On 1 January 1991, the central hospital and health care districts changed into hospital districts. The area of a hospital district is formed from the municipalities belonging to the joint municipal authority for specialised health care.
The Ministry of Social Affairs and Health is responsible for general planning, steering and monitoring of specialised health care, in regions the Regional State Administrative Agencies. The National Institute for Health and Welfare (THL) is the expert agency for specialised health care.
The joint municipal authority for specialised health care must attend to the reconciliation of specialised health care in its area and in collaboration with health centres, plan and develop specialised health care so that public health work and specialised health care form a functional whole.
The joint municipal authority for specialised health care provides the health centres in its area with the specialised health care services they need, which cannot be provided appropriately by health centres and is in charge of the supervision and quality control of laboratory and x-ray services, medical rehabilitation and other corresponding special services.
The joint municipal authority for specialised health care is also responsible for research, development and training in its area of responsibility. In addition to hospital districts, the country is divided into special areas of responsibility for the organisation of specialised level of health care.
The Government determines the special areas of responsibility so that each area has a hospital district in which area there is a university providing medical training.