Implementing a New Level of Participatory Democracy – Democratic Innovations in Well-being Governance in Finland

This qualitative case study examines how Democratic Innovations were implemented following a health system reform in Finland. Our theoretical foundation is participatory democracy, with Democratic Innovations advancing citizen roles in democracy. We first analysed the Act on Wellbeing Services Counties from 2021 to identify the overall governance structure and the Democratic Innovations placed within. We then utilized document analysis to extract which mandatory and optional Democratic Innovations were implemented, paying special attention to member selection and the connection to the overall governance structure. The main innovations are Advisory Bodies, which target service-user groups. Young people, older people, and people with disabilities participate in health and well-being governance. Their members are sent from corresponding bodies on the municipal level, implementing multi-level citizen participation. The bodies can at most take a consultative position, and they do not yet have formalized pathways to influence.