In healthcare, changes sometimes happen quietly. And then there are those moments when a small technical regulatory adjustment signals that an entire way of thinking has reached its end.
We have just lived through the latter.
The repeal of Section 16 of the Decree on Healthcare Professionals nearly a year ago reached its final conclusion on June 4, when the Ministry of Social Affairs and Health issued a regulation removing the eight-year age limit from the list of medicinal substances available to opticians. This is not a cosmetic change. It marks the end of a period in which regulation lagged behind reality—and at times even stood in opposition to it—for decades.
Age limits were originally introduced out of caution. That was understandable. But at some point, caution turned into stagnation. Purposeful regulation became regulation that no one, despite repeated attempts, could convincingly justify—yet it remained in force.
This is a classic feature of Finnish healthcare: it is known that something does not work, but there is no courage to touch it, even though reality has long since moved on.
The use of diagnostic medicinal substances in the work of an optometrist—or a licensed optician with limited prescribing rights—is not new. It has been part of everyday clinical practice for over a decade. Education has progressed, competence is systematic, and international practice is clear: the same work has long been carried out elsewhere without artificial restrictions—safely for patients.
And yet, here we held on to a number in the appendix of a decree. That is precisely the core of the issue.
Safety does not arise from numbers. It does not arise from age limits. It arises from competence, training, and from a professional knowing what they are doing—and when they should not act.
The age limit never made the practice safe. It merely made some well-justified examinations impossible.
This regulation is important precisely because of what it symbolizes. It shows that the system is ultimately capable of correcting itself—albeit slowly. And above all, it shows that a model based on competence will eventually prevail over assumptions locked into structures and opinions unsupported by evidence.
From a broader perspective, this is about much more than a single decree and its appendix.
We have a chronic problem with access to care. Demand is increasing as the population ages and primary-level services struggle. In eye health, this is particularly evident. And yet we continue to hold on to structures and specialist-driven policies that prevent the full utilisation of trained professionals.
That is no longer caution. It is a waste of resources.
Removing a single age limit will not solve the whole issue. But it shows the direction. Regulation can be dismantled intelligently—without compromising patient safety. In fact, the opposite is often true: patient safety improves when work can be done properly.
At the same time as I welcome this step, one uncomfortable question must be asked: how many similar “technical details” still remain in our system? How many of them unnecessarily slow down access to care and, instead of improving patient safety, actually weaken it?
The end of an era does not feel like anything. There is no ribbon-cutting, no speeches. There is only the moment when it becomes clear that the old way of thinking could no longer carry forward.
Panu Tast
Managing Director
Näkeminen ja silmäterveys Näe ry
This blog post was first published on the Hoiva&Terveys blog (only in Finnish) on June 5, 2026.
