development report 2012 - UMAR

Development Report 2012
Development by the priorities of SDS – A modern welfare state and higher employment
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Box 8: Networks of public service providers
In education at lower levels, the public network, which mostly consists of public institutes, strongly prevails, whereas
at the tertiary level, almost half of educational establishments are privately operated, with the majority having no
concession. In pre-school education, the relevant services are mostly provided by kindergartens, which are an integral
part of the public network. 1 There are very few private kindergartens that are not part of the public network, but their
number is slowly increasing. Unlike kindergartens, the network of establishments in primary education has, owing to
decreasing registration, been falling since 2005, while the proportion of private schools is negligible. In this respect, the
number of public primary schools decreased, while the number of private primary schools rose, but not to a significant
degree. 2 During SDS’s implementation, the network of schools in upper secondary education also fell, with all but one
being part of the public network. Over the same period, the number of public upper secondary schools decreased,
while the number of private schools with or without a concession remained unchanged. During SDS’s implementation,
the number of post-secondary vocational schools increased as a result of promoting enrolment in tertiary education.
Approximately one half of post-secondary vocational schools are public, while privately operated establishments in
this area comprise the other half. 3 During the aforementioned implementation period, the number of higher education
institutions also increased substantially for the same reason. The expansion of the network of higher education
institutions was, above all, the result of the establishment of private equivalents where the number of institutions with
or without a concession increased.
In the health sector, the award of new concessions in recent years almost stopped. Within the public health service
network, however, the share of funds received by private entities for healthcare services is nevertheless increasing.
The decrease in the number of concessions awarded within the public health service network in recent years is, above
all, the result of the systemic changes expected. According to HIIS data, the number of contracts entered into with
private service providers in 2011 even fell by six for the first time (after rapid growth in 2006 and 2007, it gradually
decreased in the following years), while the employment growth rate recorded by concessionaires stabilised (in 2010
the share of employees recruited by concessionaires to perform healthcare services accounted for 14.2%; during the
period 2001–2010, this share increased from 9.4% to 14.4%). The number of private practice doctors has remained
almost unchanged since 2008. Since 2009, private practice doctors/specialists have also been able to participate in
the HIIS national calls for tenders related to the implementation of the priority programmes selected, the purpose of
which is to increase accessibility and quality, and to contribute to a reduction in waiting times for certain surgeries and
other treatments. This is probably the main reason why, with respect to the total amount of HIIS funds earmarked for
health programmes, the share received by private service providers has, for the first time since 2009, been increasing
again (13.1% in 2010 and 13.3% in 2011). In addition to service providers included in the public healthcare network,
healthcare activities are also carried out by doctors working in full-time private practice. According to Medical Chamber
data, there were 216 such doctors in 2011 (210 in 2010), the majority of whom worked in dentistry (154). On the other
hand there were only three general practitioners and two paediatricians, while in recent years a substantial increase
can be observed especially in the number of specialists working in outpatient clinics (57).
Social care is characterised by a significant extension of capacities and programmes, the main reasons being an
increased scope of private entities, and NGO programmes. The number of public institutes has remained more or
less the same 4 throughout SDS’s implementation, while the number of private service providers having the status of
concessionaire is increasing. Private providers are developing in the area of care for elderly and disabled people. In
residential homes for the elderly and occupational activity centres, approximately one fifth of all capacities 5 are held by
private providers included in the public network (in 2005 slightly more than one tenth). There are practically no private
service providers outside the public network. Within the public network, approximately one tenth of private homecare
service providers have a concession; there are also some private providers who work outside the public network
without a concession. In other parts of this sector, service providers are mostly public institutes. Unlike other activities,
this area is characterised by the increased presence of non-governmental organisations that perform various social
assistance programmes co-financed from public funds. 6 These programmes employ almost one tenth of all social care
employees who perform a significant volume of activity-related work on a voluntary basis 7 .
1
In the 2010–2011 academic year, there were 869 (out of 891) kindergartens which were part of the public network (including 856 public kindergartens
and 13 private kindergartens with concession), and 22 private kindergartens without concession that are not part of the public network.
2
Upon the beginning of the implementation of SDS there was one private primary school, whereas during 2020 Strategy implementation, one primary
school began operating in 2008/2009 and one in 2010/2011 (Ministry of Education and Sport, 2011).
3
Since private vocational higher schools with concession also launch programmes without concession and receive most of the relevant funds from
private sources, private higher schools with concession are since 2011/2012 considered private schools according to the methodology adopted within
the Ministry of Education and Sport.
4
It only changes due to reorganisations.
5
In 2010 all residential homes for the elderly accommodated 16,666 users, while concessionaires offered 3,378 concessionary places. In 2011 occupational
activity centres, for which more recent data are available, accommodated 3,098 users, while concessionaires offered 594 places.
6
These are programmes intended for various vulnerable groups of people, e.g. victims of violence, the homeless, drug addicts, people with mental
disorders, etc.
7
In 2010 the social assistance programs included 1,445 employees, 958 providers who were paid under other arrangements, and 10,861 volunteers.