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aria-label="Lisää artikkeleita aiheesta Terveys" class="aw-l7odld jXfkxq">Terveys</a></div><h1 class="sc-aXZVg cZXpWU yle__article__heading yle__article__heading--1">THL:n pääjohtaja Mika Salminen pelkää, että hyvinvointialueet ja kunnat karsivat palveluita ja olettavat, että toinen hoitaa</h1><p class="aw-1gybjub aw-5vja16 jxdWmn eeXVLF yle__article__paragraph">Alijäämäiset hyvinvointialueet suunnittelevat terveysasemien sulkemisia ja myös sairaalaverkko on muutosten edessä. Työterveyden asiakkaat ovat kuitenkin ohituskaistalla.</p><div class="aw-e30oo3 blLbha"></div><figure class="aw-u5oz0a clzEhy yle__article__figure"><script type="application/ld+json">{"@id":"74-20078380","@context":"https://web.archive.org/web/20240312023031/https://schema.org","video":{"@type":"VideoObject","description":"Mika Salminen arvioi, mikä on oikea mittari, jolla voi arvioida terveydenhuollon onnistumista.","name":"Mika Salminen arvioi millä voi mitata terveydenhuollon onnistumista","thumbnailUrl":"https://web.archive.org/web/20240312023031/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_431,w_767/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-42973859c268d07fd2f","uploadDate":"2024-03-09T11:45:39+02:00"}}</script><div class="aw-1a00tic ircCun"><div><div data-testid="video-player" class="aw-1kfkhk6 kyBcqJ"></div></div></div><figcaption class="aw-kr26k0 iEoONW"><span>Mika Salminen arvioi, mikä on oikea mittari, jolla voi arvioida terveydenhuollon onnistumista.</span></figcaption></figure><div class="aw-1wk2icm iaIVgA"><div class="aw-qww0lc eFtfQt"><div class="aw-x5rn7a iKNQRH"><span class="aw-z7z0zi hEWAhM">Seija Vaaherkumpu</span><span class="aw-z7z0zi hEWAhM">, </span></div><div class="aw-x5rn7a iKNQRH"><span class="aw-z7z0zi hEWAhM">Jenni Frilander</span></div></div></div><div class="aw-1hwlbbb iumvhG"><div class="aw-64d2lh cPAYLb"><div class="aw-kzjed4 dgiUVP yle__article__date"><time class="aw-lsqctp jPSFYl yle__article__date--published" datetime="2024-03-09T08:05:36+02:00">9.3. 8:05</time><span aria-hidden="true" class="aw-131q90r bsXkQk">•</span><time class="aw-lsqctp jPSFYl yle__article__date--modified" datetime="2024-03-09T11:53:41+02:00">Päivitetty 9.3. 11:53</time></div></div><a href="https://web.archive.org/web/20240312023031/https://yle.onelink.me/46xJ/07zyq6zz?deep_link_sub1=74-20078380" class="aw-pqa0kd GtYAc">Avaa Yle-sovelluksessa<svg width="24" height="24" viewbox="0 0 24 24" fill="none" aria-hidden="true"><path d="M15 2a1 1 0 1 0 0 2h3.586l-9.293 9.293a1 1 0 1 0 1.414 1.414L20 5.414V9a1 1 0 1 0 2 0V3a1 1 0 0 0-1-1h-6ZM5 7a1 1 0 0 0-1 1v11a1 1 0 0 0 1 1h11a1 1 0 0 0 1-1v-6a1 1 0 0 1 2 0v6a3 3 0 0 1-3 3H5a3 3 0 0 1-3-3V8a3 3 0 0 1 3-3h6a1 1 0 1 1 0 2H5Z" fill="currentColor"></path></svg></a><div class="aw-itub5i eehAxh"><div><button aria-label="Jaa artikkeli" aria-disabled="false" id="share-menu-button" aria-haspopup="true" class="Buttonstyles__ButtonBase-sc-17sr1bx-0 Buttonstyles__ButtonText-sc-17sr1bx-3 jrqhnK kvhUhF"><span class="Buttonstyles__iconSize-sc-17sr1bx-4 Buttonstyles__IconWrapper-sc-17sr1bx-6 cazOWd dPcqZv yds-button__icon"><svg width="24" height="24" viewbox="0 0 24 24" fill="none" aria-hidden="true" class="aw-wi5224 fZrvxl"><path fill-rule="evenodd" clip-rule="evenodd" d="M12.43 