I MI CUNG NG DICH V CNG VIT NAM

PHN I NHNG TIN TRIN 20 NM QUA TRN TH GII TRONG QUAN NIM V THC TIN V DCH V CNG V CUNG NG DCH V CNGI. MT S VN QUAN NIM V DCH V CNG I.1. Khi nim dch v cng Dch v cng (t ting Anh l public service) c quan h cht ch vi phm tr hng ha cng cng. Theo ngha kinh t hc, hng ha cng cng c mt s c tnh c bn nh: 1. l loi hng ha m khi c to ra th kh c th loi tr ai ra khi vic s dng n; 2. vic tiu dng ca ngi ny khng lm gim lng tiu dng ca ngi khc; 3. v khng th vt b c, tc l ngay khi khng c tiu dng th hng ha cng cng vn tn ti. Ni mt cch gin n, th nhng hng ha no tha mn c ba c tnh trn c gi l hng ha cng cng thun ty, v nhng hng ha no khng tha mn c ba c tnh trn c gi l hng ha cng cng khng thun ty. Khi nim dch v cng c s dng ph bin rng ri chu u sau Chin tranh th gii ln th hai. Theo quan nim ca nhiu nc, dch v cng lun gn vi vai tr ca nh nc trong vic cung ng cc dch v ny. T gic ch th qun l nh nc, cc nh nghin cu hnh chnh cho rng dch v cng l nhng hot ng ca c quan nh nc trong vic thc thi chc nng qun l hnh chnh nh nc v m bo cung ng cc hng ha cng cng phc v nhu cu chung, thit yu ca x hi. Cch hiu ny nhn mnh vai tr v trch nhim ca nh nc i vi nhng hot ng cung cp hng ha cng cng. Cch tip cn khc xut pht t i tng c hng hng ha cng cng cho rng c trng ch yu ca dch v cng l hot ng p ng nhu cu thit yu ca x hi v cng ng, cn vic tin hnh hot ng y c th do nh nc hoc t nhn m nhim. T in Petit Larousse ca Php xut bn nm 1992 nh ngha: dch v cng l hot ng v li ch chung, do c quan nh nc hoc t nhn m nhim. Khi nim v phm vi dch v cng c s bin i ty thuc vo bi cnh ca mi quc gia. Chng hn, Canada, c ti 34 loi hot ng c coi l dch v cng, t quc phng, an ninh, php ch, n cc chnh sch kinh t- x hi (to vic

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lm, quy hoch, bo v mi trng, v cc hot ng y t, gio dc, vn ho, bo him x hi,). Trong khi , Php v Italia u quan nim dch v cng l nhng hot ng phc v nhu cu thit yu ca ngi dn do cc c quan nh nc m nhim hoc do cc t chc t nhn thc hin theo nhng tiu chun, quy nh ca nh nc. Tuy vy, mi nc li c nhn thc khc nhau v phm vi ca dch v cng. Php, khi nim dch v cng c hiu rng, bao gm khng ch cc hot ng phc v nhu cu v tinh thn v sc kho ca ngi dn (nh gio dc, vn ho, y t, th thao, thng c gi l hot ng s nghip), cc hot ng phc v i sng dn c mang tnh cng nghip (in, nc, giao thng cng cng, v sinh mi trng,..thng c gi l hot ng cng ch), hay cc dch v hnh chnh cng, bao gm hot ng ca c quan hnh chnh v cp php, h khu, h tch, m c hot ng thu v, trt t, an ninh, quc phng; cn Italia dch v cng c gii hn ch yu hot ng s nghip (y t, gio dc) v hot ng kinh t cng ch (in, nc sch, v sinh mi trng) v cc hot ng cp php, h khu, h tch do c quan hnh chnh thc hin.

Hp 1: Hng ha v dch v cng ct li v m rngKhu vc cng ct li bao gm cc dch v (ch yu l hng ha v dch v cng thun ty pure public goods and services) m chnh ph l ngi duy nht cung cp v mi cng dn bt buc phi nhn khi c nhu cu v chng. Chnh ph cung cp cc loi dch v ny da trn c s php l v nguyn tc qun l nh nc c bn. C th lit k mt s dch v nh: php lut, an ninh, quc phng, cc ngun phc li x hi, mi trng v phng dch, cp giy s hu (ti sn, nh t), giy t ty thn (h chiu, visa, chng minh th), giy chng nhn (khai sinh, khai t, hn th), ng k thnh lp (doanh nghip, hip hi, t chc) Khu vc cng m rng bao gm cc dch v cng (ch yu l hng ha v dch v cng khng thun khit- impure) m ngi tham gia cung cp c th l nh nc v nhiu t chc khc (t nhn, cc t chc x hi, cng ng). S cung cp cc loi dch v ny rt linh hot, ty thuc vo nhu cu ngi tiu dng, khng mang tnh c quyn v c th min ph hoc tr ph. l cc dch v nh: y t, gio dc, giao thng th, thng tin, c s h tng,Ngun: World Bank, World Development Report 1997

