Socially Sustainable Finland 2020 - Strategy for social and health policy
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Socially Sustainable
Finland 2020
Strategy for social and health policy
Contents
To the reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2
Towards social sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The challenges and opportunities of the 2010s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Strategic choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1. A strong foundation for welfare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2. Access to welfare for all . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
3. A healthy and safe living environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Putting policies into practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Cooperation secures welfare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Active influence in international cooperation . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Knowledge-based decision-making . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Effective communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Trends in social protection expenditure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Strategy monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Strategy indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
To the reader
The purpose of our strategy is to achieve a We have drawn up this strategy in dialogue
socially sustainable society in which people with our interest groups and partners. This
are treated equally, everyone has the oppor- strategy, the strategies of agencies in our
tunity to participate, and everyone’s health adminstrative sector and the strategic lines
and functional capacity is supported. in various policy areas constitute a strategic
framework that is knowledge-based, and
There are many factors that will influence which we have the will to put it into practice.
3
how well we attain this goal, including eco-
nomic trends and the pluralisation of society. Implementing the strategy requires extensive
All of our decisions shape the future and national and international cooperation, in-
must be grounded in social sustainability. teraction and open communication. In prac-
tice, it can only be done through democratic
Finland is at the top of the field in several decision-making and in accordance with the
international studies on welfare. Work and policies of the Government Programme in
participation will serve to lay a strong foun- effect at any given time. Social sustainability
dation for our future welfare too. It cannot is both a means and an end.
be built as a system-oriented effort, and we
cannot aim at just improving the average level
of welfare. Social sustainability requires us to Helsinki, December 2010
reduce the welfare and health differentials
between citizens and to improve the status Kari Välimäki
of the most vulnerable members of society. Permanent Secretary
Towards social sustainability
Sustainable development involves economic,
social and ecological sustainability.
Strategic choices
A socially sustainable society
■■ treats all members of society fairly, 1. A strong foundation for welfare
4 ■■ reinforces participation and a sense of
community, ■ Health and welfare in all policies
■■ supports health and functional capacity, ■ Longer working careers through
■■ provides the security and services wellbeing at work
required by its members. ■ Balancing the various areas of life
■ Sustainable social protection financing
Finland in 2020
2. Access to welfare for all
Finland in 2020 is a socially sustainable and
vibrant society. Equality, mental and material ■ Reduce differentials in welfare and health
wellbeing, gender equality, and economic, ■ Customer-oriented services
social and ecological sustainability contribute ■ New service structures and operating
to the balanced development of society. practices
■ Strong sense of social inclusion
Social sustainability requires a functioning
social protection system1 that helps citizens 3. A healthy and safe living
cope with risks in life. Everyone has the right
environment
to social wellbeing, participation and the best
health possible. ■ Strengthen the viability of the environment
■ Ensure that society can continue to
A welfare state pursues both social and eco-
function under exceptional circumstances
nomic goals. Economic development provides
the operating potential for the welfare state,
while social protection strengthens the
balance of society and of the economy. A
correctly scaled and well-functioning social
protection system is a strength in society.
1
The concept of ‘social protection’ is here used in a broad sense, including income support, social welfare and
health care services, preventive action, occupational safety and health, and to some extent gender equality.
The challenges and opportunities of the 2010s
Demographic change, the globalisation of the The weakening of the carrying capacity of the
economy and technological advancements natural environment worldwide is affecting
are changing the operational field of social people and the environment.
protection, challenging established practices.
Finland’s population will age faster than that
The world economy has become less predict- of most other countries in the near future.
able. The operating environment is complex, This will have an impact on all of society. We 5
and the importance of national borders has must be able to provide social welfare and
diminished. Industrial production continues health care services, pensions and other forms
to migrate to Asia, and the world is becoming of social protection to everyone regardless of
multipolar. European integration is becoming the increasing pressures on public finances.
deeper and more extensive, and cross-border
mobility and multiculturalism are increasing.
Changes in technology Globalisation
Demographic change
and interaction
Changes in employment
and working life Social and health policy Changes in the economy
Pluralisation of society Regional development
State of the living
environment
■■ Increases in life span and the number of active years in life bring new opportunities.
■■ The ageing of the population is a challenge for the sustainability of public finances.
■■ Chronic lifestyle illnesses will become more common.
