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Kainuu Region and Its Self-Government Experiment

Kainuu Region and Its Self-Government Experiment. Congress of local and regional authorities, Helsinki 30.11.2010. Population of the municipalities of Kainuu 2009 total 82 626. Tampere. 9 332. 3 128. 2 789. 3 918. 1 521. 3 401. Turku. 9 632. 10 697. 38 208. Helsinki.

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Kainuu Region and Its Self-Government Experiment

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  1. Kainuu Region and Its Self-Government Experiment Congress of local and regional authorities, Helsinki 30.11.2010 Alpo Jokelainen

  2. Population of the municipalities of Kainuu 2009 total 82 626 Tampere 9 332 3 128 2 789 3 918 1 521 3 401 Turku 9 632 10 697 38 208 Helsinki Alpo Jokelainen

  3. Kainuu population projections(Statistics) Alpo Jokelainen

  4. The law of Kainuu governance experiment Regional functions (§ 4): • Region planning • Regional development • Healthcare • Social services (except for children´s day-care) • Secondary education = upper secondary schools and vocational schools • General economic development • Cooperation with other regional developers • Supervision of the region´s interests • Control of state budget funds for Kainuu • Law + municipal decisions Alpo Jokelainen

  5. The purpose of the experiment A centralised arrangement of basic public services enables securing the service quality, availability and economy in Kainuu in the long term, despite the threatening population forecasts. At the same time, the citizens living in the eight Kainuu municipalities will have equal opportunity to receive basic public services. Alpo Jokelainen

  6. The Joint Authority of Kainuu Region(in parentheses is the numbers of employees in 2008, total 3785) REGIONAL COUNCIL Inspection board REGIONAL BOARD Executive director Steering Committee Planning and Development Division (25) Board of Kainuu Occupational Healtcare enterprise Individual Care Division Board of Kainuu Vocational Institute, a municipal enterprise Social and Healthcare Board Education board Social and Healthcare Division (2885) Educational Division (642) General services (233) Alpo Jokelainen

  7. Regional Board • Regional Board I- Chairman is executive director Alpo Jokelainen- The regional council appoints for term - 10 other member / municipal law • - Vaala`s representative in matters relating to the provincial union • tasks • decides internal tasks of the Joint Authority of Kainuu Region • Regional Board II(16 members)- Regional Board I and leaders of local state authorities- decides of the use of development funds => state authorities, “operating • budgets” • Regional Board III (34 members + about15 other participants)- MYR assembly (go-operation group)- Regional strategic plan, programme and operational programme, decisions of • projects over 500 000 € Alpo Jokelainen

  8. Municipal financing for the Joint Authority of Kainuu Region is determined as follows: Municipal contributions to the Joint Authority of Kainuu Region is defined as a percentage of deferred tax.Deferred tax funding includes revenues (local taxes (19.25%), community taxes and property taxes (2009)) general funding of social and health from the state, additional funding based of sparsely populated area, tax revenue based on the alignment of the state tax and compensations.Education state grants are paid for the education provider. Alpo Jokelainen

  9. Kainuu finances (2009) • Total expenditure 315 meur • Social and health care 237 meur ( 75 %) • Education 48 meur ( 15 %) • Administaration, development and services 22 meur ( 7 %) • Financial expenditure and investments 8 meur ( 3 %) • Total income 315 meur • Municipal payment 222 meur ( 70 %) • Customer and patient charges 38 meur ( 12 %) • State subsidies and sales revenues 52 meur ( 17 %) • Operating revenues from other services 3 meur ( 1 %) Alpo Jokelainen

  10. Growth rate of expenditures, % / year Alpo Jokelainen

  11. Annual margins and depreciation € / resident Alpo Jokelainen

  12. KAINUU DEVELOPEMENT FUND, V. 2010 TOTAL 61.324 € mill. / DIVISION AND UTILIZATIONS Alpo Jokelainen

  13. ORGANIZATION OF SOSIAL AND HEALTH DIVISION full-time in addition of own work the specialty of corresponding SOCIAL AND HEALTHCARE BOARD SOCIAL- AND HEALTH DIRECTOR EXECUTIVE BOARD Environmental Health Management support Medical services Health and disease management services Family services Senior ziticens services Kainuu Health Senior Citizens ServiceRegion I(Kajaani Region)Senior Citizens ServiceRegion II(Sotkamo, Kuhmo)Senior Citizens ServiceRegion III(Ylä-Kainuu)Shared Services Health Monitoring Veterinaryservices Enviromental´s Healtcare laboratory Manage- ment, Delelope- ment and Planning Laboratory andpathologyRadiologyPharmaceutical ServiceEquipment ServiceParamedic;Anesthesia andintensive care Adult mental healthServicesand addiction treatmentReception andHealth Centre,ActionDental healthcare servicesOperational treatment Conservative treatmentEmergency room Services Families with children.social servicesFamilies with childrenhealth servicesAdult social servicesDisability Services Division Level: appropriate higher education sector and experience in management. Alpo Jokelainen

