Kihniö Council for the Elderly and Disabled's statement on the Pirkanmaa welfare area plan regarding the target state of reception services

The mayors of the small municipalities of Pirkanmaa and the municipality of Kihniö have made a statement on the Pirkanmaa welfare region service network study and the target state presented in it. The statements state that the Pirkanmaa welfare region will not make hasty decisions about the service network of social and health services before the alternative operating models presented can be truly assessed in terms of both costs and effectiveness. In addition to the statements, the Kihniö Council for the Elderly and Disabled wants to express its own concern for residents in a weaker position. 36,1% of Kihniö residents are over 64 years old and the proportion of pensioners is 40,5%. In the whole country, the corresponding number of 64-year-olds is 23,1% and the proportion of pensioners is 26,0%. The morbidity index in Kihniö is also higher than average compared to Pirkanmaa.

According to the Finnish Constitution, people are equal before the law. Equality should be reflected in the accessibility, timeliness and availability of services. In particular, the targeting of services should take into account the needs of those people who need services the most. The elderly and disabled in Kihniö should not be placed in a different position on the basis that they live in Kihniö. According to the guidelines of the Finnish Institute for Health and Welfare, the organizer and provider of social and health services must ensure that all people have access to and benefit from services equally, regardless of factors related to the person. In our view, equality will not be achieved if the brick-and-mortar office is abolished in Kihniö. The planned changes will target the elderly the most by requiring them to travel the longest distances to access the services.

The situation of the closure of the health center is planned digital services and mobile services. In the target state, other service channels have been defined as a prerequisite for the branch network, which include piloted and launched mobile services. The idea of ​​bringing mobile services close to home, to homes and other facilities sounds good and serves especially the elderly and disabled. However, we are unsure about how the service will be implemented, because even at the moment, the existing mobile services are suffering from a shortage of resources. It also seems that there is too little time left for the pilot to gain sufficient understanding that the mobile service reaches everyone who needs it, and that they are sufficient. We are also concerned about how mobile services may increase the passivity, loneliness and functional capacity of the elderly.

Regarding the expansion of digital reception services, we are concerned about how digital services are going to be implemented for the elderly. In the target state, it is estimated that the share of digital reception services would increase significantly. However, not all elderly people have sufficient skills or the required equipment and connections. Doctors Elina Miettola and Riikka Hämeenoja also agree, who took a position in an opinion piece in Aamulehti on 22 August 2023. The implementation of digital reception services would require guidance and orientation for the elderly and other vulnerable populations. In order for the target state to convince us and the residents, there should be a plan for the implementation of digital reception services, how and with what resources it will be ensured that the service reaches the residents who need them and that the residents know how to use them well enough. The municipality does not have sufficient resources to carry out sufficient orientation. We also see it as important that physical encounters with professionals are maintained. Inadequate digital skills may affect access to care. Inadequate skills may delay access to care, making treatment more demanding and expensive, but also impairing the resident's quality of life. This also increases the already high burden on hospital services.

The plan does not include a cost comparison of what it would cost to do business at the Virtai or Parkano offices and to implement mobile and digital services compared to continuing to receive the service at the Kihniö health center. Moving services to Parkano or Virtai would also mean that residents would have to order Kela rides. A Kela ride costs €25/one way. Several Kela rides per week can mean significant financial losses. For example, the treatment and identification of certain diseases involves laboratory tests that must be monitored regularly.

In addition, it remains unclear how the impact of the change has been or will be assessed. Have the costs taken into account the preventive importance of the availability of services? How will the adult clinic be implemented and how have caregivers and hearing clients been taken into account? Will the Local Market continue to be implemented in Kihniö? Have indirect costs been taken into account? In addition to the quantitative impacts, the plan has not taken into account the qualitative impacts of the change on residents and the municipality as a whole.

The condition assessments made of the health centres in the target area plan are inadequate and do not directly describe the actual situation. The target area would also require significant additional investments in larger health centres. However, Kihniö currently has good and functional facilities that meet the space requirements. The oral health care facilities have recently been renovated. The clinic facilities are also good and functional. The premises also house an adult clinic. Kihniö also has good facilities for laboratory activities and a rehabilitation pool that is in active use. The pool is also used for rehabilitation services provided by physiotherapy and for supervised activities at the community college. People with intellectual disabilities also have their own shifts. Kihniö would also have the opportunity to implement, for example, communal living in the premises of the health centre and the former nursing home. A total of 13 rooms would be available as empty space.

The Kihniö Council for the Elderly and Disabled considers it important to maintain the health center in order to provide equal services for the elderly and disabled. We are concerned that with the implementation of the planned target state, access to care for the elderly and disabled will become challenging or even impossible. We are also concerned about the increase in inequality and loneliness and the decline in functional capacity. We hope that you will take into account how future decisions will affect the quality of life of the elderly and disabled population in Kihniö and thus also the future and vitality of the entire Kihniö.

Kihniö Council for the Elderly and Disabled

National Senior Citizens' Week will be celebrated from 1 to 8 October 2023. The theme is Let's make age a number.

The Finnish Federation of Elderly Care aims to draw attention to older people and their position in society through the Elderly Week campaign. The focus is on making the voices of older people heard at all levels of society.

The Finnish Federation of Elderly Care hopes that events based on the theme will be organized in different parts of Finland.

• The fitness course for older drivers started on September 11.9th and 10 participants registered for the course.
• Get the Elderly Out campaign 18.9-1.10
• Pirha requests a statement on the Pirkanmaa welfare region's elderly welfare plan for 2024-2025
• Issues discussed in the Pirkanmaa Welfare Region Senior Citizens Council:
  • § 58 Legality and quorum of the meeting
  • § 59 Inspection of minutes
  • § 60 Right to be present and speak
  • § 61 Replacement of the deputy recorder
  • § 62 Meaningful and communal life through diverse activities in the fourth sector
  • § 63 Pirkanmaa welfare region budget for 2024
  • § 64 Budget proposal of the Council for the Elderly for 2024
  • § 65 The Senior Citizens Council's position on the report of the Multi-Service Committee
  • § 66 Processing of the service network
  • § 67 Proposal on organizing outdoor activities for the elderly
  • § 68 Establishment of working groups
  • § 69 Proposal to improve the efficiency of meeting proceedings
  • § 70 Matters to be noted
  • § 71 Other matters
• Issues discussed in the Pirkanmaa Welfare Region Disability Council
  • § 69 Legality and quorum of the meeting
  • § 70 Inspection of minutes
  • § 71 Right to be present and speak
  • § 72 Service network survey of reception services and working-age social services in the Pirkanmaa welfare area
  • § 73 Analysis of the calculation of the need for beds in the Pirkanmaa welfare area
  • § 74 Pirkanmaa welfare region budget for 2024
  • § 75 Review of the minutes of the meeting of the Disability Council of 9 August 2023
  • § 76 Changing the meeting time of the September meeting
  • § 77 Other matters
  • § 78 Closing of the meeting
• Let's arrange the next meeting time.