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11V10.8122C15.113 10.5699 14.9748 10.4239 14.7432 10.4239Z" fill="currentColor"></path><path d="M12.0846 8.41359C12.1301 7.57715 12.4701 7.20312 13.1831 7.20312H13.1838C13.8614 7.20312 14.1661 7.56532 14.1975 8.41202L12.0846 8.41359Z" fill="currentColor"></path><path d="M31.4197 13.2932H25.348L23.7136 18.0002H20.0957L26.4898 0.198242H30.7749L37.0436 18.0002H33.1032L31.4197 13.2932ZM28.4689 3.60924L26.1405 10.5302H30.6719L28.4689 3.60924Z" fill="currentColor"></path><path d="M49.178 18L45.1885 11.925H42.4616V18H38.9421V0.621C38.9421 0.621 41.1944 0 45.2332 0C49.8676 0 52.6393 1.62 52.6393 5.2515C52.6393 8.9595 50.3601 10.5525 48.7258 11.277L53.3826 18H49.178ZM42.466 9.1125H46.4556C48.1661 8.3925 48.9586 7.47 48.9586 5.6025C48.9586 3.6585 47.5706 2.889 45.2914 2.889C43.8541 2.889 42.466 3.1365 42.466 3.1365V9.1125Z" fill="currentColor"></path><path d="M55.4691 17.9996V0.24707H67.5319V3.25757H59.0109V7.71257H66.3677V10.6016H59.0109V14.9846H67.7558V17.9996H55.4691Z" 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href="/web/20240425201317/https://yle.fi/t/18-220306/fi" aria-label="Lisää artikkeleita aiheesta Politiikka" class="TagLinkstyles__TagLinkBase-sc-w5hh4y-0 doqXHU">Politiikka</a></div><h1 class="sc-beySPh kuTmyG yle__article__heading yle__article__heading--1">Muistio paljastaa: Uudenmaan hyvinvointialueiden yhdistäminen toisi miljoonasäästöt, hallitus päätti toisin</h1><p class="aw-1gybjub aw-5vja16 dvotnq YVZwc yle__article__paragraph">Sosiaali- ja terveysministeriö varoittaa hallitukselle tarkoitetussa muistiossa, että hyvinvointialueiden säästöt voivat myöhemmin kostautua.</p><figure class="aw-u5oz0a eiswpX yle__article__figure"><script type="application/ld+json">{"@id":"74-20085614","@context":"https://web.archive.org/web/20240425201317/https://schema.org","image":{"@type":"ImageObject","description":"Hallitus sopi lähivuosien taloudenpidosta kehysriihessä huhtikuun puolivälissä.","copyrightHolder":"Henrietta Hassinen / 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data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240425201317im_/https://images.cdn.yle.fi/image/upload/ar_1.4992503748125936,c_fill,g_faces,h_424,w_636/dpr_2.0/q_auto:eco/f_auto/fl_lossy/v1713183788/39-1270995661d1a949d2fb 2x, https://web.archive.org/web/20240425201317im_/https://images.cdn.yle.fi/image/upload/ar_1.4992503748125936,c_fill,g_faces,h_424,w_636/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1713183788/39-1270995661d1a949d2fb 1x"/><img alt="Kehysriihen aloitus pitkän pöydän ääressä." src="https://web.archive.org/web/20240425201317im_/https://images.cdn.yle.fi/image/upload/c_crop,h_3361,w_5987,x_0,y_375/ar_1.7777777777777777,c_fill,g_faces,h_431,w_767/dpr_1.0/q_auto:eco/f_auto/fl_lossy/v1713183788/39-1270995661d1a949d2fb" class="aw-1l9m598 kDMeTj"/></picture></div><div class="aw-45s348 rjAqP"><button aria-disabled="false" class="Buttonstyles__ButtonBase-sc-17sr1bx-0 Buttonstyles__ButtonSecondary-sc-17sr1bx-2 kVAHoB jUvsxe"><span class="Buttonstyles__TextWrapper-sc-17sr1bx-7 fTwJAM yds-button__content">Avaa kuvien katselu</span></button></div></div></div><figcaption class="aw-kr26k0 gwXnFP"><span>Hallitus sopi lähivuosien taloudenpidosta kehysriihessä huhtikuun puolivälissä.