its Universal Health Insurance (Genel Sağlık Sigortası) system. Under this system, all residents registered with the Social Security Institution (SGK) can receive medical treatment free of charge in hospitals contracted to the SGK
Peter Crampton on public health in New Zealandmhjbnz
Prof Peter Crampton (Dean and Head of Campus, University of Otago Wellington)
specialist in public health medicine, argues that public health is a social, political, economic and justice issue, not a medical one. After charting the course of change to our health system since the 30’s, he urges every citizen to articulate in all their relationships (personal, professional, civil), their commitment to public health as a right of citizenship. He also agues that the goal of the public health system is to reduce inequalities and produce just outcomes for all New Zealanders.
http://dosomething.org.nz
1.0. Introduction:
The Open Government Partnership (OGP) is a global initiative that aims at promoting transparency, empower citizens, fight corruption and encourage use of new technologies to improve governance. The OGP is overseen by a multi-stakeholder International Steering Committee comprised of Government and civil society representatives. One of the major benefits of OGP is to improve service delivery and make Governments more responsible and accountable to their citizens. Given the benefits of this initiative, Tanzania declared its intention to join OGP during the launching meeting. The decision to join OGP is an important step to complement the Government‟s ongoing efforts to strengthen good governance across all sectors. Good governance has been a critical element to enhance and sustain peace and stability, economic growth, social development and poverty reduction in Tanzania. It is on this basis, that the Government formulated the National Framework for Good Governance (NFGG) in 1999 as a guide to institute good governance in the country. The NFGG envisages a broad-based national partnership for development of good governance. Such a partnership includes Central and Local Governments, Private Sector, Faith-Based and Civil Society Organizations consistent with OGP principles. To spearhead good governance across the Government, several key and cross-cutting governance reforms are being implemented. These core reforms are; the Public Service Reform Program (PSRP), the Local Government Reform Program (LGRP), the Legal Sector Reform Program (LSRP), the Public Financial Management Reform Program (PFMRP) and the National Anti-corruption Strategy and Action Plan (NACSAP). In line with these reforms, sector specific programmes have been undertaken to improve service delivery through the implementation of Decentralization by Devolution (D-by-D). These programmes constitute the policy and strategic framework for enhancing accountability, transparency and integrity in the use of public resources in order to improve service delivery.
The Government has also established and continues to strengthen, empower and improve performance of institutions dealing with issues of good governance, integrity and combating corruption. These include the Ethics Secretariat the Prevention and Combating of Corruption Bureau and the Commission for Human Rights and Good Governance. Other accountability institutions include the Public Procurement Regulatory Authority, the National Audit Office and the Parliamentary Watchdog Committees. In addition to this, Tanzania has enacted laws that require leaders and senior public officials to disclose their incomes and assets to the Ethics Secretariat as a measure to instill integrity in public life.
http://www.opengovpartnership.org/countries/tanzania
In this month's edition:
• Richard looks at the great debate of devolution
• Stephen reviews the election manifestos and summarises each one from a local government perspective
• Nichola looks at the cost budgeting nightmare
• Neil's third and final article in the series of dealing with local authority land collaboration/joint ventures
• the second article from Angelica looking at best value duty
• Sarah provides an employment update
• Anja reviews the Procurement Policy Notes published during the first quarter of the year, and
• Anja and Emma look at the new guidance on awarding contracts under the Public Contract Regulations 2015.
Seema Hafeez presentation on United Nations E-government Survey Leveraging ...SEEMA HAFEEZ
UN E-Government Survey 2010 focuses on the issue of how willing and ready are the governments around the world to improve the access, and quality, of basic economic and social services to the people
Seema Hafeez presentation to 3rd parliamentary forum 2010SEEMA HAFEEZ
UN e-government Index; how willing and ready are the governments around the world to:
–improve the access, and quality, of basic economic and social services to the people ; and
–involve them in public policy making via e-participation.
