Some history of Tampere and shopping

I can't believe it is Friday already. I met with Kari-Matti Hiltunen, the Medical Director of Tays this morning. We discussed medical training - it is very similar to in England. The students are usually the top grade and have studied biology, chemistry, physics but also psychology. They study for 5 years within which they will spend about a year in general practice. They then do a final 6 months consolidation period and then chose where they will specialise. Many of the doctors do private work in their evenings and weekend - generally 1 or 2 evenings a week. This may not continue for much longer with the introduction of strict waiting times for referrals and treatment and management.

He thought that the general population are quite healthy but the main problems are alcoholism, depression and the elderly. The new legislation has introduced clear patient pathways, ensuring that new technologies are researched and evidence-based and also monitoring drug expenses so making sure that they prescribe generically.

Regarding nursing - as in the UK there are large numbers approaching retirement age and younger people are not being attracted into nursing mainly due to the relatively low salaries. About 30,000 nurses are no longer working clinically. This is not a problem with doctors as their salaries are relatively high, so no change there! It is difficult to attract nurses from other countries as they need to speak Finnish and not many people outside of Finland do.

I then went for lunch - I am still getting used to having such an early lunch break. I went for my lunch at 11.30 and there were already many people in the dining area. It was a good chance to catch up with BBC news on my phone - reading about the travels of the Olympic flame and then the sad story of the patient with dementia who had over 100 carers. I decided to be brave and try the non-alcoholic beer. I suspect it is like Dr Pepper's but I did not like it, so I shall stick to water! It is quite strange that everywhere has small cups or glasses. In my flat I always make 2 cups of coffee and likewise in the canteen everyone takes 2 glasses to have their water / milk / beer.

After lunch I met with Petri Pommelin who is responsible for patient safety. we had an interesting discussion around incident reporting, service design and what he termed "identification of doings that do not add value for the patient". This includes waiting times for patients, staff not knowing where equipment is stored and is along the lines of the productive ward. Petri's role is to help staff identify the problems and then support them in finding solutions. He felt that it was crucial to have buy-in from senior managers to succeed in this. He also suggested that it was helpful to have some staff who could bring in experiences from outside of health and also staff who had worked in other areas.

My final meeting was with Rainer Zeitlin whose title is "Medical Expert". He has been appointed to lead the changes as a result of the legislation. One of their goals is developing "treatment chains". The idea behind these is to link social and health care so that there is no duplication and everyone is clear where their responsibility lies within the patient journey and so ensure there are no gaps in the chain. It was interesting to hear more from him about the current political situation in Finland. For over 50 years there has been a socialist government and President. However, last year the new President who was elected was from the conservative party, who represent those who are well educated and often are entrepreneurs. It was interesting as his views were slightly different from Arto, the national co-ordinator.

The government are very concerned about the increasing numbers of elderly people and the impact this is having on health care costs.The recent legislation focuses on improving the nutritional status of the elderly, increasing their levels of exercise and focusing on their living environments. Previously many elderly have moved into general hospitals when they become more frail or unwell but now there is a move to keep them at home and support them there. This may not necessarily be that much cheaper but it is recognised that it is better to retain their independence as far as possible.

He finished by telling me about a model of work - when we start a new job it is like climbing up a mountain. After about 5 - 7 years we get to the top. We can then chose to stay in the job and so simply climb back down the same mountain and live in the valley and forget about the view and perspective from the top; or we can carry on climbing by taking on new roles and responsibilities and maintain that perspective.

I then met Pirjo and we took the bus into Tampere. We walked to the Vapriikki museum. We went to the William Lomax exhibition "Dear Maggie". William Lomax was a photographer who moved to Finland from England and then wrote letters to his fiancée - "Dear Maggie..." to tell her what it was like. The photographs he has taken are really amazing - they look very modern even though most were taken from about 1890 - 1910. They have a real clarity and are a great record of the time.

We then went to the "In flight - Birds at Vapriikki" - and was lots of stuffed Finnish birds including a golden eagle, swans and found out that the birds I had seen near the flat were related to ravens. We went into an area and put on 3-d glasses and then experienced what it would be like to fly - it really was quite amazing.
The next exhibition was about the history of Tampere and the Tammerkoski rapids which made much more sense as I had done the walk yesterday. I had not appreciated that until 1809 Finland was under Sweden and then it was annexed to Russia. It was only in 1917 it gained it's independence. Finland then experienced a civil war in 1918 between the reds and the whites. Tampere was a red area, which was really socialist and consisted of the workers. This started in January and lasted until May. The whites took over the area and collected about 11,000 reds into the main square. There were many deaths and Pirjo said that it is still a great sadness for the older people. Unfortunately then it was closing time at the museum but we said that we will have to come back as it is a really interesting place and we still have more areas to explore.

Vapriikki Museum

We walked back over the rapids and on the bridge Pirjo pointed out the locks attached to the bridge - these are put there by couples when they become engaged as a sign of their love and they throw the keys into the rapids so that their love should remain.

Many have the names of the couple engraved on the padlock

We walked down to the harbour and went to one of the shopping centres. I bought a beautiful reindeer candle holder - a fitting souvenir! Tomorrow we shall be going to Pyynikki for a walk in the old forest so I'm hoping it will be a bit drier as it has been quite wet today.