</span><span> Kuva: Henrietta Hassinen / Yle</span></figcaption></figure><div class="aw-1wk2icm cLQuDx"><div class="aw-qww0lc bXDRBg"><div class="aw-x5rn7a cuuZMC"><span class="aw-z7z0zi jvmail">Tulikukka de Fresnes</span></div></div></div><div class="aw-1hwlbbb dUitsS"><div class="aw-kzjed4 hdUrXi yle__article__date"><time class="aw-lsqctp iTvOCQ yle__article__date--published" datetime="2024-04-25T14:38:57+03:00">14:38</time><span aria-hidden="true" class="aw-131q90r hSduuB">•</span><time class="aw-lsqctp iTvOCQ yle__article__date--modified" datetime="2024-04-25T17:10:38+03:00">Päivitetty 17:10</time></div></div></header><section class="yle__article__content"><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Merkittäviä, satojen miljoonien eurojen lisäsäästöjä on hyvin vaikea saada aikaan hyvinvointialueiden tehtäviä ja velvoitteita karsivilla lakimuutoksilla, todetaan sosiaali- ja terveysministeriön STM:n 19. maaliskuuta päivätyssä muistiossa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">STM:n muistion mukaan hyvinvointialueiden tehtävien karsiminen voi kostautua kustannusten kasvuna muissa palveluissa tai etuuksissa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Ministeriön mukaan on mahdollista, että toivottuihin säästöihin ei päästäkään, kun vaikutuksia lasketaan tarkemmin. Sen mukaan säästöillä voi olla valtion talouteen merkittävämpi negatiivinen vaikutus kuin yksittäisillä säästötoimilla.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Lisäksi muistiossa arvioidaan, että lakimuutoksilla on merkittävä riski kaatua perustuslaillisiin ongelmiin, jos sosiaali- ja terveydenhuollon palveluita rajataan lakia muuttamalla.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Hallituspuolueista on arvosteltu sosiaali- ja terveysministeriötä siitä, että se ei ole aktiivisemmin etsinyt säästökohteita. Nyt julki tullut muistio tarkentaa kuvaa siitä, minkälaisia vaihtoehtoja hallituspuolueilla oli ennen kehysriihessä tehtyjä päätöksiä.</p><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Ministeriö yhdistäisi hyvinvointialueita</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">STM on tehnyt muistion valtiovarainministeriön toimeksiantona, ja se arvioi siinä mahdollisuuksia säästää karsimalla hyvinvointialueiden tehtäviä ja velvoitteita.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">STM:n mukaan muun muassa yöpäivystysten, synnytyssairaaloiden ja kakkossairaaloiden palveluvalikoimaa karsimalla on vuodesta 2026 alkaen mahdollista säästää 20 miljoonaa euroa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Vuosina 2027 ja 2028 vastaava erikoissairaanhoidon säästömahdollisuus olisi 30 miljoonaa euroa.</p><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Kansliapäällikkö: Uuttamaata ei valmistella</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">STM listaa säästökohteeksi myös Uudenmaan erillisratkaisun purkamisen eli Uudenmaan hyvinvointialueiden yhdistämisen. Säästö olisi muistion mukaan 60 miljoonaa euroa vuonna 2028, jos viisi hyvinvointialuetta yhdistetään.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Viiden hyvinvointialueen yhdistäminen sekä ”ryhmärahojen” poistaminen toisi 65 miljoonan säästöt vuonna 2028.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Säästöt syntyisivät esimerkiksi työvoiman laajemmasta käytöstä sekä viiden alueen hallinnon, asiakasmaksujen, hankintojen, investointien, tukipalvelujen sekä muiden toimintojen yhtenäistämisestä ja tehostamisesta.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Vuoden 2028 jälkeen Uudenmaan erillisratkaisun purkamisesta syntyvä säästö olisi vieläkin merkittävämpi, STM laskee.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">STM:n kansliapäälliikö <strong class="aw-ak79eh fyQnLO yle__article__strong">Veli-Mikko Niemen</strong> mukaan Uudenmaan hyvinvointialueiden vähentämistä koskevaa ehdotusta ei ministeriössä valmistella.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">– Uuttamaata koskeva ehdotus, kuten monta muutakaan ehdotustamme, ei edennyt kehysriiheen, Niemi kommentoi sähköpostitse.