Vit Nam, nn tp trung nhiu hn vo chc nng phc v x hi ca nh nc, m khng bao gm cc chc nng cng quyn, nh lp php, hnh php, t php, ngoi giao,... qua nhn mnh vai tr ch th ca nh nc trong vic cung cp cc dch v cho cng ng. iu quan trng l chng ta phi sm tch hot

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ng dch v cng (lu nay gi l hot ng s nghip) ra khi hot ng hnh chnh cng quyn nh ch trng ca Chnh ph ra, nhm xo b c ch bao cp, gim ti cho b my nh nc, khai thc mi ngun lc tim tng trong x hi, v nng cao cht lng ca dch v cng phc v ngi dn. iu 22 ca Lut T chc chnh ph (2001) quy nh: B, c quan ngang B l c quan ca Chnh ph thc hin chc nng qun l nh nc i vi ngnh hoc lnh vc cng tc trong phm vi c nc; qun l nh nc cc dch v cng thuc ngnh, lnh vc;. iu ny khng c ngha l nh nc c quyn cung cp cc dch v cng m tri li nh nc hon ton c th x hi ha mt s dch v, qua trao mt phn vic cung ng mt phn ca mt s dch v, nh y t, gio dc, cp thot nc, cho khu vc phi nh nc thc hin. C th thy rng khi nim v phm vi cc dch v cng cho d c tip cn nhiu gc khc nhau, chng u c tnh cht chung l nhm phc v cho nhu cu v li ch chung thit yu ca x hi, ca cng ng dn c v nh nc c trch nhim m bo cc dch v ny cho x hi. Ngay c khi nh nc chuyn giao mt phn vic cung ng dch v cng cho khu vc t nhn th nh nc vn c vai tr iu tit nhm m bo s cng bng trong phn phi cc dch v ny v khc phc cc bt cp ca th trng. T nhng tnh cht trn y, dch v cng c th c hiu l nhng hot ng phc v nhu cu thit yu ca x hi, v li ch chung ca cng ng, ca x hi, do nh nc trc tip m nhn hay y quyn v to iu kin cho khu vc t nhn thc hin. I.2. Cc loi dch v cng, phng thc cung ng v cc c im chnh ca dch v cng I.2.1. Cc loi dch v cng Cn thit phi c s phn loi ng n cc hnh thc dch v cng hnh thnh c ch qun l ph hp. Th d, i vi cc loi hnh dch v cng quan trng nht, thit yu nht nh y t, gio dc, c s h tng, xa i gim ngho, nh nc c trch nhim dnh cho chng nhng ngun lc u tin. Dch v cng c th phn loi theo nhiu tiu ch khc nhau, xt theo tnh cht ca dch v, hoc theo cc hnh thc dch v c th, Th d, xt theo tiu ch ch th cung ng, dch v cng c chia thnh ba loi, nh sau: - Dch v cng do c quan nh nc trc tip cung cp: l nhng dch v cng cng c bn do cc c quan ca nh nc cung cp. Th d, an ninh, gio dc ph thng, chm sc y t cng cng, bo tr x hi,

