Health and social services reform will change structures
Prime Minister Rinne's Government launched preparations for the reform of healthcare and social welfare (shorter name: health and social services reform). The aim of the reform is to
- make significant changes to the organisation,
- and financing of health and social services,
which are currently the responsibility of the municipalities. The aim is to carry out the health and social services reform in a controlled manner and in stages.
The health and social services reform will transfer the responsibility for organising health and social services to self-governing regions that are larger than municipalities. These regions will be called counties. The responsibility for organising rescue services, too, will be transferred to the counties.
There will be at least 17 counties. Special arrangements have been proposed for the current Uusimaa region.
In future, decision-making power in the counties will rest with directly elected councillors. Participation of county residents will be strengthened and user democracy will be reinforced. The counties will receive most of their funding from the central government.
The establishment of counties will affect municipalities' obligations
The establishment of counties and creating a financing system for them means that the current system of discretionary central government transfers to municipalities must be changed and taxation legislation amended. In addition, the reform will transfer the current staff of the municipal sector in the fields of healthcare, social welfare and rescue services to the service of the counties.
The right of counties to collect taxes will be examined in a parliamentary committee. A study will examine which duties of municipalities, joint municipal authorities and the state can be transferred to counties. These matters will be prepared during 2020.
What role will the Ministry of Finance have in preparing the health and social services reform?
The Ministry of Finance will participate in the preparation of the health and social services reform led by the Ministry of Social Affairs and Health. The Ministry of Finance will be responsible for the legislative preparation concerning the establishment, administration, financing, personnel and property arrangements of the counties.
Additionally, the Ministry of Finance's preparatory responsibility includes any necessary proposals for legislative amendments concerning the tasks and financing of municipalities. Moreover, the Ministry will prepare the necessary amendments to tax legislation. The reform will also affect the preparation of the General Government Fiscal Plan.