Introduction
Finnish-speaking primary care doctors and nurses serve patients who do not speak sufficiently good Finnish for a doctor consultation. This is estimated to be 5-10% of all such consultations. These medical professionals are able to use English as well, but this means that their time is taken away from patients who speak Finnish. Procuring non-Finnish speaking doctor/nurse services for this first-contact scope of work from the private sector will improve outcomes for ALL demographic groups and reduce overall costs at the same time.
About 5-10% of the population is served by Finnish-speaking doctors even though Finnish is not a language they are fluent in. Add to this another 10-20% of the population who could be willing to receive medical care in English if there was effectively no waiting time. This is wastage of precious resources for no significant benefit. Procure non-Finnish speaking doctor/nurse services for a limited scope of work from the private sector to improve outcomes for ALL demographic groups and reduce overall costs at the same time. We can pilot on a small scope and then expand.
The current attempt to balance the healthcare budget is framed as a tension between cutting costs (by reducing resources) or raising taxes. Innovative solutions that NEITHER cut resources NOR raise taxes are particularly valuable because they are financially sustainable and improve health outcomes.
What will be improved
- We will have a larger pool of GP doctors and/or Nurse Practitioners
- Some current healthcare workers will have their workload spread out more
- Finnish speakers will have easier access to doctors because Finnish-speaking doctors will be freed up to serve Finnish speakers
- Swedish speakers will have easier access to doctors because we can add doctors to the labour pool even if they speak only Swedish
- Those who speak neither Finnish nor Swedish fluently can still see a doctor who speaks English or who speaks another language they are fluent in
- Internationals will be able to get integrated to Finnish healthcare culture in their own language so they do not overconsume
- This service will be a ready test-bed for innovative programs in healthcare
- We create a possibility to re-introduce the family medicine system to Pohjanmaa to save costs over the long term
How it can be implemented
- A private company can be contracted to provide manpower if restrictions on mandatory language skill (eg both Finnish and Swedish) cannot be circumvented by Valvira
- The company can be owned by the municipality, or fully private, or even be from another EU country
- If Valvira can lift its language requirements and qualify doctors who speak English but not Finnish/Swedish, it could theoretically be done completely under the hyvinvointialue
- If the company is owned by the municipality or hyvinvointialue, it can serve other municipalities as well and any profits are channeled into Pohjanmaa region
- If the company is a foreign company providing telehealth services, it will use the EU prescription system and could be “onshored” to Finland gradually to add to in-person clinical visit resources
- The contract is not on a per-visit basis, but “healthcare as a subscription” and based on population covered
- This ensures that outcome and performance metrics across public and private health are aligned and that the hyvinvointialue is not just buying labour from private companies at marked-up rates
- This system limits excess costs while ensuring maximum possible supply
- Ergo this is a privatised version of social healthcare
- Telehealth (both chat and video) is always the first point of contact for non-Finnish primary healthcare, improving access speed and lowering costs
How can it be funded
- If we are able to calculate the current expenditure on GP Primary (excluding home care) medicine offered to non-Finnish speakers, we can set that or a part of it as an initial budget
- Alternatively, we could offer an opt-in co-pay system, where people have to enrol and pay but it is partially subsidised by the wellness area
- Another possible way is for it to be fully privately paid, but purchased through the hyvinvointialue so that there is stronger pooled bargaining power
Other details about this policy proposal, including caveats, pricing indicators, and unknown factors, can be found sketched out in this document.
Your feedback and engagement is welcome, and if you are also in a position to push for the implementation of this policy proposal, please contact me.