3.078a1 1 0 0 1 1.087.207l8.182 8a1 1 0 0 1 0 1.43l-8.182 8a1 1 0 0 1-1.7-.715v-3.855h-.008c-1.968.029-3.972.988-5.827 2.417L3.61 20.389a1 1 0 0 1-1.592-.981l.5-2.597.014-.062c.23-.883.58-1.911.986-2.865.4-.94.88-1.876 1.387-2.532.964-1.246 2.07-2.138 3.405-2.709 1.057-.45 2.219-.684 3.508-.76V4a1 1 0 0 1 .612-.922Zm1.388 3.298v3.48h-1c-1.529 0-2.727.202-3.722.627-.984.42-1.826 1.081-2.609 2.093-.351.454-.753 1.206-1.129 2.09a19.46 19.46 0 0 0-.874 2.525l.277-.213c2.023-1.559 4.445-2.798 7.028-2.833h2.029v3.479L19.57 12l-5.752-5.624Z" fill="currentColor"></path></svg></span><span class="Buttonstyles__TextWrapper-sc-17sr1bx-7 WDnuQ yds-button__text">Jaa</span></button></div></div></div></header><section class="yle__article__content"><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Ylen tekemän koonnin mukaan jopa yli sataa terveyskeskusta uhkaa lähivuosina lakkauttaminen.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Karsimiseen johtavat hyvinvointialueiden suuret budjettialijäämät, jotka viime vuonna olivat 1,35 miljardia euroa ja tänä vuonna arviolta 870 miljoonaa euroa. Sen pidemmälle euromääräiset arviot eivät ulotu.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Vuonna 2026 hyvinvointialueiden pitäisi saada alijäämät kuriin. Se ei onnistu ilman palveluverkon harvennusta.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Terveyden ja hyvinvoinnin laitoksen pääjohtaja <strong class="aw-ak79eh hgoSon yle__article__strong">Mika Salminen</strong> siirtäisi voimavaroja erikoissairaanhoidosta perusterveydenhuoltoon.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Terveyskeskusten lakkautuksiin ja palvelujen keskittämiseen liittyy Salmisen mielestä myös riskejä.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">– On pieni vaara, että terveyden edistäminen jää tänne väliin, vaikka se on hyvinvointialueiden vastuulla, mutta osittain myös kuntien vastuulla. Epäselvyys voi johtaa siihen, että molemmat karsivat niistä ja olettaa, että toinen sen tekee, hän sanoo.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Pahimmillaan ennaltaehkäisevän hoidon puute tai puutteellinen toteutuminen voivat johtaa Salmisen mukaan taudin tai tilan sellaiseen huononemiseen, joka pahentaa tautia niin paljon, että tarve kalliimmalle erikoissairaanhoidolle lisääntyy. Tämä voi johtaa huonoon kierteeseen, Salminen ennakoi.</p><h2 class="sc-gEvEer kGTkjt yle__article__heading yle__article__heading--2">Töissä käyvät ovat ohituskaistalla</h2><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Suomi on Euroopan mittakaavassa poikkeus työterveyshuoltonsa takia. Työterveyshuollon asiakkaat pääsevät Salmisen mukaan helpommin lääkäriin kuin vaikkapa työttömät.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">– Muualla ei ole sellaista järjestelmää, jossa työssä olevat ovat ohituskaistalla muuhun väestöön nähden, Salminen sanoo.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Salmisen mukaan koko järjestelmää pitäisi katsoa ja uskaltaa tarkastella myös työterveyshuollon roolia.</p><h2 class="sc-gEvEer kGTkjt yle__article__heading yle__article__heading--2">Salminen: Sairaaloissa keskittäminen voi tuoda etua</h2><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Tammikuussa sosiaali- ja terveysministeriö julkaisi selvityksen erikoissairaanhoidon keskittämisestä. Hyvinvointialueet suhtautuivat siihen kriittisesti. Alueilla haluttaisiin pitää kiinni oman alueen sairaaloista.