Georg Henrik Wrede

The social and health care reform is facing its next round. The starting point for safeguarding Swedish interests is significantly better now than before. Both the government base and the government program are more clearly positive towards a bilingual Finland compared to the previous government period.

This is the big picture, where the foundation for legislation is laid and how the entire system is built around social and health care. The challenges, however, remain largely the same as before. It involves both the economy and, particularly in Uusimaa, how the region is divided, as well as where to practically find staff. Prime Minister Rinne’s government decided that 18 regions should be formed, and that Uusimaa, the capital region, or the Helsinki region should have a special solution. An area with 1.65 million people becomes too large, especially compared to the other 17 regions.

The issue of Uusimaa is central to Swedish-speaking Finland

The issue of Uusimaa is central to Swedish-speaking Finland, although it is not the only one. Of the approximately 290,000 registered Swedish-speaking citizens, 130,000 live in Uusimaa. The municipalities in Uusimaa seem to be in complete agreement that it would be best for Uusimaa to be divided into five areas.

How the division of areas turns out is therefore of great importance. It will especially be important how the boundaries of the areas are drawn with regard to representation in the decision-making bodies. Separate committees are a possibility when it comes to organizing the implementation of linguistic rights in the future. In today’s health care districts, there are minority language committees.

In health care, reference is often made to Section 5(2) of the Patient’s Rights Act (785/1992), which concerns the patient’s right to information. It states that “A health care professional must provide information in such a way that the patient sufficiently understands its meaning. If a health care professional does not master the language used by the patient or if the patient, due to hearing, vision, or speech impairment, cannot make themselves understood, an interpreter must be used as far as possible.”

The points discussed are naturally how “sufficiently” and “as far as possible” are interpreted. In the Language Act (423/2003), however, Section 10(1) provides a clear stipulation: “In contacts with state authorities and bilingual municipal authorities, everyone has the right to use Finnish or Swedish.” This means that in matters of national languages in bilingual joint municipalities, one always has the right to their own language, and this applies without exception.

In practice, many still experience that what ultimately determines communication in the meeting between customer/client and caregiver is the individual language skills of the persons involved. It is therefore less about representation in decision-making bodies or structures and more about the meeting between people.

A user perspective is therefore what we seek in Swedish. From that viewpoint, a major change in the setup we are facing is the much-debated freedom of choice, which was the stumbling block for Prime Minister Sipilä’s government in the social and health care reform, is now not included. In southern Finland, the freedom of choice could have been a possible way to achieve functioning service in Swedish.

One could imagine that providers of health services who could practically guarantee service in Swedish would attract those who explicitly wanted care in Swedish. It is true, however, that this could mean longer distances to the service, something we already see in the setup with how close it is to Swedish schools.

In addition to the structures, it is also about how the customer/client prioritizes in different situations. On that point, a situation where the Swedish-speaking population is a small minority places great pressure on the individual. I myself have often been in the situation where the opening phrase “Päivää – Goddag!” is the only thing said in Swedish, regardless of what rights the Language Act theoretically would have given me. On that point, there is a big difference between choosing a provider who has clearly expressed their willingness to serve in Swedish compared to one who is forced by legislation to do so.

This article by Georg Henrik Wrede was previously published in Swedish on Kommuntorget.