  14. ORGANIZATION OF EDUCATION DIVISION BOARD OF EDUCATION EDUCATION DIVISION DIRECTOR BOARD OF EDUCATION VOCATIONAL EDUCATION UPPER SECONDARY SCHOOL EDUCATION Vocational education servicesWelfare sectorCulture (Director of EducationBusiness and industryNatural ResourcesTourism and CateringTechnology and Transport SectorKuusamo unit / Tourism KAO = Kainuu Vocational College • Units: • Kajaani High School Kuhmo High School •  Sotkamo High School Filiaal High School Hyrynsalmi High School Paltamo High School Puolanka High School Suomussalmi High School Alpo Jokelainen

  15. ORGANIZATION OF GENERAL SERVICES REGIONALBOARD GENERAL SERVICES Administrative Services IT -services Personnel Services Financial Services Material Services Technical Services Nutrition Services Transportation Services General services Personnel- Service and service Relationship matters Accounting The procurement office Building systems Nutrition Services Archive- and data Protection services Well-being and collaboration Sales Activities Central warehouse Engineering Economic- and debt Counseling services Payroll Alpo Jokelainen

  16. Experiences 1 • Regional decision-making works fine • Enlargement of collaboration, productivity increase by 20% • Payroll • ”Accountancy services” • IT -service • Clear synergies • Health services and care for the elderly: a single • administrative • No overlapping • Treatment processes are designed, functional • Elderly housing and residential care are in the same unit • Municipality billing is fixed in advance => predictable • Homecare has been increased • Social welfare • Improved legalstatus of customers • Better quality due to expertize of personnel • Harmonized actions in Field work Alpo Jokelainen

  17. Experiences 2 • Combining of small high school administration and teaching • adiministrative costs; nearly half off • municipality costs – 50% • wider choice for students • Vocational and secondary education for synergies • Student welfare services • Finance • Student services • Harmonized operational practices, (quality management system) • IT-systems • Sharing of facilities and equipment • Adult education co-operation • Joint development projects Alpo Jokelainen

  18. Experiences 3 • - Municipalities finances have been strengthened in 4 • years more than 70 000 000 EUR- State provincial operations management capabilities is fierce • The service changes are justified and there is no return to old • system • Support services (catering, cleaning, techical services) need • for the gathering = productivity, increasing possibilities for • better productivity • By strengthening of small municipality economy, the current • structure of the municipalities has been able to maintain Alpo Jokelainen

  19. Summary of social and health services1 • Focus on health promotion •  Investment in research and development to ensure • all time improvement Success criteria • Deep integration and cohesion • Financing modell • Own research and development increased •  Staff commitment Alpo Jokelainen

  20. Summary of social and health services 2 • Preventive work and the developement of services has been • possible • In the last year people have got services more than in the past • People has been little dissatisfied because it has been • necessary to limit doctor´s action desk because of the lack of • doctors • There has also been difficulties in access to dental care • Initial assessment of the need for care is well realized • Customer feedback is good, imago is not Alpo Jokelainen

  21. How long is the waiting time for doctor´s in non-hazardious cases? (average) Kainuu: Less than 2 weeks Alpo Jokelainen

  22. Standardized expenditures of social-, health- and elderly carein Finland / Year 2008 (€/people, index=100) Alpo Jokelainen

  23. Summary of social and health services3 • We have succeeded in: • expenditure growth has been restrained • availability of services in Kainuu is secured • citizen equality has been improved • Kainuu model transferability and innovations: • social care, basic and specialized health care are combinated • no overlapping (laboratory, logistics and maintenance of • equipment) • unbroken service chain, specialist consultations • economy and funding is fixed in advance, no single action invoicing for • municipalities • reducing exces plant locations • ensuring excellence= acute hospital only there, where experts is => dissatisfaction with the smaller municipalities Alpo Jokelainen

  24. Contacts: Alpo Jokelainen Region Mayor, Chairman of the Board Puh. 044 336 6700, alpo.jokelainen@kainuu.fi Alpo Jokelainen

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