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Uudellamaalla on tällä hetkellä neljä hyvinvointialuetta: Länsi-Uusimaa, Keski-Uusimaa, Vantaa-Kerava ja Itä-Uusimaa. Helsinki vastaa sote-palveluistaan itse.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Muistiossa todetaan, että hyvinvointialueiden yhdistäminen olisi ”erittäin iso muutos”, joka edellyttää kunnollista valmistelua ja resursointia.</p><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Ei säästöjä perusterveydenhuoltoon</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Perusterveydenhuolto tulisi muistion mukaan jättää lisäsäästöjen ulkopuolelle.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">STM toteaa muistiossa, että perusterveydenhuollon osuus sosiaali- ja terveydenhuollon kokonaiskustannuksista on vain 18 prosenttia, sen rahoitusta on jo kutistettu suhteessa kustannusten kasvuun, ja että hyvin toimivana se säästää erikoissairaanhoidon kustannuksia.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Sen sijaan muistion mukaan perusterveydenhuollon kustannuksia olisi mahdollista hillitä, ja hoidon laatua parantaa edistämällä potilaan ja lääkärin välisen henkilökohtaisen hoitosuhteen jatkuvuutta.</p><h2 class="sc-guDLey kEXXRR yle__article__heading yle__article__heading--2">Kehysriihi päätti toisin</h2><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Hallitus ei huomioinut kehysriihessä STM:n ehdotusta Uudenmaan hyvinvointialueiden karsimisesta.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Riihen päätöksillä yöpäivystyksiä vähennetään Iisalmessa, Jämsässä, Kouvolassa, Raahessa ja Varkaudessa. Oulaisissa, Kemissä, Salossa, Savonlinnassa ja Valkeakoskella ei tehdä enää ympärivuorokautista leikkaussalivalmiutta edellyttäviä leikkauksia. Näiden säästövaikutukseksi hallitus on arvioinut noin 26 miljoonaa euroa.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Hallitus myös höllensi vanhusten ympärivuorokautisen hoivan hoitajamitoitusta 0,6:een työntekijään asiakasta kohti. Hoitoon pääsyn takuuta pidennettiin perusterveydenhuollossa kahdesta viikosta kolmeen kuukauteen, suun terveydenhuollossa kuuteen kuukauteen. Näistä kertyisi 130 miljoonan euron säästöt.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph">Lisäksi hallitus hakee säästöjä rajaamalla tiettyjä hoitoja julkisessa terveydenhuollossa. Esimerkkeinä on mainittu sterilisaatioiden rajaaminen ja estetiikkaa lähenevä plastiikkakirurgia.</p><p class="aw-1gybjub aw-1p7kakr dvotnq kRlVjV yle__article__paragraph"><em class="aw-18vh2pl dniCWk yle__article__emphasis">Klo 17.10 Lisätty kansliapäällikkö Veli-Mikko Niemen kommentti</em></p></section><footer class="yle__article__footer"><div><div class="aw-1n3c5tg kPUaoB"><a href="/web/20240425201317/https://yle.fi/t/18-220306/fi" aria-label="Lisää artikkeleita aiheesta Politiikka" class="TagLinkstyles__TagLinkBase-sc-w5hh4y-0 jgCydh">Politiikka</a><a href="/web/20240425201317/https://yle.fi/t/18-327171/fi" aria-label="Lisää artikkeleita aiheesta Hyvinvointialueet" class="TagLinkstyles__TagLinkBase-sc-w5hh4y-0 jgCydh">Hyvinvointialueet</a></div></div></footer></article></div></div><div class="RecommendedPostArticleHeadlines__Container-sc-4ab2ba0f-0 hrAMbS"><section aria-label="Suosittelemme" class="no-print"><h2 class="Group__SrHeading-sc-560bbb4-3 hWLMPZ 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opiskelijoiden rahallinen asema on verrattuna aiempiin sukupolviin? Selvitimme</a><a href="/web/20240425201317/https://yle.fi/a/74-20085567#comments" class="Typography-sc-d683ebd5-0 StoryCommentsCount__CommentsLink-sc-892b935b-0 Vysny dinlwZ MinimalHeadlines__StyledStoryCommentsCount-sc-121ecf9d-5 QwTKJ"><svg viewbox="0 0 24 24" height="16" role="img" aria-label="Kommentit