Accessibility of health services - transporting people and servicesSTN IMPRO
IMPRO:n järjestämässä Paikkatieto sote-uudistuksen tukena -seminaarissa 8.10.2019 Helsingin yliopistolla Oulun yliopiston Tiina Lankila ja Tiina Huotari esittelivät tuloksiaan terveydenhuollon saavutettavuus -tutkimuksistaan. Esityksessä keskityttiin erityisesti palveluiden mobiliteettiin sekä asiakkaiden liikkumiseen.
Paikkatiedon hyödyntäminen terveydenhuollon uudistuksessa ja arvioinnissaSTN IMPRO
IMPROn järjestämässä Paikkatieto sote-uudistuksen tukena seminaarissa 8.10.2019 THL:n sote-arvioinnista vastaava projektipäällikkö Kimmo Parhiala esitteli paikkatiedon tuomia mahdollisuuksia sote-järjestelmään.
Hallitusohjelma ja sote-palvelujärjestelmäSTN IMPRO
IMPROn järjestämässä Paikkatieto sote-uudistuksen tukena seminaarissa 8.10.2019 sosiaali- ja terveysministeriön lääkintäneuvos Timo Keistinen esitteli uuden hallituksen sote-suunnitelmaa. Keistinen on mukana sote-uudistuksen valmistelussa.
IMPROn järjestämässä Paikkatieto sote-uudistuksen tukena -seminaarissa 8.10.2019 Oulun yliopiston dosentti Harri Antikainen esitteli paikkatiedon hyödyntämistä sote-alan päätöksenteossa. Esityksen keskiössä erityisesti palveluiden optimointi ja kustannustehokkuus.
Walking and cycling in accessibility researchSTN IMPRO
IMPROn järjestämässä Paikkatieto sote-uudistuksen tukena seminaarissa 8.10.2019 Helsingin yliopiston Digital Geography Labin tohtorikoulutettava Elias Willberg esitteli matka-aikojen optimointia. Tutkimuksessaan hän keskittyy palveluiden saavutettavuuteen pyöräilyn ja kävelyn näkökulmasta.
Optimizing Geographic Access to Health CareSTN IMPRO
IMPROn järjestämässä Paikkatieto sote-uudistuksen tukena seminaarissa 8.10.2019 Pohjois-Carolinan yliopiston Eric Delmelle esitteli Yhdysvalloissa tekemäänsä tutkimusta terveyspalvelujen optimoinnista paikkatietoa hyödyntäen.
IMPROn järjestämässä Paikkatieto sote-uudistuksen tukena seminaarissa 8.10.2019 Pohjois-Carolinan yliopiston Eric Delmelle esitteli nousevia teemoja terveysmaantieteen saralla. Esityksen keskiössä on uusien teknologioiden ja niiden datan hyödyntäminen terveysmaantieteessä.
Geospatial costs of delivering health in FinlandSTN IMPRO
IMPRO project's presentation at Understanding Present and Future Public Service Delivery Costs, a kick-off workshop hosted by OECD, Brussels, June 28th, 2019.
Geospatial Health as Interdisciplinary Research for Health Care Reform and Pl...STN IMPRO
Geospatial Health as Interdisciplinary Research for Health Care Reform and Planning. Markku Tykkyläinen – Mikko Pyykönen – Sami Sieranoja – Pasi Fränti – Tiina Laatikainen
University of Eastern Finland, IMPRO, Joensuu
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
2. WHY THE REFORM?
The population is ageing rapidly and there is a growing need for services but less
money to finance them.
Although the quality of care is regarded generally good, there are regional disparities
in access to and availability and quality of services.
Socioeconomic inequalities persist in Finland.
At present the responsibility to organize health and social services belongs to
municipalities (local authorities, 295 in mainland Finland), many of which are too
small and financially too weak to carry this responsibility.
25.4.2018 Esityksen nimi / Tekijä 2
3. AIMS OF THE REFORM
Narrowing down the differences in people's health and wellbeing.
