Integrating Service User and Workforce Involvement: Slovakia Marta Kahancová and Mária Sedláková Final conference, Brussels, 30.1.2015 With financial support.

Integrating Service User and Workforce Involvement: SlovakiaMarta Kahancová and Mária Sedláková Final conference, Brussels, 30.1.2015

With financial support of the EC

Research questions and data• Impact of user involvement on which actors are represented

within systems of social dialogue • Are new forms of direct user involvement encouraged?

What implications for traditional representative voice? • How is the scope and agenda of social dialogue changing?

Are the interests of service users compatible with the interests of social partners?

• What are the consequences for the social partners and workplace practice?

• 25 semi-structured interviews (patients’ organizations, educational councils, school boards; trade unions, employer associations, government representatives and experts)

Drivers of user involvement Transition from state socialism to democracy• Growing importance of civil society and civic

participation New public management reforms • user involvement in a bottom-up perspective

(competition - focus on service quality, hospital independence from public services, school self-governance);

• top-down perspective: Healthcare Surveillance Authority

NGO initiatives for efficiency and transparency in public services

Public services social dialogueEDUCATION:• Bargaining coverage within public services 100%• Independent multi-employer bargaining without collective

agreements• New actors: trade union fragmentation

HEALTHCARE - HOSPITALS: • Bargaining coverage 95% (independent from public services)• Multi-employer bargaining, dualization • New actors: trade union fragmentation• Shift away from traditional bargaining to protests, strikes,

political action

Forms of user involvementSlow institutionalization• Structure inherited from socialism (education) or

newly developing (healthcare)•Real practice: started only upon NPM reforms, mid-

2000s•National level: interest fragmentation;

underdeveloped collective representation of users •Establishment level: micro-level platforms of user

involvement, individual user involvement better developed (healthcare), collective user involvement increasingly important (schools)

Impact on social dialogue Actors: diversity of interests, thus users’ influence on

the established actors in social dialogue is limited Processes: little interaction between user involvement

and social dialogue;• Sector level: distinct channels of influence• Establishment level: modest formalization (user

feedback – hospital) to limited formalization (direct interaction of users with teachers – school)

Outcomes: some overlap in agendas, establishment level – work organization and working time adjustments due to user pressures

User pressure without user involvement

Dominant trend in Slovakia Until present – limited direct impact on social dialogue,

but potential impact

NGO initiatives facilitate a better understanding for users of the connection between service quality and the quality of working conditions in schools and hospitals

Empowering users to exert pressure on quality of public services directly and through social dialogue

INEKO experience in running internet portals evaluating Slovak schools and hospitals

Peter Golias

INEKO Director

January 30, 2015

Brussels, Conference on integrating service user & workforce involvement in public services

INEKO portals Education (2012): http://skoly.ineko.sk/ Health care (2014): http://nemocnice.ineko.sk/

Starting points, ideas behind:• Need for higher quality and efficiency of public services• „You cannot manage what you do not measure“• Money should follow quality and efficiency• Need for better information available to the public

• Existing but hidden/unavailable data• Increasing computer power enabling processing of big data

Goals• Attract public attention to discussion about quality and

efficiency of schools and hospitals• Inform public about how different schools and hospitals

meet selected quality & efficiency indicators• Through better information (and subsequent choice of

providers) increase public pressure on improving quality & efficiency of schools and hospitals

Indicators• Primary and secondary schools:• Standardized tests results• Unemployment rate (only for secondary)• Exceptional results (e.g. in national competitions)• Other: State inspection, teacher/pupil ratio, etc.

• Hospitals:• Patient opinion (from surveys)• Patient complaints• Official quality indicators (e.g. mortality, waiting lines)• Other: Financial health, transparency, etc.

Target groups & Experience

Target groups:• Consumers (parents, students, patients)• Journalists• Providers (schools, hospitals)• Policy makers and regulators

Experience:• Publishing data helps to improve their quality• State is often reluctant to cooperate (conflict of interest,

mistaken data)• Many providers do not like to be evaluated• There is much room for improvement of data and

methodology

Thank you for your attention!