How much does democracy cost in the wellbeing services counties?

The health and social services reform that came into effect at the beginning of 2023, created a new governance structure for the welfare regions, with decision-making power for social and health services and emergency services shared between elected representatives, officials, residents and the state administration. As the wellbeing services counties have now operated for nearly two years, it is an opportune time to assess how the decision-making system and its participatory structures have functioned. This report examines the period from 1 January 2023 to 30 June 2024.

The aim of this study is to provide information about how the wellbeing services counties balance efficient decision-making and democracy. The report also seeks to identify measures to improve regional decision-making while reducing costs, without compromising regional democracy. The report includes data concerning the costs of decision-making in the wellbeing services counties. Data was collected from publicly available sources, through requests for information and interviews with elected officials and public servants.

The governance structures and decision-making processes of the wellbeing services counties differ significantly from the previous municipal and joint municipal authority models. According to the interviews conducted for this study, the current governance structure is perceived as more functional than average in regions that had prior experience with joint municipal authorities or other forms of collaborative preparation. In these wellbeing services counties, the existing structures and operating models already resembled the organisational framework of the wellbeing services counties, which has facilitated a smoother transition.

A key challenge in the new governance structure has been finding a balance between efficiency and democracy. The number of decision-making bodies varies across regions. In regions with fewer governing bodies, there is generally greater satisfaction with the efficiency and functioning of decision-making.

However, some elected officials feel that the influence of county councils is often overshadowed by the decision-making power of the county executive or local government officials. This is partly due to the council members’ uncertainty about which issues fall under their jurisdiction. Their satisfaction is also influenced by transparency of communication, and how the decision-making power is distributed from the county council and executive to other governance bodies such as committees and sub-committees.

Resident participation methods – such as public meetings, citizen panels and surveys – are still evolving in the wellbeing services counties. Many of the interviewed elected representatives and local government officials perceived that their impact on decision-making was minimal. The resources allocated for resident participation and the means to promote engagement also varied across the wellbeing services counties. The interviewees expressed a desire for these participation methods to be further developed in future council terms.

The costs of democracy were primarily assessed through compensation paid to the elected officials, such as meeting fees and annual allowances, as well as other costs directly tied to governance structures. The overall costs varied between regions. However, the so-called democracy budget represents only a fraction of the total operating expenses of the wellbeing services counties.

The recommendations of the study focus on improving the governance structures and resident participation in the wellbeing services counties. It is recommended that the governance structures should be streamlined, and that the decision-making authority should be more clearly distributed between the elected representatives and local government officials to enhance its efficiency while strengthening democratic participation. Regarding resident participation, it is recommended that a set of metrics should be established to assess the effectiveness of the participation methods, along with creating an active cooperation network for developing these methods and sharing best practices. Furthermore, the wellbeing services counties should define a diverse yet clear framework for the participatory methods that supports the residents’ ability to influence decision-making and service development.