Recipes for Systemic Change - Helsinki Design Lab

example, under the Performance Management System, programmes aredeveloped by policy area, across different ministries rather than by oneparticular ministry. Under the OECD Public Management Review, ministriesare required to develop strategies for increasing lateral interaction andnetworking with other parts of the government.D5.3 Local Reform: Supporting Small-Scale InnovationAt the smallest scale of local service provisions, pilot programmes,which include hospital redesign, administrative restructuring, and familyeducation, seek to improve the citizen’s experience of the welfare state. Suchprogrammes support innovative approaches to welfare service delivery bysponsoring small-scale, prototypical solutions intended to address largersystemic problems.The Pareto programme at the Aalto University School of Science andTechnology is one example of how architectural and urban design thinkingmay be applied to address the question of elder care facilities. The programmeis developing prototypical solutions for problems in the built environmentof the welfare system. Some solutions include the development ofmobile technologies for home care, the conversion of a standard hospitalinto a more holistic wellness centre, and the unification of different carefacilities into a single health campus.The Finnish Well-being Centre develops and promotes a system forelder care that incorporates services, knowledge, and architecture into acomprehensive design package. In Finland, these prototype systems arecurrently in use; Japan, which faces the second most rapidly ageing populationin the world, is also developing similar systems.D5.4 The Kainuu Regional ExperimentMunicipalities are the main organisational node for the provisionof welfare services in Finland. The municipalities are responsible for thedesign, provision, and oversight of all aspects of health and social care services.Out of Finland’s 348 municipalities, 248 had populations of less than10,000 in 2008 (StatsFi). In order to counter the problems of scale inherentin providing complex welfare services to such small, decentralized populations,many municipalities may work in collaboration with other municipalitiesfor the deliver of services, while others purchase necessary servicesdirectly from another municipality, private provider, or public organization.“There is a wide variety of cooperation between municipalities in boththe provision of basic services and regional development. Inter-municipalcooperation is often the most appropriate and economically sound301