Hyvinvointialueen itsehallinnon rajoilla. Miten oikeus riittäviin terveyspalveluihin rajaa hyvinvointialueen paikallista itsehallintoa?
Avainsanat:
itsehallinto, perusoikeudet, hyvinvointialueet, sosiaali- ja terveyshallinto, terveyspalvelutAbstrakti
On the borders of the self-government of wellbeing services counties. How does the right to adequate medical services limit the self-governance of
wellbeing services counties?
In Finland’s social and healthcare reform, a new level of administration was established, i.e., 21 self-governing wellbeing services counties. Wellbeing services counties are responsible for arranging social care, healthcare and rescue operations in their area. The highest decision-maker in wellbeing services counties is the democratically-elected regional council, and one of the goals of the reform was to strengthen the democratic control of these duties. However, the content of the services that are the responsibility of the welfare services counties has been comprehensively regulated, and as early as the preparation phase of the reform, the Constitutional Law Committee of the Finnish Parliament drew attention to the fact that this self-government remains quite thin.
In the article, we discuss how the legislation on the content of healthcare limits the authority of regional councils, and evaluate the implementation of the self-governance of the wellbeing services counties. A binding minimum quality level has been set for most of the healthcare services. Wellbeing services counties can produce services exceeding this minimum level, but considering their financial situation, this possibility is mostly theoretical. The conclusion of the article is that the self-governance of wellbeing services counties regarding the contents of healthcare services is mainly limited to service network issues and, within certain limits, to the choice of the production form. Wellbeing services counties cannot necessarily even be considered self-governing as defined in the European Charter of Local Self-Government.
