Date when decision was rendered: 27.11.2000

Judicial body: Supreme Administrative Court = Högsta förvaltningsdomstolen = Korkein hallinto-oikeus

Reference: Report no. 3118; 794/3/99

Reference to source

KHO 2000:63.

Yearbook of the Supreme Administrative Court 2000 July-December

Högsta förvaltningsdomstolens årsbok 2000 juli-december

Korkeimman hallinto-oikeuden vuosikirja 2000 heinä-joulukuu

Place of publication: Helsinki

Publisher: Edita

Date of publication: 2001

Pages: pp. 99-110

Subject

disabled persons, social rights, right to social, health and medical services, equality, non-discrimination,
handikappade, sociala rättigheter, rätt till social- hälsovårds- och sjukvårdstjänster, jämlikhet, icke-diskriminering,
vammaiset, sosiaaliset oikeudet, oikeus sosiaali- ja terveyspalveluihin, tasa-arvo, syrjintäkielto,

Relevant legal provisions

sections 1 and 3 of the Act on the Status and Rights of Patients; sections 14-1-2 and 14-3 of the Primary Health Care Act; sections 6, 19 and 22 of the Constitution Act

= lag om patientens ställning och rättigheter 1 § och 3 §; folkhälsolagen 14 § 1 mom. 2 punkten och 14 § 3 mom.; grundlagen 6 §, 19 § och 22 §

= laki potilaan asemasta ja oikeuksista 1 § ja 3 §; kansanterveyslaki 14 § 1 mom. 2 kohta ja 14 § 3 mom.; perustuslaki 6 §, 19 § ja 22 §.

Abstract

A municipal senior physician had decided to order to X, as part of the medical treatment provided by the municipality, one or two pairs of orthopaedic shoes per year.X had applied for three pairs of orthopaedic shoes.Because of the nature of her disability X wore out several pairs of special shoes per year.This was confirmed by various expert reports.

The county administrative court handled the case as an administrative dispute and dismissed the claim.The court held that the municipality had no specific legal obligation to provide orthopaedic appliances for everyone in need of such appliances and that the decisions on granting orthopaedic appliances are made within the framework of the budgetary means allocated for the social and health services in the municipality.

The Supreme Administrative Court did not agree with the lower court.In its decision, the Supreme Administrative Court referred, among other provisions, to the Primary Health Care Act as well as to section 19 of the Constitution Act, concerning the duty of the public authorities to guarantee for everyone adequate social, health and medical services, and to section 6 of the Constitution Act, concerning equality before the law and the prohibition of discrimination.The Court ruled that the municipality had, under public law, the obligation to provide X with the necessary appliances for medical rehabilitation.In the Court's opinion, the municipality had not shown that it was unable to provide X with the orthopaedic appliances she needed, within the framework of the budgetary funds allocated for social and health services.The municipality had also failed to show that there would have been reasons, acceptable under section 6 of the Constitution Act, to give priority to other health or medical services to the effect that it was not possible to meet with X's individual needs.The Supreme Administrative Court quashed the decision of the county administrative court and ordered the municipality to provide X with orthopaedic shoes in accordance with her medically assessed needs.

31.5.2006 / 2.6.2006 / RHANSKI

Date when decision was rendered: 19.6.2002

Judicial body: Supreme Administrative Court = Högsta förvaltningsdomstolen = Korkein hallinto-oikeus

Reference: Report no. 19.06.2002/1516; 1257/3/00

Reference to source

KHO 2002:43.

Yearbook of the Supreme Administrative Court 2002 January-June

Högsta förvaltningsdomstolens årsbok 2002 januari-juni

Korkeimman hallinto-oikeuden vuosikirja 2002 tammi-kesäkuu

Place of publication: Helsinki

Publisher: Edita

Date of publication: 2004

Pages: pp. 361-372

Subject

right to social, health and medical services, social rights, equality, non-discrimination,
rätt till social-, hälsovårds- och sjukvårdstjänster, sociala rättigheter, jämlikhet, icke-diskriminering,
oikeus sosiaali- ja terveyspalveluihin, sosiaaliset oikeudet, tasa-arvo, syrjintäkielto,

