In 2024, more than 20,000 students are missing from higher education student health care – or rather, from its funding.
Great effort has been made to add these students into the funding, as their use of FSHS services and especially the assessment for the need of treatment is considerable.
In the beginning of next year, the state is suddenly acknowledging the missing students and including them in the funding of the FSHS.
Including them for this year, however, seems to be utterly impossible.
What is this all about?
The Finnish Student Health Service (FSHS) looks after the health and well-being of higher education students in Finland. In 2024, doing this has been exceptionally difficult. The FSHS has struggled to provide students with the legally required high-quality and accessible health care services while being clearly underfunded.
In the 2024 state budget, funding for the FSHS has been allocated for 281,000 higher education students. Already in last autumn, the National Union of University Students in Finland (SYL) expressed concerns on the matter, as the estimate of 281,000 students is leading to a clearly undersized budget.
At that time, it was already clear that the proposed budget would cause serious problems for FSHS and its services.
Indeed, the undersized estimates and the financial crisis were already noted within the first half of 2024. In a press release published in early March, the FSHS stated the number of students covered by its services, which new estimates indicated to be significantly higher than 281,000.
In addition, the effects of inflation and salary raises in health care had been ignored when determining the amount of funding per student, the second essential element of the funding model for student health care. Quite the opposite, in fact. In 2023, the FSHS received EUR 320,16 of funding per student, while in 2024 the amount had decreased to EUR 319,90.
The funding shortage has led to cost savings worth millions despite growing demand for services
In other words, the undersized estimates for the state budget have forced the FSHS to cut down on its services and make cost savings worth millions of euros in 2024, while the demand for its services has reached record levels due to the growth in student numbers.
Growth which the funding model has failed to compensate to the FSHS.
The victims of this difficult economic situation are the higher education students who have needed the health services, as well as the increasingly burdened FSHS professional staff.
Finnish higher education students have done their part in funding the services of the FSHS; as the number of students has been higher than estimated, the amount of paid health care fees is also expected to be higher. It is estimated that FSHS funding from students in 2024 will eventually reach approximately EUR 21 million.
However, it has always been understood that state funding to the FSHS should also be adjusted to match the corrected number of students. This would ensure that the share of contributions would comply with the principles set in section 14 of the Act on healthcare for students in higher education (the state contributes 77% of the funding for services, while students contribute 23%).
Increased state funding through the supplementary budget was requested
At the beginning of 2024, the FSHS considered that it had sufficient grounds to apply for additional funding for the current year due to unforeseen circumstances, i.e. the increased number of students.
According to the Act on healthcare for students in higher education (section 16), the state must ensure that Kela has sufficient funding for higher education student health care if such funding is necessary to ensure the availability of student health care services due to sudden or unforeseen reasons.
Accordingly, the FSHS submitted a thoroughly detailed application to Kela for a total of EUR 6.6 million in additional funding, which included financial adjustments of almost EUR 2 million to student health care.
SYL raised the issue during the government discussion held in April. Our demands for additional funding at that time were based on the aforementioned application to Kela.
Kela made a proposal to the Ministry of Social Affairs and Health in May, based on the application of the FSHS. According to the proposal, the FSHS should receive EUR 4.2 million of additional funding for the current year due to the increased number of students. According to Kela, the FSHS could allocate the amount it deems necessary from the additional funding in order to unravel the healthcare queues already caused by the funding shortage.
The Ministry of Social Affairs and Health noted the need for additional funding for the FSHS in September and proposed for EUR 2 million of additional funding in the third supplementary budget for 2024.
The Ministry of Social Affairs and Health notes that in the budgets of recent years, the estimate for the number of students, used to determine FSHS funding, has been lower than the actual number of students, and that this has gradually resulted in an estimate that is missing 22,000 students.
Accordingly, The Ministry of Social Affairs and Health noted that the financing situation of the FSHS can be considered an unforeseen reason in accordance with section 16 of the Act on healthcare for students in higher education. The estimated number of students is 281,000 in the state budget, whereas according to the Ministry of Social Affairs and Health’s updated estimate there were already 303,000 students in September.
Some damage had already been done, however, as scaling the health care services appropriately would have required additional funding from the very beginning of the year.
Additional funding is legally justified, so where is it?
On Thursday 10 October, the Finnish Government published its proposal for the third supplementary budget for 2024. Despite all previous proposals and statements, the proposed supplementary budget contains no additional funding for the FSHS.
No additional funding, even though the need and basis for it have been noted by both Kela, which is responsible for FSHS services, and the Ministry of Social Affairs and Health, which monitors the funding.