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">– Uudistuksen jälkeen on luonnollista, että on karsittavaa. Kyllä meidän täytyy löytää yhteistyötä ja palveluiden jakamista sairaaloiden välillä. Joka ikisessä sairaalassa ei ole tarpeen olla kaikkia palveluita, Salminen sanoo.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Hänen mukaansa sosiaali- ja terveysministeriön sairaalaselvitys muodostaa hyvän alun ja ohjenuoran.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">– Asiassa tarvittaisiin kuitenkin poliittista rohkeutta myöntää, että niin keskittämistä kuin työnjakoakin tarvitaan, jotta sairaalapalvelut voidaan taata jatkossakin kaikille niitä tarvitseville, Salminen arvioi.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Hänen mukaansa keskittämisestä on erityisen selvää etua vaativassa erikoissairaanhoidossa.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">– Sairaaloissa keskittäminen tuo taloudellisia säästöjä, ja se voi parhaimmillaan nostaa hoidon laatua, koska tapauksia on riittävästi taitojen kehittämistä varten, Salminen sanoo.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Saman asian voi ilmaista myös niin, että kaikissa sairaaloissa ei ole tarkoituksenmukaista tarjota kaikille kaikkea.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Potilaat hyötyvät, jos heitä hoitaville erikoislääkäreille on karttunut kokemusta ja tietyn erikoisalan vaativan hoidon osaajia on samassa yksikössä useita jakamassa tietoa toisilleen.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">Ei kuitenkaan vain hyvää ettei jotain huonoakin.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph">– Haittaa potilaalle voi koitua pidemmästä matkasta palveluun, mutta haitan suuruus riippuu myös vaivan tai sairauden laadusta.</p><p class="aw-1gybjub aw-1p7kakr jxdWmn ilDxnw yle__article__paragraph"><em class="aw-18vh2pl bZqHKZ yle__article__emphasis">Korjattu 9.3. klo 9.13: Hyvinvointialueiden alijäämät ovat tänä vuonna arviolta 870 miljoonaa euroa, ei 870 miljardia euroa.</em></p></section><footer class="yle__article__footer"><h2 class="aw-zh6d69 dMYkJU">Aiheesta enemmän: Paketissa 4 linkkiä</h2><h2 class="sc-eqUAAy ctFUoD yle__article__heading yle__article__heading--3" aria-hidden="true">Aiheesta enemmän</h2><div class="yle__article__links" role="list" aria-label="Aiheesta enemmän"><div role="listitem" class="aw-124ec9l cFgRwb"><div class="aw-yq4wj5 hkKela"><div class="aw-fou4nx hULxUh"><div class="aw-aqrehu kskGQO"><div class="aw-ej1jxx Vjwex"><a href="/web/20240312023031/https://yle.fi/t/18-216363/fi" aria-label="Lisää artikkeleita aiheesta Terveydenhuolto" class="aw-l7odld jXfkxq">Terveydenhuolto</a></div><h3 class="aw-x9ikft cGmEmT"><a href="https://web.archive.org/web/20240312023031/https://yle.fi/a/74-20077863" class="aw-3ocnud eBKakF">Nyt puhuvat entiset konsultit: Hoitajat ja lääkärit piti ”säröttää” uudistusta varten, jotta heidät saataisiin luhistumaan</a></h3><time class="aw-4gocmc guzJZN">8.3.