The Ministry of Social Affairs and Health has prepared a government proposal on changing the law on health care and social welfare regarding regulations on preparedness for disturbances and exceptional circumstances. The mayors of the 21 biggest cities in Finland believe the proposal does not improve but rather weakens the possibilities to administer social and health care and other critical services during exceptional circumstances. If approved and ratified, the legislative proposal would break the current, well-functioning structures, cause overlapping work and increase costs. Proposals of this magnitude concerning the functions, jurisdiction and autonomy of municipalities should be carefully prepared in cooperation with the municipal field, not in the midst of crisis.
According to the proposal, hospital districts with university hospitals would be given the task of leading and coordinating the general planning on preparedness of social and health care as well as maintaining situation awareness. The transfer of the responsibility on the direction and execution of social and health care services from municipalities and joint municipal authorities to hospital districts in an exceptional situation endangers the maintain of control of the overall situation. Hospital districts do not have the capacity or know-how in the administration of basic health and social services. The mayors believe that the proposal causes confusion in the currently functional local structures on liabilities and management and creates uncertainty in dealing with the current epidemic.
The swift preparation schedule has been justified by the exceptional circumstances due to the coronavirus pandemic. According to the mayors, the exceptional circumstances do not provide sufficient grounds for too strict a schedule. A significant change such as the one proposed here requires a thorough preparing regardless of the prevailing circumstances.
In the proposal, neither the liabilities and tasks of municipalities and joint municipal authorities in terms of basic health care, social care and preparedness nor the effects of the suggested changes on the functioning of the municipalities and joint municipal authorities have been sufficiently considered. The proposal contains inadequacies and has been prepared with too limited a scope. Furthermore, the proposal does not address the key issues that have manifested in the administration of the current disturbances. In addition to pandemics, other types of exceptional circumstances need to be considered in the developing of preparedness. These may include problems in the distribution of water or electricity or other severe disturbances with infrastructure.
The current legislation gives good and sufficient grounds to solve problems detected during acute crisis. For instance, common situation awareness and information exchange required for crisis management can be improved within the framework of current legislation. For this, it is essential that information exchange and obtaining an overall picture should be enhanced among the different actors of state administration and between the state, the large cities and the hospital districts. However, individual and hastily implemented legislative changes do not help in solving challenges that remain mainly functional.
This statement was issued by the C21 network of mayors, municipal leaders that represent the cities of Helsinki, Espoo, Tampere, Vantaa, Oulu, Turku, Jyväskylä, Lahti, Kuopio, Kouvola, Pori, Joensuu, Lappeenranta, Hämeenlinna, Vaasa, Rovaniemi, Seinäjoki, Mikkeli, Kotka, Salo and Porvoo. The network meets regularly to strengthen communications in the area of municipal policy and jointly promote the best interests of the country’s largest cities.