In addition, the Ministry of Finance did not propose any additional funding or any corrections to the student number estimate in its supplementary budget proposal, which was published on Wednesday 25 September.
At the same time, it is acknowledged that the problem does exist and that student health care does indeed have missing students this year. For example, the Government’s budget proposal for 2025 (TAE25) once again confirmed that a more correct number of students for 2024 would be 303,000, just as the Ministry of Social Affairs and Health estimated.
In other words, even the Finnish Government itself states that 22,000 students are currently missing from FSHS funding (and the estimated number of students) for 2024.
The situation is made even more difficult by the fact that, due to a legislative amendment that entered into force on 1 January 2024, FSHS funding is no longer revised automatically to match increased student numbers. This is problematic, as the FSHS must nevertheless adjust its services to meet the increased demand caused by the increased number of students.
As a result of the legislative amendment, supplementary budget procedure is the only remaining way to correct the amount of FSHS funding during the operating year. This last resort is now being undermined before it has even been used.
We hereby voice our concern and appeal to the people working on the supplementary budget
The financing of student health care for the current year is at a simply unsustainable level. The situation is set to be corrected for next year, as an increase of 26,000 to the student number estimate is being proposed. Thus, from the beginning of 2025, the estimate for the number of students will be 307,000.
However, the revision of the estimate for next year and the resulting slight improvement to the funding will not fully repair this year’s situation, as a considerable care backlog from this year is expected to burden FSHS operations well into the next year.
However, there’s still time to react and prevent this care backlog from carrying over into 2025. Parliament has the authority to provide the FSHS with at least the additional EUR 2 million which the Ministry of Social Affairs and Health proposed for this year’s operations and for taking care of the healthcare queues.
This way, the Finnish Student Health Service would receive the well-deserved resources for solving students’ health problems and implementing preventative actions. At the same time, we could find those missing 22,000 students.
Together, we could incorporate the missing students into the funding of the same health and well-being services that support their ability to study.
Our appeal is not unreasonable. After all, this is about securing necessary services for the particularly vulnerable higher education students who already struggle with their health.
Sources
Open source material:
Laki korkeakouluopiskelijoiden opiskeluterveydenhuollosta (695/2019), Finlex.
Valtion talousarvioesitys 2024, momentti 33.60.35: Valtionosuus korkeakouluopiskelijoiden terveydenhuoltoon.
Valtiovarainministeriön ehdotus vuoden 2024 kolmanneksi lisätalousarvioksi, momentti 33.60: Sosiaali- ja terveydenhuollon tukeminen.
Hallituksen esitys eduskunnalle vuoden 2024 kolmanneksi lisätalousarvioksi, momentti 33.60: Sosiaali- ja terveydenhuollon tukeminen.
Valtion talousarvioesitys 2025, momentti 33.60.35: Valtionosuus korkeakouluopiskelijoiden terveydenhuoltoon.
Material disclosed through information requests:
Kelan Etuuksien ja palvelujen suunnitteluyksikkö 3.5.2024: Ylioppilaiden terveydenhoitosäätiön lisärahoitusesitys vuodelle 2024, STM:n kirjaamo.
STM 11.9.2024: III lisätalousarvioesitys 2024, Ministeriön ehdotus, Pääluokka 33 SOSIAALI- JA TERVEYSMINISTERIÖN HALLINNONALA, STM:n kirjaamo.
STM 11.9.2024: III lisätalousarvioesitys 2024, LTAE III 2024 Asianmuutoslomake ja Ehdotuksen sisältö VN/15826/2024, 11.9.2024, STM:n kirjaamo.
STM 26.9.2024: Lisätalousarvio III 2024, Ministeriön vastine VN/15826/2024, Liite 33.60.35, Valtion korvaus Ylioppilaiden terveydenhoitosäätiön opiskeluterveydenhuoltoon (KJ), STM:n kirjaamo.
Online publications:
SYL 22.11.2023: Hoitoon vasta 2030-luvulla? YTHS:n rahoitusta nakerretaan monesta suunnasta.
YTHS 4.3.2024: YTHS:n vuoden 2024 rahoitus riittämätön kattamaan suunniteltua toimintaa – opiskelijamäärä vahvassa kasvussa.
SYL 4.3.2024: SYL jakaa YTHS:n huolen opiskeluterveydenhuollon resursseista ja säätiön vuoden 2024 taloustilanteesta.
SYL 15.4.2024: SYL määräsi kehysriihen neuvottelijoille opiskeluterveydenhuollon reseptin.
