Let's get down to work!

The new Director General has already endured a baptism of fire at Kela. Elli Aaltonen wants to look forward and create better service experiences for Kela’s customers.

Kela’s new Director General took up her post at the same time that management of basic social assistance was transferred to Kela. Not the easiest time to start a new job!

“This has been like a marriage without a honeymoon. I guess a baptism of fire like this would make anyone stronger. For me it’s been a learning curve all the way,” says Elli Aaltonen with a smile.

The Director General says that she enjoys leadership – her doctoral dissertation discussed leadership in the social services, and she has held many leadership posts during her career. Therefore, she would have liked to start her new job at Kela in different circumstances.

“My first tasks included clearing the backlog, recruiting hundreds of people at once and quickly training them in basic social assistance.”

Service by experience

The changes in working life can already be seen in the fields of banking and insurance as well as many sectors in public administration.

“All these have started to produce social and healthcare services. Kela could do the same thing. If digitalisation is destroying jobs, we should reconsider the nature of work.”

Kela is an expert on pharmaceuticals, medical treatments, rehabilitation and social insurance.

“We should get down to work now. Kela is a strong supplier of public insurance for people in various life situations: we provide pensions, pharmaceutical reimbursements, unemployment and sickness benefits, the Kanta.fi service. ICT competence should increasingly be taken in the direction of the service experience.”

Kela’s Kanta service is safe and prevents prescription drug abuse, but more development is needed. The service could become a customer-specific healthcare register with information about medication, diagnoses, care and self monitoring.

Partnership in social welfare and healthcare reform

Aaltonen says that a pharmacy is like Fazer chocolate – a strong brand in itself: what you see is what you get. Appearance and location may change, but the contents are the same. The Director General prefers not to comment on pharmacy deregulation, and wants to let the politicians take their time considering this.

“I'd rather find ways for pharmacies that are successful in their customer services to further develop and expand their operations. Pharmacies represent pharmaceutical safety, professional competence, responsibility and reliability. They are the cornerstones for future success.”

The social welfare and healthcare reform will offer pharmacies new cooperation opportunities and partnerships in functions such as pharmaceutical distribution, information and evaluations. We should have more hospital and health centre pharmacies, says Aaltonen.

“Counselling, services and guidance should be offered proactively. The evaluation of pharmaceutical care for elderly or chronically ill patients or patients with multiple diseases should also be included in the reform.”

Evaluation of pharmaceutical care

The Director General often goes travelling around Finland to meet people. They regularly ask her about pharmaceuticals.

“When permanent medicine expenses have been accepted in your income support, the electronic medicines voucher is automatically transferred to a pharmacy. People have been pleased with this. During the first three months of this year, Kela sent as many as 460,000 vouchers to pharmacies.”

In 2016, Kela’s pharmaceutical reimbursements totalled EUR 1.3 billion. Kela studies and evaluates the impact of its savings targets, such as increasing the customer’s responsibility or changing refund categories. Half a million basic social assistance vouchers indicate that part of customers’ responsibilities and lower refunds are now paid with basic social assistance.

“There are diseases such as type II diabetes that need further research. The refund category for non-insulin treatment was lowered and the annual maximum amount a person needs to pay came into effect at the beginning of this year. Regarding health, it is not right if more insulin is prescribed and used or if people stop buying their medicines.”

The impact of the cuts in pharmaceutical reimbursements remains to be seen. A reference price system may have to be considered for price control. “We should consider the sources of various compensations and their impact on healthcare,” Aaltonen says.

Simpler social security

Aaltonen is worried about the over 300,000 carers in Finland; she would like to see pharmaceutical care delivered to them at home. Carers don’t necessarily even get municipal service support.

“There's a myriad of things a carer has to decide for their loved one, and many of these things are related to medicines. The carer's job is a hard one, and all possible support and information is needed.”

The Director General would like to make social security simpler. She has a positive attitude towards basic income, provided that it is developed further.

“Minimum benefits should be included in the same law, and incentive traps removed. Kela should become a provider of a comprehensive customer experience instead of distributing benefits in slices. This should keep us busy for the next 80 years.”

• Elli Aaltonen, 63, Doctor of Social Sciences, is the Director General of Kela, the Social Insurance Institution of Finland. Started in her new post in January 2017.
• Was Member of Board at Kela for eight years, some of that as Vice Chairperson.
• Worked previously as Director General of the Regional State Administrative Agency for Eastern Finland.
• Enjoys walking, gym, films, reading and music in her spare time.

Text: Tarja Västilä