Service user involvement and
social dialogue
The Case of Slovakia – interim report
Marta Kahancová and Mária Sedláková
Central European Labour Studies Institute
Bratislava, Slovakia
With financial support
from the European Union
Research partner meeting, Utrecht, June 6, 2014
Outline
Existing structures for service user involvement
National stakeholder interviews: progress
Preliminary findings: an overview
 Healthcare (hospitals)
 Education (secondary schools)
 Why are users not involved?
 Conclusion (link to matrix)



Structure of user
involvement: healthcare
Structure of user
involvement: education
National stakeholder
interviews


Healthcare sector:

Association of State Hospitals (sectoral level)

Trade Union of Physicians in Slovakia (sectoral level)

Trade Union of Nurses and Midwives (sectoral level)

Slovak Trade Union of Health and Social Services (sectoral
level)

Hospital Banská Bystrica (establishment level)

Hospital Nitra (establishment level)

Hospital Žilina (establishment level)
Education sector:

Trade Union of Workers in Education and Science of Slovakia
(sectoral level)
Preliminary findings:
healthcare

Sectoral level



Individual cases – most common; appeals through the Healthcare
Surveillance Authority
Limited indirect influence on social dialogue
Organized involvement at the sector-level – not existing; missing
active patients’ organization at the national level (fragmentation of
interests, narrow-focused organizations)
No influence on social dialogue
Establishment level


Individual involvement – most common; questionnaires on patient
satisfaction, management of quality in larger hospitals
Limited indirect influence on social dialogue
Organized involvement – less common; ad-hoc basis, usually
result of broader dissatisfaction with a certain issue (working hours
of specialists, ordering of patients, etc.)
Limited indirect influence on social dialogue
Preliminary findings:
education

Sectoral level



Individual user involvement – not existing
No influence on social dialogue
Organized/collective user involvement – Student councils/parliaments;
Representative invited to four partite committee
Direct influence on social dialogue (but: effectiveness matters)
Establishment


Individual – daily student-teacher interaction
Limited indirect influence on social dialogue
Organized – three levels: class meetings (students with the teacher),
student parliament, parents council
Limited indirect influence on social dialogue
Preliminary findings summary
 Healthcare:


Patients organizations exists, however, they are not active at national
level, do not participate and/or directly influence social dialogue
Patients not part of the tripartite committee (neither formally nor
informally)
 Education:



Representative of The Student Council of Secondary Schools of the
Slovak Republic invited to join the social dialogue at the sectoral level,
(but: what effect of this participation?)
Users formally not part of the four partite committee (Trade Unions,
Employers, Ministry of Education, Regional Government)
Organized vs. unorganized, collective vs. individual user
involvement
Why limited user
involvement?

Healthcare:

-

-

Sector-level
diverging interests of patients’ organizations and trade unions (e.g.
criminal responsibility of healthcare professionals, working time)
fragmentation in the structure of patients’ organization
Lack of interest in user involvement at the Ministry of Healthcare
(sectoral tripartism – limited trade union influence, patients’
organizations excluded)
Establishment-level
too intimate relationship between the doctor and the patient
Diverging interests of patients and trade unions (e.g., right for
service)
Establishment

Individual – daily student-teacher interaction
Why limited user
involvement?

Education:
-
Importance is put on day-to-day interaction between student and
teacher/ parent and teacher at the institutional level
Although student parliament exist, daily interaction perceived as
sufficient to represent students and parents needs expressed through
already existing trade unions