An increasing number of municipalities introducing service vouchers

Press release 3 March 2011

According to a survey conducted by Sitra and the Association of Finnish Local and Regional Authorities, service vouchers are particularly used for social services, but their introduction for use in healthcare services is also planned for this year. In social services, it seems that service vouchers extend from the caring of close relatives, domestic services and support services to service housing in particular where service vouchers are mainly used for intensified service housing and the service housing of the disabled.

The joint survey of Sitra and the Association of Finnish Local and Regional Authorities is the first report implemented during the new Act on service vouchers in regard to using service vouchers and planning their use in municipalities and municipal federations. The survey, conducted in January 2011, was participated by 225 municipalities and municipal federations.

According to the survey, 102 municipalities and municipal federations use service vouchers. 120 municipalities and municipal federations are planning to introduce service voucher or expanding their use. The most popular purposes of the vouchers are domestic services, related support services and services during the leave of a person taking care of a close relative, for example.

“Municipalities need an opportunity to use various production methods for providing their social and healthcare services. The advantage of service vouchers is that they can be allocated to areas where there is a market and an opportunity to create competition. Service vouchers are very suitable for arranging individual services, regardless of the extent,” says Jussi Merikallio, in charge of social and health matters, the Association of Finnish Local and Regional Authorities.

According to Merikallio, the survey results indicate that the introduction of service vouchers requires time. The number of plans clearly exceeds the implementations.

“The survey results show that the elected official of municipalities have adopted the service vouchers,” says Tuomo Melin, in charge of Sitra’s service voucher project.

According to Melin, municipalities have traditionally used service vouchers for the caring for close relatives, domestic services and support services. During the current year, service housing and healthcare services are rapidly being included in the service voucher system.

Service voucher use likely to quadruple in service housing

Currently, 94 municipalities and municipal federations use service vouchers in their social services. 86 municipalities and municipal federations are planning service voucher introduction or expanding their use.

In addition to domestic service and caring for close relatives, service housing is a new, strongly growing application for service vouchers. Plans are particularly prepared for intensified service housing and the service housing of the disabled. A total of 15 municipalities and municipal federations use service vouchers for service housing, and as many as 64 are planning their introduction.

The City of Tampere introduced service vouchers in intensified service housing as of June 2010. The city prepared its pilot project as part of the service voucher project funded by Sitra. The pilot for services for the elderly specified the rules, that is, the acceptance criteria for service providers concerning housing and domestic services for the elderly.

Daycare is a growing service area

In the survey, eight municipalities reported that they use service vouchers for daycare where the main applications are daycare centres and private daycare. 10 municipalities and municipal federations are planning service voucher introduction or expanding their use. Turku has led the way in daycare. The Tampere and Oulu regions are carrying out a national daycare project with Turku, and the experiences and results from it are available for all municipalities.

Service vouchers for healthcare services

In basic healthcare, 27 municipalities and municipal federations use service vouchers. 32 are planning to introduce service vouchers or expand their use. The corresponding figures are six and 10 for specialised healthcare, two and five for rehabilitation, as well as four and 13 for dental care.

Service voucher users in specialised healthcare include Kuusamo, Ylöjärvi and the Hospital District of Helsinki and Uusimaa, among others. Parkano, Kalajoki and Kemi are considering introduction. In addition to specialised healthcare, the introduction of service vouchers is the most frequently considered in dental care. Tampere and Vantaa, for example, are in the process of considering the introduction.

A service voucher pilot of the Hospital District of Helsinki and Uusimaa (HUS) in cataract surgery will be fully active as of March. The scope of the pilot and the number of surgeries exceeds the total scope of all other projects in specialised healthcare.

“After rule adjustments and minor price checking, we have reached a mutual understanding with the service providers. Now everything is ready for launching the pilot,” Hans Ramsay, in charge of the service voucher project concerning eye disease treatment at HUS.

Best practices for municipalities

“The equality of citizens and social justice is the starting point of best practices. All citizens should have the freedom of choice regardless of their level of income. Based on this, we want to provide municipal actors with best practices concerning service vouchers, which is why we share the information, know-how and documentation obtained from the pilot projects for utilization,” says Tuomo Melin.

Sitra and the Association of Finnish Local and Regional Authorities together arrange rule training and service voucher days which everyone may attend without a fee. The rulebook for those in charge of service vouchers specifies the acceptance criteria of service providers. The service voucher project will prepare best practices for service voucher implementation and pricing models.

About the research

• The joint survey of Sitra and the Association of Finnish Local and Regional Authorities is the first report of its kind implemented during the new Act on service vouchers in regard to using service vouchers and planning their use in municipalities and municipal federations.
• The survey was conducted in January 2011 and it was participated in by 225 municipalities and municipal federations.
• The new Act on service vouchers took effect on 1 August 2009.

Highlighting costs

• The survey also investigated how willing municipalities were to specify the service production costs in the bills to customers.
• 13 municipalities of municipal federations report that they notify the service production costs to the customers. In most cases, the production costs are specified in bills for domestic care and daycare.
• 19 municipalities or municipal federations are planning to notify the service production costs to the customers.
• A total of 178 responses were obtained to the question concerning production costs.

For further information, please contact:
Tuomo Melin, Senior Lead, Municipal Programme, Sitra, phone +358 40 183 4158, firstname.lastname@sitra.fi,
Jussi Merikallio, Director, social and health matters, the Association of Finnish Local and Regional Authorities, phone +358 9 771 2602, firstname.lastname@kuntaliitto.fi