Socialinės globos paslaugos Lietuvoje : nuo hierarchinio prie mišrios globos ekonomikos modelio

LTŠiame straipsnyje analizuojami pastaruosius kelis dešimtmečius Europoje, o po nepriklausomybės atkūrimo ir Lietuvoje vykstantys socialinės globos paslaugų organizavimo ir finansavimo pokyčiai, rodantys mišrios globos ekonomikos įsitvirtinimo tendenciją. Į socialinės globos paslaugų sritį įtraukiant rinkos elementus, ima konkuruoti paslaugų teikėjai, o tai skatina gerinti paslaugų kokybę, mažinti jų kainas, užtikrina didesnį paslaugų pasirinkimą. Po nepriklausomybės atkūrimo Lietuvoje pradėta kurti šiuolaikinė socialinės globos sistema per palyginti trumpą laikotarpį spėjo patirti gana didelius pokyčius: nuo sovietiniu laikotarpiu gyvavusio centralizuoto socialinės globos modelio, pagrįsto valstybiniu reguliavimu, buvo pereita prie decentralizuotos socialinės globos paslaugų sistemos, o pastaruoju metu joje, kaip ir kitų Europos šalių socialinės globos paslaugų sistemose, įsigali rinkos principai. Šie pokyčiai pirmiausia sietini su finansavimo sistemos pertvarkymu. [Iš leidinio]Reikšminiai žodžiai: Socialinė globa; Mišri globos ekonomika; Paslaugų pirkimas; Rinka; Modelis; Social care; Mixed economy in custody; Purchase of services; Market; Model.

ENThis article is about mixed economy entrenchment in the social care services. The aim of the paper is to analyse the circumstances and assumptions of changes in provision of social care services and the specific features of their financing in hierarchic organization and in the mixed economy of welfare. The article identifies those aspects of social care services that are reason for the Governmental intervention. On the other hand, some new developments in society like growing social expenditures and increasing stress on consumer choice, push social care service sector toward market. In Lithuania social care services organization and financing was based on hierarchical structure until 2006 when the new Social Services Act was adopted. Social care services provision, organization and financing functions were attributed to ministries, counties and municipalities. In Lithuania the budgetary financing of social care services agencies was dominant. Social care services were mainly provided by budgetary agencies or NGOs public agencies, which were directly financed from the municipality or state budgets. The adoption of the new social services legislation in 2006 embedded the prerequisites for entrenchment of market mechanism: the concept of social care services purchase and the method of calculating the cost of social care services originated, and the municipality can buy social care services to residents by the procedure based on the Law on Public Procurement. In this article the term “financing model” means the method of financing of social care services (how resources go to services providers) and the principles that determine techniques of calculating expenditures, which are necessary for the provision of services.Thus, when we speak about the change of social care services financing model, we speak about the transition from financing of services which is based on the provision of resources to refund the whole expenditures necessary for the provision of services according to the estimated costs, to the purchase of services when the cost of service is fixed to a particular client and the selection of a service provider is based on the procedure of public procurement and competition of those services providers. The article analyses the purchase of social care services as an essential element of the services system organized in the mixed economy. The purchase of services is the several stages process of interaction between service provider and municipality as the organizer of the services. This process means that services are specifically accommodated to the needs of a particular client. Current legal basis allows transition of Lithuanian social care sector from the bureaucratic model of coordination of social care services to the mixed economy model. However, due to the fact that a period of development of social care services in Lithuania is still short and public institutions responsible for social care relay more on own service agencies instead of purchasing care services, it is too early to announce the beginning of this transition. [From the publication]