The government programme for the years 2007-2010

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

Abstract

The government programme is formulated when a new government is formed. After parliamentary elections a new government was appointed in April 2007. From the health policy perspective, the most important themes of the new programme are to increase co-operation between municipalities and between primary and secondary care, reform user-fees in municipal services, promote quality and effectiveness of services, scale up health promotion and primary health care, and endorse private service production.

Purpose of health policy or idea

Each time when a new government is formed, the government programme is agreed upon by the political parties participating in the government. It is a plan of action defining the main tasks facing the incoming administration. The prime minister monitors the implementation of the programme. Normally government changes every four years after the parliamentary elections.

After the last parliamentary elections in March 2007, the new government was appointed in April 2007. The name of the new government programme is "A responsible, caring and rewarding Finland". It has about 70 pages alltogether and includes about 20 different tasks related to health policy.

Tasks related to organisational structure

• The project to restructure municipalities and services will be carried forward and necessary legislative amendments will be prepared (see HPM 7/2006);
• The development of electronic information systems will be continued (see HPM 9/2007);
• The Primary Health Care Act and the Act on Specialized Medical Care will be combined into a comprehensive Health Care Act to lower the barriers between primary and secondary care and to improve co-operation;
• Seamless service chains in primary care, secondary care and closely related social services, including preventive measures, will be improved;
• The role of primary health care will be reinforced. Also special measures will be taken to develop social work, emergency care, and mental health care and substance abuse services;
• Steps will be taken to improve the evaluation of the quality and effectiveness of the services and supervision and guidance of services will be improved;
• The municipalities' capabilities for research, development and service innovations will be enhanced;
• A social and health care services innovation project will be carried out aimed at improving the patient empowerment, effectiveness and cost-efficiency of services, developing the division of duties and expanding the diversity of services;
• The availability of sufficiently qualified personnel will be ensured by means of on-the-job training, competitive compensation plans, developing the content of work and management systems.

  Tasks related to access to services

• The system of guaranteed access to health care services will be reviewed, and the necessary changes to the time limits and procedures will be made (see HPM 7/2006);
• The citizens' right to seek care across municipal borders will be expanded.

  Tasks related to costs/financing

• A revision of the user-fees of municipal social and health care services will be carried out to adjust for inflation. At the same time, a system will be created under which the charges will, in future, be adjusted to reflect the changes in actual cost levels and that the patient or client charges do not induce people to select inappropriate forms of treatment;
• User-fee ceilings in municipal services will be reformed;
• In order to raise cost awareness, the transparency of the pricing and financing of municipal services will be increased, the objective being that the customer is informed not only of his or her own share of the cost but also of the total cost of the service provided;
• The outpatient drug reimbursement system will be reformed so that cost containment is more efficient. A special working group will be appointed by the Ministry of Social Affairs and Health to look into the issue;
• The state contribution to National Health Insurance will be included within the general state spending limits (previously it was not included);
• Municipal finances will be strengthened by increasing the state subsidies to municipalities.

  Tasks related to health promotion

• Multisectoral four year government programme "Policy programme for health promotion" will be carried out;
• Taxes on alcoholic beverages and tobacco products will be raised.

  Tasks related to private service production

• Government promotes partnerships between the public, private and third sector in the provision of services. The adoption of the purchaser-provider model in the municipal services will be encouraged;
• The use of the municipal service vouchers in social and health services will be extended as appropriate. The service voucher system will be expanded to home nursing from the beginning of 2008 (see HPM 10/2007);
• The National Health Insurance reimbursement for private dentists' fees will be increased from 30 to 40 per cent;
• Commercialisation and exporting of health care innovations will be encouraged in the social and health care services innovation project.

Main points

Main objectives

The function of the government programme is to be an agreement between the coalition parties on the political objectives of the government. General objectives of the programme in terms of health policy are to ensure the funding and availability of good quality and efficient social and health services and to increase population health.

Type of incentives

State level direct political steering of the development of health care services.

Groups affected

State, Municipalities, Health care providers

Degree of Innovation	traditional		innovative
Degree of Controversy	consensual		highly controversial
Structural or Systemic Impact	marginal		fundamental
Public Visibility	very low		very high
Transferability	strongly system-dependent		system-neutral

The government programme is rather consensual and it does not contain any radical propositions in terms of health policy.

Political and economic background

During the last two decades the Finnish governments have typically been coalition governments, which are based on two of the three largest political parties (the Finnish Centre Party, the National Coalition Party and the Finnish Social Democratic Party) while one of them is the leading opposition party.