aiheesta" color="currentColor" class="StoryCommentsCount__StyledIcon-sc-892b935b-1 LYDYo"><use xlink:href="https://web.archive.org/web/20240425201317im_/https://yle.fi/uutiset/assets/img/icons-v5.svg#message-square"></use></svg>224 kommenttia</a></h3></div></li><li class="MinimalHeadlines__TriggeredItem-sc-121ecf9d-0 jAFdSU"><div class="MinimalHeadlines__BulletContainer-sc-121ecf9d-6 gRixtB"><div class="MinimalHeadlines__BulletCell-sc-121ecf9d-7 btMNEP"><div aria-hidden="true" class="MinimalHeadlines__Index-sc-121ecf9d-3 fyvVXK">5</div></div></div><div class="MinimalHeadlines__Texts-sc-121ecf9d-1 jcTisf"><a href="/web/20240425201317/https://yle.fi/t/18-215440/fi" 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","type":"heading"},{"alt":"Kehysriihen aloitus pitkän pöydän ääressä.","source":"Henrietta Hassinen \u002F Yle","aspect":1.4992503748125936,"caption":"Hallitus sopi lähivuosien taloudenpidosta kehysriihessä huhtikuun puolivälissä.","id":"39-1270995661d1a949d2fb","type":"image","alts":[{"language":"fin","value":"Kehysriihen aloitus pitkän pöydän ääressä."}],"blurhash":"LYQ+D,t3xBxt~QngMwR*R:S*xtof","tags":[{"label":[{"language":"fin","value":"Kehysriihi"}],"extId":"18-66043"},{"label":[{"language":"fin","value":"kehysriihi"},{"language":"swe","value":"rambudgetering"}],"extId":"18-275156"},{"label":[{"language":"fin","value":"hallitus"},{"language":"swe","value":"styrelse"}],"extId":"18-155495"},{"label":[{"language":"fin","value":"hallitukset"},{"language":"swe","value":"regeringar"}],"extId":"18-218788"},{"label":[{"language":"fin","value":"hallituspolitiikka"},{"language":"swe","value":"regeringspolitik"}],"extId":"18-214416"},{"label":[{"language":"eng","value":"Public 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maaliskuuta päivätyssä muistiossa.","type":"text"},{"text":"STM:n muistion mukaan hyvinvointialueiden tehtävien karsiminen voi kostautua kustannusten kasvuna muissa palveluissa tai etuuksissa.","type":"text"},{"text":"Ministeriön mukaan on mahdollista, että toivottuihin säästöihin ei päästäkään, kun vaikutuksia lasketaan tarkemmin. Sen mukaan säästöillä voi olla valtion talouteen merkittävämpi negatiivinen vaikutus kuin yksittäisillä säästötoimilla.","type":"text"},{"text":"Lisäksi muistiossa arvioidaan, että lakimuutoksilla on merkittävä riski kaatua perustuslaillisiin ongelmiin, jos sosiaali- ja terveydenhuollon palveluita rajataan lakia muuttamalla.","type":"text"},{"text":"Hallituspuolueista on arvosteltu sosiaali- ja terveysministeriötä siitä, että se ei ole aktiivisemmin etsinyt säästökohteita. Nyt julki tullut muistio tarkentaa kuvaa siitä, minkälaisia vaihtoehtoja hallituspuolueilla oli ennen kehysriihessä tehtyjä päätöksiä.","type":"text"},{"text":"Ministeriö yhdistäisi hyvinvointialueita","level":2,"type":"heading"},{"text":"STM on tehnyt muistion valtiovarainministeriön toimeksiantona, ja se arvioi siinä mahdollisuuksia säästää karsimalla hyvinvointialueiden tehtäviä ja velvoitteita.","type":"text"},{"text":"STM:n mukaan muun muassa yöpäivystysten, synnytyssairaaloiden ja kakkossairaaloiden palveluvalikoimaa karsimalla on vuodesta 2026 alkaen mahdollista säästää 20 miljoonaa euroa.","type":"text"},{"text":"Vuosina 2027 ja 2028 vastaava erikoissairaanhoidon säästömahdollisuus olisi 30 miljoonaa euroa.","type":"text"},{"text":"Kansliapäällikkö: Uuttamaata ei valmistella","level":2,"type":"heading"},{"text":"STM listaa säästökohteeksi myös Uudenmaan erillisratkaisun purkamisen eli Uudenmaan hyvinvointialueiden yhdistämisen. Säästö olisi muistion mukaan 60 miljoonaa euroa vuonna 2028, jos viisi hyvinvointialuetta yhdistetään.","type":"text"},{"text":"Viiden hyvinvointialueen yhdistäminen sekä ”ryhmärahojen” poistaminen toisi 65 