In this paper an investigation is made into the relationship between competitive tendering and contracting (CTC) and satisfaction with health and care services in Norwegian municipalities. There is an ongoing public debate concerning privatization and contracting as a way of providing municipal services. Several studies suggest improved productivity as well as service quality as a result. Based on public choice and property rights theories, public organizations are argued to be inefficient. Thus far, we have little knowledge about the effects of CTC on citizens' evaluations of the services exposed to CTC. To explore this, data from the Norwegian Citizen Study, covering over 35,000 individuals is employed. The findings show that citizens and users are more satisfied with health and care services that are subject to CTC compared to those provided solely by the public sector. 2 Points for practitionersThe findings of this paper encourage competitive tendering and contracting of health and care services. A positive relationship is found between CTC and satisfaction with these services. Findings provide support for arguments made in Scandinavian evaluations; the introduction of competition and contracting is argued to increase municipal focus on service quality, increased service-oriented care and is suggested as representing an improvement in attention to 'secondary needs' of residents. This is especially important for public managers in social democratic countries where the use of CTC is still a controversial topic.

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Local governments increasingly choose to provide a wide range of services