Finnish Medical Association boss would make private hospitals pay for aftercare of their patients

CEO of private hospital group Mehiläinen would settle for 2-week guarantee period

Heikki Pälve

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When a private hospital performs an operation on a patient, it should also see to the treatment of the possible complications. This is the view of the Finnish Medical Association's Chief Executive Officer, Dr. Heikki Pälve.
      “As a starting point, it would seem fair if everyone took the responsibility for the care they provide from the beginning to the end. Either by providing the care themselves, or by purchasing it from somewhere else”, Pälve says.
     
The division of responsibility between the private and public health sectors became topical on Monday, when Helsingin Sanomat reported on a case in which the Hospital District of Helsinki and Uusimaa ended up paying hundreds of thousands of euros for the aftercare of a patient that had undergone surgery in the Turku-based private hospital Pulssi.
      According to Pekka Järvinen of the Ministry of Social Affairs and Health, in addition to the division of accountability between the private and public health sectors with regard to the treatment of complications, further clarification is also needed on certain other issues.
      One such is when deciding whether the society should sponsor cancer treatments given in private clinics, if a decision has been made in a public hospital to discontinue the administration of treatments.
     
“In my understanding the private and public sectors have differing criteria with regard to entering into treatment. At least partly it must be a question of money. If there is willingness to pay, treatments are being offered by the private sector, even if the outcome is not by any means guaranteed”, Järvinen says.
      CEO Matti Bergendahl of the Mehiläinen Group, a respected provider of private health care services in Finland, does not accept the statement that the criteria for receiving treatment would be different in a private hospital.
     
“We are very careful in ensuring that the treatment recommendations are followed”, Bergendahl says.
      In Bergendahl’s view, the suggestion that the aftercare needed by a patient should automatically be compensated for is needlessly “peremptory”.
      Instead, he considers the present practice equitable, in which the hospital is held accountable for the treatment of customary post-operative complications manifested within two weeks of the surgery.
      Such a clause is included for example in the contracts with which hospital districts purchase surgical procedures from Mehiläinen.
     
According to Bergendahl, Mehiläinen has decided not to embark on performing weight loss surgeries, such as gastric banding or gastric bypass, because the hospital chain’s Helsinki unit no longer has facilities for adequate post-operative monitoring.
      Hitherto, disputes over the accountability of private hospitals have been somewhat rare in Finland.
      Director Tarja Holi of the National Supervisory Authority for Welfare and Health (VALVIRA) remembers one incident from the recent years, in which it was ruled that a private clinic had failed to comply with the treatment criteria jointly agreed with the public health care side.
      The case in question related to a cataract operation.


Previously in HS International Edition:
  Municipalities left with hefty bill for treatment of complications after patient´s bariatric surgery in private hospital (26.10.2009)

Helsingin Sanomat