New state level research and development agency

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

In February 2008 the Government decided to merge the National Public Health Institute (KTL) and the National Research and Development Centre for Welfare and Health (STAKES) to form a new national research and development agency. The objective of the reform is to improve the efficiency of the state level health and social sector research and development activities. The goal is that the new agency will start in January 2009.

Purpose of health policy or idea

The government decided in February 2008 to merge two sector research agencies working under the supervision of the Ministry of Social Affairs and Health (MSAH) to form a new national research and development agency. These agencies are the National Public Health Institute (KTL, about 900 employees) and the National Research and Development Centre for Welfare and Health (STAKES, about 500 employees). The role of KTL has been to carry out research on diseases and their prevention, to collect data on communicable diseases, health behaviour and the effects of health promotion. The role of STAKES has been to monitor and evaluate activities in social welfare and health care services, and to carry out research and development work in these fields. These agencies manage extensive registers on health, well-being and service system. One of the main objectives of both agencies is to provide information for municipalities to assist their task in the provision of health and social services.

The objective of the process is to remove functional overlap between agencies, to increase co-operation between scientific disciplines, to strengthen the steering of sector research, to create a stronger structural and financial basis for the research and development activities, and to reorient the focus of the activities (for example decrease basic research and increase the development activities and policy relevant research).

Main points

Main objectives

To improve the efficiency of state level health and social sector research and development activities.

Type of incentives

Perceived sub-optimal use of resources for state level social and health sector research and development work.

Groups affected

State administration, municipalities and other service providers

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

Merging of the agencies is not a completely new idea but it is a major step in the development of state administration of social welfare and health care.

Political and economic background

The reform is connected to the change of the government. After the parliamentary elections in March 2007, the new government was appointed in April 2007 (See HPM report "The government programme for the years 2007-2010"). Compared to the previous government, the most notable change was that after 12 years as a strong political party in the government the Social Democrats moved to opposition and after 4 years in opposition the National Coalition Party ascended to the government (the prime minister remained the same). As a consequence, in terms of traditional political divisions the new government moved the government power balance to the right. The reform of the sector research activities of the state administration is explicitly stated as a goal in the government programme.

The reform takes place concurrently when the long-term Director General of STAKES retires in May 2008.

Change of government

The new Government was appointed in April 2007 after the Parliament elections

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

The predecessor of KTL is the State Serum Laboratory founded in 1924 which was renamed as Public Health Laboratory in 1970 and as the National Public Health Institute in 1982. STAKES has been founded in 1992 when the National Board of Social Welfare and Health was dismantled. This was connected to the process where the state gave up its earlier regulatory and financial power to steer municipal services and concentrated on setting general policy objectives and on guidance by information.

Discussion on relocation of the activities of STAKES in state administration and possible overlap of the activities of different agencies under the Ministry of Social Affairs and Health (MSAH) has been going on for many years. In 2004 Professor Huttunen (former Director General of KTL) made a report commissioned by the government's Science and Technology Policy Council on sector research in state administration. In that report it was suggested that STAKES should be merged with the National Authority for Medicolegal Affairs and the National Product Control Agency for Welfare and Health.

Soon after the current government was formed, the Ministry of Social Affairs and Health (MSAH) named Professor Huttunen and Mr. Mäki-Lohiluoma (Deputy Director General of the Association of Finnish Local and Regional Authorities) to prepare a report on how to reorganise the functions of the agencies under the MSAH and make them more efficient. Their report was publicised in December 2007. They suggested that KTL and STAKES should be merged together to form a new national research and development agency. The report suggested also that two mental hospitals and several foster homes which had come under administration of STAKES in previous organisational changes should be placed under the municipal administration or changed as independent units.

Their report included also a proposal to form a larger agency for social and health sector supervision by merging the National Authority for Medicolegal Affairs (about 70 employees) and the National Product Control Agency for Welfare and Health (about 90 employees).

Initiators of idea/main actors

• Regierung

• Leistungserbringer

Approach of idea

The approach of the idea is described as:
new:

Stakeholder positions

The government strongly supports the reform. Also the Association of Finnish Local and Regional Authorities, municipalities and hospital districts support the reform. Both agencies have been rather reserved for the merger idea but see that it can provide opportunities to improve the state level research and development activities. No stakeholder does explicitly oppose the reform.

Actors and positions

Regierung
The government	sehr unterstützend		stark dagegen
The National Public Health Institute	sehr unterstützend		stark dagegen
The National Research and Development Centre for Welfare and Health	sehr unterstützend		stark dagegen
Leistungserbringer
The Association of Finnish Local and Regional Authorities	sehr unterstützend		stark dagegen
Municipalities	sehr unterstützend		stark dagegen
Hospital districts	sehr unterstützend		stark dagegen

Influences in policy making and legislation

The merging of the two agencies needs changes in several acts. The needed legislative changes will be made during 2008.

Legislative outcome

n/a

Actors and influence

Regierung
The government	sehr groß		kein
The National Public Health Institute	sehr groß		kein
The National Research and Development Centre for Welfare and Health	sehr groß		kein
Leistungserbringer
The Association of Finnish Local and Regional Authorities	sehr groß		kein
Municipalities	sehr groß		kein
Hospital districts	sehr groß		kein

Positions and Influences at a glance

Adoption and implementation

The strategy for the new agency will be defined by June 2008. After that decisions are made on the organisational structure of the new agency. The goal is that the new agency will start in January 2009. MSAH has the leading role in the process together with STAKES and KTL. The merger process involves significant amount of work, for example in merging infrastructures. There is not yet a decision on financial resources of the new agency but permanent employees are not going to be discharged.

Monitoring and evaluation

Evaluation mechanism has not been specified at this point of the process.

Expected outcome

There is the possibility that the reform can achieve stated objectives. However, much depends on the decisions to be made on strategy, organisation and directors of the new agency. One pitfall of the reform is that two agencies will only formally be merged in one organisation, but activities are not seamlessly integrated and refocused. A major challenge is that currently there are significant functional differences between the agencies.

Impact of this policy

Qualität	kaum Einfluss		starker Einfluss
Gerechtigkeit	System weniger gerecht		System gerechter
Kosteneffizienz	sehr gering		sehr hoch

The new agency may have better possibilities than current agencies to support the positive developments in the municipal health care system as it can bring better co-ordination of the state level activities in the field and stronger focus in development work.

 

References

Sources of Information

The National Research and Development Centre for Welfare and Health (STAKES). www.stakes.fi/EN
The National Public Health Institute (KTL). www.ktl.fi/portal/english/

Author/s and/or contributors to this survey

Vuorenkoski, Lauri and Ilmo Keskimäki

Empfohlene Zitierweise für diesen Online-Artikel:

Vuorenkoski, Lauri and Ilmo Keskimäki. "New state level research and development agency". Health Policy Monitor, April 2008. Available at http://www.hpm.org/survey/fi/a11/4