Small- and medium-sized enterprise (SME) policies tend traditionally to focus on supply-side support instruments. However, public procurement provides a potential demand-side SME policy tool to enhance SMEs and maintain competition in the market. SMEs are often under-represented in public procurement compared to their overall economic weight. Existing literature provides limited information on the instruments of public service providers to create business opportunities for SMEs. The aim of this single case study is to describe the role of SMEs in the statutory public service provision of primary social and healthcare. The study also provides insight into the public service provider's ability to facilitate SME access to public procurement and thereby to enhance the efficiency of the local market. We found that a service voucher system could be an additional option for public procurement, as it allows more flexibility in involving small businesses in the production of public services.