the centralisation, Denmark will decrease its hospitals with emergency care from 40 in 2007 to 21 in 2020. The changes have been criticised by residents in areas far from emergency hospitals. To compensate, some of the regions offer paramedic helicopter response in addition to ambulances. In addition, since 1999 the government has obliged Danish hospitals to increase their productivity by 2% per year for the same budget, in the expectation of possible benefits from technical progress, but often leading to cutbacks in services. A growth in bureaucracy has generally been observed by doctors and employees. In the Capital Region and Zealand Region, a new electronic health record system developed by Epic Systems has been described as a major scandal, causing unresponsive IT systems, wrong prescriptions, more time-consumption and a lack of overview. Doctors and other employees have demanded the withdrawal of the system, but the regions insist that it will remain in place and errors be corrected. Regions are responsible for providing primary care to all citizens. This is carried out through contracts with general practitioners who for the most part own their clinics and provide treatment free-of-charge for the public, according to specifications laid down by the region. According to doctors, the burden of documentation and administration has increased, and the amount of young doctors wishing a career as general practitioners has diminished. Since many areas have been affected by physician shortage, the regions have been compelled to open region-owned clinics to fill the gaps. Administration and politics Regions are led by directly elected councils (), which each consist of 41 members. The head of the council is the regional council chairman (), who is elected by the council from its members. Elections are held simultaneously with municipal elections every four years. The latest Danish local elections were held on 21 November 2017. Unlike the former counties, regions are not entitled to levy their own taxes, but rely on central state funding (around 70%) and funding from the municipalities (around 30%). A central government "health contribution" tax () on income which was 8% when it was introduced from 2007 initially replaced most of the county tax (). With income taxes in the lowest bracket being raised 1 percentage point a year, the health contribution tax was eliminated in 2019. In 2012 this tax was lowered to 7%, 2013 6%, 2014 5%, 2015 4%, 2016 3%, 2017 2%, 2018 1%.