■■ Demographic and regional diversification threatens to continue to increase.
■■ The municipal and service structure is in a state of transition.
■■ Leveraging technology and information resources will expand the operating potential
of the social welfare and health care sector.
■■ The mobility of the population challenges welfare structures and practices.
■■ Working life and forms of work are changing.
■■ Social and health policy is increasingly being shaped in an international context.
■■ Ecological trends worldwide curb the potential for welfare.
■■ Forms of interaction between people change rapidly.
Strategic choices
1. A strong foundation for welfare
■■ Health and welfare in all policies
■■ Longer working careers through wellbeing at work
■■ Balancing the various areas of life
■■ Sustainable social protection financing
6
Welfare and prosperity are created through work Taxes, social security contributions, social
and through the involvement of all members of benefits, income transfers and services must
society. Funding for Finland’s welfare society form a coherent framework that encourages
relies on balanced economic development. paid employment and ensures that employees
can retire healthy. An incentive-based social
With demographic change public expenditure protection system encourages people to promote
will increase. At the same time, the working their welfare themselves.
age population is decreasing, and the growth
potential of the economy is declining. Social and Health and welfare in all policies
economic sustainability require a high emp-
loyment rate, healthy and capable citizens, and We must invest in health, functional capac-
effective and efficient social welfare and health ity and the prevention of social problems.
care services. We must shift our focus from treating the
sick to actively promoting wellbeing. This
Social protection increases people’s welfare by will improve the quality of life and increase
supporting health and functional capacity, by employment, boost productivity and business
providing security in changing life situations, success while restraining the growth of social
by reinforcing a sense of community and by expenditure.
equalising differences in society. Social protec-
tion also promotes stable economic growth and Society must support citizens in choices that
competitiveness by reinforcing work ability and will help them improve their quality of life.
by offering opportunities for employment, train- The aim is to take health aspects into account
ing and rehabilitation. in all social decision-making, in business life,
in the workplace and in organisations.
7
Municipal leaders are responsible for stra- Longer working careers through
tegic decisions to promote health and social wellbeing at work
wellbeing in their respective municipalities.
The means for pursuing this include com- Because the working age population is de-
munity planning, sports and culture services, creasing, working careers must be extended
early childhood education, youth work, good both at the beginning and end of working
school environments, and jobs. Promoting life, unemployment must be reduced, and
physical health, mental health and social disabilities and absences due to illness must
wellbeing will be incorporated into social be curtailed. The overall aim is to lengthen
welfare and health care services at every stage working careers by an average of three years
in life. The foundation for health and welfare by 2020.
is laid in childhood.
The attractiveness of working life must be
Tax policy can be used to support healthy increased by improving working conditions
choices. More attention will be paid to the ad- and wellbeing at work. The better people
verse effects of too little exercise, unhealthy feel in the workplace and the more healthy
nutrition, smoking and alcohol use. they are, the longer their working careers
will be and the more productive they will
Alcohol and tobacco products are responsible be. Working conditions must be jointly
for up to half of the health differential bet- developed by management and personnel.
ween various population groups, measured Responsibility for this always rests with the
by mortality. The overall aim is to decrease employer. Employers must ensure that they
the consumption of alcohol and tobacco treat their employees equitably, and manage-
products and to maintain a zero tolerance ment must be made a key concern in the
policy on drugs. Moreover, problems caused policy on wellbeing at work. Nevertheless,
by smoking, drugs, alcohol, gambling and employees themselves have a huge responsi-
accidents in the home and in leisure time bility for maintaining their work ability and
must be prevented more effectively. professional competence.
The pension system will be reformed to take whose work ability or functional capacity is
longer life expectancies, the reconciliation temporarily or permanently impaired will
of work and family life, changing working be supported. Paths through rehabilitation
conditions and cross-border migration better and training to employment for the partly
into account. The pension, rehabilitation and disabled will be strengthened. The partial
unemployment insurance systems must be sickness allowance, partial disability pen-
developed as a single entity. sion and part-time pension systems will be
developed so as to allow for work at reduced
Working careers will be extended with the capacity and to encourage pensioners to work
aid of social insurance, pension insurance part-time. The capacity of and incentives for
8 companies, the employment and economy employers to hire employees with partial
administration and social welfare and health work ability will be supported.
