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Sote and Brexit, the ugly twins

20.03.2019

Anyone who has recently opened a newspaper, switched on a TV or visited a shopping centre cannot fail to be aware that this spring Finland goes to the polls again – and not just once, but twice, since parliamentary elections in mid-April are quickly followed by European elections at the end of May. Publication of the candidate numbers four weeks or so before election day normally signals the start of the active phase of campaigning, but this time around – thanks to the demise of the health and social care reform bill – we’re a week ahead of schedule.

Juha Sipilä’s decision to submit his government’s resignation notice came as a surprise to most observers, especially since Finland will take over the rotating presidency of the EU on July 1st this year. The reasons for this dramatic development are naturally tactical – the Centre Party, National Coalition Party and Blue Reform will now have five weeks to argue openly amongst themselves over why Sipilä’s key piece of legislation has finally sunk beneath the waves – and after repeated warnings from all directions, not only the opposition, that this was the most likely outcome.

This is not a time for rejoicing or gloating. Millions of euros of taxpayers’ money have gone into the preparations for these reforms. Fortunately, in Central Finland there is considerable consensus about the direction we should be taking in these matters and much of the work done can used to good effect down the line. The new state-of-the-art central hospital, Sairaala Nova, will be completed in 2020. New digital solutions are already in the pipeline.

But let’s be clear about the reasons the reform failed: firstly, the well-being of ordinary people who need care got lost along the way, as did another key consideration, simplifying the system in order to minimize cost pressures and improve sustainability. Secondly, the crude compromise between the Centre Party and the conservatives – ‘we get provincial government, you get freedom of choice’ – was always contentious and constitutionally unsound. And thirdly, just like British prime minister Theresa May’s attitude to Brexit – my deal or no deal – the reform just did not have the input or support from opposition parties. Broad political and popular support is a must for any major reform. Neither Sipilä nor May sought the assistance of other parties until their projects were on the rocks. At the national level we clearly need a reset, and a quick one – a return to the original goals of the reform, a sustainable, integrated care system that meets the needs and wishes of its customers, irrespective of age, income or place of residence. A much lower annual cap on the cost of treatment and medicines might also be part of the reform package. A progressive government led by the SDP is undoubtedly best placed to finally bring this about.

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