natgillin/translations-raw huggingface dataset:
Naturligvis har grupper af forbrugerrepræsentanter haft medindflydelse på beslutninger i den offentlige sektor i mange år i Storbritannien, Frankrig, Belgien og andetsteds, f.eks.
Since 1984, a number of other health authorities in the UK have created a post to represent consumers atmanagement level, or more usually have simply added "consumer" to the list of responsibilities of existing managers, particularly directors of nursing.
CHC (distriktssundhedsråd) og Comités d'Usagers (forbrugerudvalg). Men disse organer er blevet kritiseret meget i litteraturen (f.eks.
However, the potential for conflict of interest in such a situation is unfortunate - many practices have been identified which take place for the convenience of nursing staff but are not in the interests of consumers, e.g. set times for getting up and going to bed, set visiting hours - and someone whose responsibility covers both nursing and consumers may not be in the best position to resolve such conflicts.
84, 31, 94, 128, 137, 33, 46) for at mangle magt og uafhængighed, for at være blevet »hæftet« på systemer, og ikke integreret i dem.
Recently the UK journal Public Administration devoted an entire issue to consumerism (123).
De er også blevet kritiseret for at ikke have »tænder« eller ressourcer og for ikke at vække ret stor offentlig interesse.
It concluded that consumerism cannot be a "bolt-on extra" to be affixed while everything else goes on as before.
Sidstnævnte problem kan være et resultat af alle de andre.
The Local Government Training Board has pointed out (102) that no one method will do - that a comprehensive multifaceted strategy for change is needed.
Administratorer i den offentlige sektor har ikke anset det for at være nødvendigt at samarbejde med sådanne grupper, hvilket har bevirket, at de er blevet endnu svagere.
The Institut Français des Sciences Administratives has concluded that isolated piecemeal measures fail to attack the causes of dysfunction, thus ensuring that difficulties wrill reappear in other forms.
I lignende stil har der i myndigheder i de fleste EF-lande længe været krav om offentlig høring, især i forbindelse med byggetilladelser, men sådanne møder »har en tendens til at være rituelle begivenheder ... frustrerende for begge parter ...« (31); »en proceduremæssig 'mølle', man skal igennem, og der så glemmes« (101).
There is a consensus among those concerned to bring about consumeroriented service that change has to permeate every level within an authority.
Det er intet under, at offentligheden ikke er interesseret i at deltage.
The OECD, which has an on-going programme looking into relations between public administrations and their clients, asked, "Who is responsible for responsiveness?" and the answer was: everyone involved in the administration (114).
Inden vi går videre og ser på nogle af disse eksperimenter, vil vi gerne forsøge at besvare en indvending, som hyppigt fremsættes mod ideen om forbrugermedindflydelse i beslutninger i den offentlige sektor: at den er unødvendig, fordi det demokratiske valgsystem allerede giver forbrugere magt.
A White Paper that looked at public service renewal in Ireland in 1986 called for a range of personnel initiatives such as merit pay, consumer relations training, performance appraisal with an emphasis on results, not tasks, and other initiatives, including removal of physical barriers to consumers (hatches etc.), improving the physical appearance of reception areas, creating a consumer services manager post, an element of budgetary autonomy for local managers, opening hours to suit the consumer, and regular monitoring.
De kan også definere forpligtelser for forbrugere.
Implications for workers
Den store vanskelighed med alle disse former for forbrugermedindflydelse er, at nogle forbrugere simpelthen er for svage eller sårbare til at deltage. Løsningen, i det mindste i Storbritannien, Sverige og USA, er »advokat« støtte.
The consumer initiatives described in Section III have major implications - both positive and negative - for working life.
Støtteordningen har været vellykket til at hjælpe alle typer af ufordelagtigt stillede forbrugere, ikke blot personer med handicap.
□ a scheme to provide individual UK civil servants with £1,000 cash bonuses for boosting departmental performance and image was described by the trade union as "an outrageous slap in the face" for staff who worked as a team (18)
En nyligt foretaget undersøgelse (156) var i stand til at dokumentere forbedringer i sundhedsindekser og reduktioner i klager som følge af »advokat« projektet.