care services. The aim is for social insurance
to constitute a system promoting work and Entrepreneurship will be supported by
the maintaining of functional capacity and promoting wellbeing at work for private
work ability. entrepreneurs and by improving their so-
cial security. The potential for occupational
The risk of permanent working incapacity safety and health and for occupational health
must be reduced by promoting health and care at SMEs will be enhanced.
work ability, by improving working condi-
tions and by enhancing occupational health Extensive unemployment conflicts with the
care. Particular attention must be paid to aims of the welfare society. The exclusion of
those occupations that carry the greatest the unemployed from working life will be
health risks. The incidence of musculos- prevented by boosting their work ability and
keletal diseases and mental health problems functional capacity and by providing them
must be reduced. with treatment and rehabilitation. Coopera-
tion between the education, employment and
Preventive occupational health care must social welfare and health care administrations
focus on maintaining work ability, evaluat- will be ensured so that all young people can
ing health hazards at work, and the early receive adequate training and find jobs. There
identification of diminished work abil- must be a clear division of responsibilities.
ity. Sufficiently early treatment and
timely rehabilitation require seamless Balancing the various areas of life
cooperation between occupational
health care, other health care Social protection must be able to respond to
services and the workplace. an increasing variety in life patterns, as stu-
dies, work, leisure time and responsibility for
All people of working age, family members intermingle at various stages
even those with par tial in life. Wellbeing at work and wellbeing in
work ability, must have the leisure time affect each other greatly.
opportunity to engage
in working life accord- The demands of working life are increas-
ing to their abilities. ing. Atypical employment relationships are
The participation in becoming increasingly common. New forms
working life of those of work and employment flexibility must
be taken better into account in working life. Sustainable financing for social insurance can
Social protection must encourage people to be ensured by securing a sufficient and broad 9
maintain their skills and to change job duties contribution base. The financing base for
or jobs. social protection must be secured even in an
increasingly international operating environ-
Smoothly combining work and family life ment. Because of cross-border migration, the
improves wellbeing at work and at home, social insurance rules must be developed so
increasing the birth rate, the employment that benefits and contributions are balanced.
rate and the capacity of families with children
to manage their everyday lives. Family leave, Social sustainability can be ensured by curb-
high-quality early childhood education serv- ing pressures on expenditures and payments.
ices and flexible working hours help reconcile The overall aim is to keep the increase in
work and family life. The need for reconcilia- social security contributions under control
tion is heightened in the case of single parents and to invest pension funds profitably and
and employees whose elderly, ill or disabled safely.
family members require assistance.
In order to ensure that the pension system
The system for providing care to small chil- functions coherently, the preparation of pen-
dren must adapt to the different needs of sion legislation will be concentrated at the
children and families and support the bal- Ministry of Social Affairs and Health.
anced growth and development of children.
Families must have alternatives available for Clarifying the financing for social welfare and
organising child care. Family leave must be health care services will enable the maximum
divided more equally between fathers and benefit to be drawn from available resources.
mothers. Long-term efforts to strengthen the Standardising customer fees will support the
role of fathers will be continued. Parents have harmonisation of basic and special services
responsibility for their parenthood and for while keeping fees reasonable.
the rights and responsibilities that it entails.
Finland will be needing foreign employees in
Sustainable social protection financing the future. Cooperation between authorities
is being improved to prevent the emergence
Sustainable financing for a sufficient, fair of a dual job market and to ensure an equita-
and comprehensive insurance coverage can ble competitive position for employers. Public
be ensured with a high employment rate. finances will be strengthened by combating
The tax, social security contributions and the grey economy.
social protection system must function so
that employment is always the more profit-
able option.
2. Access to welfare for all
■■ Reduce differentials in welfare and health
■■ Customer-oriented services
■■ New service structures and operating practices
■■ Strong sense of social inclusion
It is a strength of Finnish society that we look added personnel, unless we can increase the pro-
10
after each other. Everyone is entitled to basic ductivity of services. Social welfare and health
income support and sufficient social welfare care services will remain labour-intensive in the
and health care services. A life of human dignity future too, but productivity can be improved by
must be ensured under all conditions. These reorganising services and introducing new ways
rights and the equality principle are written into of producing them.
the Constitution of Finland.
