Page 184 - ES 2020-21_Volume-1-2 [28-01-21]

Healthcare takes centre stage, finally! 167

Finland The Finnish Constitution It sets out patients’ right Health system governance is
sets out the requirement to information, informed shared by the center and the
that government must consent to treatment, the municipalities. Standards of care
provide adequate care right to see any relevant are practically embedded within
for all, providing the medical documents, the right the Finnish constitution, which
legal foundation for to complain and the right to provides the legal foundation for
national regulation such autonomy. Further national national regulation. The Finnish
as the 1992 Act on the legislation defines the quality regulatory system can be
Status and Rights of and standards of healthcare. characterized by a system of self-
Patients. There are national standards regulation and voluntarism, with
for selected specific service some aspects of meta-regulation
categories, such as elderly such as mandated continuous
care. improvement; external clinical
audit; mandated incident
reporting system; consumer
complaints through valvira
as main national regulatory
body, the Regional State
Administration, and the
ombudsman.
Germany The Social Code Book Stipulations set out in the Regulation of healthcare in
sets the regulatory Social Code Book are further Germany’s federal system is
framework for major defined by the Federal Joint shared between the federal
actors, their roles Committee (G-BA), which and state governments and
and obligations in issues binding directives on corporatist actors. A 2010
the statutory health treatments, quality assurance hospital quality report included
insurance (SHI) system. and minimum standards of quality data from almost 1,800
Thus, quality and care, which are implemented hospitals and showed that,
effectiveness measures by SHI funds, hospitals and compared to 2009, 65 quality
of services within associations of physicians. indicators had improved.
the SHI system have Areas of regulation are: However, for the majority of
to comply with the quality management; quality indicators (n = 236),
current level of medical external quality assurance; there was no change, while
knowledge and take cross-sectoral quality deterioration was observed for
account of required assurance; regulation 8 indicators. Evaluations of the
technical quality. on quality of structures, activities of regulatory bodies
Service providers must processes and outcomes; remain limited. The G-BA,
safeguard and develop regulation on assessment and dominated by corporatist actors,
the quality of services monitoring of services by was delegated a high degree
they provide. SHI-accredited physicians. of decision-making power
concerning the definition of
the health basket and is non-
transparent.