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-Dch v cng do cc t chc phi chnh ph v khu vc t nhn cung cp, gm nhng dch v m Nh nc c trch nhim cung cp, nhng khng trc tip thc hin m u nhim cho t chc phi chnh ph v t nhn thc hin, di s n c, gim st ca nh nc. Th d, cc cng trnh cng cng do chnh ph gi thu c th do cc cng ty t nhn u thu xy dng. - Dch v cng do t chc nh nc, t chc phi chnh ph, t chc t nhn phi hp thc hin. Loi hnh cung ng dch v ny ngy cng tr nn ph bin nhiu nc. Nh Trung quc, vic thit lp h thng bo v trt t cc khu dn c l do c quan cng an, t chc dch v khu ph v y ban khu ph phi hp thc hin. Da vo tnh cht v tc dng ca dch v c cung ng, c th chia dch v cng thnh cc loi nh sau: - Dch v hnh chnh cng: y l loi dch v gn lin vi chc nng qun l nh nc nhm p ng yu cu ca ngi dn. Do vy, cho n nay, i tng cung ng duy nht cc dch v cng ny l c quan cng quyn hay cc c quan do nh nc thnh lp c y quyn thc hin cung ng dch v hnh chnh cng. y l mt phn trong chc nng qun l nh nc. thc hin chc nng ny, nh nc phi tin hnh nhng hot ng phc v trc tip nh cp giy php, giy chng nhn, ng k, cng chng, th thc, h tch, ( mt s nc, dch v hnh chnh cng c coi l mt loi hot ng ring, khng nm trong phm vi dch v cng. nc ta, mt s nh nghin cu cng c quan im nh vy). Ngi dn c hng nhng dch v ny khng theo quan h cung cu, ngang gi trn th trng, m thng qua vic ng l ph hoc ph cho cc c quan hnh chnh nh nc. Phn l ph ny mang tnh cht h tr cho ngn sch nh nc. - Dch v s nghip cng: Bao gm cc hot ng cung cp phc li x hi thit yu cho ngi dn nh gio dc, vn ha, khoa hc, chm sc sc kho, th dc th thao, bo him, an sinh x hi,( S nghip l mt t gc Trung quc, c dng theo nhiu ngha. Theo ngha hp, t s nghip dng ch nhng hot ng chuyn mn nhm p ng nhng nhu cu ca x hi v c nhn con ngi, ch yu l v nhng lnh vc lin quan n s pht trin con ngi v vn ho, tinh thn v th cht). Xu hng chung hin nay trn th gii l nh nc ch thc hin nhng dch v cng no m x hi khng th lm c hoc khng mun lm, nn nh nc chuyn giao mt phn vic cung ng loi dch v cng ny cho khu vc t nhn v cc t chc x hi. - Dch v cng ch: L cc hot ng cung cp cc hng ho, dch v c bn, thit yu cho ngi dn v cng ng nh: v sinh mi trng, x l rc thi, cp nc sch, vn ti cng cng th, phng chng thin taich yu do cc doanh

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nghip nh nc thc hin. C mt s hot ng a bn c s do khu vc t nhn ng ra m nhim nh v sinh mi trng, thu gom vn chuyn rc thi mt s th nh, cung ng nc sch mt s vng nng thn I.2.2. Cc hnh thc cung ng dch v cng Trn thc t, c nhng loi dch v rt quan trng phc v nhu cu chung ca c cng ng, nhng t nhn khng mun hoc cha iu kin tham gia, v n khng mang li li nhun, hoc do t nhn khng quyn lc v vn t chc vic cung ng, th d nh cc dch v phi u t ln xy dng kt cu h tng, dch v tim chng, cu ha, thot nc, i vi nhng loi dch v ny, hn ai ht nh nc c kh nng v trch nhim cung ng cho ngi dn. Bn cnh , cng c nhng loi dch v m th trng c th cung cp nhng cung cp khng y , hoc d to ra s bt bnh ng trong x hi, lm nh hng n li ch ca ngi tiu dng ni ring v ton th x hi ni chung, chng hn nh dch v y t, gio dc, in, nc sinh hot, Trong trng hp , nh nc c trch nhim trc tip cung ng hoc kim sot th trng t nhn p ng nhng quyn li c bn ca ngi dn. Tuy nhin, trn thc t, nh nc khng phi l tc nhn duy nht cung ng dch v cng. Tu theo tnh cht v loi hnh, dch v cng c th do cc c quan nh nc trc tip thc hin hoc c th c chuyn giao cho khu vc phi nh nc. C th thy r rng, theo thi gian, vai tr ca nh nc v cc tc nhn khc trong cung ng dch v cng c s bin i ng k dn n cc dng thc cung ng dch v cng khc nhau. Hin nay, vic cung ng dch v cng hu ht cc nc thng thng c tin hnh theo cc hnh thc sau: - Cc c quan nh nc trc tip cung ng dch v cng. Theo hnh thc ny, nh nc chu trch nhim trc tip cung ng dch v cng i vi cc dch v lin quan n an ninh quc gia v li ch chung ca t nc (nh quc phng, an ninh, h tch) m ch c c quan cng quyn mi c t cch php l lm. Nh nc vi vai tr ch o ca mnh, cng trc tip cung ng cc loi dch v thuc cc lnh vc v a bn khng thun li u t (v d vng su, vng xa) m th trng khng th hoc khng mun tham gia do chi ph qu ln hay khng c li nhun. Cc n v s nghip do nh nc thnh lp cung ng nh cc bnh vin v trng hc cng, cc c s cung cp in nchot ng tng t cc cng ty nhng khng v mc tiu li nhun. Ban u, nh nc u t cho cc n v , sau h s t trang tri v khi cn thit c th nhn c s h tr b p ca nh nc. - Nh nc chuyn mt phn hot ng cung ng dch v cng cho th trng di cc hnh thc:

