Abstract
Location policies of public services such as health care have a great impact on urban and regional structures. Hence, we criticise the general failure of national public sector policies to account for regionally unequal conditions. Conversely, we question the sufficiency of current regional planning concepts for a spatially sensitive location policy of public services. In this theoretical-conceptual contribution, we review the literature on public service provision and the logics of public facility location systems, especially concerning their explanatory value under different regional urbanisation conditions. We reinterpret the conceptual limits of the prime planning concepts of ‘central places’ and ‘polycentricity’ – represented by their underlying spatial logics of hierarchy and complementarity – by employing the ‘central flow theory’ of Taylor, Hoyler, and Verbruggen. With the help of the ‘territory-place-scale-network (TPSN) framework’ of Jessop, Brenner and Jones, we perform a conceptual shift to ultimately outline an integrative ‘central places and flows planning approach’. It accounts for unequal regional conditions for public service locations, and thus manages to integrate economic, political, and spatial components of service provision. We illustrate the feasibility of the central places and flows planning approach using the case of the Finnish social and health care sector. The (failed) Finnish governance reform plans of 2015–2019 for the health care sector are a telling example of spatially un-sensitive sector policies. The reform plans wanted to advance free market elements and enhance the free choice of clients. These aims implicitly re-enforced centre-favouring conditions at the expense of peripheral regions.
Highlights
Location policies of public services such as health care have a great impact on urban and regional structures
In this theoretical-conceptual contribution, we review the literature on public service provision and the logics of public facility location systems, especially concerning their explanatory value under different regional urbanisation conditions
They concentrate on subnational levels of government to re-negotiate sectoral policy competences, for instance in social, educational, and health care sectors, between national, new regional, and local levels – at times accompanied by municipal mergers
Summary
This article analyses a recent attempt of rescaling the Finnish social and health care sector, which is an example of welfare state restructuring in the Nordic context. Reaching beyond the case analysis, our contribution develops a theoretical-conceptual argument against the lack of cross-sectoral integration between social and health care policy and strategic urban and regional planning. Integrating the logic of public service provision into research on functional urban systems, the article arrives at a ‘central places and flows planning approach’, which will add the missing spatial component to the provision logic. This approach informs both future sectoral planning and urban and regional planning. We will first elaborate the context and explain the methodological steps towards answering the research questions
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