The National Audit Office notes that although the Ministry of Social Affairs considers competence assessment crucial for ensuring the quality of healthcare, it remains voluntary and does not provide tangible benefits for employees.

Only a small percentage of healthcare workers undergo the assessment, and the state has not taken action to encourage more workers to participate. As a result, healthcare professionals with outdated knowledge and little interest in self-development can continue working without hindrance.

"Although the audit revealed that the majority of healthcare workers are systematically engaged in self-improvement, professional associations indicated that employees with insufficient knowledge and skills, and little interest in self-development, may operate for years without anyone paying attention to their inadequate competence," said Auditor General Janar Holm.

The National Audit Office pointed out that, as of the beginning of the year, less than a quarter of specialist doctors had a certificate of competence assessment, and for nurses and midwives, the figure was below 10 percent. Around 60 percent of dentists had a certificate.

Competence assessment provides an advantage, for example, to private healthcare institutions when participating in tenders.

The current competence assessments are not uniform – some fields have more thorough and substantial assessments than others, as the assessments are organized by the respective associations themselves. Additionally, not all fields conduct competence assessments, as their implementation depends on the willingness of the professional associations. For instance, not every medical specialty offers the possibility of undergoing such an assessment.

The Ministry of Social Affairs strongly recommends competence assessment but does not consider making it mandatory feasible. The National Audit Office believes the ministry has taken a resigned stance on the matter.

The National Audit Office suggests that the demand for competence assessment and the rate of participation can still be increased, even if it remains voluntary, by providing support to the associations.

One foundation for ensuring competence is the legal requirement for 60 hours of continuing education. However, this is not accessible to all healthcare workers.

According to the National Audit Office, professional associations considered the failure to meet the continuing education requirement problematic, but there is no precise data on its scope. The biggest obstacle to completing the training is the lack of a substitute during the training period.

The National Audit Office believes it is essential to ensure that healthcare workers participate in continuing education at least to the required extent. Adequate financial support for these training sessions must be ensured, and participation should not depend on the type, size or capacity of the institution to offer training. Additionally, the National Audit Office stresses the need to establish oversight to ensure compliance with the continuing education requirements.

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