In the UK, the BMA (the doctors' union) rejected government proposals for "minor" improvements in patient complaints procedures, e.g. extending the time limit from eight to 13 weeks, because it "...would be a profound change that is unacceptable... " (145)
Det stiller situationen i en interessant belysning at bemærke, at folk på et hospital i Storbritannien — i den offentlige sektor — som var ansat af det lokale forbrugersundhedsråd til at mægle for patienter, som ikke talte engelsk, aktivt blev afvist af personalet. »Der var tidspunkter, hvor det tydede på, at personalet foretrak at anvende rengøringsdamen til at tolke fremfor at tilkalde en af (projekt) medarbejderne« (24).
D a survey of UK public sector consumers' schemes conducted by the Community Projects Foundation concluded, "...there is growing evidence of union opposition to, or at least suspicion of, initiatives... such as decentralisation, more locally­accountable maintenance systems, and the reorganisation of offices to remove physical barriers between staff and public" (SV­
»Advokater« arbejder i et helt personligt forhold med hver enkelt forbruger for at repræsentere og fremme deres interesser som individer efter bedste evne.
Consumers have priorities. But to say that service providers interpret consumer needs in ways which reflect other priorities "...is not a criticism of workers; it is an observation on the reality of their working lives".
Men i en meget mere virksomhedsomfattende holdning var Camberwell Health Authority (sundhedsmyndighed) den første i Storbritannien, der ansatte en forbrugerrepræsentant til at sidde i myndighedens bestyrelse.
In a study of the health services (128), for example, staff nurses viewed a range of activities, from setting up a patient information video in the waiting room, to attending meetings of Patient Participation Groups, as an "extra" duty.
En ny stilling, Head of Consumer Services (chef for forbrugerservice), blev oprettet i 1986, og jobbeskrivelsen forlangte, at den ansatte i stillingen skulle repræsentere forbrugeren i alle virksomhedsbeslutninger, bidrage til virksomhedens planlægningsproces, opstille standarder, indføre et kvalitetssikringsprogram og formulere en klageprocedure.
Working hours can change: counter clerks gave up the two and a half hour noon shut-down in certain French prefectures so as to provide a service when most consumers could use it; British judges have been asked to surrender part of their long holiday break, in a recent UK Civil Justice review, and to sit two evenings a week, to suit consumer needs better.
Siden 1984 har et antal andre sundhedsmyndigheder i Storbritannien oprettet en stilling til at repræsentere forbrugere på ledelsesplan eller har, hvilket er mere almindeligt, blot føjet ordet »forbruger« til listen over de eksisterende lederes ansvar, især sygeplejedirektørers.
colleagues, new job functions, creating problems for workers. In Stockport, in the UK, a researcher has described the "real grief" (73) felt by social workers at the break-up of old teams necessitated by decentralisation.
Muligheden for interessekonflikter i en sådan situation er dog uheldig — der er blevet identificeret mange praktiske foranstaltninger, som finder sted til sygeplejepersonalets fordel, men som ikke er i forbrugernes interesse, f.eks. faste tidspunkter, hvor patienten skal stå op og gå i seng, faste besøgstider — og en person, hvis ansvar omfatter både sygeplejersker og forbrugere, har måske ikke de bedste forudsætninger til at løse sådanne konflikter.
In the Islington decentralisation scheme, social workers, housing specialists and environmental health officers working in the new neighbourhood units were expected to deal with anyone who came in "off the street", whatever their problem; the consumer goal was to provide a no-wait, accessible, coordinated service, but staff worried that this would lead to a "dilution of professional skills" (79).
For nylig overgav det britiske tidsskrift, Public Administration, en hel udgave til forbrugerisme (123).
The worker reaction to decentralisation in Islington has been studied in some detail, and illustrates a great many other worker concerns.
Denne konkluderede, at forbrugerisme ikke kan »hæftes på« som et ekstra punkt, som blot føjes til, medens alt andet fortsætter, som det plejer.
There was a fear of being isolated in the neighbourhood office.
Local Government Training Board har peget på (102), at der ikke findes én metode, som er tilstrækkelig — men at det er nødvendigt at have en omfattende flersidig strategi for omstillinger.
The various professionals represented in each unit (social work, housing etc.) blocked a plan to appoint a supervisor in each office who would straddle departments and coordinate services, because each professional felt it was fairer to be supervised by their own heads who understood their professional subject, in central headquarters.
Institut Français des Sciences Administratives har konkluderet, at det ikke er lykkedes isolerede, sammenstykkede foranstaltninger at fjerne årsagerne til funktionsforstyrrelser, men at sådanne foranstaltninger blot bevirker, at der opstår vanskeligheder på andre områder.
