Employment Relations Research Centre
New challenges for public service social dialogue –
the case of Denmark (national report)
Nana Wesley Hansen & Mikkel Mailand
FAOS – Employment Relations Research Center
Department of Sociology, University of Copenhagen
End Project Conference, Brussels, January 30, 2015
Project funded by European Commission DG Employment, Social Affairs and
Inclusion / VS/2013/0362
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Introduction
Schools
1. Development in user involvement
2. Actors, levels and types of involvement
3. Consequences for and relation to social dialogue
4. Case study
Hospitals
1. Development in user involvement
2. Actors, levels and types of involvement
3. Consequences for and relation to social dialogue
4. Case study
Comparison and conclusions
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Schools
The focus
•
•
The Danish Folkeskole (1814): Primary and lower secondary
education
2013: 1.312 public schools and 548 private schools
Recent development in user involvement:
•
Folkeskole reform (collective bargaining conflict) 2013
• Strained social dialogue
• Strengthened user role: school-community connection
rather than free choice!
• Strengthened management focus! (Reform initiative:
Yearly student satisfactory survey from 2014)
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Schools
Parents
• National/regional: 1934 school councils/ 1935 The National
Association of School Parents’ formed
• Regional/municipal: Ad hoc integration
• School: 1989 school boards introduced through legislation
• Class: Parent-teacher meetings
Pupils
• National: 1969 first national organization formed, 2004
Danish Association of Pupils (DSE), 2014: Direct satisfaction
survey
• Regional/municipal: Ad hoc integration
• School: Represented in school boards and student councils,
• Class: Students involved on day-to-day basis
Other actors
• Industrial associations, local cultural and sports clubs
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Schools
Consequences for and relations to social dialogue
•
More groups are consulted and participates in defining school at
national and municipal political level – strengthening of user
groups
•
Wish to strengthen user involvement at school level
(indirect/direct)
•
No actual pressure, two parallel legitimate systems
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Case – Vejle Municipality and Central City School
•
‘The School in Motion’ - a radical innovative bottom up process
in order to develop the school including all kinds of users consultation
•
Concurrently, cut backs in the school sector in the municipality
including loss of teaching positions
•
Isolation of local branch of The Danish Union of Teachers strained social dialogue!
•
Steering group continues into the reform implementation local
trade union regains strength, funds following
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Case – Vejle Municipality and Central City School
•
Vejle Central City School very active in ‘The School in Motion’ - a
project
•
Bringing the school into the local community and the local
community into the school
•
Strong partnership between school leader/shop steward
•
Example of how the reform has direct influence at School board
– chairman from local community (not parent)
•
Local shop steward very pro user involvement – no threat to
social dialogue but necessary for the school
•
Social context of school important: Large city school, lowest
grade average in municipality, pupils with other ethnicity and
mother tongue, students who drop out elsewhere
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Hospitals
The development of user involvement in hospitals
•
In-/direct user involvement always existed; increased a lot last 3-5 years
•
Drivers: demographic pressure, technology, learning, new org., demands
Who are involved – and who are most active *
•
Ministry of Health *
•
The five regions and their interest org. Danish Regions (social partner) *
•
Local Government Denmark
•
The hospitals: 53 public and approx. 35 (smaller)private *
•
Users + user organisations: Danish Patients and member org (18 org.) *
•
Trade unions: most importantly three for doctors and one for nurses
•
The general practitioners
Who are the users
•
Patients first, relatives second
Hospitals
Indirect (organisational) user involvement
•
Sector level: No permanent body, but hearings and ad hoc partnership
•
Regional level: All regions now obliged to have a Health User Council
•
Hospital/depart. level: Councils at some hospitals – include not only users
•
Great variation in aim, scope and quality of councils – learning by doing
Direct user involvement - examples
•
Daily rounds with patients: A traditional weak form of involvement
•
The involving talk (den indvolverende stuegang)
•
Informed approval (det informerede samtykke)
•
Shared decision-making (fælles beslutningstagning)
•
User guided contact (brugerstyret kontakt)
•
National survey of the experiences of patients (LUP)
Hospitals
Consequences for and relations to social dialogue
•
Social dialogue and user involvement take place in different fora
•
Happens only occasionally that the user involvement actors and social
partners takes parts in the same decision making processes (employers?)
•
No signs that the growing user involvement will replace social dialogue
•
User involvement potentially an agenda for greater SP influence, but
trade unions hesitate (to varying degree) to fully engage with the
agenda. However, trade unions interest and engagement is increasing
Case hospital – user panel, oncology depart., Herlev hospital
About the case and case-selection
•
Positive description, users + user organisation involved (no trade union)
•
Set-up in 2010 (one of two pilots); 9-12 users, 1 cancer ngo, 2 staff reps
•
Training (initially) and recruitment in the hands of the ngo
•
Staff rep (Head nurse and co-leader of department) chair of user panel
Activities of the user panel
•
5 – 6 annual meetings 1 – 1 ½ hours focused on ‘tasks’ given by chair –
nearly all tasks connected to LUP
•
Tasks not directly about treatment: waiting-room; communication; being
a relative; lifestyle; design of interior; etc.
•
The users (excluding ngo rep) holds pre-meetings to prepare tasks and to
have their own space for discussions
Case hospital – user panel, oncology depart., Herlev hospital
Scope, impact ad evaluation
•
No plans to increase scope of agenda to include treatment of patients
•
Relatively narrow agenda, but real influence
•
Decision-making processes evaluated positively
•
Somewhere between consultation and partnership, leaning towards former
•
Chair and ngo have different perceptions of role of panel and labels
Role of trade unions and relations to employee involvement body
•
No interests from trade unions
•
User involvement not addressed in Cooperation Council (one exception)
•
Interviewees do not find TUs interested in user involvement generally
•
No impact on working conditions; loose plans to involve users in recruit.
The user council and the rest of the hospital
•
Different forms used, steering panel from 2014, UI in ‘New HH’
Conclusions
The findings – across sectors
•
Two quite different stories: show the importance of sectors/policy areas
•
User involvement not new, but has increased recently in both sectors
•
Most (indirect?) user involvement situated somewhere in our continuum
between consultation and partnership, leaning towards the former
•
So far the impact on user involvement on social dialogue and vise-versa is
limited
The findings – sector variation
•
Most forms of user involvement are only a few years old in the hospitals most forms of user involvement has a long history in the schools
•
Trade unions in the school sector are clearly more involved in user
involvement than in the hospital sector, although they too have they limits
•
More ‘multipartite’ fora found in the school sector than in the hospitals
Conclusions
Hypotheses: Why do user involvement and social dialogue not mix
•
Social dialogue, despite weaknesses, still strong and institutionalised.
Actors have monopoly on representation on wages and working condition
etc. and have no interests or incentives to give up on these
•
Hence, user involvement have to add to rather than replace social dialogue
•
Why TU in hospitals do not enter UI agenda more: Fear of loosing
monopoly, fear of work pressure, do not feel they represent users
Hypotheses: explaining sector variation (+ supported hypothesis, - not supp.)
•
The Folkeskole embedded in participatory democratization project > The
Folkeskole a participatory democracy incl. user involvement. Hospitals not
part of such a project and hierarchical service provider-user relations +
•
History and power of user organisations –
•
Power-relations between trade unions and user organisations -