</time></div></div><div class="aw-vhyz8i mQzOb"><div class="aw-8sjfvz juaHCW"><div class="aw-1njknqq euollB"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125392265e848116a452 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125392265e848116a452 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125392265e848116a452 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125392265e848116a452 1x"/><img alt="Kuvituskuva, jossa terveyskeskuselementtejä ja sitaatit: "Hoitajia kuvataan laiskoina, lihavina ja hankalina" ja "Rikotaan mieli siitä ammattiosaamisesta"." src="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125392265e848116a452" class="aw-1l9m598 bTKagC"/></picture></div></div></div></div></div><div aria-hidden="true" class="aw-4s1vft kcSOOZ"><hr class="aw-mkek3u lkNxNt"/></div><div role="listitem" class="aw-124ec9l cFgRwb"><div class="aw-yq4wj5 hkKela"><div class="aw-fou4nx hULxUh"><div class="aw-aqrehu kskGQO"><div class="aw-ej1jxx Vjwex"><a href="/web/20240312023031/https://yle.fi/t/18-327171/fi" aria-label="Lisää artikkeleita aiheesta Hyvinvointialueet" class="aw-l7odld jXfkxq">Hyvinvointialueet</a></div><h3 class="aw-x9ikft cGmEmT"><a href="https://web.archive.org/web/20240312023031/https://yle.fi/a/74-20077723" class="aw-3ocnud eBKakF">Aluevaltuutetut kertovat, miten vallanpuute turhauttaa: ”Ilman verotusoikeutta aluevaltuustot ovat silkkaa läpsyttelyä”</a></h3><time class="aw-4gocmc guzJZN">8.3.</time></div></div><div class="aw-vhyz8i mQzOb"><div class="aw-8sjfvz juaHCW"><div class="aw-1njknqq euollB"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125447865e99e983e198 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125447865e99e983e198 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125447865e99e983e198 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125447865e99e983e198 1x"/><img alt="Päijät-Hämeen hyvinvointialueen aluevaltuuston kokous." src="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125447865e99e983e198" class="aw-1l9m598 bTKagC"/></picture></div></div></div></div></div><div aria-hidden="true" class="aw-4s1vft kcSOOZ"><hr class="aw-mkek3u lkNxNt"/></div><div role="listitem" class="aw-124ec9l cFgRwb"><div class="aw-yq4wj5 hkKela"><div class="aw-fou4nx hULxUh"><div class="aw-aqrehu kskGQO"><div class="aw-ej1jxx Vjwex"><a href="/web/20240312023031/https://yle.fi/t/18-327171/fi" aria-label="Lisää artikkeleita aiheesta Hyvinvointialueet" class="aw-l7odld jXfkxq">Hyvinvointialueet</a></div><h3 class="aw-x9ikft cGmEmT"><a href="https://web.archive.org/web/20240312023031/https://yle.fi/a/74-20077808" class="aw-3ocnud eBKakF">Suomesta on katoamassa yli sata terveysasemaa – katso kartalta oman alueesi tilanne</a></h3><time class="aw-4gocmc guzJZN">7.3.</time></div></div><div class="aw-vhyz8i mQzOb"><div class="aw-8sjfvz juaHCW"><div class="aw-1njknqq euollB"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125440165e98385dc03a 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125440165e98385dc03a 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125440165e98385dc03a 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125440165e98385dc03a 1x"/><img alt="Tammelan terveysaseman julkisivu, maassa laikuittain lunta." src="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125440165e98385dc03a" class="aw-1l9m598 bTKagC"/></picture></div></div></div></div></div><div role="listitem"><div class="aw-1agkcb5 fxEGCY"><div class="aw-124ec9l cPCgwX"><div