In 2023, Finland’s health and social services reform introduced centralized governance and funding to enhance cost efficiency. This study investigates strategic alignment among executive management, county councilors, and government ministries within newly formed wellbeing services counties. A validated questionnaire distributed to 4,786 stakeholders yielded responses from 604 executive managers (12.6%) and 106 county councilors (7.4%). Findings revealed significant misalignment between management and politicians regarding financial resources, customer satisfaction, and strategic processes. Politicians were more concerned about financial constraints yet viewed organizational and political resources more favorably. They also perceived strategic goals as clearer but overly ambitious compared to management. Additional divergences emerged between local and national levels: top management prioritized cost reduction and service network revisions, while county councilors and ministries emphasized differing priorities. Ministries were perceived as restrictive and often at odds with local strategies. Free responses highlighted ongoing issues, including inadequate financial and personnel resources and inconsistent political decision-making. These findings parallel Norway’s centralized reforms, where local decision-making was constrained, hampering strategic initiatives. Finland’s reform has similarly induced strategic misalignment, shaped by centralized control and financial pressures. Ongoing research will explore whether alignment improves over time, offering insights into enhancing coherence and system performance.