Staff were opposed to being made accountable to the local Residents' Forum, because they worried about consumers "pursuing vendettas" against staff.
Blandt de involverede er der almindelig enighed om, at det er nødvendigt, at der sker ændringer på ethvert niveau inden for en myndighed for at få forbrugerorienteret service.
Getting close to the consumer can be threatening and painful. When a senior manager in a UK health authority sat in on discussions with consumers about services provided to people who care for the disabled at home, he was forced to confront new realities: "I heard about our services from these carers in terms that never survive transmission up the hierarchy" (89).
OECD, som har et løbende program, der ser på forholdet mellem offentlige administrationer og deres klienter, spurgte: »Hvem er
Many other problems have been raised by workers with regard to consumeroriented initiatives: open plan offices, the removal of
London Borough of Richmond, som for nylig vandt en pris (RIPA/Hay award, 1987) for forbrugerorienterede ledelsesinitiativer, er aktiv på flere områder.· markedsundersøgelser, kontrol med klager, personalemedindflydelse, forbrugerhøringsgrupper og virksomhedsinformationsstrategi.
But it would be unfair and totally misleading to suggest that in every instance workers have opposed consumerism in the public sector. Workers have responded enthusiastically in some cases, particularly when attention has been paid to changing the culture of organisations, as in the Groningen example in the Appendix.
I Italien indførte byen Modena en lang række forandringer, bl.a. fjernede de personalets anonymitet, skaffede bedre afskiltning på rådhuset, oprettede en lokal ombudsmandslignende service og udførte regelmæssige opinionsundersøgelser blandt forbrugere.
Official trade union attitudes are changing too, e.g. in the UK the head of the UCW (communications workers) has agreed that "consumers ... should have direct channels into the decision making structures of public enterprises" (139); in France, public sector unions (FGAF, SNUI) have been turning their attention to serving the consumer (58).
En hvid bog, der så på fornyelse af den offentlige sektor i Irland i 1986, krævede en række personaleinitiativer som f.eks. lønforhøjelse for personale, som gjorde sig fortjent til det, uddannelse i forbrugerrelationer, præstationsvurdering med vægt på resultater, ikke opgaver samt andre initiativer, bl.a. fjernelse af fysiske barrierer for forbrugere (lemme m.v.), forbedringen af det fysiske miljø i receptionsområder, etableringen af en stilling for en forbrugerservicechef, et element af budgetselvstyre for lokale ledere, åbningstider der passede forbrugeren samt regelmæssig kontrol.
In fact, increasingly consumerism is coming to be viewed as the instrument by which public sector employees can gain greater public respect and esteem, a sense of purpose, job enrichment and job satisfaction:
Lignende helhedsprægede indfaldsvinkler er blevet forlangt i andre lande, bl.a. Frankrig og Tyskland.
D in Sweden, employees are getting new guarantees of job protection, training and promotion opportunities to go along with consumer initiatives.
Kort sagt har der været almindelig udbredt enighed om, at det, for at forvandle tjenesteydelser i den offentlige sektor fra traditionelle bureaukratier til organisationer,
D in the UK, the Local Government Training Board has, through its experience with dozens of local authorities that have introduced consumer initiatives, identified many worker benefits including, very importantly, that when
som betjener offentligheden, er nødvendigt at bruge en indfaldsvinkel, der omfatter »hele organisationen«, og at se på forbrugere, medarbejdere og ledelsesmetoder.
D despite the difficulties that were anticipated for workers prior to Islington's decentralisation, a recent internal review found that "industrial relations problems have been minimal" in practice (87).
D En ordning til at betale individuelle britiske embedsmænd et bonusbeløb på £1000 for at sætte afdelingens præstation og image i vejret blev af fagforeningen beskrevet som »et skandaløst slag i ansigtet« for personale, der arbejdede som et team (18).
The question of provider/consumer power places the issue of consumerism firmly in the realm of politics.
D I Frankrig, i byen Reims, ønskede administra­tionen at spørge forbrugere om deres syn på servicen, men spørgeskemaerne blev aldrig uddelt, fordi fagforeningerne satte sig imod det; de var bange for, at undersøgelsen ville identificere personalemedlemmer, der var uhøflige. I Storbritannien afviste BMA (den britiske lægeforening) regeringens forslag til »mindre« forbedringer i patientklageprocedurer, f. eks. at udvide tidsfristen fra 8 til 13 uger, fordi det »... ville være en dybtgående ændring, som er uacceptabel« (145).