class="aw-yq4wj5 hkKela"><div class="aw-fou4nx hULxUh"><div class="aw-1587oi3 hGyQrh"><svg height="12" viewbox="0 0 321 48" fill="none" xmlns="http://www.w3.org/2000/svg"><path d="M48 2.22629V45.7737C48 46.9605 46.971 48 45.8431 48H2.25365C1.02898 47.9979 0 46.9605 0 45.7716V2.22629C0 0.991101 1.02898 0 2.25365 0H45.8431C46.971 0 48 0.991101 48 2.22629ZM18.6058 17.0928H17.8314C16.9813 17.0928 16.693 17.6252 16.4847 18.5384L14.3236 27.9339H13.9533C13.1579 27.9612 12.7959 27.8518 12.5371 26.8186L10.3487 18.5279L10.3255 18.4353C10.1593 17.8061 9.97203 17.0907 9.09877 17.0907H8.28022C7.53321 17.0907 7.10605 17.501 7.10605 18.2186C7.10605 18.6142 7.21126 19.1971 7.43852 20.0577L9.76161 28.3442C10.193 29.9666 11.1125 30.6905 12.7454 30.6905H13.7513C13.6187 31.3849 13.4525 32.174 13.3515 32.4917C12.9432 33.7585 12.3309 33.9899 11.2725 33.9899C10.3382 33.9899 9.73004 33.9184 9.28605 33.8658L9.24817 33.8616C8.98724 33.8321 8.78103 33.809 8.58533 33.809C7.96458 33.809 7.59423 34.1961 7.59423 34.8463V35.3935C7.59423 36.0773 7.94774 36.3235 8.32861 36.4856C8.90097 36.7444 9.6122 36.8854 11.7291 36.8854C13.8986 36.8854 15.5062 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fill="white"></path><path d="M32.3866 22.4374C32.5086 20.2069 33.4198 19.2094 35.3304 19.2094H35.3325C37.1485 19.2094 37.965 20.1753 38.0491 22.4331L32.3866 22.4374Z" fill="white"></path><path d="M84.2043 35.448H67.9323L63.5523 48H53.8563L70.9923 0.528015H82.4763L99.2763 48H88.7163L84.2043 35.448ZM76.2963 9.62401L70.0563 28.08H82.2003L76.2963 9.62401Z" fill="white"></path><path d="M131.796 48L121.104 31.8H113.796V48H104.364V1.656C104.364 1.656 110.4 0 121.224 0C133.644 0 141.072 4.32 141.072 14.004C141.072 23.892 134.964 28.14 130.584 30.072L143.064 48H131.796ZM113.808 24.3H124.5C129.084 22.38 131.208 19.92 131.208 14.94C131.208 9.756 127.488 7.704 121.38 7.704C117.528 7.704 113.808 8.364 113.808 8.364V24.3V24.3Z" fill="white"></path><path d="M148.656 47.9999V0.659927H180.984V8.68793H158.148V20.5679H177.864V28.2719H158.148V39.9599H181.584V47.9999H148.656Z" fill="white"></path><path d="M188.628 47.9999V0.659927H220.956V8.68793H198.12V20.5679H217.836V28.2719H198.12V39.9599H221.556V47.9999H188.628Z" fill="white"></path><path d="M237.948 47.9999H228.588V0.659927H237.348L260.256 30.5999V0.659927H269.688V47.9999H262.584L237.948 16.5359V47.9999V47.9999Z" fill="white"></path><path d="M305.064 35.448H288.792L284.424 48H274.728L291.852 0.528015H303.336L320.136 48H309.576L305.064 35.448ZM297.168 9.62401L290.928 28.08H303.072L297.168 9.62401Z" fill="white"></path></svg></div><div class="aw-z9iqnp bYzAUE"><a href="https://web.archive.org/web/20240312023031/https://areena.yle.fi/1-66757684" class="aw-wgen1m gdmTjL"><h3 class="aw-cp2loj icbluK"><span class="aw-mwf8bp hozjw">Ykkösaamu: </span>Mika Salminen</h3></a></div></div><div class="aw-vhyz8i mQzOb"><div class="aw-8sjfvz juaHCW"><div class="aw-1njknqq euollB"><picture><source data-testid="source-for-S" media="(max-width: 767px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125545765ec1cfb99c28 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.0,c_fill,g_faces,h_104,w_104/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125545765ec1cfb99c28 1x"/><source data-testid="source-for-M" media="(min-width: 