Complaints about health and social services
What should I do if I am dissatisfied with the service?
If you are dissatisfied with the service or treatment given to you, take the issue up first with the person who gave the treatment or made the decision, or their supervisor. It may be possible to resolve the matter through discussion. The party responsible for the operations is obliged to remedy any deficiencies. In addition, there may be some misunderstandings related to the situations that have caused dissatisfaction, and these can be cleared most rapidly through discussion.
When social services staff report a shortcoming or a threat of a shortcoming they have detected to their supervisors, the supervisor is obliged to react to the report without delay. The supervisor shall report the matter to the party arranging the service, which in the case of private service providers is the local authority. If the supervisor fails to react to the shortcoming or take action to remedy it, the staff should report the matter to the Regional State Administrative Agency.
If you are dissatisfied with the way you were treated or the quality of service, you may file a written objection about the matter directly with the service unit. The service unit may be a day care centre, health centre, health clinic, social welfare office, nursing home, etc. This will bring the shortcoming immediately to the attention of the person in charge, and it can be addressed promptly. They must provide a written response to your objection within about four weeks.
You may file the objection using the service unit’s own form or as a freeform document. If you write a freeform document, enter ‘Objection’ as the heading. Send the objection directly to the director of the service unit or to the person responsible for the branch in question at the local authority.
You may file an objection on behalf of a family member if they are unable to do so themselves.
If you remain dissatisfied after receiving a response to your objection, you may file a complaint with us. If you have not filed an objection before filing a complaint, we can forward your complaint to the service unit in question as an objection.
Before you file a complaint, however, we recommend that you engage the service unit in discussion and then, if necessary, file an objection.
You may file a complaint with the Regional State Administrative Agency. We will notify you as soon as possible if your complaint will not lead to an enforcement matter being opened.
Cases where there is a suspicion of malpractice leading to the death or severe permanent injury of a patient are handled by the National Supervisory Authority for Welfare and Health (Valvira).
Frequently asked questions
The status and rights of social welfare customers are provided for by law, in the Act on the Status and Rights of Social Welfare Clients (in Finnish). You can read a brief description of the status and rights of customers on our website.
The status and rights of patients in health care are provided for by law, in the Act on the Status and Rights of Patients (in Finnish). You can read a brief description of the status and rights of patients on our website.
- informing customers of their rights
- working in other ways to promote and exercise customers’ rights
- assisting customers with preparing objections and complaints
- assisting customers in cases of patient injury.
An ombudsman will not issue an opinion on the content of the care or service given to the customer or on the customer’s diagnosis. Contact information for ombudsmen is available at the service unit.
If you are dissatisfied with entries made in your customer documents or patient documents, please contact the service unit where those entries were made. The Regional State Administrative Agency cannot change entries in health care patient records or social welfare customer records.
The Patient Insurance Centre manages compensation for personal injury caused in health care services.
Frequently asked questions about the enforcement of care services for the elderly
Service providers are responsible for ensuring that their services comply with the requirements imposed in their operating licence. Nursing home service providers are expected to self-regulate, this being the principal form of enforcement. The self-regulation plan must be publicly available, and it must be monitored. Care services for the elderly are secondarily enforced by local authorities, Regional State Administrative Agencies and the National Supervisory Authority for Welfare and Health (Valvira).
Local authorities are responsible for arranging the services and for enforcement of both its own and outsources services.
At the Regional State Administrative Agency, we enforce the arranging of services by local authorities and the operations of other public-sector and private-sector service providers.
The National Supervisory Authority for Welfare and Health (Valvira) is responsible for enforcement in cases that are of major importance in terms of scope or principle. We will forward a case to Valvira if necessary, according to the agreed division of duties.
The supreme overseers of legality in Finland are the Parliamentary Ombudsman and the Chancellor of Justice. If all legal avenues in Finland have been exhausted, official decisions may be appealed to the European Court of Human Rights.
- Social Welfare Act (1301/2014); the previous Act (710/1982) defined the regulations for and means of enforcement
- Social Welfare Decree (607/1983)
- Act on the Status and Rights of Social Welfare Clients (812/2000)
- Act on Private Social Services (922/2011)
- Decree on Private Social Services (1053/2011)
- Act on Supporting the Functional Capacity of the Older Population and on Social and Health Services for Older Persons (980/2012); also referred to as the Act for Elderly Care and Services
Local authorities are responsible for arranging services for the elderly. Local authorities are also responsible for enforcement of their own services and of outsourced services.
Local authorities must always notify the Regional State Administrative Agency for their region of any shortcomings or abuses found. Local authorities are also obliged to guide and advise service providers so as to cause any shortcomings to be rectified. Certain enforcement measures specified by law, such as suspending operations, can only be undertaken by the Regional State Administrative Agency or the National Supervisory Authority for Welfare and Health (Valvira). These measures are provided for in the Act on Private Social Services.
When a local authority acquires services from a private service provider, the local authority or joint municipal authority must ensure that the services outsourced are consistent with the level of quality required from an equivalent municipal operator.
