Dissertation: Municipality client criteria can raise the threshold of care for older people
“My aim was to define the internal and external factors that influence the formation of the threshold of care, which makes it difficult for the client to access the services”, says Perttola.
Her study combines critical legal dogmatics with methods of empirical legal research. Most of the procedural provisions to be considered are included in the Act on Supporting the Functional Capacity of the Older Population and on Social and Health Care Services for Older Persons (980/2012), which came into effect in 2013 in Finland.
The law has been implemented effectively in the municipalities, and the effects on the service structure in accordance with the objectives of the law have been realized quickly.
“However, the application directives indicate unforeseen effects of the implementation of the law, which raise the threshold of care contrary to the intention of the legislator”, says Perttola.
From legal guarantees into barriers
The study implicates that the assessment of the client’s physical and cognitive capacity has set aside social considerations in the application directives. As a result, the older person’s own home and remaining capacity are transformed from legal guarantees of the client’s welfare into barriers to adequate care.
According the study, components of the threshold of care are information about the services and the clients’ opportunities to make use of them, the municipal application directives for the provision of services, and the possibility to influence the content and the way the services are carried out.
Fulfilling the client’s freedom of choice by using service vouchers raises the threshold of care when they are used in services related to low capacity, where the conditions for autonomous choice are primarily low. When clients are unable to exercise their freedom of choice in full, they become proxy-consumers under the direction of others.
“The threshold of care can be lowered by applying the current procedural provisions in a way that ensures the best possible implementation of the service principle and fundamental and human rights. No significant deficiencies were found in the regulation itself”, says Perttola.
The public examination of M.Sc. (Admin) Laura Perttola’s doctoral dissertation ”Kynnyksen yli: julkisoikeudellinen tutkimus vanhuspalvelujen saamisen edellytyksistä” will be held on Friday 20 December 2019 at 12 o’clock in auditorium Kurtén (Tervahovi), University of Vaasa. The field of dissertation is Public Law. The defence will be held in Finnish.
Professor, Docent Toomas Kotkas (University of Eastern Finland) will act as opponent and Associate Professor, D.Sc. (Admin); LL.M Niina Mäntylä as a custos.
Laura Perttola, tel +358 29 449 8214, email laura.perttola(at)uwasa.fi
Perttola, Laura (2019) Kynnyksen yli: julkisoikeudellinen tutkimus vanhuspalvelujen saamisen edellytyksistä. Acta Wasaensia 437. Väitöskirja. Vaasan yliopisto.
Publication pdf: http://urn.fi/URN:ISBN:978-952-476-896-2