Health, social services and regional government reform is one of the biggest ever administrative and operational overhauls in Finland. The reform impacts the jobs of hundreds of thousands of people and affects the services of every citizen in the country. In South Karelia only reform impacts more than 5000 jobs.
The aim is to transfer regional services to counties from the 1st of January 2019. The first county council elections will be held in connection with the first round of the presidential election in January 2018. The term of the county councils will begin on 1 March 2018. The new counties will begin operating on 1 January 2019.
The Government outlined the launching of preparations for the regional government reform. In South Karelia the Regional Council of South Karelia is in charge of these preparations.
Actually, here in South Karelia the reform has been on the way for years. South Karelia Social and Health Care District (Eksote) is a joint municipality authority of the region. Eksote already produces health services, family and social welfare services, and services for senior citizens for the whole area of South Karelia ( also for immigrants).
Counties and municipalities
In the reform 18 counties (autonomous areas) will be established in the beginning of yr. 2019. These 18 counties (regional government) will be responsible for healthcare and social welfare, rescues services, environmental healthcare, regional development duties and tasks related to the promotion of business enterprise, planning and steering of use of regions, promoting the identity and culture of the counties as well as other statutory regional services assigned to the counties.
In the future one strong organiser, county, will be responsible for the steering and structure of provision, assigned official duties, regional assessment of the efficiency, cost-effectiveness and quality of healthcare and social services, and for supporting service users’ freedom of choice .
The municipalities (such as the city of Lappeenranta and Imatra) will continue to exist as communities of local involvement, democracy, children education, culture and vitality. They will also continue to be responsible for services related to sports, culture and other leisure activities, youth
services, local industrial policy, land use, construction and urban planning.
Draft bills for comments
The Government published reform draft bills in June 2016. In the end of August, the Ministry of Social Affairs and Health and the Ministry of Finance will circulate for comment the Government’s draft proposal on the health, social services and regional government reform.
The key laws contained in the draft proposal are the Counties Act, the Act on Organising Health and Social Services, the Implementation Act, the Act on Financing the Counties and the Act on Central Government Transfers to Local Government for Basic Public Services. The commenting period is ten weeks, until 9 November.
Following the consultation round, the ministry will publish a summary of the comments received in November-December, after which the Government will decide on a final proposal and submit it to Parliament.
Duties of the counties (2019)
1) Healthcare and social welfare.
2) Preventive services and support for municipalities’ expert services in order to promote social wellbeing and health, preventive substance abuse work, health protection and regional
alcohol administration and tobacco control.
3) Rescue services: The provision of rescue services and pre-hospital emergency care will be the responsibility of five counties that maintain a university hospital based on the counties’
collaborative catchment areas. The collaborative catchment areas will be laid down by the
Act on Organising Healthcare and Social Welfare Services and the Counties Act. Counties will
manage duties associated with rescue services and finance the provision of such services.
4) Environmental healthcare and food control, animal health and welfare, including related
control. A municipality with adequate resources can, however, agree with the county that the
responsibility for organising these tasks is transferred to the municipality (usually a city).
The right to transfer tasks would require a provision laid down in a special act and
determining the criteria by law.
5) Regional development and its funding. Instead of Regional Councils, counties will in the
future serve as the general authorities for regional development. The counties will take care
of the regional development duties previously assigned to the regional development
authority, to Regional Councils and to the Centres for Economic Development, Transport and
the Environment, as laid down in the statutes on regional development and the
administration of structural funds activities.
6) The organisation and development of regional joint services includes not only the joint
services enacted by law but also the establishment of a single digital service channel for
public services and the organisation and provision of joint services together with the
municipalities – in cases where legislation allows counties and municipalities to have joint
services. This duty also includes potential agreements on providing regional state authority
branches with facilities and support services if they cannot be provided by the regional state
authority with nationwide responsibilities.
7) Steering of regional land use and construction and nurturing of the regional cultural
8) Planning of regional traffic systems.
9) Regional planning and organisation of public transport and duties related to discretionary
government transfers for public transport as well as duties related to discretionary government
transfers for private roads. In this connection, the duties assigned under the Public Transport
Act to municipalities and their co-operation bodies will not be reorganised.
10) Promoting the identity, dynamism, culture, wellbeing and sports activities of the counties.
11) Developing and funding business life, business enterprise and an ambience for innovation, as well as related enterprise and advisory services.
12) Rural development, promotion and funding of agriculture, food industry, rural industries, game and fishing industries, and provision of support for farmers, as well as services related to these duties.
13) Organisation of farm relief services for farmers and fur producers and farm relief duties of local authorities.
14) Control of plant production and plant health.
15) Organisation of employment and economic development services and
promotion of immigrant integration: Employment and economic
development service provision can be enacted – or assigned if statutory
criteria are met – to be taken care by a municipality (city) possessing adequate resources or by private or third sector operators.
16) Duties in water supply promotion and planning, use and management of water resources, control of flood risks and duties related to regional natural resources, as well as ensuring the implementation of tasks related to the environment, water supply and water courses and tasks related to water and seawater management.
17) Provision and distribution of data on the environment and improvement of environmental awareness.
18) Regional preparedness included in the national security strategy and support for it, as well as its coordination with the counties’ duties.
19) Building supervision in those counties where all municipalities in the county have agreed to transfer such supervision to the county and allocated funding for it.
20) Any duties under the mandate of the county and assigned to the county by an agreement between all municipalities in the county, provided the municipalities have allocated funding for those duties.
21) Other statutory duties that Regional Councils currently manage. The counties can further develop these duties and related cooperation.
22) Managing international matters and connections relating to the duties
of the counties.
More information: http://alueuudistus.fi/en/frontpage