Integrating Service User
and Workforce
Involvement: Slovakia
Marta 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 selfgovernance);
• top-down perspective: Healthcare Surveillance
Authority
 NGO initiatives for efficiency and transparency in public
services
Public services social dialogue
EDUCATION:
• 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 involvement
Slow institutionalization
• Structure inherited from socialism (education) or
newly developing (healthcare)
• Real practice: started only upon NPM reforms, mid2000s
• 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:
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•
•
•
Standardized tests results
Unemployment rate (only for secondary)
Exceptional results (e.g. in national competitions)
Other: State inspection, teacher/pupil ratio, etc.
• Hospitals:
•
•
•
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Patient opinion (from surveys)
Patient complaints
Official quality indicators (e.g. mortality, waiting lines)
Other: Financial health, transparency, etc.
Target groups & Experience
 Target groups:
•
•
•
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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!