Finland

Citation

(2006), "Finland", International Journal of Health Care Quality Assurance, Vol. 19 No. 3. https://doi.org/10.1108/ijhcqa.2006.06219cab.001

Finland

Edited by Jo Lamb-White

Europe, Middle East and Africa

Finland

OECD: Finish Health Health Care Systems Performs Well - Finalnd is Encouraged to Pursue Reforms

Keywords: Pharmaceutical products, Finland

The Organisation for Economic Co-operation and Development (OECD) has released its review of the Finnish health system that states that the Finnish health system performs well in international comparisons. Total health expenditure as a share of gross domestic product is 7.4 per cent in Finland, well below the OECD average (8.8 per cent in 2003). On the whole, public health spending is well under control in Finland. Finns also report higher satisfaction with their health system than people in many other OECD countries.

The technical quality of health services is good, there are policies that favour prevention, the level of professional skills among the health personnel is high, and many indicators show results that are above the OECD average. For example, death rates from diseases of the circulatory system have clearly decreased in 30 years, cancer screening is organised comprehensively, availability of kidney transplants is good, and access to urgent hip repairs following falls among the elderly is expeditious in Finland.

Structures and incentives should be examined

According to the OECD reviewers, the recent reforms to the Finnish health system as well as the plans to develop health care, including the National Project to Secure the Future of Health Care Services, are good. The OECD views, however, that these measures are not sufficient. Technological change and rising expectations will be putting the health system under increasing strain in future. Also, Finland will be facing the problem of an ageing population sooner than many other countries and this poses a great challenge for the Finnish health system.

The OECD views that in international comparisons one of the black spots of the Finnish health system are the rapidly increasing pharmaceutical expenditure and the arrangements of national health insurance reimbursement in general, long waiting times as well as shortage of health personnel. There is still room for improvement with regard to access to appointment with health centre physicians and elective surgery, although the targets for maximum waiting times for treatment and the guidelines on treatment that came into force in spring 2005 seem to have reduced the queues. Mainly on the grounds of experience from other countries, the OECD reviewers express, however, their concern that the improvements the timeframe reform has generated will not necessarily be permanent.

Consequently the OECD encourages Finland to pursue more structural reforms of the health system in order to ensure financial sustainability and good value for money. The report introduces several different kinds of incentives that should motivate the health personnel to achieve comprehensive cost efficiency that takes into account both the quantity and quality of services. In all the OECD report introduces more than 20 recommendations for future reform.

Employed population in better position

The OECD criticises Finland for inequitable access to some services with reference to international comparisons that suggest that access to general practitioners in Finland is comparatively inequitable across income groups. The employed population seems to have better access to general practitioners due to occupational health care whereas the non-employed population has to rely on services provided by health centres and the private sector. Furthermore, the employed population has access to free occupational health care whereas the non-employed population who typically are worse off must pay for appointments with general practitioners.

Previous review dates from 1998

The last time the OECD reviewed the Finnish health system was in 1998 as a part of an annual economic survey. The review played a role in enhancing the debate on the development of health care in Finland that later resulted in the National Health Project. The present review is more thorough and extensive than the review of 1998.

One of the aims of the present review was that an outsider’s review could provide tools to continue and possibly revise the National Health Project. It should be noted that the OECD Review was initiated in autumn 2004 and, therefore, it could not take into account the Project to Restructure Municipalities and Services launched in May 2005 or its plans to reform the health system structures.

The report “OECD Reviews of Health Systems: Finland” was released on Wednesday 7 December 2005 at the House of Estates in Helsinki. The report is published in the OECD Reviews of Health Systems Series.

Further information: http://e.finland.fi