International Journal of Public and Private Healthcare Management and Economics, 3(1), 17-32, January-March 2013 17
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ABSTRACT
This paper presents a baseline picture of the co-operation between service purchasers and private elderly
care and primary health care providers both at the national level and at the level of local welfare regimes in
Finland. Data from two national surveys and from interviews conducted in six municipalities are analysed.
The perceptions of the co-operation during the contractual period differed substantially between the private
providers and the municipalities. The differences were evident especially between the for-proft providers and
the municipalities. In general the private providers would be willing to work together with the municipalities,
but to them it seems that the municipalities lack interest in this. The municipalities, in turn, considered that
contracting is mostly a tool to reduce administrative responsibilities. However, in order to be able to gain
benefts from contracting, to avoid excessive transaction costs and to co-ordinate the network of different
service providers, the municipalities should invest in contract management and also be active during the
contractual period.
Perspectives on Purchaser-
Provider Co-Operation
in the Local Welfare
Regimes in Finland
Liina-Kaisa Tynkkynen, School of Health Sciences, University of Tampere, Tampere, Finland
Sami Fredriksson, National Institute for Health and Welfare (THL), Helsinki, Finland
Juhani Lehto, School of Health Sciences, University of Tampere, Tampere, Finland
Keywords: Contract Management, Contracting Out, Mixed Methods, Public-Private Partnership, Public
Sector Reform
INTRODUCTION
This paper explores the co-operation between
service purchasers (i.e. municipalities) and
private for-profit and not-for-profit elderly care
and primary health care providers in the context
of the local welfare regimes in Finland. We use
the term co-operation to refer to a concept that
might also be labelled Public-Private Partner-
ship (PPP). However, due to its ambiguous
character (e.g. Weihe, 2008) we prefer a more
general term co-operation. At the operational
level we have divided co-operation into four
dimensions: information sharing, trust, evalua-
DOI: 10.4018/ijpphme.2013010102