Centralising health care administration in Finland: an inevitable path?

The discussion on the optimal degree of decentralisation and centralisation in the organisation of health systems is ongoing. Since the early 2000s, successive Finnish national governments have attempted to reform the health and social care system to increase the size of administrative units that organise services and to strengthen central steering. So far, developments have materialised mostly in the form of bottom-up solutions without being underpinned by a fundamental national level reform. However, the direction is towards more central steering, planning and organisation of services either through national reform or through bottom-up reforms implemented at local and regional level.