The gradual city-ness and town-ness of public service locations: Towards spatially sensitive sector policies

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.