Healthcare system in Finland

Public health care

In Finland, municipalities are responsible for organising and financing health care. A municipality can organise services by providing them itself or in collaboration with other municipalities or purchasing services from private companies or from organisations. If necessary, treatment can also be purchased from abroad.

Health services are divided into primary health care and specialised medical care. Primary health care services are provided at municipal health centres.

Specialised medical care is usually provided at hospitals. Municipalities form hospital districts that are responsible for providing specialised medical care in their area. In addition, joint municipal authorities belong to five catchment areas for highly specialised medical care, which are formed around the University Hospitals of Helsinki, Turku, Tampere, Oulu and Kuopio. The most demanding treatment is provided in these.

The treatment of some demanding rare illnesses or diseases has been centralised nationally in one hospital or healthcare unit. The treatment of children with congenital heart diseases (Helsinki University Central Hospital, HUCH), organ transplants (HUCH), severe burns (HUCH) and hyperbaric oxygen therapy (Turku University Central Hospital) are some examples.

The health services that the municipality must provide are laid down separately in the relevant Act. The municipalities can, within the limits of legislation, determine the scope and content of services and decide on how they will be provided. For this reason, there may be municipality-specific differences in services.

The treatment of a patient is provided in either primary health care or specialised medical care depending on the level of care they require. The doctor assesses the need for treatment and, if necessary, refers the patient to specialised medical care. Patients cannot choose themselves whether the treatment they require is provided in the primary health care or specialised medical care system. Patients can, however, choose the health centre responsible for treatment and the unit providing specialised medical care.

Private health care

Private health services complement municipal services, providing more than a quarter of all social and health services in Finland. Private service providers, i.e. companies, independent practitioners, organisations and foundations, may sell their services to municipalities, to joint municipal authorities or directly to clients. Private operators provide both primary health care and specialised medical care services. In Finland, private health services are partly subsidised with public funds since Kela pays reimbursement for medical expenses.

Private healthcare companies must apply for a licence for their operations from a Regional State Administrative Agency or the National Supervisory Authority for Welfare and Health (Valvira).  A licence is not needed when a healthcare professional provides services as an independent practitioner. However, independent practitioners must report their activities to the Regional State Administrative Agency. Licensed healthcare professional must have a licence granted by Valvira to practice their profession.

Organisations

There are numerous organisations in Finland that provide social and health services for various patient and client groups. The services supplement public healthcare, and their aim can be, for example, to promote public health or support patients in coping with their disease or illness. Peer support and expertise by experience are crucial to the activities provided by organisations. The activities of the third sector are not profit driven and are frequently based on voluntary work.

The umbrella organisation for social and health sector non-governmental organisations (NGOs) in Finland is SOSTE. Information about social welfare and health sector NGOs has been compiled on the website of SOSTE.

Healthcare professionals

Healthcare professionals in Finland are divided into licensed professionals and professionals with a protected occupational title. Licensing means that an individual has completed a training programme laid down in the relevant legislation and decrees and has been authorised to work in the profession in question and to use the occupational title in question. The licence is granted by the National Supervisory Authority for Welfare and Health (Valvira).

Information on all licensed healthcare professionals is entered in JulkiTerhikki, the registered database maintained by Valvira. The register is public and open to everyone. You can check the professional qualifications of the person who treated you. The register contains information on the individual’s registration number and professional practise rights.

The professions with protected occupational titles may also be practised by those who otherwise possess the requisite training, experience and competence. A healthcare professional with a protected occupational title does not necessarily require authorisation by Valvira to use a protected occupational title. Information on persons using a protected occupational title is entered in JulkiTerhikki.

The authority must notify the authorities of other EU countries if the operations of a health care professional are limited or prohibited.

Steering of health care

In Finland, the Ministry of Social Affairs and Health (STM) is responsible for social and health policy and prepares legislation. The ministry steers health care in collaboration with the agencies and institutions under it. Agencies under the Ministry of Social Affairs and Health include

• the National Institute for Health and Welfare (THL)
• the Finnish Medicines Agency (Fimea)
• the Radiation and Nuclear Safety Authority
• the Finnish Institute of Occupational Health (TTL)
• the National Supervisory Authority for Welfare and Health (Valvira).