Anne Puronaho has gone through nine change negotiations in four years because her employer keeps making losses

Change negotiations are formal discussions between an employer and employees about major workplace changes. They can concern staffing reductions, reorganising work, wider commuting areas or a new management structure. They matter because decisions can affect jobs, locations and entire work communities.

Anne Puronaho represents thousands of Tehy members in Central Finland. She began as a union representative when the area was still a hospital district. After wellbeing services counties began operating in early 2023, her work changed sharply. Central Finland has since held nine rounds of negotiations, and Puronaho has taken part in all of them.

The repeated negotiations reflect continuing financial pressure and service changes. The latest round considered reductions of up to 492 person-years, a work area covering the whole region and management reform. Earlier negotiations preceded health-centre and ward closures, which caused reassignment for hundreds of employees. Puronaho now receives more requests for practical support during dismissals, layoffs and hearings.

The proposed changes concern both the number of jobs and how work is organised. Central Finland’s wellbeing services county is examining up to 492 person-years of reductions. It is also considering expanding the work area from local arrangements to the whole region. A management-system reform is part of the same negotiations.

The changes can alter where employees work, which services remain open and how decisions are made. Earlier negotiations led to health-centre and hospital-ward closures. Those closures ended entire work communities and resulted in hundreds of employees being reassigned. Some employees have seen their own unit threatened repeatedly.

These measures are linked to Central Finland’s severe financial situation. The county must save until 2030 to cover an approximately 300-million-euro deficit. It avoided losing its independence after a Ministry of Finance assessment procedure. Although the economy has shown a turn, uncertainty continues, and the latest negotiations may reshape jobs and leadership across the entire region.

Across Finland, wellbeing services counties, HUS and Helsinki have held or are holding change negotiations. Survey responses indicate that wellbeing services counties plan to reduce at least 2,700 person-years during the year. A person-year describes the workload of one full-time employee for one year, so the figure measures work capacity rather than necessarily an equal number of individual people.

The planned reduction is slightly more than one percent of the counties’ workforce. The total workforce is about 230,000 people. The figure therefore looks limited in proportion to the whole workforce, even though its effects can be concentrated in particular services, units or professional groups.

The article also warns that planned reductions do not equal mass dismissals. Employers mainly leave vacancies unfilled and do not extend fixed-term contracts. Dismissals are used only as a last resort. In addition, total staffing has grown in many regions, especially where demand for services has increased or expensive temporary agency labour has been reduced.

A workforce can become smaller without large waves of dismissals. Employers can stop recruiting for open positions and allow vacant jobs to remain empty. They can also choose not to renew fixed-term contracts when those agreements end. These methods reduce staffing gradually and avoid dismissing as many permanent employees.

The article identifies this as the main way wellbeing services counties are reducing staff. Dismissals are used only as a last resort. This helps explain why the number of actual dismissals has remained smaller than public impressions might suggest, even though counties have announced substantial person-year reductions.

The approach can still change services and increase uncertainty. Employees may face reassignment, wider work areas or threatened units even without dismissal. The article also notes that some dismissed workers return to the same employer within a few months if demand for services rises. Workforce reductions can therefore be temporary, uneven and difficult to see from dismissal figures alone.

When health centres or hospital wards close, the impact reaches beyond individual jobs. Entire work communities can disappear, and employees may need to move into other units or duties. Local residents may also lose nearby services or face changed arrangements, although the article does not detail the new service distances or availability.

In Central Finland, earlier negotiations led to health-centre and ward closures. These closures resulted in the reassignment of hundreds of employees. Some workers have repeatedly seen their own unit threatened during successive negotiation rounds. The changes therefore affect both where people work and whether their familiar team continues to exist.

For employees, the repeated uncertainty causes anxiety about job permanence and continuity. Puronaho supports workers before, during and after formal hearings. The changes also reshape regional services and staffing. Because the county must make savings through 2030, further reorganisations remain possible, even though large-scale dismissals have so far largely been avoided.

A wellbeing services county can cut some jobs while its total workforce grows. The key is that reductions and recruitment may happen in different services. A county may remove administrative, expert or support positions while adding workers where care demand is increasing. The article says cuts have affected those areas more than healthcare staffing.

Several forces explain the growth. Demand is rising, including in services for older people. Counties are also bringing purchased services back in-house and reducing their reliance on expensive temporary agency workers. Those changes can require more directly employed staff, even while other posts disappear or remain unfilled.

The Ministry of Finance’s Ville-Veikko Ahonen says total staffing has increased and social and healthcare staffing has not collapsed. This challenges the impression created by negotiations and dismissal news. However, growth does not remove local disruption. Employees can still be reassigned, units can close and teams can disappear while the workforce expands elsewhere.

The article focuses on deficits and state oversight, but it does not explain how wellbeing services counties are funded. Under established Finnish arrangements, their main funding comes from central government, supplemented by client fees and some other revenue. Counties do not generally finance their core operations through ordinary municipal taxation. This funding structure matters because spending must cover services across a changing population.

Rising demand can increase costs faster than available funding. More older people may need care, while staffing, facilities and purchased services remain expensive. If income does not keep pace with these costs, an annual shortfall accumulates as a deficit. Cutting temporary agency work or bringing services in-house may improve finances, but can also require new permanent staff.

The article estimates the counties’ combined deficit at more than 1.5 billion euros by year-end. Eighteen regions have deficits, with repayment deadlines from 2027 to 2031. The Ministry of Finance is concerned that financial development is diverging, and its decisions will affect next year’s budgets.