Enhancing equality and accessibility of health and social services.
Curbing costs: savings of EUR 3 billion by year 2030
25.4.2018 Esityksen nimi / Tekijä 3
4. KEY POINTS OF THE REFORM
Establishment of counties – a new level of governance – and responsibility to organize services
from municipalities to counties
Responsibility of financing, steering and monitoring the counties to central government
Integration of social and health services
Freedom of patient choice
Public, private and third party providers of services
25.4.2018 Esityksen nimi / Tekijä 4
5. COUNTIES
Responsibility to organize social and health services will be shifted from 295 municipalities to 18 counties.
The counties will have also other duties, such as rescues services, environmental healthcare, regional
development duties.
The counties will constitute a new democratic and autonomous level of governance.
Autonomy of the counties will be limited – no right to levy taxes, strong state regulation.
In the organization of the county, the organizer-producer model will be applied: a service utility for the production
of services
5 collaborative catchment areas
25.4.2018 Esityksen nimi / Tekijä 5
6. STATE
State will finance the public health and social services as well as the other functions of the
counties.
The financing will flow through the counties to the service providers
State will steer the counties (functioning, investments, service structure).
State will monitor, evaluate and supervise the counties. If a county ‘fails’ it will be incorporated
into another county.
Compared with the current situation, the role of the central government will be stronger.
25.4.2018 Esityksen nimi / Tekijä 6
7. INTEGRATION OF SOCIAL AND HEALTH CARE
Integration of social and health care is seen as a central tool for reaching
the aims of the reform:
– 10 % of population uses 80 % of social and health care costs, 5 % of
population who uses social and health care services uses 57 % of social
and health care costs
– integration of services would serve the needs of these population groups
in particular
Integration at the level of financing, organizing and producing the services
25.4.2018 Esityksen nimi / Tekijä 7
8. FREEDOM OF PATIENT CHOICE
Right to choose a public, private or third sector social and health centre for primary health care
Right to choose the provider of services by a voucher issued by the county
Right to choose the provider of services by a personal budget in the services for ageing and disabled people
The county may set conditions for service providers
All providers which meet the conditions set in law and defined by the county must be approved (s&h centres and
vouchers)
25.4.2018 Esityksen nimi / Tekijä 8
9. PUBLIC, PRIVATE AND THIRD PARTY PROVIDERS
Services within the scope of the Act on Freedom of Patient Choice
will be provided by public, private and third-sector operators.
There must always be public production available (19 §+124 § of
Finnish Constitution)
The counties are responsible for making sure that public, private
and third-sector services work seamlessly together, that information
flows smoothly and that the services meet quality criteria.
25.4.2018 Esityksen nimi / Tekijä 9
10. CURRENT STATE OF THE REFORM
The legislative package which comprised of more than 40 laws is being
processed by the Parliament.
The recast version of the Act on Freedom of Choice is being discussed by
the Constitutional Law Committee
The legislative package should enter into force on 1.7.2018, the
responsibility for services will be shifted to counties on 1.1.2020.
But… will the Parliament approve the package?
25.4.2018 Esityksen nimi / Tekijä 10
11. CONCLUSIONS 1/2
Finland’s forthcoming health and social services reform is
revolutionary in its scope and impact, even in the international
context. Implementation of the reform is a challenging task.
The increased size of the organizers and the strengthening of their
economic capacity may lead to reduced inequalities in health and
wellbeing. But will they be strong enough?
Managing the system of freedom of choice will require strong
resources which some of the counties will not necessarily have.
25.4.2018 Esityksen nimi / Tekijä 11
12. CONCLUSIONS 2/2
Plans to slow the rate of expenditure growth are ambitious. Is there
a risk of underfunding the health and social care system? How to
guarantee equality?
Are there sufficient tools to prevent disruption of integration?
The time frame for implementing the reform?
Yet, the reform is necessary…
25.4.2018 Esityksen nimi / Tekijä 12