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Municipal decision makers have the right and responsibility to have transparent access to information about the social and health-care services purchased and provided in municipalities and their quality and accessibility.
The key aim of the Maisema (Landscape) survey jointly implemented by Sitra, the Nordic Healthcare Group and the City of Raisio was to find good health-care practices and to support their development.
Utilising the Raisio-developed purchaser-provider model and its various tools, the Maisema project compared health-care and elderly care services in the City of Vaasa and in the Jämsä and Turku regions, all in all in nine different municipalities.
The survey was a success, since the tools of the Raisio model also functioned well in the municipalities taking part in the comparison. With the help of the tools in the model, it was possible to make visible the entire service ranges of health-care services in various municipalities as well as differences in their activities and cost structures. At the same time, it was possible to see what caused differences in costs.
The Raisio model streamlines management
In Raisio’s purchaser-provider model, the services are purchased by the municipal council purchasers and provided by the social and health-care board. Decision makers in both parties have their respective charts: the purchasers have a purchasing chart while the providers have a resources chart. Together these charts transparently reveal the service ranges – including any distortions. On the basis of the information provided by the charts, the decision makers can steer and manage services as well as rectify distortions in the structure, which are the single most important reason for excess costs. The City of Raisio is of the opinion that the municipal decision makers have the right to transparent access to information about the services purchased and provided and their quality and accessibility.
The importance of customer-needs evaluation
Customer-needs evaluation is the key in the purchaser-provider model. Competitive tendering and outsourcing easily create cost savings of a few euro in unit prices, but if this leads to losing a good professional customer-needs evaluation, the costs may well increase. Therefore, the Raisio model has also paid particular attention to customer-needs evaluation processes.
Development entails transparency The Raisio model considerably increases transparency in the overall management of services, decision –making, and development monitoring. Parallel monitoring of finances and the continuous development of activities are necessities if a municipality wishes to overcome the challenges of future health care. The development of the model will next focus on better inclusion of quality attributes.
Independence and competence of municipalities increases
According to the Maisema survey, the purchaser-provider thinking in the Raisio model is easy to employ in other municipalities as well, for example, when they are thinking about policies for the Paras (Best) Project. Moreover, the model has extensive experience of combining social and health-care services. All these items have also been documented in the new Government Programme. Instead of drifting helplessly, municipalities will be provided with competence to steer the purchase and provision of social and health-care services.
The Raisio model is not a traditional purchaser-provider model, where the two are completely separate. The idea of the model is first to learn the necessary skills for purchase and provision as well as transparency. This will only be followed by the assessment as to whether purchasing competence should be located in a separate organisation. This is often required by the restructuring of municipalities and services and the host municipality model. Moreover, the Maisema project noted that the Raisio model would be an excellent fit for the reforms mentioned in the Paras Project.
Eero Vaissi