Finland requires regions to provide end-of-life care

Finland’s Parliament has passed a law requiring wellbeing services counties to provide palliative and hospice care for terminally ill patients, Yle reports. The change comes as Koivikko, a hospice in Hämeenlinna, has received the keys to a new building costing 4.7 million euros.

The law takes effect at the start of 2027. Until now, care has been guided only by recommendations, and provision has varied widely between regions. The new requirement applies to hospices, hospice units and home hospitals across the country.

Riikka Koivisto, who has led Koivikko since 2011, said the hospice had faced a severe financial crisis. In October 2015, it had just four patients despite having capacity for 13, leaving it with a monthly deficit of 60,000 euros.

“I wondered if this was how I would fail,” Koivisto recalled. She once recorded a video from an empty patient room warning that the hospice might soon be unable to pay staff. It was viewed more than 16,000 times.

Support later came through bequests and donations. One elderly woman who visited the hospice left it hundreds of thousands of euros in her will. Other gifts included homes and carefully invested funds. By 2018, the foundation had a surplus of almost 600,000 euros.

Juho Lehto, a professor of palliative medicine and chief physician at the Pirkanmaa wellbeing services county, said provision had improved over the past decade. Koivikko has become part of the palliative care centre for the Kanta-Häme region, and referrals have improved.

Lehto said the law was needed because previous recommendations had not been enough, and some regions were cutting recently established services. Without dedicated services, he said, patients may instead be treated in emergency departments and specialist hospital wards, “worse and more expensively.”

Good hospice care requires enough qualified staff, as well as training and quality monitoring, Lehto said. The new building is the first in Hämeenlinna designed from the outset as a hospice. Koivikko’s former premises are for sale.

Volunteers also play an important role at the hospice. Satu Soininen, 27, is one of about 30 volunteers and said she was not afraid of being with someone at the end of life. She has recommended volunteering to friends and said she had learned a lot about being present.

The World Health Organization has estimated that demand for palliative care will grow rapidly. In Finland, just 16 per cent of people received specialist palliative care near the end of life in 2019, compared with about half in advanced countries.