Basic health care does not function well enough
The fact that the public administration is in all municipalities, and there are considerable
responsible for ensuring basic rights does not regional differences in the quality and availa-
negate the responsibility of the individual for bility of services. Multi-channel funding for
his/her choices. The balance of the rights and services distorts procedures, creates unnecessary
responsibilities of the individual and of society costs and misdirects services. The restructuring
promotes social sustainability. of local government and services has progressed
more rapidly than expected especially concern-
Those who live on social security alone are at ing municipal mergers, but from the point of
risk of descending into poverty. There is concern view of the sustainability of social welfare and
over the social exclusion of young people, over health care structures, the reform is falling
increasing inequality between children and short of its goal. Developing the service system
families with children, and over the inherited requires clear and sustainable long-term policies
social exclusion. as to how to organise local social welfare and
health care services after the ongoing project is
As the age structure of the population changes, completed.
the number of elderly people is increasing, de-
mentia and other chronic illnesses are becom- Reduce differentials in welfare
ing more common, and the number of patients
with multiple complaints is increasing. This
and health
translates into an increase in expenditure on Finland has considerable differences in wel-
social and health care services and a need for fare and health between population groups
and genders, and these cannot be narrowed by
social welfare and health care measures alone:
the most efficient way to do this is through
close cooperation between administrative
sectors.11
The EU has set the strategic goal of signifi- Coherent and comprehensive insurance cove-
cantly reducing the number of people in rela- rage will ensure that no one can fall through
tive poverty and at risk of social exclusion the cracks. Income and working conditions
by 2020. Finland is also preparing a national for those engaged in working life will be
action plan intended to improve the status of secured by reinforcing universally binding
low-income people, socially excluded people collective agreements and by enforcing mini-
and the unemployed and to alleviate long- mum working conditions.
term poverty and poverty among families
with children. The principal means for doing Housing costs can be lowered to a level mana-
this is to provide sufficient basic security and geable by benefit recipients by developing the
appropriately targeted services. Minimum housing support system. Opportunities for
benefits will be tied to the consumer price the homeless and other special needs groups
index, and the sufficiency of basic security to gain a home of their own will be improved
will be periodically assessed. through cooperation between various sectors.
A job is the best protection against poverty Customer-oriented services
and social exclusion, but it is not enough on
its own. Income support, related municipal The focus of social welfare and health care
services and employment services must form services will be shifted increasingly to preven-
a seamless whole. In particular, family work tive action. The service system must be able
for helping families with children cope with to provide early and efficient assistance to
their everyday lives must be improved from people who cannot cope themselves. Exper-
a customer-oriented perspective so that it is tise in prevention must be increased among
sufficient. all professional groups in the social welfare
and health care services, and the availability
Public health is best improved by targeting of preventive services must be improved.
measures towards improving the relative
status of the most vulnerable members of so- Services will be comprehensively reformed
ciety. In addition to social welfare and health so that users will be actively involved in
care services intended for all, measures will their development. Users must be provided
be targeted at vulnerable population groups with updated and unbiased information on
such as low-income elderly people. The treatment options and service providers. This
availability of substance abuse and mental will increase the capacity of users to take
health services will be improved. responsibility for nurturing their own health
and welfare.Robust basic services are capable of early Competitive tendering must focus on social
intervention in problems and illnesses and of welfare and health care policy perspectives.
supporting customers to cope independently. Instead of short-term price competitions,
Minority groups and those living in difficult we must create partnerships for efficiently
conditions also need targeted services. In- providing services. Service funding will be
dependent living, functional capacity and changed so as to favour economic, customer-
participation of older people will be primarily oriented services.
supported in their own living environment,
with the assistance of new technology. The Medical care is an integral part of social
12 starting point here is available, equitable, welfare and health care services and patient
effective and customer-oriented services. care. The overall aim is to provide high-
quality and cost-effective medical care at a
Services for families with children will be reasonable price for everyone who needs it.
developed into a coherent entity by bringing Well-functioning social welfare and health
together all services supporting child deve- care services benefit from medical care
lopment, preventing problems and provid- services and vice versa. Good availability of
ing help, across current sectoral boundaries. medicines and a professional pharmaceutical
Adult and child psychiatry services, child distribution system will be secured under all
welfare services, child guidance clinics and circumstances.
