Down syndrome family fears loss of specialist care under Pirkanmaa restructuring

Pirkanmaa’s planned overhaul of disability services will shift care for milder developmental disabilities from specialist clinics to primary health care, prompting fears among families and staff that expertise will be lost.

The change, slated for January 2027, follows a new national Disability Services Act and chronic physician shortages at the Pirkanmaa wellbeing services county. Only two of seven doctor posts at the Nokian Pitkäniemi developmental disability polyclinic have been filled, and the county says it is using locum doctors to fill gaps.

A mother of a teenage son with Down syndrome, identified only as Sofia to protect the child’s privacy, said her family has relied on the polyclinic for developmental and health monitoring. Under the new model, she fears they will be turned away.

“It feels like we end up teaching the primary care staff about Down syndrome and related conditions instead of receiving the care we need,” Sofia said. She described bringing printed growth charts to well-baby visits because the clinic lacked ready-made tools for children with Down syndrome.

Sirpa Rainesalo, chief medical officer at Pirkanmaa wellbeing services, said the shift is not about saving money but about concentrating scarce specialist resources on the most complex cases. “The polyclinic will focus on conditions requiring advanced expertise, while routine illnesses will be handled elsewhere,” she said.

Tuija Kaivanto, chair of the county’s disability council, countered that savings are likely. “The background is clearly financial,” she said. “Families and staff are worried that primary care lacks the training to meet these patients’ needs.”

The county’s preparations for the change are still under way. In 2024 the Finnish Administrative Court issued a reprimand over staffing shortages and long-standing organisational problems at the polyclinic; the reprimand was lifted in May 2025.