Relevant legal provisions

sections 1, 3 and 4 of the Act on the Status and Rights of Patients; sections 14-1-2 and 14-3 of the Primary Health Care Act; sections 6, 19 and 22 of the Constitution Act

= lag om patientens ställning och rättigheter 1 §, 3 § och 4 §; folkhälsolagen 14 § 1 mom. 2 punkten och 14 § 3 mom.; grundlagen 6 §, 19 § och 22 §

= laki potilaan asemasta ja oikeuksista 1 §, 3 § ja 4 §; kansanterveyslaki 14 § 1 mom. 2 kohta ja 14 § 3 mom.; perustuslaki 6 §, 19 § ja 22 §.

Abstract

A medical officer of a health centre had ordered that X, because of her injuries, should receive physical therapy as part of the medical treatment provided by the municipality.However, a decision had been made in the municipality to the effect that due to a shortage of funds physical therapy would in general not be provided for persons between the age of 18 and 64 years.X was 42 years old.Because the municipality could not provide the necessary treatment, X should have sought physical therapy at a private clinic at her own expense.

The administrative court held that the municipality had no specific legal obligation to provide physical therapy for everyone in need of such therapy.Decisions to grant medical rehabilitation are made within the framework of the budgetary funds allocated for the social and health services in the municipality.In the court's opinion, the municipal authorities had not exceeded their discretionary powers when excluding, due to a shortage of funds, persons of working age from physical therapy provided by the municipality.

In its decision, the Supreme Administrative Court referred to section 19 of the Constitution Act, concerning the duty of public authorities to guarantee for everyone adequate social, health and medical services, and to the prohibition of discrimination in section 6 of the Constitution Act and section 3 of the Act on the Status and Rights of Patients.The Court found that adequate health and medical services cannot always be provided without giving priority to some services over others.However, when putting services in priority order the prohibition of discrimination must be taken into account.In addition, the municipal authorities have a duty to assess a person's state of health and his or her individual need for adequate health and medical services.A person cannot be denied adequate health and medical services which are based on his or her medically assessed needs merely on the basis of the person's age.The Supreme Administrative Court quashed the decision of the administrative court and returned the case to the municipality for reconsideration.

5.6.2006 / 5.6.2006 / RHANSKI

Date when decision was rendered: 19.6.2006

Judicial body: Supreme Administrative Court = Högsta förvaltningsdomstolen = Korkein hallinto-oikeus

Reference: Report no. 1572; 2997/3/04

Reference to source

KHO 2006:38.

Yearbook of the Supreme Administrative Court 2006 January-June

Högsta förvaltningsdomstolens årsbok 2006 januari-juni

Korkeimman hallinto-oikeuden vuosikirja 2006 tammi-kesäkuu

Place of publication: Helsinki

Publisher: Edita

Date of publication: 2009

Pages: pp. 612-620

Subject

disabled persons, social rights, right to work, right to social, health and medical services,
handikappade, sociala rättigheter, rätt till arbete, rätt till social-, hälsovårds- och sjukvårdstjänster,
vammaiset, sosiaaliset oikeudet, oikeus työhön, oikeus sosiaali- ja terveyspalveluihin,

Relevant legal provisions

sections 1 and 8 of the Act on services for persons with disabilities; sections 4, 5 and 6 of the Decree on services for persons with disabilities; sections 18 and 19 of the Constitution Act

= lag om service och stöd på grund av handikapp 1 § och 8 §; förordning om service och stöd på grund av handikapp 4 §, 5 § och 6 §; grundlagen 18 § och 19 §

= vammaisuuden perusteella järjestettävistä palveluista ja tukitoimista annettu laki 1 § ja 8 §; vammaisuuden perusteella järjestettävistä palveluista ja tukitoimista annettu asetus 4 §, 5 § ja 6 §; perustuslaki 18 § ja 19 §.

Abstract

According to the Act on services for persons with disabilities, a municipality shall arrange transportation services for a severely handicapped person if such services, because of the nature of the person's disability, are necessary in order for the person to manage in his or her daily life.The Decree on services for persons with disabilities prescribes that transportation services include transport to and from work within the person's municipality of residence or a neighbouring municipality.The municipality can arrange the transport or compensate to the disabled person any reasonable transportation costs.

