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NEWS ANALYSIS: Well, well...supervision is back in vogue

Ideal of freedom turned into longing for official oversight after a fake doctor was caught

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By Päivi Repo
      The recent furore about bogus doctors and the care for the elderly have caused mixed feelings - for many reasons.
      The fake physician was seen as a criminal with disturbed behaviour. However, there would have also been other ways of looking at it.
      For example, the counterfeit physician's colleagues reported that it had been easy to cooperate with the man.
      For its part, the National Supervisory Authority for Welfare and Health (VALVIRA) made it known that the suspicious doctor had been insecure, leaning on others.
      No doubt about that.
      Nevertheless, one might have thought that maybe he was a master of multi-disciplinary collaboration, which has become an everyday phenomenon in several fields, including healthcare services.
Somebody could also have concluded that the number of applicants admitted to study medicine is too small, as many individuals who have a passionate desire to work in the field - and who would obviously be able to cope with the requirements - are left out in the cold every year.
      Should the number of study places be increased, as there is a shortage of physicians in Finland?
      Or is the reality in the field different from what the applicants imagine?
Another question is whether or not the entrance examinations are focusing on the right skills.
      Today, those skills include mathematics, physics, and chemistry. Could physicians benefit more from psychology, for example?
      The ability to deal one-on-one with patients - the old "bedside manner" - is today stressed more than it used to be, but still many patients evaluate the doctor’s competence on the basis of his or her communication skills.
      Weak communication will stick in a person’s mind more firmly than the competence or otherwise of the doctor in question.
In discussons on the care for the elderly, people were lamenting how badly a private company has been taking care of old people in Sweden.
      However, the fact that the same company is in the habit of repatriating all profits to an offshore tax paradise seemed to cause even more resentment.
      The real objects of the debate - the old people themselves - were forgotten. Regrettably, the same is apparently happening here - time and time again.
      The quality of care for the elderly has been the talk of the town several times during the current millennium.
      It is true that there have been some improvements, but between the headline-grabbing incidents, attention has been turned to other issues.
Are we then forgetting, for example, that in order to take good care of old people, there should be enough money and employees?
      Already now, there have been warnings that these services are facing cuts because of the poor financial straits of municipalities and the state.
      Will anyone stand for the the elderly?
However, the most surprising request to come out of the past few days was the demand for greater public oversight and scrutiny.
      It welled up as if from the tomb, as in recent years supervision has been regarded more or less as restraining and fussy.
      It is said to destroy entrepreneural activity and to curb creativity. After all, all we want is freedom!
      What brought supervision back into style?
      It is hardly that our desire to follow the rules closely has increased - one can see that every day in traffic.
The government reduced the number of social and healthcare supervisors in the regional administration reform programme, when the National Authority for Medicolegal Affairs (TEO) and the National Product Control Agency for Welfare and Health (STTV) merged in 2009, creating a new central office of the administrative sector of the Ministry of Social Affairs and Health - known as the National Supervisory Authority for Welfare and Health (VALVIRA).
      Last spring, Valvira was fretting about the fact that the number of personnel should be reduced, even though the duties of the authority were increasing day by day.
      The message was not heard, even though one phony doctor had already been found.
When we call for more supervision, we may be longing for something else.
      Security, perhaps?
      So that in the maelström of faceless market forces, there could be at least one person who is in charge and on whom pressure could be brought to bear.
      Hopefully, we could all remember then that the supervisors do not have absolute authority over certain things that afftect their work, such as for example resource allocation.
      Otherwise it is easy to foresee the consequences: nobody in their right mind will seek a post of supervisor in the future.
      Whom will we then call to account for wrongdoings?
Helsingin Sanomat / First published in print 28.11.2011

Previously in HS International Edition:
  Authorities to investigate hundreds of medical degrees from abroad (16.11.2011)
  Daughter of deceased patient of suspected bogus doctor files complaint (11.11.2011)
  Fake doctor may have treated thousands of patients in Southern Finland (10.11.2011)
  Phony doctor hurts credibility of Karkkila health services (11.1.2010)
  Fake doctor scandal: Confusion over cancelled resignation of VALVIRA chief (22.11.2011)
  Ministry promises VALVIRA help in fake doctor hunt (18.11.2011)

See also:
  Act on care services for the elderly is under preparation in Finland (7.11.2011)
  Questions over private contractor hired to run public health care in Raseborg (16.11.2011)

PÄIVI REPO / Helsingin Sanomat

  29.11.2011 - THIS WEEK
 NEWS ANALYSIS: Well, well...supervision is back in vogue

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