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Service voucher – freedom of choice in social and healthcare services
The purpose of Sitra’s service voucher project is to increase the freedom of choice for local residents. The service voucher will improve service availability, shorten queues, diversify service provision and promote cooperation between municipalities and private service providers.
Sitra has supported service voucher pilots which have led to the establishment of best practices and deployable service voucher models. The project includes the participation of services for the elderly, disability services, day care services, oral health, primary health care and specialised care.
The use of the service voucher in social and healthcare services
The new service voucher legislation took effect in August 2009. A municipality or a municipal federation may use service vouchers in organising social and healthcare services, which are provided by the private sector and approved by the municipality. Service vouchers can be used to complement and support municipal services for the good of the residents and for increasing their freedom of choice.
The municipality decides on:
- the introduction of the service voucher system
- which services will be purchased with service vouchers
- the criteria for service provider approval
- the value of the service voucher
The service voucher isn’t necessarily a tangible printed voucher. They can also take the form of an electronic card or a decision by the authorities.
How will service vouchers be used?
Municipalities and municipal federations
The guide on the introduction of the service voucher explains how this is carried out at a municipal level. Rulebooks support introduction and determine the legal relationships between the municipality, the service provider and the customer. Rulebooks are currently available in a number of areas. The rulebooks are available in Finnish only.
Service voucher rulebook – common model
Primary health care
- Rulebook for primary health care
- Rulebook for primary health care – the Oulu freedom of choice model (to be published in 2012)
Rulebook for orthopaedics
- Rulebook for trigger finger surgery
- Rulebook for endoscopy-assisted surgical treatment for meniscal tear of the knee joint
- Rulebook for median nerve entrapment patients
- Rulebook for ganglion surgery
- Rulebook for hallux valgus surgery
Rulebooks for eye diseases
- Rulebook for dental care (to be published in 2012)
Services for the elderly
Citizens as service users
The service voucher offers a new way of choosing and using social and healthcare services. It may be used for procuring a given item or service. The customer may choose the service provider based on his or her own preferences and needs.
The objective is to increase the customer’s freedom of choice, improve the availability of services, diversify service production and promote cooperation between municipalities, business services and private service providers. The service voucher will have a given monetary value, and service vouchers may be provided to residents either on the basis of means-testing or in equal amounts.
The service voucher project has published a brochure containing answers to questions on the use of the service voucher and the purposes for which it may be used, the opportunities it offers and the terms and conditions. The brochure is available in Finnish and in Swedish.
Service voucher pricing models: best practices
Equality of citizens and social justice are the starting points of the pricing policy. When determining the value of the service voucher, it must be considered whether it should be means-tested or based on equal amounts and whether a price ceiling should be applied. The price ceiling sets a maximum limit on how much may be charged for a service. Thus the municipality can control the amount of the customer’s entitlement.
Introduction of the service voucher is expanding rapidly
The service voucher project (under Sitra’s Municipal programme) conducted a survey on the use of the service voucher and the overall status of its introduction through interviews with local governments. According to the survey conducted in January 2011 and the interviews, 111 municipalities use the service voucher for 338 services. The number of municipalities using the service voucher is estimated to be 10–15 percent higher than the number indicated by the survey and interviews.
According to the survey, 120 municipalities were planning to introduce the service voucher or to expand its use to new services, health services and assisted living in particular. A number of additional municipalities and municipal federations have also announced they would introduce the service voucher.
In the introduction, health services are emerging as the most popular area in which the service voucher offers a means for reducing queues and responding to the need for urgent assistance.
In social services, it seems that service vouchers extend from the caring of close relatives, domestic services and support services to assisted living, in particular where they are used largely for advanced assisted living services for the disabled.