miljoonan säästöt vuonna 2028.","type":"text"},{"text":"Säästöt syntyisivät esimerkiksi työvoiman laajemmasta käytöstä sekä viiden alueen hallinnon, asiakasmaksujen, hankintojen, investointien, tukipalvelujen sekä muiden toimintojen yhtenäistämisestä ja tehostamisesta.","type":"text"},{"text":"Vuoden 2028 jälkeen Uudenmaan erillisratkaisun purkamisesta syntyvä säästö olisi vieläkin merkittävämpi, STM laskee.","type":"text"},{"text":"STM:n kansliapäälliikö **Veli-Mikko Niemen** mukaan Uudenmaan hyvinvointialueiden vähentämistä koskevaa ehdotusta ei ministeriössä valmistella.","type":"text"},{"text":"– Uuttamaata koskeva ehdotus, kuten monta muutakaan ehdotustamme, ei edennyt kehysriiheen, Niemi kommentoi sähköpostitse.","type":"text"},{"text":"Uudellamaalla on tällä hetkellä neljä hyvinvointialuetta: Länsi-Uusimaa, Keski-Uusimaa, Vantaa-Kerava ja Itä-Uusimaa. Helsinki vastaa sote-palveluistaan itse.","type":"text"},{"text":"Muistiossa todetaan, että hyvinvointialueiden yhdistäminen olisi ”erittäin iso muutos”, joka edellyttää kunnollista valmistelua ja resursointia.","type":"text"},{"text":"Ei säästöjä perusterveydenhuoltoon","level":2,"type":"heading"},{"text":"Perusterveydenhuolto tulisi muistion mukaan jättää lisäsäästöjen ulkopuolelle.","type":"text"},{"text":"STM toteaa muistiossa, että perusterveydenhuollon osuus sosiaali- ja terveydenhuollon kokonaiskustannuksista on vain 18 prosenttia, sen rahoitusta on jo kutistettu suhteessa kustannusten kasvuun, ja että hyvin toimivana se säästää erikoissairaanhoidon kustannuksia.","type":"text"},{"text":"Sen sijaan muistion mukaan perusterveydenhuollon kustannuksia olisi mahdollista hillitä, ja hoidon laatua parantaa edistämällä potilaan ja lääkärin välisen henkilökohtaisen hoitosuhteen jatkuvuutta.","type":"text"},{"text":"Kehysriihi päätti toisin","level":2,"type":"heading"},{"text":"Hallitus ei huomioinut kehysriihessä STM:n ehdotusta Uudenmaan hyvinvointialueiden karsimisesta.","type":"text"},{"text":"Riihen päätöksillä yöpäivystyksiä vähennetään Iisalmessa, Jämsässä, Kouvolassa, Raahessa ja Varkaudessa. Oulaisissa, Kemissä, Salossa, Savonlinnassa ja Valkeakoskella ei tehdä enää ympärivuorokautista leikkaussalivalmiutta edellyttäviä leikkauksia. Näiden säästövaikutukseksi hallitus on arvioinut noin 26 miljoonaa euroa.","type":"text"},{"text":"Hallitus myös höllensi vanhusten ympärivuorokautisen hoivan hoitajamitoitusta 0,6:een työntekijään asiakasta kohti. Hoitoon pääsyn takuuta pidennettiin perusterveydenhuollossa kahdesta viikosta kolmeen kuukauteen, suun terveydenhuollossa kuuteen kuukauteen. Näistä kertyisi 130 miljoonan euron säästöt.","type":"text"},{"text":"Lisäksi hallitus hakee säästöjä rajaamalla tiettyjä hoitoja julkisessa terveydenhuollossa. Esimerkkeinä on mainittu sterilisaatioiden rajaaminen ja estetiikkaa lähenevä plastiikkakirurgia.","type":"text"},{"text":"*Klo 17.10 Lisätty kansliapäällikkö Veli-Mikko Niemen kommentti*","type":"text"}],"subjects":[{"description":{"fi":"Alkuperältään politiikka on käytännön tai teorian vaikuttamista toisiin ihmisiin globaalilla, kansallisella tai yksilöllisellä tasolla. Nykyisessä yleiskielessä sanalla politiikka tarkoitetaan usein johonkin tiettyyn kokonaisnäkemykseen tai aatteeseen pohjautuvaa toimintaa, jolla pyritään vaikuttamaan valtiollisiin, valtioiden välisiin tai yhteiskunnallisiin asioihin tai jolla hoidetaan niitä.","sv":"Politik betyder ursprungligen 'statskonst', och avser som regel alla de åtgärder och handlingar som hör till det allmänna livet (kommuner, stater, mellanstater), och inrymmer allt från diskussioner om offentliga angelägenheter till statlig verksamhet och organisation. 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