family counselling clinics must provide com-
prehensive support for families, augmenting The social welfare and health care electronic
basic services. Efficient referral for services data management control system will be
will ensure that children and families receive strengthened. The overall aim is to create
the support they need. an information system for the social welfare
and health care sector, consisting of national
New service structures and information system services and regional
solutions based on them. The first features
operating practices to be implemented are the e-prescription and
People often see social and health services as the national health archive. A national social
fragmented and system-oriented. A coherent archive will be developed alongside these,
and sustainable structure must be created for to be implemented in stages after the health
the social welfare and health care sector by archive. National information system services
local government and service reform. will enable information to be transferred
across organisation boundaries and operat-
Services must be provided in units large ing processes to be made more efficient and
enough to have the potential to provide effective. A coherent information format will
smoothly flowing high-quality services and make it easier to control, study and compile
to maintain a high degree of professional statistics on the service system.
competence. Everyone who needs help must
continue to have access to it, regardless of Through planned and effective control of
where they live. Private social welfare and standards, resources and information, attain-
health care services augment and provide ment of the targets of the new social welfare
alternatives to municipal services. and health care legislation and creation of
comprehensive service frameworks will beensured. Supervision of social welfare and The third sector is a key player in the promo-
health care services will be standardised na- tion of health and welfare, in the prevention
tionwide from the perspective of the interests of problems and in the development of new
and safety of service users. Service quality operating practices. The overall aim is for
criteria, risk management anticipation, in- authorities and NGOs to work together to
formation systems and cooperation between increase social participation. Revenues from
expert bodies and supervisory bodies will the Slot Machine Association (RAY) will be
be improved. Quality criteria apply to both used to support the promotion of health and
public and private service providers. social welfare by non-profit associations. The
status of these NGOs will be secured in the 13
Strong sense of social inclusion development of the social welfare and health
care sector.
Social and health policy will be used to sup-
port social participation and a life of human
dignity for women and men of different ages
and for various language and cultural minori-
ties.
The opportunities afforded by an increase
in the number of healthy years in life must
be embraced. Policies must be reformed so
as to improve the potential of the elderly to
use their resources to contribute to their own
wellbeing and that of their community and
society at large.
Membership in a workplace community Multiculturalism increases the plurality and
reinforces a sense of social inclusion. The innovation of society. The integration of
overall aim is to create pathways from un- immigrants and their families into Finnish
employment to working life. Unemployment society must be supported. The overall aim
among young people and older people in is to instil positive attitudes towards immi-
particular must be prevented, as they are grants and other minorities and to improve
at a higher than average risk of permanent their real possibilities of finding jobs. Studies
unemployment. Special solutions will be and social welfare and health care services
developed for the difficult to employ and for immigrant women in particular must be
the long-term unemployed, such as a job bank supported.
to help in transferring to the open labour
market, and the transitional labour market. Reducing violence is a national goal. The
Cooperation within the social welfare and overall aim is to find an efficient, nationwide
health care services in rehabilitation chains model for preventing violence, consisting of
must be enhanced, and a customer-oriented actions taken simultaneously in various ad-
approach boosted. ministrative sectors. This will also serve to
strengthen a sense of community and internal
security.3. A healthy and safe living environment
■■ Strengthen the viability of the environment
■■ Ensure that society can continue to function under exceptional circumstances
The health and welfare of citizens are affected Strengthen the viability of the
by the state of their living environment. Climate environment
change and ecosystem decline curb the potential
14 for wellbeing. Social and ecological sustain- Improving the quality of the living environ-
ability require the safeguarding of a good life ment calls for cooperation between ministries
even when the resources available are shrinking. and administrative sectors, and also coopera-
Each generation should leave a better environ- tion at the regional and local levels. Local
ment for future generations. authorities must take health protection and
the promotion of health and welfare bet-
The equitable distribution of welfare is a chal- ter into account in community planning
lenge not only locally but globally too. Global decision-making and monitoring.
population changes, economic disruptions,
poverty and inequality impose strains on so- Cooperation between municipalities in the
cial coherence. Inequality and segregation of provision of environmental health care will
residential areas involve security risks too. be enhanced. Cross-sectoral and international
cooperation is required to prevent health
Climate change, environmental problems and risks to citizens from the air, soil, water or
declining natural resources may cause a wide food. The implementation of the European
range of health threats such as pandemics and Union’s new chemical legislation will improve
epidemics. These respect no boundaries; they the safety of chemicals on the market.
