Social welfare and health care services

Social welfare and health care services are services essential to the wellbeing and everyday life of people. The Non-Discrimination Ombudsman regularly receives contacts, in which someone has experienced unfair treatment or discrimination against in municipal social welfare or disability services. The Ombudsman also receives contacts related to health care and specialised medical care.

Discrimination in social welfare and health care services 

Discrimination in social welfare and health care services may involve, for example:

• the personnel not providing personal assistance to a patient with a disability at the ward,
• not providing a sign language interpreter for the patient,
• telephone calls being the only way to contact health care, 
• denial of the necessary reasonable accommodations for a person with disabilities in decision-making or health or medical care,
• inaccessible social welfare and health care facilities or health and medical care equipment, 
• patients not receiving service in their own native language in Finnish, Swedish at a health centre in a bilingual municipality or in Sámi language in the Sámi homeland,
• patient is treated less favourably than others because of their origin. 

The Non-discrimination Ombudsman occasionally receives contacts because linguistic rights have not been realised in social welfare and health care services. Everyone has the right to use Finnish or Swedish when dealing with a state authority or an authority in a bilingual municipality. This also applies to health centres, the emergency clinic or social welfare services. Provisions on the matter can be found in the Language Act. 

The right of the Sámi to use their own language at courts of law and when dealing with other authorities is laid down in the Sámi Language Act. The Non-discrimination Ombudsman is aware of the fact that the realisation of rights varies and there are also clear language-specific differences in the availability of services. Investments should be made in developing services in the Sámi language by means such as increasing the availability of personnel with language skills. 

The Ombudsman has also received contacts on the inaccessibility of social welfare and health care facilities and equipment. The Constitution of Finland guarantees sufficient social welfare and health care services for everyone. Social welfare and health care services must be accessible and barrier-free so that the right of people with disabilities to social welfare and health care services can be realised.

The Non-Discrimination Ombudsman also receives many contacts about customers who have not received the service or benefit for which they have applied from the municipality or Kela, the Social Insurance Institution of Finland. The Ombudsman cannot change the decisions that have been made or give orders to other authorities or private parties. A negative decision can be appealed by following the appeal instructions.

Equality in social welfare and health care services must be promoted

Authorities have a duty to promote equality. The needs of different customer groups must be taken into account, and the equality of different groups in social welfare and health care services must be promoted systematically and in a goal-oriented manner. Authorities are required to draw up an equality promotion plan to support the work done to promote equality. The plan should also take account of the requirements of the Act on the Status and Rights of Social Welfare Clients and the Act on the Status and Rights of Patients on the good treatment of customers and taking individual needs and the customers’ culture and native language into consideration.  

For people with disabilities, authorities and private service providers must make the necessary reasonable accommodations in order to ensure that the right of people with disabilities to equal social welfare and health care services is realised in individual cases of using the services. Reasonable accommodations must also be made when the authorities make the decision to grant services or benefits. Reasonable accommodations may mean, for instance, that the client’s own contribution to a transport service granted for studies in accordance with the Act on Disability Services and Assistance is adjusted to a reasonable level. In health care, it may mean at its simplest that the patient’s needs due to disability are taken into account in the services.

According to the Act on the Status and Rights of Social Welfare Clients, the client has the right to receive good social services and non-discriminatory treatment from the providers of social services. Clients must be treated in a manner that does not offend their human dignity and respects their conviction and privacy. When social welfare services are provided, due consideration must be given to the clients’ wishes, opinion, best interests and individual needs, as well as native language and cultural background.

Legal protection in social welfare and health care services

The customers of both social welfare and health care services have many methods of legal protection available to them. Every person living permanently in Finland have the right to health and medical care required by their state of health without discrimination. Patients have the right to good quality health care and medical care. Their care must be arranged and they must be treated in a manner that does not violate their human dignity and respects their conviction and privacy. The patients’ native language and their culture and individual needs must be taken into account in their care and treatment as far as possible. The relevant provisions can be found in the Act on the Status and Rights of Patients.

Poor treatment may create an experience of discrimination. However, poor treatment does not always constitute discrimination. The Non-Discrimination Ombudsman can help with assessing whether the issue was related to poor customer service or other poor treatment, or whether discrimination prohibited by the Non-discrimination Act was involved. 

If the issue was due to something other than discrimination, or if it involved a violation of legislation other than the Non-discrimination Act, you should consider filing a complaint with the party in question or contacting the Regional State Administrative Agency or the National Supervisory Authority for Welfare and Health (Valvira).  

If you feel that you have been treated badly, you should start by trying to resolve the issue by talking about it with the person in question or their superior. You can also contact the municipal social ombudsman or the location’s patient ombudsman for advice. You can find more information on the website of Valvira (in Finnish).

If the discussion about the bad treatment or other reprehensible actions you have experienced did not have the desired result, you can file a complaint with the responsible person of the social welfare service unit or the social welfare officeholder in charge, or in the case of health care,  the director of the place of treatment; you can also file a complaint with the Regional State Administrative Agency or the National Supervisory Authority for Welfare and Health (Valvira). You can find more information about filing a complaint or issuing a reprimand on the website of Valvira (in Finnish).

If the problem is a negative decision that you have received and are dissatisfied with, you should primarily appeal the decision by following the appeal instructions included in the decision.