Hospitals charging local authorities record-high fines this year
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Local authorities struggling to balance their tight budgets are having to pay up to tens of millions of euros in transfer delay fines to large university teaching hospitals.
The fees come into play in connection with surgery or other major treatment, performed at the big hospitals. When patients have recovered sufficiently they are transferred to a facility in their own communities.
However, sometimes a patient's home municipality is unable to provide the needed care, and the patient's stay in the big hospital is extended. When that happens, the local authority is required to pay a transfer delay fee to the hospital.
Helsingin Sanomat has learned that the number of these fees paid out has been growing fast.
Five university hospitals billed a combined EUR 7.3 million in 2005. However, in the first six months this year alone, the total had reached EUR 9.5 million.
The trend seems to be continuing. "By the end of July, the fees had grown by one third",says Jari Ahvenainen, head of planning in Tampere.
"We paid more than EUR 1.8 million in a month. At this rate, the sum will exceed three million", says Tuomo Meriläinen, head of social and health services for the City of Kuopio.
Only Helsinki is getting the billing situation under control. The transfer delay fees in the early part of the year were one third of last year's level. The sums are nevertheless considerable - EUR 2.1 million by the end of July.
The biggest payers of transfer delay fee money are the cities where the university hospitals are located - Helsinki, Kuopio, Oulu, Tampere, and Turku. For instance, of the 1,772 transfer delay days compiled by Oulu University Hospital, 1,521 were for patients who are residents of Oulu.
The main reason for the fees is the same in all of the hospitals: elderly patients who are not sufficiently fit to live at home, and who need residential care at a home for the elderly, or assisted living facility, or a hospital.
"The situation was very bad in January to March", says Jari Mäki-Runsas, head of social affairs and health for the City of Oulu.
"After a meeting held in April the situation improved considerably, but it is still not good", Oulu increased its assisted living services, and bought more space in short-term treatment facilities.
Kuopio has been trying to do the same. "The basic problem is that there is not enough space available in the city's own organisation. A city hospital is not the right place - assisted living is", Meriläinen says.
The situation is similar in the southwest of Finland. The Turku University Central Hospital began to charge transfer delay fees from the beginning of April. The hospital says that the invoices totalled EUR 3 million.
"The number of patients waiting for a transfer dropped to half the number last year", says Paivi Rautava of the Turku City Hospital.
Although Turku has worked hard to shore up the gap, the city faces big challenges: the number of residents over the age of 85 increased by 200 last year. Even though they tend to be in better shape than before, a need for treatment is nevertheless growing.
Although the transfer delay fees are a big expense, they do not necessarily provide local authorities with a sufficient incentive to arrange treatment as a way of saving money, as long as there is not enough nursing personnel available.
Helsingin Sanomat
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| 25.9.2007 - TODAY |
 Hospitals charging local authorities record-high fines this year |
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