may spread quickly, and authorities must work
together to combat and prepare for them. By 2020, research-based health risk and
impact assessment must be introduced in
Worldwide economic crises have shown how all planning and projects and the permit and
important it is to have safety nets in place and approval procedures related to them.
how influential the financial and insurance
markets are. It must be possible to ensure
the vital functions of society even under
exceptional circumstances.15
Sustainable housing design and community sible use of antibiotics. Veterinary medicines
planning contribute to safety and independ- must be used with restraint for reasons of
ent coping, reduces the incidence of many public health and consumer safety.
social problems and prevents segregation of
housing districts. An obstacle-free environ- Citizens’ income must be secured even in
ment will be created by developing the com- exceptional conditions. Risks to the insurance
munity structure, ensuring ease of access and system will be prepared for through sufficient
the availability of services. guarantee arrangements. The overall aim is
to ensure that the income support and in-
Genetechnology, biotechnology and nano- surance systems can continue to function in
technology are opening up new possibilities exceptional conditions by creating sufficient
in health care and enviromental health care. unemployment insurance and social insur-
Research, regulation and guidance must be ance buffer funds.
employed to ensure that new technologies
are applied safely. The social insurance system must be organ-
ised so as to be efficient, safe for customers
Ensure that society can continue and moderate in cost. Insurance premiums
must be safeguarded through efficient risk
to function under exceptional management, profitable investments and suf-
circumstances ficient solidity. Other means include boosting
competition and supervision in the insurance
Globalisation has increased the importance
sector and preparing appropriate bankruptcy
of national and international cooperation in
regulations. Monitoring at the EU level will
combating infectious diseases. Worldwide
be enhanced by improving the operating
epidemics must be prepared for in order to
potential for the Finnish overseeing authority.
protect human health and the vital functions
of society.
Information management must function
without disruption even in exceptional condi-
Combating new, drug-resistant bacteria and
tions. The functioning of backup systems and
hospital infections requires new and more
the payment of benefits will be technically
comprehensive prevention measures and sen-
secured under all circumstances.Putting policies into practice
■■ Cooperation secures welfare
■■ Active influence in international cooperation
■■ Knowledge-based decision-making
■■ Effective communication
Strategic goals can only be attained through Operations are directed through binding
16 cooperation. Results can be produced when the legislation and resource allocation. A third
actors involved have clearly defined roles and means of guidance is information guidance,
mutually agreed operating principles. Prepara- where correct information and effectiveness
tion and decision-making must rest on a solid assessments play a key role. Because infor-
foundation of information and a will to enact mation guidance is non-binding and recom-
reforms. Open preparation allows for smoothly mendatory by nature, customer-oriented and
running cooperation with interest groups, while effective communication is needed to go with
interactive and anticipatory communication it. The best means of control for attaining a
adds to effectiveness. goal must be chosen in any given situation.
Cooperation secures welfare In order to ensure the real effectiveness of
legislation, its goals must be recorded in
Increasing employment, promoting welfare a measurable way, and responsibilities for
and health, providing early support and generating and monitoring information must
securing the effectiveness of the public be agreed on. Since monitoring may be con-
administration require close cooperation sidered a form of direction, its predictive role
between administrative sectors. No results must be strengthened. For instance, clamping
can be attained if each administrative sector down on the grey economy is linked to legisla-
jealously guards its own territory. Coopera- tion in a number of administrative sectors,
tion becomes increasingly important in the and its monitoring is therefore a joint effort
management of exceptional situations. between the occupational safety and healthauthorities, the police, the tax authorities, sustainability, including conventions and
the employment authorities and the pension recommendations of the UN, the WHO,
insurance companies. the Council of Europe and the ILO. The
prevention of the spread of infectious dis-
Social protection is being developed in inter- eases, lifestyle illnesses and social exclusion
action with key players in the field. Tripartite require extensive international coopera-
negotiations for developing income security tion, especially in neighbouring areas. EU
are ongoing. Occupational safety and health decisions and directives have a considerable
