Outsourced service

The municipalities organises healthcare services for their residents. A municipality can organise services by providing them itself or in collaboration with other municipalities, or purchase services from private companies or from organisations.

The majority of municipal operations consists of organising public services. Legislation obliges the municipalities to organise social welfare and healthcare services for their residents, but does not specify the scope, content or method of provision. The municipality decides on these itself, and there may be municipality-specific differences in operations.

The municipalities have freedom of choice in how the services are organised. A municipality can organise services itself or in collaboration with other municipalities. A municipality can also purchase services from other municipalities, joint municipal authorities or from private companies and organisations.

When a municipality or joint municipal authority procures services from private service providers, the purchased service must fulfil the requirements required when the municipality or joint municipal authority provides an equivalent service itself.

The Act on Public Contracts must be complied with in the procurement of services. The Act on Public Contracts obliges municipalities to put outsourced procurements out to tender. The Act on Public Contracts does not, however, regulate either what is procured or the terms of procurement. The municipality thus decides on the content and quality of the service to be procured and on the terms of the contract.

Since 2004, the municipalities have been able to organise services also by providing clients with service vouchers. The municipality decides whether to adopt service vouchers in organising the statutory tasks of social welfare and healthcare. If a municipality uses a service voucher, the municipality undertakes to pay the costs incurred from using the service to the value of the voucher. The value of a service voucher must, as a general rule, be reasonable.

Only a municipality and a joint municipal authority can steer clients requiring healthcare services towards outsourced services under the responsibility of municipalities to organise. A private service provider cannot therefore offer their services directly to a client as an outsourced service of a municipality unless agreed on in advance with the municipality or joint municipal authority.

A client has the right to refuse services organised by means of service vouchers, in which case the municipality must provide his or her service in some other way.

Provision as an outsourced service organised by a municipality does not affect the client´s status or his or her client fee paid for the service. Legislation on client fees stipulates that clients shall not have to pay a co-payment fee on services prescribed as free of charge.