The cuts planned by the government are not understandable.
At its meeting on 2 March, the HUS Board discussed HUS’s statement on the state’s planned funding cuts. During the meeting I submitted a counterproposal to change the content of the statement. In this post I want to explain what the issue was about and why I considered the change important.
Significant funding cuts behind the proposal
The government’s plans are not a small technical adjustment but a large-scale reform. The proposed changes to the funding law for wellbeing services counties would mean total cuts of around €194 million to the wellbeing services counties in Uusimaa and to Helsinki’s social and health services sector. HUS’s share of this would be estimated at about €62 million.
The scale becomes concrete quickly: the sum corresponds to the annual salaries of around 1,240 nurses including employer costs.
In previous years HUS has already implemented significant cost-saving measures and balanced its finances as required by law. At the same time, staff have stretched themselves in a tight resource situation, even though access to care has not yet reached the level required by law.
In February, the HUS Board also issued a separate statement describing the change to the funding model as unfair to Uusimaa, harmful to access to care, and based on the wrong incentives.
This background is important for understanding the statement discussed on 2 March.
The section I proposed to change
During the discussion I proposed that the following sentence be removed from page two of the statement:
With reference to section 2 above, HUS considers the savings proposed by central government to be understandable in themselves, and the allocation of the savings to regions acceptable when the savings are targeted in a predictable and transparent manner.
Why I wanted the sentence removed
My reasoning was both substantive and principled.
Personally, I do not consider these cuts understandable or acceptable. More importantly, I do not believe it is appropriate for HUS, in its official statement, to assess whether the cuts are understandable or to express acceptance of them.
In my view, the role of an official authority statement is to:
- assess impacts
- describe operational constraints
- highlight risks to patient care and the service system
- give decision-makers a realistic picture of the consequences
The statement should not contain a value judgement about whether the cuts are acceptable. Such wording shifts the statement away from impact assessment toward a political position—and even into contradiction with the earlier critical statement issued by HUS.
For this reason, I proposed removing the sentence.
The vote and the outcome
The Social Democratic Party (SDP) supported my proposal, and in the vote both SDP and Green members voted in favour of removing the sentence. However, the majority of the board opposed the change.
The result of the vote was 7–10, and the sentence remained part of HUS’s statement.
Although my counterproposal did not pass this time, I believe it is important to bring these perspectives forward openly. In decision-making, minority positions are also part of the democratic process—and often part of a longer discussion about the kind of healthcare system we want to safeguard in Finland.