768px)" srcset="https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_2.0/q_auto:eco/f_auto/fl_lossy/39-125545765ec1cfb99c28 2x, https://web.archive.org/web/20240312023031im_/https://images.cdn.yle.fi/image/upload/ar_1.7777777777777777,c_fill,g_faces,h_110,w_196/dpr_1.0/q_auto:eco/f_auto/fl_lossy/39-125545765ec1cfb99c28 1x"/><img alt="" 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idtWDG"><div class="MinimalHeadlines__BulletContainer-sc-79c54a90-8 hKwNaR"><div class="MinimalHeadlines__BulletCell-sc-79c54a90-9 byezyD"><div aria-hidden="true" class="MinimalHeadlines__Index-sc-79c54a90-5 ffWqMg">4</div><div class="MinimalHeadlines__ListLine-sc-79c54a90-4 cqDOIP"></div></div></div><div class="MinimalHeadlines__Texts-sc-79c54a90-2 jYVeIk"><a href="/web/20240312023031/https://yle.fi/t/18-193507/fi" class="Tag__Label-sc-10f4ee8e-0 dpErSM MinimalHeadlines__StyledTag-sc-79c54a90-3 hLpKvJ">Yhdysvallat</a><h3 class="Typography-sc-8c75a913-0 dpUGfc link-accent"><a href="/web/20240312023031/https://yle.fi/a/74-20078653" class="MinimalHeadlines__Link-sc-79c54a90-10 bMuisZ visitable-link">Hämmentävä näky: Republikaanit potkivat Joe Bidenia esittävää nukkea päähän maksua vastaan – ”Iljettävä esitys”</a></h3></div></li><li class="MinimalHeadlines__Item-sc-79c54a90-1 idtWDG"><div class="MinimalHeadlines__BulletContainer-sc-79c54a90-8 hKwNaR"><div 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Työterveyden asiakkaat ovat kuitenkin ohituskaistalla.","type":"text"},{"text":"Ylen tekemän koonnin mukaan jopa yli sataa terveyskeskusta uhkaa lähivuosina lakkauttaminen.","type":"text"},{"text":"Karsimiseen johtavat hyvinvointialueiden suuret budjettialijäämät, jotka viime vuonna olivat 1,35 miljardia euroa ja tänä vuonna arviolta 870 miljoonaa euroa. Sen pidemmälle euromääräiset arviot eivät ulotu.","type":"text"},{"text":"Vuonna 2026 hyvinvointialueiden pitäisi saada alijäämät kuriin. Se ei onnistu ilman palveluverkon harvennusta.","type":"text"},{"text":"Terveyden ja hyvinvoinnin laitoksen pääjohtaja **Mika Salminen** siirtäisi voimavaroja erikoissairaanhoidosta perusterveydenhuoltoon.","type":"text"},{"text":"Terveyskeskusten lakkautuksiin ja palvelujen keskittämiseen liittyy Salmisen mielestä myös riskejä.","type":"text"},{"text":"– On pieni vaara, että terveyden edistäminen jää tänne väliin, vaikka se on hyvinvointialueiden vastuulla, mutta osittain myös kuntien vastuulla. Epäselvyys voi johtaa siihen, että molemmat karsivat niistä ja olettaa, että toinen sen tekee, hän sanoo.","type":"text"},{"text":"Pahimmillaan ennaltaehkäisevän hoidon puute tai puutteellinen toteutuminen voivat johtaa Salmisen mukaan taudin tai tilan sellaiseen huononemiseen, joka pahentaa tautia niin paljon, että tarve kalliimmalle erikoissairaanhoidolle lisääntyy. Tämä voi johtaa huonoon kierteeseen, Salminen ennakoi.","type":"text"},{"text":"Töissä käyvät ovat ohituskaistalla","level":2,"type":"heading"},{"text":"Suomi on Euroopan mittakaavassa poikkeus työterveyshuoltonsa takia. Työterveyshuollon asiakkaat pääsevät Salmisen mukaan helpommin lääkäriin kuin vaikkapa työttömät.","type":"text"},{"text":"– Muualla ei ole sellaista järjestelmää, jossa työssä olevat ovat ohituskaistalla muuhun väestöön nähden, Salminen sanoo.","type":"text"},{"text":"Salmisen mukaan koko järjestelmää pitäisi katsoa ja uskaltaa