Commercial care of seniors opens political division

Revelations about the details of care in commercially-driven old peoples' assisted living units have triggered a political confrontation in Finland, local media reported on Wednesday.

Following the decision by control authorities to close a unit of Esperi Care in a western Finland town last week, the media reported major problems throughout the country, especially in the services of two leading care companies, Esperi Care and Attendo.

Local commentators have noted the dire reports about seniors in their beds without timely food and soaked in excrement came at the worst possible time for the current center-conservative government.

With ten weeks to go before the April general election, the government still tries to get through in parliament a health care reform that would open up also publicly financed general health care to private operators.

The public outcry about the "for-profits" in senior care may now kill the business plans for the general health care, analysts said.

In the Finnish system, old age care is the responsibility of municipalities. But during the past ten years, they have extensively outsourced the task to commercial companies.

Many municipalities have no publicly operated units left. Having first negotiated the price with the municipality, the commercial operators then make their profit through cost savings.

A former supervisor at Esperi Care told a Finnish language newspaper Helsingin Sanomat on Wednesday the company CEO had listed cleaning work, food and the care of patients, in that order, as savings targets.

The CEO resigned on Tuesday. The largest owners of the company are international investors.

On Wednesday, the entire political opposition announced it will call for a vote-of-confidence debate in parliament. The core demand is that the customer-nurse ratio should be legally defined.

But Finance Minister Petteri Orpo, who is also chairman of the Kansallinen Kokoomus (National Coalition Party), immediately rejected the idea of legal minimum levels of nurses, news agency STT reported.

Orpo told the media in parliament that neglect of customers should be more efficiently criminally sanctioned instead. In the previous government coalition of the social democrats and conservatives in 2011-2014, the social democrats demanded that the law should require seven nurses for each ten seniors in assisted living. In the end a non-binding recommendation of five nurses for each ten customers was enacted.

Marja Jylhä, professor of old age care at Tampere University, said the operators will not hire a sufficient number of nurses, if there is no binding requirement.

"And if there is no sanction, a recommendation or a requirement means nothing," she told the STT.

Orpo also dismissed the idea that the right of companies to create a surplus on the basis of public money could be restricted.

Leena Meri, chairman of the parliamentary group of the populist party Perussuomalaiset (Finns Party), had suggested that profits generated through recycling public money should be controlled.

Orpo noted though that "making a profit is part of any business activity". Instead, he said the operators should have more social responsibility.

Analyzing the situation, newspaper Keskisuomalainen noted that in a real market economy customers would simply leave a place that gives bad care.

"But large producers such as Esperi Care and Attendo have been contracted by the public sector. In this situation the senior citizen customer is an outsider and sufferer," the newspaper wrote.