出版社：Utrecht University, Maastricht University, Groningen University
摘要：The structure of health and social services will be reformed in Finland. The reform will enter into force on 1 January 2020. This means that responsibility for providing public health care and social services will be assigned to autonomous regions larger than municipalities. Health care and social services will be brought together at all levels to form customer-oriented entities, and basic public services will be strengthened. The existing multisource financing will be simplified and customers will have more freedom of choice in the services. The objective is to reduce inequities in wellbeing and health of people and to manage costs. The reform will help to bridge a large part of the sustainability gap in general government finances. The government's aim is to save EUR 10 milliard, of which approximately EUR 3 milliard should be covered through the reforms in the branch of the Ministry of Social Affairs and Health. Besides structural reforms, the steering and operating models in health care and social welfare will be thoroughly modernised. The aim is to achieve better services that are not only more customer-oriented, effective and cost-efficient than before but also better coordinated. The purpose of this study is to examine the challenges faced by leaders when integrating health and social care. The research material was collected from Master's degree students in autumn 2017 in Tampere University of Applied Sciences with the method of empathy-based stories. One third of the students worked as leaders and the rest in other responsible positions alongside their studies. We received a total of 32 stories. Through categorization of the data, various forms of leadership challenges were revealed. The research material raised the challenges of the change process. It is important to have a common goal, flow of up-to-date information and sufficient time resources for all actors to create new types of services. Consideration of emotions turned out to be very important during the change e.g. resistance to change, uncertainty, wellbeing at work. The inefficiency of hierarchical interfaces administration – political decision-makers – leaders - employees - clients was raised in the material, creating a picture of the differences in the realities of different hierarchy levels. The key is to form a sufficiently similar reality in which the main goal would remain the same throughout the organization. The leaders’ work in relation to employees was supported by a positive atmosphere in which everyone has a common goal, intense networking inside and outside their personal working area, increase in multiprofessional cooperation and transparency of work, and joint debate focusing on the opportunities created by the change. From customers' viewpoint, customer orientation, customer involvement, service guidance and high-quality services were experienced important. The change challenges the leaders’ skills in many ways. They need to keep up-to-date on change-related issues, work transparently and maintain trust in both customers, employees and strategic management. Theoretically, the research engages in discussion about change management, ethical leadership, inclusive leadership, and lean thinking.
