Language-based welfare services in times of structural change: An examination of Finland’s social and healthcare reform (2023)

This study examines the impact of Finland’s social and healthcare reform on language-based welfare services for the Swedish-speaking population of Finland. The reform shifted healthcare responsibility from municipalities to regional wellbeing service counties (WBSCs), altering established linguistic boundaries in the process. Traditionally, municipalities have ensured the provision of services in both Finnish and Swedish in bilingual areas. Post-reform, Swedish speakers that represent a majority or substantial minority within a municipality have become a small minority within larger WBSCs, some of which include unilingual areas that lack experience in providing bilingual services. Analysis of survey data indicates that Swedish speakers in majority Swedish-speaking municipalities are the most satisfied with language services, while those in minority areas are significantly less satisfied. Notwithstanding, satisfaction among Swedish speakers in majority areas has declined significantly since the reform. The study highlights the challenges of maintaining language rights within a universal healthcare system amid structural changes and emphasises the importance of addressing linguistic needs in a state with two national languages.