X, who was severely handicapped, lived in the city of Järvenpää and worked in the city of Vantaa.The distance between his home and his workplace was 22 kilometres.The social welfare board at the city of Järvenpää had decided that transportation services under the Act and Decree on services for persons with disabilities are arranged, besides within the city itself, only to three neighbouring municipalities across the city boundary and to one other municipality situated nearby but not sharing a boundary with Järvenpää.The city of Vantaa was not included in this group.Accordingly, the city of Järvenpää agreed to compensate X's transportation costs from his home to the boundary of the city of Vantaa whereas X himself paid the expenses of transportation from the boundary to his workplace.X claimed before an administrative court that the city should compensate the total cost of transport from his home to his workplace.The court decided the case in X's favour, but the social welfare board appealed against the decision to the Supreme Administrative Court.

In its decision, the Supreme Administrative Court referred to sections 18 (the right to work) and 19 (the right to adequate social, health and medical services) of the Constitution Act and the relevant provisions of the Act and Decree on services for people with disabilities.The Court noted that in administrative and court practice pertaining to services for persons with disabilities it is usually held that a "neighbouring municipality" is a municipality sharing a boundary with the municipality of residence.However, although a person can usually run his or her daily errands in the municipality of residence or a neighbouring municipality, this does not always apply to a person's work.Therefore, when compensating the costs of transport to and from work, a municipality further away than across the boundary of the municipality of residence can be regarded as a neighbouring municipality provided that the transport costs are reasonable.The Court ruled that a severely handicapped person's right to transportation services cannot be limited on the ground that a municipality has designated the municipalities it regards as neighbouring ones.In this case, X's municipality of residence, Järvenpää, is situated close to the area surrounding the capital of Helsinki, and it is quite common that people living in Järvenpää work in the metropolitan area in which the city of Vantaa is also included.Moreover, X's way to work (22 kilometres) is not exceptionally long in the metropolitan area.The Supreme Administrative Court concluded that X's travel to and from work is to be regarded as transport to and within a neighbouring municipality as prescribed in the Decree on services for people with disabilities.Under the Act on services for people with disabilities, the city of Järvenpää therefore has a duty to arrange X's transport to and from his workplace.

28.6.2006 / 8.9.2009 / RHANSKI

Date when decision was rendered: 19.6.2006

Judicial body: Supreme Administrative Court = Högsta förvaltningsdomstolen = Korkein hallinto-oikeus

Reference: Report no. 1574; 2522/3/04

Reference to source

KHO 2006:40.

Yearbook of the Supreme Administrative Court 2006 January-June

Högsta förvaltningsdomstolens årsbok 2006 januari-juni

Korkeimman hallinto-oikeuden vuosikirja 2006 tammi-kesäkuu

Place of publication: Helsinki

Publisher: Edita

Date of publication: 2009

Pages: pp. 625-632

Subject

disabled persons, social rights, right to work, right to social, health and medical services,
handikappade, sociala rättigheter, rätt till arbete, rätt till social-, hälsovårds- och sjukvårdstjänster,
vammaiset, sosiaaliset oikeudet, oikeus työhön, oikeus sosiaali- ja terveyspalveluihin,

Relevant legal provisions

sections 1 and 8 of the Act on services for persons with disabilities; sections 4, 5 and 6 of the Decree on services for persons with disabilities; sections 18 and 19 of the Constitution Act

= lag om service och stöd på grund av handikapp 1 § och 8 §; förordning om service och stöd på grund av handikapp 4 §, 5 § och 6 §; grundlagen 18 § och 19 §

= vammaisuuden perusteella järjestettävistä palveluista ja tukitoimista annettu laki 1 § ja 8 §; vammaisuuden perusteella järjestettävistä palveluista ja tukitoimista annettu asetus 4 §, 5 § ja 6 §; perustuslaki 18 § ja 19 §.

