He has asked the Ministry of Social Affairs and Health to issue guidelines to municipalities and intermunicipal joint authorities to help them follow lawful practices. 

According to the Health Care Act, supplies that are required under a treatment plan for a person suffering from a long-term illness are included in the health services that a municipality must arrange. In addition, supplies of this kind are to be provided free of charge.

"This means that each patient?s requirement of treatment supplies is assessed individually," the Ombudsman points out.

The joint authority for health centres in the Riihimäki region had issued guidelines to the health centres advising them to limit distribution of some treatment supplies so that patients themselves would have to pay for any supplies over and above a certain maximum quantity. One of the items to which the guidelines applied was blood glucose test strips for diabetic patients.

The Ombudsman found that this procedure was unlawful, because it did not leave room for the patient?s individual needs.

The Board of the joint authority also acted unlawfully when it published the name of a person who had complained about the matter in its agenda list online. Under the Act on the Openness of Government Activities, health data must be kept secret.

Underbudgeting in Kuopio

Lancets, which are used to prick the skin when measuring blood glucose, had not been distributed to diabetics in Kuopio. The explanation given for this was that a costs increase in accordance with the Health Care Act that had entered into force during the year could not be included in the city?s operational plan for health care.

In the Ombudsman's view, Kuopio acted unlawfully when it failed to discharge a task provided for in the Health Care Act, namely distribution of treatment supplies.

The Constitution obliges municipalities to ensure that statutory health services are provided. Municipalities do not meet this obligation if they fail to include the necessary appropriation in their budget or deliberately make the budget too small. If an appropriation proves inadequate, the municipality must, through a supplementary budget or by other means, ensure that its statutory obligations are met.

Ministry must intervene in the matter

Ombudsman Jääskeläinen considers it important that a concrete intervention into unlawful practices is made.

In his view, the Ministry of Social Affairs and Health's duty to guide and oversee is especially accentuated when decision making relating to the provision of treatment supplies is guided by unlawful practices and guidelines observed by a municipality or intermunicipal joint authority. 

What is additionally involved is a doctor's decision concerning treatment. According to established legal practice, a patient does not have the possibility of appealing against it.

The Ministry must inform the Ombudsman, by 1.7.2013, of what measures it has taken in the matter.

Additional info will be provided by Senior Legal Adviser Kaija Tanttinen-Laakkonen, tel. +358 (0)9 432 3377