1. New challenges for public services social dialogue Integrating service user & workforce involvement to support the adaptation of social dialogue Research partner meeting Utrecht University, June 6th Eva Knies, Peter Leisink & Mijke van de Noort With financial support from the European Union

2. Progress Desk research Interviews – hospitals (5) 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) Ministry of Education, Culture & Science Dutch council for secondary education (VO-raad) Trade unions: CNV Onderwijs, AoB National Action Committee Students (LAKS) November 15, 2015

3. What? Service user pressure – Hospitals Patient participation: making use of the unique expertise of patients aimed at increasing the quality of care 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 Patient involvement highly institutionalised; currently no explicit pressures to increase patient participation November 15, 2015

4. What? Service user pressure – Secondary education Involvement of students and parents is considered important for two reasons: Successful school results for students (individual level) Improving quality of education (macro level) Parents (and students) seem primarily interested in individual level outcomes Student/parent involvement highly institutionalised; currently no explicit pressures to increase participation November 15, 2015

5. Who? New actors – Hospitals About 10% of all Dutch citizens are members of a patient organisation Disease-specific patient organisations and general patient organisations The federation of patients and consumer organisations in the Netherlands (NCPF) is subsidised by the Dutch government November 15, 2015

6. Who? New actors – Secondary education Students and their parents are represented by the National Action Committee Students (LAKS) and the National Parents’ Council (LO) LAKS is well-organised, LO far less Discussion: to what extent do these bodies represent students/parents in general? For example: the Dutch council for secondary education sometimes passes over LAKS and LO to discuss issues with individual students/parents November 15, 2015

7. Forms? How are actors involved – Hospitals Law ‘Participation healthcare clients’ (1995): a client council for each healthcare institution Client participation on hospital level is difficult in cure institutions: representation, professionalism, short stays Often indirect representatives, instead of patients Law ‘Good Governance’ (2014): intention to make it no longer mandatory to have a client council in cure  de- institutionalisation November 15, 2015

8. Forms? How are actors involved – Secondary education Law ‘Participation in schools’ (1992, 2007) 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) The ministry of Education, Culture & Science provides a budget for council members to take courses November 15, 2015

9. Scope? On what issues – Hospitals Traditional employment issues still only discussed with trade unions/works council: work relations, employment relations, industrial relations Service quality is in the interest of all parties, but is discussed in different platforms Ad-hoc coalitions among stakeholders at national level are formed if this serves a specific goal Professional associations discuss issues of concern to both users and employees November 15, 2015

10. Scope? On what issues – Secondary education Different topics are discussed in different platforms (see hospitals) 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) Initiatives to involve parents and teachers (VO2020 tour) in discussions on future developments did not have the desired effect Issue of concern to both students/parents and teachers: working hours/’1040 hours norm’ – horizontal dialogue November 15, 2015

11. Consequences? Service user involvement & social dialogue In both sectors ‘user issues’ and ‘employee issues’ are disconnected and discussed in different platforms This is the result of institutionalisation – two sides of the coin Both user and employee participation are guaranteed but seperately 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 November 15, 2015