A local authority is also responsible for enforcement in respect of any service unit of a private care service provider located in its municipality, regardless of whether the local authority is purchasing services from that unit or not. A municipal body (e.g. the social and health services board) shall direct and enforce private social services located in its municipality. What this means is that the local authority has the power to inspect a service unit in its municipality when there is justified cause for doing so. Such cause may be a written or verbal notification of a shortcoming found at that unit. A local authority may conduct unannounced inspections.
The Regional State Administrative Agency is responsible for enforcement of social services in its region. The National Supervisory Authority for Welfare and Health (Valvira) directs us in the management of our duties. The purpose of this direction is to harmonise the operating principles, procedures and decision-making practices of the Regional State Administrative Agencies.
Individual cases of enforcement come under the jurisdiction of Valvira when a case is of major importance in terms of scope or principle, or when a case concerns the domains of several Regional State Administrative Agencies or the entire country.
In the supervision of social welfare and health care professionals, Valvira handles cases where the right of a professional to practice may have to be suspended or removed. Valvira also investigates cases where treatment or neglect of treatment is suspected to have caused the death or serious injury of a patient. Some cases may be referred to Valvira simply because of a conflict of interest in investigating a matter in our region.
It is our responsibility to enforce the operations of providers of care services for the elderly. In some cases, if we consider it necessary or if a case is of national significance, we may refer the case to the National Supervisory Authority for Welfare and Health (Valvira) for enforcement.
Local authorities are responsible for arranging care services for the elderly. They may provide these services themselves or outsource the services from a private-sector or third-sector service provider. In both cases, we enforce the operations of local authorities.
We engage in systematic enforcement according to the social welfare and health care enforcement programme that we have devised jointly with the National Supervisory Authority for Welfare and Health (Valvira) and the related regional implementation plans.
Enforcement is based on data collected from local authorities and social welfare service units. We may also, for instance, draw on studies conducted jointly by Valvira and the National Institute for Health and Welfare (THL) in enforcement. Regional characteristics such as individual care institutions are taken into account in the plans.
We direct local authorities in our areas of enforcement through means such as letters of instruction, dialogue, visits for steering and evaluation, and agreed inspections of nursing homes. We also conduct unannounced inspections. Some of our inspections are based on notifications that we receive.
Our enforcement practice is exactly the same for both private and municipal care institutions. However, the licensing procedure is different for private and municipal care institutions. We are the licensing authority for private service providers. Local authority units do not need to obtain a licence in this field.
In 2018, the most common reasons for complaints regarding care services for the elderly were:
- the service provider had insufficient care personnel
- personnel was lacking in professional competence
- personnel turnover was high, resulting in quality and safety issues: shortcomings in basic care, quality of food, medication errors and other pharmaceutical issues
- the institution provided little in stimulating activities and outdoor exercise
- the care and service plans were poorly prepared and/or not up to date
- self-regulation failings.
In 2018, we received a total of 138 complaints about care services for the elderly. The outcome was ‘drawing the attention of the party to appropriate conduct’ in six cases and ‘expressing an opinion’ in three cases.
Additionally, 152 enforcement cases involving care services for the elderly were filed in 2018. Out of these, the outcome was ‘drawing the attention of the party to appropriate conduct’ in 20 cases, ‘expressing an opinion’ in eight cases, a reprimand in five cases and an improvement notice in 12 cases. In nine cases, it was decided to continue the enforcement process.
In all, 2,846 complaints on social welfare and health care issues were filed in 2018: 1,031 concerning social services and 1,815 concerning health care. Social services complaints included not only care services for the elderly but also topics such as informal care support, housing services, rehabilitation, services for children and families and services for the disabled.
Our information service may be busy at times due to a large number of contacts, the scope of the matters being handled, or other reasons. We aim to process requests for documents and information as fast as possible; in the case of publicly available information, this should never be later than two weeks after we receive the request. If a matter requires special measures or involves an unusual amount of work (because of the large number of documents involved, because of having to redact confidential information, or because of other equivalent reasons), then a response concerning a publicly available document should be given no later than one month after we receive the request.
In certain separately specified circumstances, we may charge a fee for the time spent in retrieving information and redacting confidential information before delivering documents. If your request is subject to a fee, we will give you a price estimate in advance.
In respect of the media, the aim is that questions from media representatives will be responded to by those officials who are the best informed in the matter at hand. Matters with high media interest often overload the relevant officials, and they must prioritise their enforcement duties above publicity demands.
Inspection visits generally involve a central government enforcement official and also local government enforcement officials.
It is the responsibility of the local authority or joint municipal authority to provide medical services for residents at assisted living units for the elderly. In the case of a private service provider, the local authority or joint municipal authority must agree with the service provider on how to arrange for medical services.
The need for providing medical services at assisted living units is always assessed on the basis of the needs of the residents. Medical services must be available whenever a customer needs them. Providing medical services as a remote consultation only is not sufficient in view of the rights of the patient.