General description of the reform package

The health, social services and regional government reform will establish the new counties and reform the structure, services and funding of health and social services as well as transfer new duties to the counties. The reform is due to come into force on 1 January 2020.

Public administration in Finland will be organised on a three-tier level as follows: central government, counties (autonomous regions), local government. The existing regional divisions will be used as a basis for dividing the country into counties. There will be 18 counties in Finland,  which will organise all public healthcare and social services in their area. Some other duties will be transferred to the counties as well, from Centres for Economic Development, Regional State Administrative Agencies, Regional Councils and other joint municipal authorities and municipalities 

Once these functions have been transferred from nearly 190 different designated authorities to just 18 counties, the number of joint statutory organisations, namely different local authorities and healthcare and social welfare service providers, will be markedly reduced.

In this way services can be better managed as a regional, well-balanced structure. The aim is to provide people with services on a more equal basis than before and level out differences in health and well-being, and to curb cost increases. Basic services will be strengthened and information technology will be used more effectively.

The state shall have primary responsibility for financing the counties. The existing multi-channelled financial resourcing will be made simpler and clients in social and health services will have more freedom of choice. 

The reform aims at bridging a large part of the sustainability gap in general government finances. The Government aims to save EUR 10 billion. The reforms in healthcare and social services are expected to cover approximately EUR 3 billion of this sum by 2029.  To save EUR 3 billion, expenditure may only grow by 0.9% annually. The current annual rate of growth is 2.4%.

The counties will be multiplex

Besides healthcare and social services, the following duties will also be brought together under the counties as of 1 January 2020:

  • the duties of rescue services
  • Duties of the regional councils
  • Regional development duties and tasks related to the promotion of business enterprise  
  • Environmental healthcare
  • Planning and steering of use of regions
  • Promotion of regional culture and identity
  • Other statutory services organised on a scale that is larger than a municipality that require deliberation