and the relevant legislation are being im-
proved with the help of the social partners. 17
A single strategic development programme
is more effective in the service sector than
several separate programmes. The National
Development Programme for Social Welfare
and Health is an umbrella programme used to
manage the reform of local social welfare and
health care services. Conducting high-quality
research and making use of innovations in
the social welfare and health care sector is
important for recruitment, service develop-
ment and from the perspective of Finland’s
competitiveness. impact on operations in the social welfare
and health care sector. Immigration matters,
Impacts on men and women, i.e. gender for instance, are of constant relevance for
impacts, must be taken into account in all social protection. Social and health policy
areas of preparation and decision-making perspectives must be taken equally into ac-
concerning welfare. This will strengthen the count alongside economic, employment and
realisation of gender equality. environmental aspects in the development
of the EU internal market and competition
Active influence in international policy and in assessing the impacts of taxation
cooperation and income transfers. Finland is preparing a
national action plan for the EU2020 strategy
The Ministry of Social Affairs and Health aiming at growth and employment, while
and its administrative sector are engaged in profiling itself as a promoter of gender equa-
proactive global social welfare and health care lity and health
policy cooperation in the EU, internationally
and bilaterally. The overall aim is to influence
Knowledge-based decision-making
the preparation of decisions actively and at
the right time. Research, development and innovations in
the administrative sector generate informa-
Cooperation is based on international com- tion on the wellbeing and health of citizens
mitments and processes supporting social and on the functioning of the service system
as inputs for decision-making.It endorses the use of information in the Effective communication
improvement of social security and services.
Information is needed for instance on trends Communication is a management tool and a
in health problems, on the risk and preventive part of preparation and implementation con-
factors of illnesses, and factors governing sus- trol. Proactive and timely communications
ceptibility to illness and health choices. The support open and interactive preparation and
information basis for decision-making will enables fruitful cooperation. It also ensures
be improved through systematic foresight that people are informed about things that
efforts, which will also be used to identify concern them.
weak signals.
18 Due to rapid changes in the field of media
Strong expert institutions enhance the ef- and telecommunications and in the operating
fectiveness and cost-effectiveness of public environment, communications contents and
decision-making. A broad-based network tools are becoming increasingly complex.
of expert institutions is being set up in the Target groups are becoming fragmented.
adminsitrative sector, and sectoral research The role of the Internet and digital media is
reform and joint projects in central govern- growing. New, networked operating models
ment are being further pursued. are being sought for communication and for
liaising with interest groups.
Information resources must be made centrally
available. This will help eliminate overlap in More comprehensive coverage for control
collecting information, and the quality of data is sought. Cooperation in the adminis-
information will improve. Shared access to trative sector regarding communication and
information must be extended to the moni- expert input will be reinforced, and the
toring authorities. Safeguarding privacy must division of duties clarified. Opinion setting
always be taken into account when using in- and digital communications in international
formation resources, and citizens must also cooperation will be boosted.
have access to this information.Appendix
Trends in social protection expenditure
Development of the economic increases. The working age population will
decrease, but only moderately if immigration
dependency ratio
remains at the same level as in recent years.
The development of the economic depen- The percentage of children in the popula-
dency ratio is the most significant national tion is also expected to remain more or less
challenge for the economy of social protec- stable. The development of the economic 19
tion. Demographic projections show that dependency ratio depends not only on the
the number of elderly people will increase age structure of the population but on the
rapidly beyond 2010, as the large age groups number of employed people, so a positive
reach retirement age and the average life span trend in the employment rate would help
keep the economic dependency ratio within
reasonable limits.
% of those in work
160%
140%
120%
100%
Old age pensioners
(65 and older)
80%
Persons of working
60% age, not in work
Children (0 to 14)
40%
20%
0%
2000
2005
2040
2030
2050
1960
1990
2045
1980
2020
2025
2035
1965
1995
1985
2010
2015
1970
1975
Figure 1. Economic dependency ratio, 1960 to 2009, and projected trend to 2050.