Abstract

According to the Act on services for persons with disabilities, a municipality shall arrange transportation services for a severely handicapped person if such services, because of the nature of the person's disability, are necessary in order for the person to manage in his or her daily life.The Decree on services for persons with disabilities prescribes that transportation services include transport to and from work within the person's municipality of residence or a neighbouring municipality.The municipality can arrange the transport or compensate to the disabled person any reasonable transportation costs.

P, who was severely handicapped, lived in the capital city of Helsinki and worked in the city of Kerava.The distance between her home and her workplace was some 30 kilometres.The social welfare board at the city of Helsinki had decided that transportation services under the Act and Decree on services for persons with disabilities are arranged, besides within the city itself, to four neighbouring municipalities all within the metropolitan area.The city of Kerava was not included in this group.Therefore, the city of Helsinki agreed to compensate P's transportation costs from her home to the boundary of the city of Kerava only.P claimed before an administrative court that the city of Helsinki should compensate the total cost of transport from her home to her workplace.The administrative court rejected P's claim on the ground that because of its geographical distance from Helsinki, Kerava could not be regarded as a neighbouring municipality as prescribed in the Decree on services for persons with disabilities.P appealed against the decision to the Supreme Administrative Court.

In its decision, the Supreme Administrative Court referred to section 18 (the right to work) and 19 (the right to adequate social, health and medical services) of the Constitution Act and the relevant provisions of the Act and Decree on services for people with disabilities.The Court noted that in administrative and court practice pertaining to services for persons with disabilities it is usually held that a "neighbouring municipality" is a municipality sharing a boundary with the municipality of residence.However, although a person can usually run his or her daily errands in the municipality of residence or a neighbouring municipality, this does not always apply to a person's work.Therefore, when compensating the costs of transport to and from work, a municipality further away that across the boundary of the municipality of residence can be regarded as a neighbouring municipality provided that the transport costs are reasonable.The Court ruled that a severely handicapped person's right to transportation services cannot be limited on the ground that a municipality has designated the municipalities it regards as neighbouring ones.

The Supreme Administrative Court pointed out that it is ordinary that people living in Helsinki work in municipalities surrounding the metropolitan area.P's way to work (32-33 kilometres) is not exceptionally long in the metropolitan area.The Court concluded that P's travel to and from work is to be regarded as transport to and within a neighbouring municipality as prescribed in the Decree on services for people with disabilities.Under the Act on services for people with disabilities, the city of Helsinki therefore has a duty to arrange P's transport to and from her workplace.The Supreme Administrative Court quashed the decisions of the administrative court and the social welfare board and referred the matter back to the board for a new consideration.

28.6.2006 / 8.9.2009 / RHANSKI

Date when decision was rendered: 6.3.2000

Judicial body: Supreme Administrative Court = Högsta förvaltningsdomstolen = Korkein hallinto-oikeus

Reference: Report no. 452; 3524/3/99

Reference to source

Yearbook of the Supreme Administrative Court 2000 January-June

Högsta förvaltningsdomstolens årsbok 2000 januari-juni

Korkeimman hallinto-oikeuden vuosikirja 2000 tammi-kesäkuu

Place of publication: Helsinki

Publisher: Edita

Date of publication: 2001

Pages: pp. 111-114

Subject

social rights, right to social, health and medical services, social assistance,
sociala rättigheter, rätt till social-, hälsovårds- och sjukvårdstjänster, socialhjälp,
sosiaaliset oikeudet, oikeus sosiaali- ja terveyspalveluihin, sosiaaliapu,

Relevant legal provisions

sections 2, 6 and 10 of the Social Assistance Act; section 19 of the Constitution Act

= lag om utkomststöd 2 §, 6 § och 10 §; grundlagen 19 §

= laki toimeentulotuesta 2 §, 6 § ja 10 §; perustuslaki 19 §

Abstract

According to the Social Assistance Act, social assistance is a last-resort financial assistance under social welfare.All those who are in need of support and unable to make a living through paid work, self-employment or other benefits securing a living are entitled to social assistance.However, the Act also provides that the size of the basic amount of social assistance can be reduced up to 20 per cent, if a person's need for social assistance is due to the fact that the person has without justifiable cause refused a job or an employment measure that would secure a living for a reasonably long period, or the person has through negligence acted in such a way that work or an employment measure could not be offered.If a person repeatedly refuses a job or an employment measure, the basic amount can be reduced up to 40 per cent.The reduction can only be made if it will not endanger indispensable subsistence necessary for a life of dignity and cannot otherwise be considered unreasonable.Also, it cannot last more that two months at a time from the refusal or negligence concerned.

