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FINLAND

Health care

An important change/new law in the health care, uniform criteria for non-emergency treatment have come to force 1^st March 2005, including public health care, but also private health care working with public sick fund. Most Specialist Associations have worked with their criteria for a year, and now the system has been set up finally. Time limits for providing the treatment have been set. E.g. concerning primary health care, the access to initial assessment of a non-emergency treatment has to happen within three days by a health care professional, normally by a physician. A booklet with 240 pages consisting of all the criteria has been sent to all physicians in the country. Anyhow, no prioritisation has been set between diseases treated by different specialties. Health care professionals have been prepared themselves for the change since months, but we do not know yet, how the law will change our health care situation.

General in General Practice

A new textbook on General Practice has been published. This book has been revised totally from the earlier version in 1991 by an editorial team of seven doctors representing practising GPs as well as university professors. The heavy book with 700 pages has been written by 70 authors.

Research in Primary Health Care has been promoted by the Ministry, which set up a small working group and published a report proposing measures vital to the development of research in PHC and means to develop PHC by increasing research. The statements concerning proposals have now been requested from different actors in the health care, and the final measurements have not been decided.

Basic Medical Education and Specialist training

Medical student intake has grown considerably during the last years, and it has not been easy to find enough resources for teaching. We have five faculties, two of them have a problem-based curriculum, two a more conventional curriculum, and one a more mixed one. No changes in specialist training have happened, but family medicine is a popular specialty.

Continuing Medical Education/Continuing Professional Development

There is a law in force since last year, which stipulates the employer of the health care professionals (municipalities) to be responsible for financial resources in continuing medical education. Municipalities received state subsidy for this task, but the money was not earmarked and mostly it has not been available anywhere.

In 2003, an independent, permanent Centre for Pharmacotherapy Development (ROHTO) was established targeting especially on PHC doctors. Participatory, small group based, professionally facilitated, multi-professional sessions concerning problems and needs, defined in the local health care centres, are arranged. Use of evidence-based medicine and assessing one's own practice performance will be facilitated. As outcome of these sessions the participants are expected to provide an agreed local guideline or pattern of practice to manage clinical problems and their medication. In a previously relatively conservative atmosphere of continuing medical education, the new system has attracted GPs, and plenty of functioning groups of committed GPs have started their small-group activities.