Information from IL: The coalition is aiming for significant health and social security savings in government negotiations – These means on the table

Iltalehti went through the Ministry of Finance's proposals for cutting social security expenses. The coalition has already said that the proposals will be used when negotiating the government program. The chairmen of the parties told about the current situation of the Finnish economy at a press conference on Tuesday. IL-TVelli.harju@iltalehti.fiYesterday at 6:00

The Coalition, Basic Finns, RKP and Christian Democrats are currently negotiating the government program at Säätytalo. The big question in the negotiations is how the future government plans to curb the anticipated increase in spending in the social and health service sector in Finland.

According to information from Iltalehti, the coalition is seeking significant savings in social and health spending in order to be able to curb their growth. During the elections, the coalition already proposed that the Ministry of Finance's expenditure and structure mapping be used in the preparation of the government program.

The Ministry of Finance (MoF) presented numerous ways to cut spending on social and health services when it published the expenditure and structure survey of public finances in March.

Iltalehti went through the MoF's proposals for cutting social and health spending and compiled them for this story. These are probably the means that are on the table in the government negotiations.

Dismantling of staffing

The costs of the health and social services sector, which is responsible for organizing welfare areas, will, for example, take up almost a third of the state this year from the budget, and therefore the social security sector is under pressure to achieve savings.

According to the Ministry of Health, it is practically impossible to reduce the funding of welfare areas without a corresponding reduction in tasks or obligations.

The Ministry of Health suggests that canceling the staffing of operational units for enhanced service housing would reduce the costs of welfare areas and of the state's funding needs of an estimated 240 million euros from 2024. Sanna Marini(sd) the board decided that starting in December 2023, the dimensioning will require that there are 0.7 employees per customer.

According to VM, “the change would not affect the number of support staff, nor would it would also have an impact on the assessment of the customers' service needs”.

According to VM, the increase in the costs of services for the elderly could also be curbed by increasing communal housing for the elderly. This year, the Social Care Act has entered into force the possibility of implementing 24-hour service housing and communal living in the same building.

According to VM, if, for example, around 5 percent of 24-hour home care customers moved to communal living, savings would be around 25 million euros . However, VM points out that it would be difficult to introduce additional places quickly, so for example a gradual increase of places implemented over three years could be possible.

Anna-Maja Henriksson (r), Petteri Orpo (cook), Riikka Purra (ps) and Sari Essayah (kd) pictured at Tuesday's press conference at Säätytalo. Pete Anikari

Customer fee increases

The VM suggests that customer fees for social and health services could be increased “moderately”, for example in specialized nursing care.

The accumulation of customer fees for specialized nursing care covers about 4 percent of the operating costs and amounts to more than 300 million euros per year. According to VM, for example, a 10 percent increase in customer fees would therefore mean an increase in payment collection by around 30 million euros.

According to VM, an increase could also be considered for income-related payments collected mainly for long-term care of the elderly. Payments could take into account, for example, the client's wealth. The total accumulation of these payments is more than 500 million euros per year. Thus, for example, a 5 percent increase in fees would mean additional income of 25 million euros.

According to the Ministry of Finance, with moderate increases, fee income could be increased by, for example, 50 million euros, and state funding for welfare areas could be reduced accordingly.

The Ministry of Finance suggests that customer fees for social and health services could be increased “moderately” in, for example, special care. Elle Laitila

Changing the care guarantee

VM also presents an alternative to interfering with the care guarantee. Marin's board decided that non-urgent primary care should be available in two weeks from September 1, 2023 and in one week from November 1, 2024.

Regarding the treatment guarantee, according to VM, it would be possible to return to the situation before the law change, or the deadline for access to treatment could be eased in a way that would halve the cost impact. Repealing the care guarantee would reduce the state's costs in total at the level of 2023, according to the government's proposal, by around 130 million euros starting in 2025.

VM also proposes that, for example, the amount of training for doctors, nurses and psychologists could be permanently increased in order to improve the availability of personnel and curb salary pressure. In turn, the training of caregivers and care assistants should be reformed to increase the attractiveness of the training.

International recruitment should also be promoted, according to the Ministry of Health.

Cost rise control

VM also mentions changes to the Disability Services Act as a savings target.

This spring, right at the end of the last election period, the parliament approved the reform of the disability services legislation. The bill was changed during the parliamentary hearing so that the target group of the services expanded. According to VM, the costs of the law changes were not assessed sufficiently, but according to VM's estimate, the costs will increase from the original estimate of the law.

According to the Ministry of the Interior, in order to ensure the adequacy of the personnel and the functionality of the service system, it is necessary to consider that the new duties and obligations established in the past election period should be dismantled in a moderate manner. pay attention to controlling the rise in costs and reforming the operation.

According to the Ministry of Finance, the financing system for welfare areas should be developed in such a way that it supports the control of cost growth more strongly than at present.

There are also elements in the Finance Act that are not appropriate from the point of view of the transparency of the financial system and, on the other hand, the equality of funding between regions. An example of this is, according to VM, the permanent transition equalizations, which should be considered to be removed. Depending on the way in which the transitional equalization would be removed, the permanent cost savings would be 100–150 million euros per year.

VM also proposes canceling the reform of the nurse assessment. Anu Kivistö

Billion savings?

The coalition that formed the government presented in its economic program during the elections that social and health services could save 1 billion by curbing costs.

The coalition stated that the need for services will increase significantly in the coming years, which means an increase in costs in any case, and it is necessary to be able to curb the growth of costs while taking care of the availability and quality of services.

– The funding model must guide regions to implement the best practices throughout Finland. For example, the Welfare Association HALI (2022) has calculated that if the most expensive half of the municipality had reached the level of the median municipality in terms of unit costs, a saving of one billion euros would have been achieved in the public economy without compromising the level of service. A functioning multi-producer model improves productivity and the quality of services, the committee said.

In addition, the coalition outlined that 0.5 billion euros could be saved from public procurement, and the largest share of procurements will be made in social and health services.

– More procurements should be made from the competitive market sector and procurements from in-house companies prune. The Procurement Act will be reformed, tendering for procurement will be improved and the resources of the competition authority will be strengthened, the coalition said.

The second largest party in the government negotiations, Basic Finns, did not state the euro amounts of the savings or cuts they proposed in their economic program during the elections. As means of saving, the party presented, among other things, the precise prioritization of public spending. According to the party, austerity measures must be focused especially on immigration, development aid and climate measures.

On welfare areas, the PS, among other things, outlined that making the public procurement market more efficient is key when aiming to improve the use of public funds, and healthy competition in welfare areas distorts public business activity must be curbed by changing the Procurement Act.

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