tarkastella myös työterveyshuollon roolia.","type":"text"},{"text":"Salminen: Sairaaloissa keskittäminen voi tuoda etua","level":2,"type":"heading"},{"text":"Tammikuussa sosiaali- ja terveysministeriö julkaisi selvityksen erikoissairaanhoidon keskittämisestä. Hyvinvointialueet suhtautuivat siihen kriittisesti. Alueilla haluttaisiin pitää kiinni oman alueen sairaaloista.","type":"text"},{"text":"– Uudistuksen jälkeen on luonnollista, että on karsittavaa. Kyllä meidän täytyy löytää yhteistyötä ja palveluiden jakamista sairaaloiden välillä. Joka ikisessä sairaalassa ei ole tarpeen olla kaikkia palveluita, Salminen sanoo.","type":"text"},{"text":"Hänen mukaansa sosiaali- ja terveysministeriön sairaalaselvitys muodostaa hyvän alun ja ohjenuoran.","type":"text"},{"text":"– Asiassa tarvittaisiin kuitenkin poliittista rohkeutta myöntää, että niin keskittämistä kuin työnjakoakin tarvitaan, jotta sairaalapalvelut voidaan taata jatkossakin kaikille niitä tarvitseville, Salminen arvioi.","type":"text"},{"text":"Hänen mukaansa keskittämisestä on erityisen selvää etua vaativassa erikoissairaanhoidossa.","type":"text"},{"text":"– Sairaaloissa keskittäminen tuo taloudellisia säästöjä, ja se voi parhaimmillaan nostaa hoidon laatua, koska tapauksia on riittävästi taitojen kehittämistä varten, Salminen sanoo.","type":"text"},{"text":"Saman asian voi ilmaista myös niin, että kaikissa sairaaloissa ei ole tarkoituksenmukaista tarjota kaikille kaikkea.","type":"text"},{"text":"Potilaat hyötyvät, jos heitä hoitaville erikoislääkäreille on karttunut kokemusta ja tietyn erikoisalan vaativan hoidon osaajia on samassa yksikössä useita jakamassa tietoa toisilleen.","type":"text"},{"text":"Ei kuitenkaan vain hyvää ettei jotain huonoakin.","type":"text"},{"text":"– Haittaa potilaalle voi koitua pidemmästä matkasta palveluun, mutta haitan suuruus riippuu myös vaivan tai sairauden laadusta.","type":"text"},{"text":"*Korjattu 9.3. klo 9.13: Hyvinvointialueiden alijäämät ovat tänä vuonna arviolta 870 miljoonaa euroa, ei 870 miljardia euroa.*","type":"text"},{"type":"links","links":[{"external":{"url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20240312023031\u002Fhttps:\u002F\u002Fyle.fi\u002Fa\u002F74-20077863"},"internal":{"id":"74-20077863"},"title":"Nyt puhuvat entiset konsultit: Hoitajat ja lääkärit piti ”säröttää” uudistusta varten, jotta heidät saataisiin luhistumaan","datePublished":"2024-03-08T06:35:17+0200","subject":{"description":{"fi":"huolto","sv":"skötsel","en":"","ru":null,"se":null},"exactMatch":["finto:http:\u002F\u002Fwww.yso.fi\u002Fonto\u002Fkoko\u002Fp2062"],"updated":"2022-10-02T21:21:54+03:00","alternativeIds":["18-208"],"title":{"fi":"terveydenhuolto","sv":"hälso- och sjukvård","en":null,"ru":null,"se":null},"types":["MainConcept","Concept"],"id":"18-216363","contentHits":1637},"headline":{"image":{"alt":"Kuvituskuva, jossa terveyskeskuselementtejä ja sitaatit: \"Hoitajia kuvataan laiskoina, lihavina ja hankalina\" ja \"Rikotaan mieli siitä ammattiosaamisesta\".","source":"Janne Järvinen \u002F Yle, Getty Images, kuvakollaasi: Riikka Kurki \u002F Yle, Otso Ritonummi \u002F Yle","aspect":1,"caption":"Konsulttiyhtiön entiset työntekijät kertovat kokeneensa työnteon paikoin epäeettiseksi.","id":"39-125392265e848116a452","type":"image"},"full":"Nyt