Recently Jean Merrilees returned from spending three months at a regional centre that assesses people for equipment in Finland, as part of her degree in Occupational Therapy at the University of Northampton. Having worked for Scope for a couple of decades, advising disabled people on a wide range of issues, it was a good chance to reflect on how disability services in Finland compare to those in the UK.
Finland takes equality seriously. As you pass through the arrival gates at Jyvaskyla airport, the first thing you see is a large poster advising disabled travellers of their rights.
In the UK equality issues are legislated for in the Equality Act 2010, and Finland has very similar legislation called the Finnish Non-Discrimination Act. This similarity is not surprising as both Finland and the UK are signatories to The European Convention on Human Rights. However, it appears that the Finnish authorities have a greater commitment to implementation, as good inclusive design was evident in all the public buildings and spaces I visited, and every bus I saw was equipped for wheelchair users.
As in the UK, the entitlements of the people of Finland are further enshrined within domestic and constitutional legislation and guidance. This includes guidance on the operation of KELA, the Finnish social security and welfare system. KELA is hugely complicated and the same wrangles about funding that we see in the UK happen in Finland. However, Finnish people diagnosed with a serious health condition or impairment receive a much higher level of support in negotiating the system.
Support is provided by a network of Disability Counsellors, graduate level professionals that act as both educators and case managers. They aim to support disabled people to access the services they need and become as expert as possible in managing their condition. Disability Counsellors are both geographically and condition specific so they can also facilitate disabled people and carers networking with others experiencing similar things locally.
In many ways these state-funded Disability Counsellors fulfilled many of the information, advice and support functions that British people have to turn to voluntary sector organisations for. In Finland the charitable sector is notably smaller than in the UK and tends to focus on providing the niceties in life, such as holidays, rather than addressing basic necessities, such as housing and food poverty, as many UK charities are forced to do.
Free equipment for disabled people
On placement it was very obvious that the range of equipment that could be provided free of charge to disabled people in Finland was much greater than in the UK. Items such as specialist car seats and tricycles that many people struggle to fund in the UK were readily available. At my placement, there was an Aladdin’s cave of equipment ready to be allocated to those that needed it.
The centre was also able to provide a wide range of communication equipment and environmental controls. Their multi-disciplinary approach appeared efficient, cost-effective and very client focused, something that the NHS strives for but unfortunately doesn’t always achieve.
One of the challenges of living in Finland for those with mobility impairments is to maintain their independence during the snowy winter months. Scandinavian equipment manufacturers have risen to the challenge with a range of specialist equipment. There are wheelchairs designed specifically for snow and, if the snow is too deep for those chairs, fitted with skis.
There is even the possibility of a motorised set of tank-tracks that a wheelchair user can attach to their usual wheelchair.
Unfortunately this specialist snow mobility equipment was not available via KELA but charitable funding did appear to be available for those that needed it.
Another item of equipment that I hadn’t seen in the UK was the Citypotkuri, which translates as ‘city propeller’.
A citypotkuri resemble two scooters joined together and they are popular with older people who require some support when walking. On level ground or when going up-hill the user walks between the footplates using the handles for support as they would with a rollator. However, when travelling downhill the user stands on the footplates, sometimes achieving impressive speeds!
Interestingly, in Finland being a careworker is seen as a respected profession. Many care workers are graduates and well educated and resourced to deliver what appeared to be a high quality of care. I visited several residential care and supported living facilities and felt that, if necessary, I could have coped with me or my loved ones living there. Unfortunately I don’t think the same quality of provision is always available in the UK.
Obviously my observations are very subjective but there is also some research available. The Better Life Index enables comparisons to be made between countries in relation to 11 key measures: housing, income, jobs, community (access to social support), education, civic engagement, health, life satisfaction (subjective well-being), safety and work-life balance. When using the index to compare Finland and the UK we find that both countries generally have similar scores and perform well relative to most other countries in the world. However, Finland betters the performance of the UK in 6 out of the 11 measures. The most notable of which is education, where Finland leads the world and the UK is distinctly average. Finland also scores well for access to social support but the UK does better in terms of jobs, income and health. Yet, people living in Finland report considerably higher levels of well-being then people living in the UK.
The level of service of provision that disabled people currently receive in Finland may be at risk. Finland’s national debt is growing and austerity measures threaten. Their government is seeking ways to streamline and make efficiencies to the health and social welfare system. Whilst I was there several large strikes of health service staff took place, as they protested to highlight the detrimental effects of the cuts. Many providers and users of health and social welfare servicers are worried and afraid of what the future will be like.
Jean Merrilees, Scope Information Officer