The political context There is little to be said, under this heading, than to point out the inescapable fact that consumeroriented initiatives require political support.
Π En undersøgelse af forbrugerordninger i den britiske offentlige sektor udført af Community Projects Foundation (Instituttet for Samfunds­projekter) konkluderede: »...
As Klein has said, speaking about the health service, "...There may be good reasons for refusing to respond to patient preferences if meeting these reduces the overall capacity of the service to meet the needs of the community as a whole.
Der er i stigende grad tegn på fagforeningsmodstand imod, eller i det mindste mistanke til, initiativer ... som f.eks. decentralisering, lokalt ansvarlige vedligeholdelsesordninger og omorganisationen af kontorer for at fjerne fysiske barrierer mellem medarbejdere og publikum« (31)­
The real difficulty is to know when this argument is being invoked because of...(provider) self interest and when it is a genuine
Som Kings Fund, en sundhedsforskningsorganisation baseret i London, har peget på: »... findes der alvorlige interessekonflikter mellem servicebrugere og serviceleverandører« (92).
reason for refusing to meet consumer preferences" (94). It is up to the political leaders, in a democratic society, to supply the impetus and legitimacy to consider the consumer in all such deliberations.
Interessekonflikter opstår uvægerligt, når forbrugere og medarbejdere må være fælles om samme plads, tid og ressourcer. Forbrugere har prioriteter.
This political framework can be institutionalised, as in the Citizen Budget Commission in New York City, or the one being planned for Amsterdam, to represent consumers of local government services and set quality standards for government.
Men at sige at serviceleverandører tolker forbrugernes behov på måder, som afspejler andre prioriteter: »... er ikke en kritik af medarbejdere; det er en observation af virkeligheden i deres arbejdsliv«.
In Britain, the Labour party has proposed a similar consumer commission which would be empowered to support consumers at the political level; and the Consumers' Association in the UK has urged consumer participation to ensure consideration of consumer interests in all decisions taken to promote the internal market of 1992.
Hvilke vanskeligheder har medarbejdere forbindelse med initiativer for større forbrugerorien tering?
The degree of freedom service providers have in providing a consumer oriented service is defined by the political framework within which they have to work.
Initiativer for større forbrugerorientering kan simpelthen betyde mere arbejde.
The real problem is lack of resources The criticism has sometimes been made that consumerism is simply a case of rearranging the deck chairs on the Titanic.
I en undersøgelse af sundhedsydelser (128) anså fastansatte sygeplejersker for eksempel en række aktiviteter, fra et patientinformationsvideo i venteværelset til at deltage i møder af patientmedindflydelsesgrupper, som »ekstra« tjeneste.
Can we "talk the language of consumerism without tackling the central realities" (67) - lack of housing, low levels of benefit payments, insufficient staff?
Arbejdstider kan ændres: skrankepersonale opgav den to og en halv time lange middagspause i visse franske præfekturer, så de kunne yde en service på et tidspunkt, hvor de fleste forbrugere kunne bruge den; britiske dommere blev for nylig bedt om at opgive en del af deres lange ferie i en britisk civilretsredegørelse og at arbejde to aftener om ugen for at passe forbrugernes behov bedre.
The answer is yes. The level at which resources are set, and that is essentially a political decision, is certainly crucial to the quality of living and working conditions, but within that level decisions must still be made as to how those resources are to be distributed.
Lærernes fagforeninger beskrev dette som »groft og anstødende« (113).
In fact, if there were enough for everybody, decisionmaking would be arguably less important.
Hvis ydelsens kvalitet skal bedømmes efter forbrugernes normer, betyder det
The scarcer the resources, the more important the decisions.
uvægerligt, at professionelle må opgive en del af deres »professionalisme«.
A Key Issue Paper published in 1989 (151) in relation to the on-going evaluation of the European Poverty Programme, covering 90 projects throughout the Community, identified four institutional factors in combatting poverty, only one of which is low levels of welfare payments.
Den kan nødvendiggøre en hel ny arbejdsstil, nye forhold, nye kolleger, nye jobfunktioner og skabe problemer for medarbejdere. I Stockport i Storbritannien har en forsker beskrevet den »virkelige sorg« (73), socialrådgivere følte ved det opbrud af gamle teams, som decentralisering nødvendiggjorde.
But the fact that most European governments are now concerned to rationalise spending serves to reinforce, not weaken, the case for consumerism.
