Human-driven health

Expanding freedom of choice is a significant reform, whose eventual impacts are still difficult to predict. In order to gain a clearer idea of the possible effects, we need to conduct trials.


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Freedom of choice for users of social welfare and healthcare services is due to expand in Finland. In practice, this will mean that people have a wider variety of choices in basic services between providers in the public, private and third sectors. Customer-orientation is one of the key objectives in social welfare and healthcare reform.

It is hoped that expanding freedom of choice will improve both the level of services’ customer-orientation and the service system’s  capacity for renewal. Freedom of choice can offer people new opportunities to participate in making decisions concerning their own health and well-being, and to develop services by making their own choices and providing feedback.

However, a great deal depends on how well freedom of choice will work in practice as part of the administration and provision of services.

What do we do?

Expanding freedom of choice is a significant reform, whose eventual impacts are still difficult to predict. In order to gain a clearer idea of the possible effects, we need to conduct trials. The need for reform is not limited to individual operating models; ways of thinking and operating cultures must also be made more customer-oriented both during and after the trials.

The “People first – selection trials for social welfare and healthcare services” project supports this change by various means, and its primary objective is to implement new operating approaches, models and tools as part of the new service provision.

Also the various service providers from public, private and 3rd sector must be ready for the reform. Therefore, the project has dedicated programs to accelerate these providers in developing their competitiveness in preparation to the new freedom of choice reform environment.

The project will also be launching trials, in which new types of low-threshold service models and digital tools will be tested in connection with changes being made to operating approaches. Promoting a new service provider and innovation network is also a key part of the project.

At the beginning of 2016, we drafted a rulebook for freedom of choice trials to serve as the basis for work done by municipalities participating in the trials. The Soteuttamo concept and its attendant “matchmaking” tool were launched in January 2017. In early 2017, the Service Providers Guide was also published . The guide explains how various service providers can join trials. In 2017, the Care Gap tool will be developed and preparations will be made for its piloting in Helsinki and Karstula.

Based on Sitra pilot-accelerator experience with two public primary healthcare centers (in Iisalmi and Kiuruvesi) we are scaling this nationwide with local authorities to accelerate more and more of the 500 public primary healthcare points of presence in Finland for the new reform. We are also accelerating small and medium sized enterprises and 3rd sector actors in their competitiveness.

In co-operation with its partners, Sitra develops and trials new service models for customer and service steering, and gathers information on how the integration of social welfare and healthcare services can be promoted in practice.

Who participates?

The People first project works in co-operation with the Ministry of Social Affairs and Health service voucher trial (link in Finnish). Sitra prepared municipal trials with the Ministry of Social Affairs and Health in the autumn of 2016. We also work with the Ministry of Finance and Ministry of Economic Affairs and Employment with the various accelerator activities.

Throughout the Human driven health project, Sitra serves as a facilitator of events and draw up the content and principles governing trials together with local authorities.

Where are we now?

The project started in summer 2016 and will run until spring 2019.


We´d love to hear from You!

Tuula Tiihonen
Senior Lead, Democracy and participation
Johanna Perälä
Elina Eerola
Specialist, New forms of participation
Harri Männistö
Henna Hiilamo
Specialist, Reforming the decision-making process
Jukka Vahti
Project Director, Digital power and democracy

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