New challenges for public
services social dialogue
Integrating service user & workforce involvement to
support the adaptation of social dialogue
Research partner meeting
With financial support from
Utrecht University, June 6th
the European Union
Eva Knies, Peter Leisink & Mijke van de Noort
Progress
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Desk research
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Interviews – hospitals (5)
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Ministry of Health, Welfare & Sport
Trade unions: ABVAKABO FNV, CNV Publieke Zaak
Federation of Patients and Consumer Organisations in the Netherlands
(NPCF)
National centre for client participation (LSR)
Interviews – secondary education (5)
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Ministry of Education, Culture & Science
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Dutch council for secondary education (VO-raad)
Trade unions: CNV Onderwijs, AoB
National Action Committee Students (LAKS)
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July 2, 2016
What? Service user pressure – Hospitals
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Patient participation: making use of the unique expertise
of patients aimed at increasing the quality of care
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Explicit focus on needs of individual patients
Balance between standardization and flexibility
Increased patient participation since mid 1990s as a
result of laws and regulations, increasing number of
chronically ill patients and the introduction of market
mechanisms
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Patient involvement highly institutionalised; currently no
explicit pressures to increase patient participation
July 2, 2016
What? Service user pressure – Secondary education
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Involvement of students and parents is considered
important for two reasons:
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Successful school results for students (individual level)
Improving quality of education (macro level)
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Parents (and students) seem primarily interested in
individual level outcomes
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Student/parent involvement highly institutionalised;
currently no explicit pressures to increase participation
July 2, 2016
Who? New actors – Hospitals
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About 10% of all Dutch citizens are members of a
patient organisation
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Disease-specific patient organisations and general
patient organisations
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The federation of patients and consumer organisations
in the Netherlands (NCPF) is subsidised by the Dutch
government
July 2, 2016
Who? New actors – Secondary education
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Students and their parents are represented by the
National Action Committee Students (LAKS) and the
National Parents’ Council (LO)
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LAKS is well-organised, LO far less
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Discussion: to what extent do these bodies represent
students/parents in general?
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For example: the Dutch council for secondary education sometimes
passes over LAKS and LO to discuss issues with individual
students/parents
July 2, 2016
Forms? How are actors involved – Hospitals
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Law ‘Participation healthcare clients’ (1995): a client
council for each healthcare institution
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Client participation on hospital level is difficult in cure
institutions: representation, professionalism, short stays
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Often indirect representatives, instead of patients
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Law ‘Good Governance’ (2014): intention to make it no
longer mandatory to have a client council in cure  deinstitutionalisation
July 2, 2016
Forms? How are actors involved – Secondary education
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Law ‘Participation in schools’ (1992, 2007)
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Council composed of employees and students/parents is
mandatory
A council on the school level (MR) and a council on the
level of the institution (GMR)
Consultation and codetermination: Right to advise and
approve (some topics: right of initiative)
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The ministry of Education, Culture & Science provides a
budget for council members to take courses
July 2, 2016
Scope? On what issues – Hospitals
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Traditional employment issues still only discussed with
trade unions/works council: work relations, employment
relations, industrial relations
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Service quality is in the interest of all parties, but is
discussed in different platforms
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Ad-hoc coalitions among stakeholders at national level
are formed if this serves a specific goal
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Professional associations discuss issues of concern to
both users and employees
July 2, 2016
Scope? On what issues – Secondary education
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Different topics are discussed in different platforms (see
hospitals)
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Students/parents prefer to discuss issues in the MR (at
school level); teachers prefer to discuss issues in the
GRM (at the level of the institution)
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Initiatives to involve parents and teachers (VO2020
tour) in discussions on future developments did not
have the desired effect
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Issue of concern to both students/parents and teachers:
working hours/’1040 hours norm’ – horizontal dialogue
July 2, 2016
Consequences? Service user involvement & social dialogue
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In both sectors ‘user issues’ and ‘employee issues’ are
disconnected and discussed in different platforms
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This is the result of institutionalisation – two sides of
the coin
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Both user and employee participation are guaranteed but seperately
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Difficult to get all parties at the same table
There is no conflict of interests, but neither do user
involvement and employee participation strengthen
each other
July 2, 2016