Medarbejdernes reaktion på decentralisering i Islington er blevet undersøgt i detaljer og belyser mange af de spørgsmål, medarbejdere bekymrer sig om.
Consumerism and costs Of course, getting consumer influence does, itself, cost money in terms of staff time, training, equipment, etc.
At komme tæt på forbrugeren kan føles truende og smertefuldt. Da en overordnet leder i en britisk sundhedsmyndighed deltog i drøftelser med forbrugere om tjenesteydelser, der leveres til folk, som passer handicappede hjemme, blev han tvunget til at konfrontere nye realiteter: »Jeg hørte om vore
Possibly a case could be made for the cost effectiveness of consumer initiatives.
tjenesteydelser fra disse plejere udtrykt i ord, som aldrig kan overleve at gå videre op i hierarkiet« (89).
It is important to note, though, that amongst those authorities that are implementing or promoting consumer initiatives, there are some that justify the idea by citing the need to remain efficient and competitive on the international front.
Nye former for forhold med forbrugere kan være vanskelige at acceptere, især hvis personalet ikke har været vant til at behandle forbrugere som ligestillede.
Within the European Community, discussions are focussing increasingly on 1992 and the internal market, and in that context some officials view public sector renewal as essential for the national economy.
Mange andre problemer er blevet fremsat af medarbejdere i forbindelse med forbrugerorienterede initiativer: åbenplan-kontorer, fjernelse af lemme m.v. kan føre til, at personalet er bange for at blive overfaldet; klageprocedurer kan føre til bekymringer om, at det skal gå ud over én; fladere ledelsesstrukturer, som eliminerer mange mellemledelseslag, kan føre til færre forfremmelsesmuligheder; større bemyndigelse til frontmedarbejderne betyder, at folk højere oppe må overdrage en del af deres myndighed; selve den større myndighed med den medfølgende ansvarlighed er undertiden ikke noget frontmedarbejderne synes om — som en undersøgelse i Frankrig udtrykte det, har fagforeningen, i det mindste før i tiden, følt, at mangel på ansvarlighed var en »sejr« (84) i forbindelse med arbejdsbeskyttelse.
During a 1988 meeting that was intended to enthuse managers in the French civil service on the idea of viewing the public as consumers, a government minister told them "The administration cannot remain aloof from the search for increased competitiveness in the French economy as a whole" (107).
Men det ville være uretfærdigt og helt forkert at foreslå, at medarbejdere i alle tilfælde har modsat sig forbrugerisme i den offentlige sektor.
It seems a perfectly reasonable proposition that effectiveness and efficiency in an administration go hand in hand.
Officielle fagforeningsholdninger ændrer sig også, f.eks. har chefen for UCW (kommunikationsmedarbejdere) i Storbritannien indrømmet, at »forbrugere ... bør have direkte adgang til beslutningsstrukturen i offentlig virksomheder« (139); i Frankrig har fagforeninger i den offentlige sektor (FGAF, SNUI) henledt deres opmærksomhed på at tjene forbrugeren (58).
At an earlier meeting in France in 1987, this one organised by ARAP, the group devoted to improving relations between consumers and the public sector, the chairman opened proceedings by saying that the prosperity of the country as a whole will depend on the "service imperative" in the public sector, that 1992 is not just an opportunity for private entrepreneurs; "Nations must be prepared with a modern, responsive, skilled public sector to provide the backbone of support needed ...
Faktisk er forbrugerisme i stigende grad ved at blive betragtet som det instrument, hvormed medarbejdere i den offentlige sektor kan få større offentlig respekt og
But it is indicative of other, perhaps conflicting motives, that later in the 1988 speech referred to above the minister went on to cite, as a further reason for change, the need "...to reduce the costs and expenditure connected with public administration, which represents 40 per cent of the State's expenses..." (107).
omdømme, en mening med arbejdet, større jobberigelse og trivsel på arbejdspladsen:
As others (153) have pointed out, consumer orientation, like any concept, is capable of distortion or misuse.
D / Sverige får medarbejdere nye garantier for tryghed i ansættelsen, efteruddannelse og forfremmelsesmuligheder i forbindelse med forbrugerinitiativer.
It can be used as an excuse for cost cutting; it can be used to tell the client what the system is without changing it; it can be used to lull the client into accepting the level or nature of service no matter how inadequate; it can be used to buy a quiet life, to satisfy the demanding influential critics and ignore the disadvantaged consumers, the poor and the weak.