puhuvat entiset konsultit: Hoitajat ja lääkärit piti ”säröttää” uudistusta varten, jotta heidät saataisiin luhistumaan"}},{"external":{"url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20240312023031\u002Fhttps:\u002F\u002Fyle.fi\u002Fa\u002F74-20077723"},"internal":{"id":"74-20077723"},"title":"Aluevaltuutetut kertovat, miten vallanpuute turhauttaa: ”Ilman verotusoikeutta aluevaltuustot ovat silkkaa läpsyttelyä”","datePublished":"2024-03-08T10:00:36+0200","subject":{"description":{"fi":"Hyvinvointialue on Marinin hallituksen sote-uudistuksessa kunnista ja valtiosta erillinen julkisoikeudellinen yhteisö, jolla on alueellaan itsehallinto. 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Sopimuksen nojalla hyvinvointialueet voivat hoitaa tehtäviään yhdessä. Yhteistyön muotoja ovat: yhteinen toimielin, yhteinen virka, sopimus viranomaistehtävän hoitamisesta ja hyvinvointiyhtymä. Hyvinvointiyhtymän toimialana voi olla vain tukipalvelujen tuottaminen. Hyvinvointiyhtymälle ei voida siirtää järjestämisvastuuta.","sv":"Ett välfärdsområde är ett från kommunerna och staten separat offentligrättsligt samfund som har självstyre inom sitt område. Välfärdsområdet och dess dottersammanslutningar bildar en välfärdsområdeskoncern.\nDet finns sammanlagt 21 välfärdsområden som ansvarar för ordnandet av social- och hälsovården och räddningsväsendet.\nHelsingfors stad ansvarar för att ordna social- och hälsovården och räddningsväsendet inom sitt område. 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Videolla valtuutetut kertovat, mikä aluevaltuustossa mättää.","type":"video","id":"1-68315949"},"image":{"alt":"Päijät-Hämeen hyvinvointialueen aluevaltuuston kokous.","source":"Juha-Petri Koponen \u002F Yle","aspect":1.7777777777777777,"id":"39-125447865e99e983e198","type":"image"},"full":"Aluevaltuutetut kertovat, miten vallanpuute turhauttaa: ”Ilman verotusoikeutta aluevaltuustot ovat silkkaa läpsyttelyä”"}},{"external":{"url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20240312023031\u002Fhttps:\u002F\u002Fyle.fi\u002Fa\u002F74-20077808"},"internal":{"id":"74-20077808"},"title":"Suomesta on katoamassa yli sata terveysasemaa – katso kartalta oman alueesi tilanne","datePublished":"2024-03-07T17:51:04+0200","subject":{"description":{"fi":"Hyvinvointialue on Marinin hallituksen sote-uudistuksessa kunnista ja valtiosta erillinen julkisoikeudellinen yhteisö, jolla on alueellaan itsehallinto. 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Sopimuksen nojalla hyvinvointialueet voivat hoitaa tehtäviään yhdessä. Yhteistyön muotoja ovat: yhteinen toimielin, yhteinen virka, sopimus viranomaistehtävän hoitamisesta ja hyvinvointiyhtymä. Hyvinvointiyhtymän toimialana voi olla vain tukipalvelujen tuottaminen. Hyvinvointiyhtymälle ei voida siirtää järjestämisvastuuta.","sv":"Ett välfärdsområde är ett från kommunerna och staten separat offentligrättsligt samfund som har självstyre inom sitt område. Välfärdsområdet och dess dottersammanslutningar bildar en välfärdsområdeskoncern.\nDet finns sammanlagt 21 välfärdsområden som ansvarar för ordnandet av social- och hälsovården och räddningsväsendet.\nHelsingfors stad ansvarar för att ordna social- och hälsovården och räddningsväsendet inom sitt område. 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