27 february 2013

Meeting on the creation of an independent system to assess the performance of organisations providing social services

Transcript of the beginning of the meeting:

Dmitry Medvedev: Good afternoon. Let’s discuss the creation of an independent system to assess the performance of organisations providing social services. Their current number is estimated at around 310,000 state and municipal educational, healthcare, cultural, sports and social service institutions. And, of course, people want access to high-quality services. For its part, the state must ensure this quality is provided. State programmes contain specific targets and the required resources for achieving these objectives. But investment can only produce results if these institutions really do depend on popular assessments and on the choices people make. Every individual must be able to obtain information about hospitals, schools and libraries. This is not simply about first hand information because, thank God, all this exists, especially in this Internet age. It should also include the opinions of those who have already used these services and so have the necessary experience. This is not just a matter for state agencies, because the Russian economy, even in the social sphere, is not completely dependent on state property. This should apply to all forms of property. Feedback, monitoring, public oversight and ratings are helpful in establishing the best medical and educational institutions. This is the most objective assessment criterion. Public councils of federal, regional and municipal bodies could also provide evaluations. Perhaps it makes sense to form assessment agencies in cooperation with professional and expert communities, including federal and regional public chambers. Let’s discuss this.

It is very important to pay attention to key indicators that make it possible to assess objectively the performance of social institutions. Are they comfortable and convenient for people? Is information accessible for everyone, especially those categories that have fewer opportunities to get it? How much time do people spend in queues? How competent are the experts? This is probably the main thing.

To make it all work, we must amend legislation and draft methodological recommendations for public councils. Let’s discuss this issue as well because the Government usually completes its work by adopting a normative act. Okay, I have said what I wanted and now let’s listen to our ministers. Mr Topilin, please deliver your main report. Go ahead, please.

Maxim Topilin (Minister of Labour and Social Security): Thank you! Mr Medvedev, ladies and gentlemen. The task to create an independent system for assessing the performance of organisations is set forth in the President’s Executive Order №597 of May 7, 2012. The Government has been instructed to develop this system jointly with public organisations by April 1.

In cooperation with the professional community (we worked with the Public Chamber, the Strategic Initiatives Agency and different professional educational, cultural and healthcare institutions), our ministry has prepared a draft normative act – a draft Government resolution on this issue. We have coordinated it practically with all ministries and we think it will create the foundation for organising this work both at federal and regional levels. So what did we proceed from?

Dmitry Medvedev: What is in this document? It isn’t absolutely hollow, is it?

Maxim Topilin: It contains requirements on organising this work at the level of federal ministries and regions. This document delegates powers to public councils at federal and regional executive bodies.

Mr Medvedev, we have discussed at length with the professional community who should set the criteria and form the ratings.

To begin with, we tried to settle this issue with a Government decision but the discussion with all interested parties produced a proposal under which public councils (under Article 7 of the Law on the Public Chamber government officials are not members of public councils) as representatives of professional communities should determine the intervals between polls because only feedback can produce an independent assessment.

Dmitry Medvedev: Will people listen to these public councils at all? Won’t they tell them to get lost?

Maxim Topilin: It doesn’t matter whether people will listen to them or not. As we see it, only they can form an objective… not the assessment system that is used in our state programmes where performance is assessed by the quality of managerial decisions. It is also important to know whether people have access to cultural institutions and how quickly an ambulance gets to a patient.

 We have assessment indicators in different programmes. This time public councils, professionals and ordinary people were supposed to develop indicators that gauge public opinion on these services. You said in your opening remarks that this was the main thing – whether people stand in a queue or not…

Dmitry Medvedev: That’s not what I mean. I understand all that. Mr Topilin, maybe I’m forestalling things but I think if we adopt a normative act it should stipulate clear responsibility, if not sanctions, for violating recommendations of public councils. Otherwise it will be all talk and no action.

Maxim Topilin: We have envisaged such a mechanism. And our resolution says that public councils should submit these recommendations to the federal and regional executive bodies. And based on these recommendations and an analysis of resulting ratings, these bodies should take relevant decisions and assess this system. We do not wish to introduce any measures of responsibility for heads of institutions. It is possible to think about this, but this should be a feedback system. It will not be a talking shop. This system will enable federal and regional bodies, federal and regional executive bodies to get signals on how society and the population evaluate the services provided by institutions. We realise that this has presented a difficulty for developing this legal act, Mr Medvedev, because it is always better when it comes from below, when it comes from an initiative, or from guardianship councils or from these public councils. But here we have nothing at all as yet, and we must simply create a certain framework, a single mechanism – a unified mechanism for common understanding among ministries, departments, the professional community – to make this system work, because currently it does not exist.

We think that this system should be aimed at improving the quality and accessibility of services, at better informing consumers of services, primarily. So we pay a great deal of attention to the disclosure of information by institutions. And the indicators that the institutions must publish should be established by ministries and departments. We also think that public councils should order these ratings. Otherwise we will get a system that is convenient for officials but does not reflect reality. All work on ratings and polls will be based on surveys of the population according to certain criteria. The resolution also includes the criteria: how accessible and complete information on an institution is, that is, the disclosure of information; how convenient it is for a citizen to obtain services; how long one must wait to obtain a service; the kindness, politeness and skill of officials. The public councils can establish additional indicators and this will be welcomed. 

It would be useful to involve non-profit organisations in this work – we, jointly with the Ministry of Economic Development, have provided for such mechanism in the resolution to encourage non-profit organisations. Maybe the best institutions offering the best services deserve awards from the ministries and departments – we can think about it. 

You rightly said that this is a framework document. And beginning April 1 we will conduct pilot projects in regions in order to fine-tune this system by the end of the year at the level of federal and regional executive bodies. Mr Medvedev, both regions and ministries understand that this is only the first step; we should start this work and possibly later adjust this system. That concludes my report.   

Dmitry Medvedev: I think that signals alone are not enough. We can get signals currently via the internet – we can read what they write about a specific hospital. These signals should ultimately lead to response measures. This does not mean that everybody should be punished, but some pressure is needed. If an expert review results in a clear judgment that a social institution operates badly, it is necessary to respond. Otherwise these are not legal relations and we would be better off simply adopting a set of principles.