Source: Statistics Finland, population projection 2009Development of social expenditure support in particular. However, the increase
in the ratio of social expenditure to GDP is
Trends in social expenditure can be estimated primarily due to a decrease in GDP. In the
with the aid of population projections and long-term, population ageing will increase
economic projections. The calculations here social expenditure, above all employment
are based on trends under current legislation pensions and the costs of health care and
and show how the ratio of social expenditure long-term care. According to the calculation,
to total production would develop by 2050 if the ratio of social expenditure to GDP would
no action were taken. The baseline scenario increase by about six percentage points from
20 assumes that the productivity of work will 2008 by 2030.
increase by 1.75% in the long term and that
the GDP will increase by an average of 1.8%
Future trends in financing social
per year. It is further assumed that by 2030
the employment rate will increase to 74.5% expenditure
and the unemployment rate will decrease to Social expenditure financing pressures are
6.5%. transmitted through earnings-related pension
contributions to employers and the people
Because of the economic recession that began insured. The percentage of funding contri-
in 2009, the ratio of social expenditure to buted by the central government decreases as
GDP is anticipated to come close to 30% the ratio of national pensions and many other
between 2010 and 2013. A recession causes social security benefits to the GDP decreases.
a spike in unemployment benefits and income Local authority expenditure increases as
service costs increase.
% of GDP
36%
32% Other social security
28% Public health care
services
24%
20%
Public social welfare
services
16%
Unemployment insurance
12%
National health insurance
8%
National pensions
4%
0% Earnings-related pensions
1980 1990 2000 2010 2020 2030 2040 2050
Figure 2. Development of social expenditure (excluding user fees) under current
legislation, as a ratio to GDP, 1980 to 2007 and projection to 2050.
Source: Ministry of Social Affairs and Health21
Strategy monitoring The Ministry of Social Affairs and Health
has a carefully selected range of indicators
to monitor trends in health and welfare. The
We need indicators other than GDP for as-
indicators are used for monitoring attain-
sessing welfare trends more diversely. Mea-
ment of strategy goals and for performance
surements must be extended from economic
management. The indicators are being moni-
sustainability to social sustainability.
tored at four levels: social, economic and eco-
logical sustainability; economic and welfare
Finland has good and largely comprehensive
growth; implementation of the Government
registers and statistics available on social
Programme, policy programmes and action
protection. For instance, the use, costs and
plans; and the effectiveness and efficiency of
level of social benefits and services can be
social protection.
monitored in considerable detail. By contrast,
there is still scope for improvement in data
The following page contains a listing of in-
on the effectiveness of benefits and services.
dicators used for monitoring strategic goals.
We will continue to need a more diverse
range of measurements and information
sources. It is important for monitoring that
the decision-makers define target levels con-
cretely enough, that the indicators are well
defined, and that there is a limited number
of them.Strategy indicators
Policy 1: A strong foundation for welfare
■■ Employment rate
■■ Birth rate
■■ Life expectancy
■■ Economic dependency ratio
■■ Perceived health among people of working age
■■ Functional capacity among people over 75
■■ Percentage of overweight people in the population
■■ Alcohol consumption
22 ■■ Percentage of people who smoke daily
■■ Expected retirement age of a person aged 50
■■ New disability pensions
■■ Coverage of occupational health care
■■ Absences from work due to illness
■■ Occupational accidents
■■ Women’s earnings relative to men’s earnings
■■ Fathers receiving paternity or paternal allowance
■■ Ratio of social expenditure to the GDP
■■ Percentage of social welfare and health care expenditure in total local authority spending
Policy 2: Access to welfare for all
■■ Average life expectancy for a person aged 35, differences by educational attainment
■■ Persons who have been unemployed for more than a year
■■ Poverty risk (households, children), including EU2020 strategy indicators
■■ Income differences
■■ Young people with no basic or secondary education
■■ Availability of services
■■ Coverage of public services for the elderly aged over 75
■■ Percentage of young children in daycare
■■ Personnel in social welfare and health care services
■■ Level of minimum benefits
■■ Benefits and services for families with children
■■ Foreign nationals resident in Finland
■■ Children and adolescents taken into custody
■■ Homeless people
Policy 3: A healthy and safe living environment
■■ Health protection resources of local authorities
■■ Accidents in the home and in leisure time
■■ Epidemics and illnesses caused by household water
■■ Levels of environmental toxins in mother’s milk
■■ Violent crime
■■ Solvency of the insurance sectors
■■ Ratio of earnings-relatedt pension funds to the GDPFor health and social protection 23
MINISTRY OF SOCIAL AFFAIRS AND HEALTH Publications 2011:6 Proinno Design, Sodankylä / Helsinki University Press, Helsinki 2011
PO Box 33, FI-00023 Government, Finland
Meritullinkatu 8, HELSINKI ISSN-L 1236-2050
ISSN 1236-2050 (print)
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