Social affairs and health administration

The central government accounting offices have planned and monitored investments mainly appropriately. However, the guidelines on planning and monitoring should be developed and made more concrete so that they would provide better guidance for the identification of significant investments and the application of procedures.

The determination of the amount of deferrable appropriations is steered mainly by the spending limits in annual budgeting as part of the multi-annual spending limits procedure. The transparency of budgeting is undermined by the fact that, as a rule, appropriations carried over from previous years are not presented in the budget by item. The Ministry of Finance should ensure the appropriateness and transparency of budgeting.

The Nuotti coaching, organised by Kela, has increased the number of young men pursuing further studies. The coaching has been available without a medical diagnosis since 2019. The NAOF recommends that the low-threshold rehabilitation services for young people continue to be provided.

Regional differences in the content and scale of mental health and substance abuse services for young people, the delivery of care, and resources are large. In the future, the Ministry of Social Affairs and Health and the wellbeing services counties, the City of Helsinki and the HUS Group should ensure regional equality.

Public authorities focus on the development of digital services, but the need for alternative service channels is also widely recognised. Many groups, not just older people, need support for using digital services.

There are shortcomings in the utilisation of information on the allocation of working hours in the central government. Some agencies, in practice, hardly utilise the information on the allocation of working hours. Information on the allocation of working hours should be utilised in the agency's management, development and reporting.

Joint emergency services providing both primary and specialized 24-hour service suffer from congestion and the costs of specialized medical care increase as reception services for urgent cases are not effective and enough places for follow-up treatment are not available. Insufficiency of places for follow-up treatment also hampers the operation of hospitals and patients’ access to treatment.

The preparation of projects and reforms extending beyond parliamentary and government terms has been hampered by changing objectives, inappropriate organisation of the preparatory work, insufficient resourcing and slow decision-making. When preparations are started, it should be ensured that there are sufficient prerequisites for effective preparation.

The rigid service process applied for jobseekers currently leads to providing excessive services for independent jobseekers and inadequate services for those difficult to employ. The scarce resources of social welfare, health care and rehabilitation services make it difficult to improve the employment opportunities of persons difficult to employ. Legislation and instructions concerning the jobseeker’s service process must be developed to enable more efficient allocation of the personnel resources of TE Services based on clients’ service needs.

The achievement of the objectives included in the national Recovery and Resilience Plan has not been monitored and reported on in such a manner that it would be possible to monitor and assess the overall effectiveness of the Plan's implementation. Therefore, the results of the implementation of the Plan cannot be verified, either.

The digitalization of healthcare and social welfare requires a uniform target state, towards which the wellbeing services counties in different situations are steered. The Ministry of Social Affairs and Health has already started strategy work, and it is important to focus on it. The Ministry of Social Affairs and Health should also encourage the counties to cooperate in the ICT change and the development of digitalization in healthcare and social welfare.

The audit found no non-compliant transactions between the central government and persons and entities related to it. Final central government accounts do not include related party reporting. Therefore, it is not possible to verify from the final accounts prepared by the accounting offices in accordance with the current legislation whether the accounting offices have had transactions with entities that could be considered to be their related parties.