Challenge to Finland's health sector "not due to lack of resources”

Just a few weeks before the parliamentary elections Juha Rehula is not busy campaigning. He wants to see his term as government minister through.

"If you haven't got four years to show what you can, no campaign is going to help you," he says. The Center Party politician entered the Finnish government just under a year ago almost by coincidence when his predecessor Liisa Hyssälä left politics. He is now very busy getting a range of important reforms through parliament before the April general elections and the inevitable political reshuffle which follows. 

The health and social care sector budget makes up a considerable part of Finland's budget, taking up €19 billion out of the total €54 billion annual budget. There is no shortage of challenges. Far too many youths have problems which could see them ending up as social outsiders even before they've taken one step inside working life. Rehula has just met his Swedish colleague, Minister for Social Security Ulf Kristersson, in Stockholm to discus the problem of young people taking early retirement. 

Rehula shows us an article in Swedish tabloid Aftonbladet on young Swedish pensioners.

"We're in the exact same situation. It's part of working life but we must think of a way to reach young people before they fall through the system."

This is also about being able to guarantee that everyone who can work will work and pay taxes. When a large generation reaches retirement age it becomes difficult to finance the health and social sector. 

"We cannot afford this in two ways. We cannot afford loosing them and continue funding sickness benefits. We need them in working life."   

Juha Rehula doesn't see the challenges in the health and social care sector as a result of a lack of resources, but more as a question of re-prioritisation and of managing new, smarter solutions. Finland now has more doctors and nurses and other resources than ever before. 

"We must really shape up to move forward, the resources are there. The debate about public versus private care - good versus bad - is completely unnecessary. Health sector financing must be re-examined, it is a product of its time."

Juha Rehula feels those who work in the health and social care sector should be allowed to get on with what they are trained to do, namely to look after people. While some bureaucracy is necessary, doctors should not have to spend their days filling in forms.

Long career

Juha Rehula is 48 this summer and has been a national politician since 1996. Before that he spent many years as a municipal politician and as a municipal employee.

But people who don't know him are wrong when they think he has been involved with politics his whole adult life. He was born into a farming family and was given his first bit of land to grow sugar beets at the age of three. 

"I was 6 or 7 when I got my first pay for weeding the beet fields - one penny per square metre. I have never received pocket money, only pay for work.” 

He spent his earnings from the sugar beet fields to buy a cassette player. 

"We kept it in a backpack and played Hurriganes and Juice Leskinen (popular Finnish artists) while we were working. The backpack was passed around between friends. We kept it with us at all times."

Juha Rehula had a summer job at a factory making refrigerators, he has been a surveyor's assistant, a warehouse assistant in a hardware store, he has worked at a sawmill and he has filled various municipal roles.

Started his own

He experienced how difficult it could be to qualify for means tested social assistance during the economic crisis in the early 1990s when he couldn't find a job. His partner, now wife, drew a salary which meant Rehula ended up without any unemployment benefit. He had to start his own business instead.

"Officially I have not been unemployed for one single day, but I worked with my own company for several years."

This is his work history.

"I have managed to work for a surprising number of years. 

He got his first staff job as late as in 1996, which was the same year he entered parliament and as a result had to resign almost immediately.

A good employer?

”Father was a good employer and the most important thing was that he taught me the value of money.  We were paid to work. Every time we needed money we needed a very good argument. I think that is a good system."

Realist

Juha Rehula says he is realistic about what he has achieved during his brief period of power. 

"I belong to a group of politicians who say nobody can make something happen on their own, not even government ministers.

Among the issues Rehula is proud of is the reform of means-tested social assistance and the reduction in queues to apply for changes to income linked social protection. When he started the wait was 17 months - now it is 13 months and the goal is six months.

The staff responsible for processing the amendments have been given more resources and the processes have been simplified. 

"That's an area where I feel I have made an impact."

The biggest change is still happening though, and it is all about changing attitudes toward depression and working life. People dare talk about their illness as a normal thing. This also opens up opportunities to seek and receive help. 

"We can change the laws as much as we want but if attitudes don't change, nothing happens.

The Masto project which just ended, focused on more active cooperation between health sector workers, workplaces, organisations and authorities in order to control the number of people taking early retirement because of depression. 

"These are the things I will write about in my memoirs.

Juha Rehula's personal driving force is the human dimension. The morning we meet he has just heard about a young women who has just been hired for the first time after a long period of rehabilitation and support work. These are the stories which make his work seem meaningful.