X had been granted social assistance.When making the decisions on X's social assistance, the municipal official had also asked X to register with an unemployment office as a job seeker.However, X had repeatedly refused to do so.X had earlier been registered as a job seeker but had cancelled his registration.He admitted that this was because, due to outstanding taxes, he did not wish to receive any taxable income.Because of X's repeated negligence, it had not been possible to offer him a job.Consequently, the basic amount of the social assistance granted to X was reduced, first by 20 per cent, then by 40 per cent and again by 40 per cent, each time for a period of two months.X appealed against the latest decision, claiming that it was not possible to make two consecutive 40-per-cent reductions.The social welfare board upheld the decision of the municipal official, and so did the county administrative court and the Supreme Administrative Court.

In its decision, the county administrative court noted that X had several times been urged to register as a job seeker by a date determined in the decisions on social assistance.Because X had not done so, he had through his negligence acted so that it had not been possible to offer him work.The court held that the maximum period of two months for a reduced basic amount of social assistance is to be counted from the date by which the applicant is expected to have registered as a job seeker.A new reduction can be made immediately after the previous reduction period.The court found that in X's case the reduction cannot have been considered as unreasonable and had not endangered X's indispensable subsistence necessary for a life of dignity.The Supreme Administrative Court agreed with the county administrative court.

Section 19-1 of the Constitution Act guarantees for everyone the right to receive indispensable subsistence and care, if that person cannot obtain the means necessary for a life of dignity.Section 19-1 creates a subjective right, and a person in need of indispensable subsistence and care can base his or her claim before the authorities directly on this provision of the Constitution Act.In practice, however, the implementation of the right is dependent on benefits as determined by norms below the constitutional level, in this case the Social Assistance Act.

The Social Assistance Act provides explicitly that social assistance is used to ensure at least the minimum income needed for a life of human dignity.It thus links the basic amount of social assistance to the protection guaranteed in section 19-1 of the Constitution Act.In drafting the Social Assistance Act, it was considered that a reduction of the basic amount of social assistance was possible if a person's need for social assistance is due to the fact that the person has without justifiable cause refused a job or an employment measure that would secure a living for a reasonably long period.However, a provision was included in the Act, according to which the reduction can only be made if it will not endanger indispensable subsistence necessary for a life of dignity and cannot otherwise be considered unreasonable.

In this case, both the county administrative court and the Supreme Administrative Court based their decisions on the Social Assistance Act, without any explicit reference to section 19 of the Constitution Act.However, in their deliberations, both courts took into account the requirement of reasonableness and the fact that the decision of the municipal official did not endanger the mimimum requirements of a life of human dignity.

The Social Assistance Act is silent on the number of subsequent reductions in cases of repeated refusals and negligence.In the view of the Supreme Administrative Court, several consecutive reductions are possible on certain conditions.Regrettably, in the brief reasoning of its decision, the Supreme Administrative Court does not discuss the constitutional right to indispensable subsistence and care.It thus leaves open the question as to how many consecutive reductions of the basic amount are possible without eventually touching upon the core of the right to indispensable subsistence, in cases where the grounds for the reductions as such are in accordance with the law and necessary for reaching a justified purpose (in this case, employment).

The case exemplifies the last-resort character of social assistance as well as the duties imposed on the person in need of social assistance in that context.The Social Assistance Act explicitly provides that all people are responsible for their own maintenance according to their abilities.With social assistance being the last resort, in X's case the primary means of assistance was employment and measures and benefits relating to unemployment, which he repeatedly refused.It was also not possible for X to freely choose the measures of assistance of his own preference.

18.6.2013 / 18.6.2013 / RHANSKI