Is the EU steering national social and health policy making? A case-study on Finland's national reform

• Published in: Health policy (Amsterdam) 2024-07, Vol.145, p.105078-105078, Article 105078
• Main Authors: Heinonen, Noora, Koivusalo, Meri, Keskimäki, Ilmo, Tynkkynen, Liina-Kaisa
• Format: Article
• Language: English
• Subjects: Country-specific recommendation; Economic policy; European Semester; European Union; Finland; Governance; Health Care Reform; Health Policy; Humans; Policy Making; Social and health policy
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2024.105078

•In 2013–2020, Finland received country-specific recommendations to reform national social and health care.•National social and health care reform was pursued since 2005, but the reform was implemented only in 2023.•The country-specific recommendations were mostly in line with reaffirmed national interests.•The European Semester created an EU level pathway to steer national policy reform.•Nationally the country-specific recommendations were discussed entirely separately from the reform. As part of the European Semester, Finland received country-specific recommendations (CSRs) in 2013–2020 that encouraged the reform of national social and health services. These recommendations were part of efforts to balance public finances and implement public-sector structural reforms. Finland has been struggling to reform the national social and health care system since 2005. Only on 1 January 2023 did the new wellbeing services counties become liable for organizing social, health, and rescue services. Studying the CSRs for Finland enables us to understand better what genuinely occurs at the EU member state level. This data-driven case study aims to disclose the relevance of the European Semester for Finland in the pursuit of a national social and health system reform. The mixed-method approach is based on the research tradition of governance, and the study contains features of data sourcing and methodological triangulation. Empirically, the research material consists of Finland's official policy documents and anonymous semi-structured elite interviews. The study highlights that although the received CSRs on the need to restructure social and health services corresponded to Finland's views, their influence to national reform efforts was limited. The CSRs were administered according to the established formal routines, but separately from the national reform preparations. The CSRs, however, delivered implicit steering, which were considered to affect social and health policy making in various ways.