Lessons from the health system resilience testing pilot in Finland

Abstract

Abstract Finland is a Nordic welfare state with universal access to health care. The health system has recently undergone a major reform and health care and social and rescue services are organized by 21 well-being service counties, the city of Helsinki and Helsinki-Uusimaa Hospital district which all get funding from the state. Publicly funded health services are mainly provided by public health centers and hospitals. The resilience testing tool developed by the European Observatory on Health Systems and Policies and the OECD was piloted in Finland in the early April 2023. The participants (n = 17) represented e.g. the key ministries, the Prime Minister's Office, Ombudsman for children, well-being service counties, municipalities, and the university hospitals. The tool was piloted by using a pandemic scenario in which those most seriously affected are small children with substantially increased hospitalizations and mortality. The adults are mainly asymptomatic. At population level the spreading of the disease is rapid and overwhelms the service system in waves. The scenario was chosen because it is difficult to predict the onset and cause of the next pandemic, or its effects on the health system. The Covid-19 pandemic placed health systems around the world to a test, but it is important that preparedness to the next pandemic is not developed solely based on the experiences from Covid-19. In this presentation we describe the main lessons learned from the Finnish resilience testing pilot. These include both lessons related to the tool itself and its further development as well as lessons from the discussions based on the pandemic scenario. The discussions by the multi-stakeholder group reflected well the health system subfunctions presented in the resilience testing tool framework. However, the discussions also captured themes that are not currently visible in the framework such as ethical considerations, values, and political determinants of health system response.