Among other things, we asked Uusimaa’s politicians who sit on the board of HUS for their comments on the resourcing of birthing activities in the region.
In hospital circles, at the turn of the year, the transition to social security time is in a doubtful mood.
About the resource shortage of the Helsinki and Uusimaa hospital district (HS)
There has also been news about the capital’s resource shortage (HS) throughout the fall.
Helsinki’s second maternity hospital, Kätilöopisto, was closed due to bad indoor air problems in 2017. Before that, smaller units in Porvoo and Tammisaari had already been closed in Uusimaa.
Yle Uutiset set out to find out where Kätilöopisto’s annual over 4,000 births have gone.
Before the closure of Kätilöopisto in 2017, 4,146 children were born there and 5,921 at the Women’s Clinic. Last year, 9,223 children were born at the Women’s Clinic. For a long time, it was a so-called good baby year in Helsinki.
However, it also appears from THL’s birth statistics that since 2017, the number of births at Jorvi Hospital in Espoo has gradually increased.
How is it possible to combine hospitals under one roof? By what means has the operation of the Women’s Clinic and the maternity hospitals in the entire HUS area been enhanced so that the functions of the closed Midwifery Hospital and the Porvoo Maternity Hospital have been taken care of within ten years?
12 of the 17 members of the board answered the survey.
What do politicians know about resources?
– In addition to the capital region, the people of Porvoo and Eastern Uusmaa give birth in at least Hyvinkää and Kotka.
Tight finances and centralization have, at least according to the members of the HUS board, been desirable things and in line with HUS’s strategy.
The Helsinki politicians of the HUS board have quite opposite views on the resources for maternity services.
– The entire operation of HUS was under-resourced and the situation threatens to worsen. HUS receives its money from the state through welfare regions.
According to the calculations of the Ministry of Finance, Uusimaa’s social security funding for 2023 is around 6.1 billion euros.
From the beginning of 2024, HUS will receive more than half, 59 million euros, of the 116 million euros for university hospitals in the Ministry of Finance’s proposal.
At the beginning of next year, the board of the HUS corporation will also change.
The Helsinki representatives of the previous government will continue in it, and the new representatives of the four new welfare areas will continue.
HUS moves into social security era in a crisis atmosphere
In the fall, HUS announced financial difficulties and a deficit of up to 90 million euros in the budget. Lohja maternity hospital in Uusimaa was under threat of surgery. Abolishing it would have saved around 3.5 million euros. However, the shutdown was avoided.
Last year was particularly busy in Uusimaa’s maternity hospitals, because more children were born in a corona year than in a long time. According to THL’s birth statistics, 13,791 children were born in the Helsinki and Uusimaa region in 2021, while in 2019 the number was 12,743.
This year, according to industry director Seppo Heinonen, the region has returned to the pre-coronavirus level.
– We have now dropped to the birth volume we had before the epidemic. It seems to be in a downward direction as far as we know the calculated times six months ahead, Heinonen states.
The women’s clinic has always treated the most demanding births in the region. Even now. The region also has the largest number of elderly birthers and those whose birth requires procedures, such as induction. The sections have also increased.
Home births have become more common. However, according to Heinonen, it is not due to a lack of space.
– It is a treatment model introduced in 2010 or thereabouts. Such a polyclinic start-up, which is in use internationally. There is strong evidence that it is a working model, says Heinonen.
This is how the Women’s Clinic works now
Since the Women’s Clinic building has not grown in size, the Department of Gynecology and Obstetrics at HUS has adapted its operations in other ways, so that the births of the closed Kätilöopisto hospital have also been able to fit into the Women’s Clinic.
One way has been to shorten the hospital stay of women giving birth compared to before, i.e. mother and child are being discharged faster than before.
– Treatment times have been shortened. Not very much, but a little, industry manager Heinonen admits.
More special family rooms have been rented from the premises of a nearby hotel as a patient hotel.
– We have a patient hotel that serves postpartum care, Heinonen says.
They can also be accessed by an escort if there is room. It’s not always.
During peak times, the lack of space is compensated for by referring women giving birth from the Women’s Clinic to other maternity hospitals in the region: Espoo, Lohja and Hyvinkää. Due to the worst congestion peaks, births have even been directed to hospitals in the neighboring counties of Lahti and Kotka.
– The decreasing number of births has helped us to survive, Heinonen sums up.
What has been caused by the boost?
There is a shortage of competent nursing staff everywhere. It’s a big problem at the Women’s Clinic, especially when you can’t get people to work three shifts. Senior nurse Satu Polkko reminds that the availability of nursing staff has become difficult throughout the country.
One reason is salary. The salary and the demands of the work do not match. It’s busy all year round.
– Now we finally completed the labor market tour in October. We can expect salary increases in our social security agreement, but they will not come all at once, but over the course of years, says Jaara.
The women’s clinic now treats both basic health and high-risk births. In some European countries, for example in the Netherlands, home births are mostly preferred. In Helsinki, we are now further and further away from that. According to Heinonen, our legislation also steers in this direction.
By renewing the counseling and guidance of birth mothers, cooperation will be made between all maternity hospitals in the region.
Therefore, referring births to different hospitals during peak times is not ending, but it seems to remain a permanent modus operandi.
*The quotes raised in the story are excerpts from the answers of HUS board members to questions about the resourcing of maternity services in Uusimaa.*