After the parliamentary elections in March 2007, the new government was appointed in April 2007. It is a coalition of the Finnish Centre Party (8 ministers), the National Coalition Party (8 ministers), the Green Party (2 ministers) and the Swedish People's Party (2 ministers). The Prime minister is Mr. Matti Vanhanen (the Finnish Centre Party), who was already the head of the previous government. Compared to the previous government, the most notable change was the move of the Finnish Social Democratic Party from government to opposition and the move of the National Coalition Party from opposition to government. The Finnish Social Democratic Party had been in the government for the previous 12 years. As a consequence the new government is more of a right-wing government as previous government had been.

Change of government

After the parliament elections in March 2007

Purpose and process analysis

Current Process Stages

	Idea	Pilot	Policy Paper	Legislation	Implementation	Evaluation	Change
Implemented in this survey?

Origins of health policy idea

The government programme is formulated by the political parties forming the new government. Many themes in the programme come from the (internal and public) documents which these parties produced for the election campaigns. Naturally opposition parties did not have any direct influence on the development of the government programme.

Some of the tasks defined in the programme are continuations from the previous government programme but there are also some new emphases. For example the promotion of private provision, creation of a comprehensive Health Care Act, reforming user-fees, increasing the transparency of the pricing and financing of municipal services and the expansion of patient rights to seek care across municipal borders are relatively fresh emphases.

Initiators of idea/main actors

• Government: Concerning health policy issues

• Providers

• Political Parties

Approach of idea

The approach of the idea is described as:
amended: Continuation for the programme of the previous government

Stakeholder positions

The government programme reflects the targets of the political parties forming the government and naturally they are very supportive of the programme while opposition parties have many objections to it. For example the Social Democratic Party and the Left Wing Alliance are rather opposed to the promotion of private service provision. Generallyproviders (municipalities, hospital districts and private providers) do not have any strong negative or supportive position on the government programme, although they can have strong positions on some specific issues. Health policy issues of the new government programme have so far not been discussed in the media very much.

Actors and positions

Government
The government	very supportive		strongly opposed
The Ministry for Social Affairs and Health	very supportive		strongly opposed
Providers
Municipalities	very supportive		strongly opposed
Private providers	very supportive		strongly opposed
Political Parties
The parties in the government	very supportive		strongly opposed
The parties in the opposition	very supportive		strongly opposed

Influences in policy making and legislation

The programme will lead to legislation changes. Political parties in the government have the majority of seats in parliament so they have good possibilities to pass legislation reforms which are necessary for the implementation of the programme.

Legislative outcome

pending

Actors and influence

Government
The government	very strong		none
The Ministry for Social Affairs and Health	very strong		none
Providers
Municipalities	very strong		none
Private providers	very strong		none
Political Parties
The parties in the government	very strong		none
The parties in the opposition	very strong		none

Positions and Influences at a glance

Adoption and implementation

Key actors in the implementation of the health policy tasks included in the government programme are the government and the Ministry of Social Affairs and Health. Other actors are parliament (when legislation or state budget changes are needed), other agencies in state administration and municipalities as the organizers of the health services.

A more detailed and implementation-oriented National Development Programme for Social and Welfare is made based on the government programme for the next four years. The development programme will be approved by the government in November 2007. The Advisory Board of Social and Health Care appointed by the government have the responsibility of preparation, implementation and follow-up of the development programme. The board is chaired by the Minister of Health and Social Services and it includes a few other key stakeholders. The board has appointed five regional working groups which are responsible on adoption and implementation of the development programme in the regional level.

Monitoring and evaluation

The office of the prime minister and the political parties involved in the government will monitor closely the implementation of the government programme. The outcome of the programme is also closely evaluated by other political parties.

Review mechanisms

Final evaluation (internal), Final evaluation (external), Mid-term review or evaluation

Dimensions of evaluation

Outcome

Results of evaluation

Not yet availabe

Expected outcome

It can be expected that the programme, if successful, will increase co-operation between municipalities, between primary and secondary care providers and between public and private sector. Presumably it will also increase quality, effectiveness, cost-containment and innovativeness to some extent. Increasing user-fees in municipal services can increase the financial barriers for access to services among low-income people.

Impact of this policy

Quality of Health Care Services	marginal		fundamental
Level of Equity	system less equitable		system more equitable
Cost Efficiency	very low		very high

Impact of the government programme is very difficult to estimate at this point, though it has rather good possibilities to achieve at least part of its objectives.

References

Sources of Information

The Government Programme "A responsible, caring and rewarding Finland" http://www.vn.fi/hallitus/hallitusohjelma/pdf/en.pdf

Author/s and/or contributors to this survey

Vuorenkoski, Lauri

Suggested citation for this online article

Vuorenkoski, Lauri. "The government programme for the years 2007-2010". Health Policy Monitor, October 2007. Available at http://www.hpm.org/survey/fi/a10/1