Helsinki (30.01.2019 - Heikki Jokinen) Gross neglect is thought to be the reason for one death in privatised elderly care and this has created a major debate in Finland. However, trade unions have been warning about these problems for a long time.
In the eye of the storm right now is Esperi Care, a private company that is taking care of some 8 000 elderly people and others in need of special care. It had a turnover of 231 million euro. The main owner of Esperi is the Intermediate Capital Group, an asset manager company based in Britain.
Valvira, the National Supervisory Authority for Welfare and Health, announced on 25 January that it would suspend operations at Esperi's nursing home in the town of Kristiinankaupunki.
They suspect that an elderly resident’s death was caused by negligence and three other neglected residents have been moved to municipal medical care.
Esperi Care CEO for 16 years, Marja Aarnio-Isohanni has earned more than 12 million euro from the company. A part of this comes from the loan she gave to the company - for which the company pays an incomparable 12-15 per cent rate of interest. Aarnio-Isohanni left her job as CEO on 29 January.
Now, after the case in Kristiinankaupunki, many problems and breaches in the privatised social welfare services has been reported in the media. In January the City of Helsinki also considered to close a private kindergarten as it was operating out of an illegal premises - a former storage unit.
Unions had signalled alarm bells
Nothing in all this is new for the trade unions. Tehy - The Union of Health and Social Care Professionals in Finland, published a survey one year ago conducted for those working at Esperi Care.
Tehy revealed that the duty rosters regularly include ghost workers, replacements not being hired, overtime not always paid and medication dispensed by employees without authorisation to do so.
Similar problems come up in a new Tehy survey carried out for those who are working at another elder care company, Attendo. A total of 56 per cent of respondents said that patients were put at risk during the last 6 months.
As Valvira is only responsible for supervising the minimum number of professional employees, the private companies often hire too few people to do other work, like cleaning and kitchen work. These jobs are then done by the health care professionals and patients are left without care.
According to Yle News one ex-manager of a facility says that "Esperi Care senior management ordered them to systematically reduce nurses' working hours on shift rota by five percent, although the company had pledged to provide 100 percent staffing in its supplier agreement with the local municipality".
"Moreover, they were encouraged to favour non-Finnish-speaking substitutes since they were less likely than native Finns to be as familiar with labour laws", Yle News reports.
Problems accumulate in privatised services
Yle News also quotes the Tehy Legislative Chief Vappu Okkeri who says that private nursing homes have far more serious problems with quality of service than institutions run by a city or municipality.
"The problems with Esperi are the worst, though similar negligence also occurs in other conglomerates such as Attendo and Mehiläinen," Okkeri said.
"The real reason is an unhealthy culture of competition. Municipalities try to make savings by outsourcing their elder care, but businesses need to make profit, so the vicious circle is complete."
Päivi Niemi-Laine, President of the Trade Union for the Public and Welfare Sectors JHL says that the Esperi case is just the tip of the iceberg.
"The situation has been allowed to continue for far too long. Now the Government must take stock of the situation and take immediate measures", she says. JHL are demanding more precise legislation on the rules governing private social and health care services.
Niemi-Laine stresses that when tendering health and social care services criteria other than price must be considered.
"Privatisation as such cannot be an alternative and tendering should not result in a poorer quality of service."
"Trade unions have been highlighting the problems with care for the elderly for a long time now, the Esperi case cannot come as a surprise for the Government. We do not want to hear of even one more single case where the desire for profit has led to human suffering". Niemi-Laine says.