Improving the Quality of Public Services: Putting the Citizens at the Centre of Administrative Action

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A joint initiative of the OECD and the European Union, principally financed by the EU Improving the Quality of Public Services: Putting the Citizens at the Centre of Administrative Action Dr. Elke Loeffler Governance International Conference on Public Administration Reform and European Integration Budva, Montenegro 26-27 March 2009 OECD

The boundary between service providers and service users has shifted Increasingly we are seeing greater involvement of users in services, for example - The use of expert patients in UK hospitals - Parents of teenagers patrolling the streets at night to prevent riots in hot spots in Denmark - Citizens drive buses for citizens to complement the offer of public transport in the small-sized local authority Brieselang close to Berlin - In Montenegro

A question for you What s the more important issue for professional staff in the public sector in 2009, A. To improve the quality of the service they can deliver to their service users? OR B. To help their service users to work with them to improve their quality of life?

There was a wide range of views from our focus groups Professionals across all sectors have woken up to the fact that they need to do things with people rather than for people (UK focus group) Most doctors appreciate better informed patients but about one third of doctors prefer to be the only clever participant in the care process (Czech focus group) Danish society is a bit different. Somehow we gave all social affairs to the public sector and people do not want to get involved. (Danish focus group)

A slight difference of opinion... Interviewer How important is the role of citizens in public services? Public official Well, I don t really know... but not very, I would say Citizen VERY important I m active on on environmental and health issues, a bit less active in safety

Findings of a European citizen survey (2008) Level of User-Involvement in Europe (environment, health, community safety) UK Germany Czech Republic France Denmark 56 53 52 51 48 0 100 The index is a min-max (0-100) scale, with 0 representing minimum co-production (answering "never" to all the co-production questions) and 100 representing maximum (answering "often" to all the co-production questions).

It is time to ask citizens new questions NOT ONLY how satisfied are you with our services? BUT ALSO what impact do we make on your quality of life?

It is time to ask ourselves new questions NOT ONLY how should we improve our organisation? BUT ALSO how can we work better with other service providers, users and their families and communities?

This implies a new perspective... To look at the cleanliness of streets, and not how to improve the quality of street cleaning services To look at health and not at the management of illness To look at life-long learning and not the management of schools To decide on what outcomes matter most with our citizens, not in management meetings...

with implications for quality management While providing high quality services remains important, outcomes matter most to citizens Quality of life issues will raise the interest of politicians quality will no longer be the exclusive domain of technicians

and a new ways of assessing quality Measuring user satisfaction is not enough, we need to assess social capital as well. While self-assessments with staff suggestions remain important for continuous change, new ideas for radical change are more likely to come from citizens and other external stakeholders of a public agency. Standardisation may be useful in some contexts but responsive services tailored to the needs of different service users and their families require flexible solutions with user involvement and empowered staff

New Quality Improvement Strategies in Europe

Co-design of services for young people The most popular section 1,000 monthly hits / 20 e-mails with Qs per day Regional Young Space Consultants Coordination Information about drugs/new substances Regional coordination centres about drug & alcohol abuse Counselling about road and safety Advice about driving licenses www.stradanove.net Counselling about jobs by trade unions Particularly about unusual jobs Cooperation with Informagiovani ensures the accuracy and updating of infomation on study opportunities, leisure activities, rights and duties, travel

Co-management of resources: The Porto Alegre Approach of the City of Cordoba Longest standing experience with participatory budgeting in Europe (since 2000) Mix of territorial bottom-up approach and sectoral approach Elected citizen PB delegates play important role in defining the methodology (in particular indicators used in budget matrix) and monitoring the implementation of approved proposals Final selection of proposals is made by City Council with local councillors, citizen delegates and representatives of local associations

Co-delivery of social care for elderly in rural areas The Villa Family in villages in the East of France allows two host families to look after 3 elderly people each, as part of family life but with some privacy and independence.

Co-assessment of public services and quality of life by lay inspectors In the UK housing inspections are done by inspectors of the Audit Commission who now involve a tenant representative. in Sardinia, representatives of a citizen association act as hygiene police in hospitals In the Paris suburb Bobigny, a citizen inspectorate checks to what extent the local council does what it promises to do and reports on the finding in an independent report going to every household.

A Co-Assessment Report Card: The point of view of key stakeholders of a public housing area in the UK

Expected benefits of citizen involvement in public services Cutting costs Making public services more responsive to users, building in users holistic perceptions of what quality of life outcomes they desire Providing more differentiated services and more choice Improving public service quality by bringing in the expertise of service users, and often of their families and communities as well

Issues for discussion: what co-production of public services implies for government Citizen involvement implies that professionals are no longer the gatekeepers and only experts is the civil service ready for this change? Co-production is not without risks e.g. giving responsibility to young people to run their own youth club Co-production does not scale up naturally but often remains at local, neighbourhood or even individual level. How can it be embedded in government policy and managerial practices? What skills need to be developed among professionals to work more effectively with citizens?

Contact Thank you for your attention Dr. Elke Loeffler Email: elke.loeffler@govint.org URL: www.govint.org