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+ U quyn cho cc cng ty t nhn hoc t chc phi chnh ph cung ng mt s dch v cng m nh nc c trch nhim bo m v thng c ngun kinh ph t ngn sch nh nc nh v sinh mi trng, thu gom v x l rc thi, xy dng v x l h thng cng thot nc v.vCng ty t nhn hoc t chc phi chnh ph c u quyn phi tun th nhng iu kin do nh nc quy nh v c nh nc cp kinh ph ( loi dch v no c thu tin ca ngi th hng th ch c nh nc cp mt phn kinh ph). + Lin doanh cung ng dch v cng gia nh nc v mt s i tc trn c s ng gp ngun lc, chia s ri ro v cng phn chia li nhun. Hnh thc ny cho php nh nc gim phn u t t ngn sch cho dch v cng m vn tham gia qun l trc tip v thng xuyn cc dch v ny nhm m bo li ch chung. + Chuyn giao trch nhim cung ng dch v cng cho cc t chc khc i vi cc dch v m cc t chc ny c iu kin thc hin c hiu qu nh o to, khm cha bnh, t vn, gim nh(bao gm cc hip hi ngh nghip, cc t chc x hi), c bit l, cc t chc ny tuy l n v t nhn hoc phi chnh ph nhng c khuyn kch hot ng theo c ch khng v li nhun, ch thu ph t trang tri. + T nhn ho dch v cng, trong nh nc bn phng tin v quyn chi phi ca mnh i vi dch v no cho t nhn song vn gim st v m bo li ch cng bng php lut. + Mua dch v cng t khu vc t nhn i vi cc dch v m t nhn c th lm tt v gim c s ngi lm dch v trong c quan nh nc, nh bo dng phng tin phng chy, cha chy, cc phng tin tin hc, p ng nhu cu v phng tin i li, lm v sinh v cng vic phc v trong c quan I.2.3. Cc c im ca dch v cng Cc loi dch v cng v cc hnh thc cung ng dch v cng tuy c c im, tnh cht khc nhau, song chng c nhng c im chung c bn nh sau: - Dch v cng c tnh x hi, vi mc tiu chnh l phc v li ch cng ng p ng nhu cu ca tt c cng dn, khng phn bit giai cp, a v x hi v bo m cng bng v n nh x hi, mang tnh qun chng rng ri. Mi ngi u c quyn ngang nhau trong vic tip cn cc dch v cng vi t cch l i tng phc v ca nh nc. T c th thy tnh kinh t, li nhun khng phi l iu kin tin quyt chi phi hot ng dch v cng. - Dch v cng cung ng loi hng ha khng phi bnh thng m l hng ha c bit do nh nc cung ng hoc y nhim cho t chc, c nhn thc hin,

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p ng nhu cu ton x hi, bt k cc sn phm c to ra c hnh thi hin vt hay phi hin vt. - Vic trao i dch v cng khng thng qua quan h th trng y . Thng thng, ngi s dng dch v cng khng trc tip tr tin, hay ng hn l tr tin di hnh thc ng thu vo ngn sch nh nc. Cng c nhng dch v cng m ngi s dng vn phi tr mt phn hoc ton b kinh ph; song nh nc vn c trch nhim m bo cung ng cc dch v ny khng nhm mc tiu li nhun. - T gc kinh t hc, dch v cng l cc hot ng cung ng cho x hi mt loi hng ho cng cng. Loi hng ha ny mang li li ch khng ch cho nhng ngi mua n, m cho c nhng ngi khng phi tr tin cho hng ha ny. V d gio dc o to khng ch p ng nhu cu ca ngi i hc m cn gp phn nng cao mt bng dn tr v vn ho ca x hi. l nguyn nhn khin cho chnh ph c vai tr v trch nhim quan trng trong vic sn xut hoc bo m cung ng cc loi hng ha cng cng. Vi s a dng ca cc loi dch v cng, ca cc hnh thc cung ng dch v cng, v nhng c im ca dch v cng, c th thy rng cung ng loi dch v ny mt cch c hiu qu khng phi l mt vn n gin. Nh nc phi xc nh r loi dch v no nh nc cn gi vai tr cung ng ch o, loi dch v no cn chuyn giao cho khu vc t nhn v cc t chc x hi, loi dch v no nh nc v khu vc t nhn c th phi hp cung ng v vai tr iu tit, qun l ca nh nc v vn ny nh th no. Kinh nghim ca nhiu nc nhng nm qua cho thy rng, trong cung ng dch v cng, nh nc ch trc tip thc hin nhng loi dch v cng m khu vc phi nh nc khng th lm c v khng mun lm. Nu nh nc khng chuyn giao vic cung ng dch v cng cc lnh vc thch hp cho khu vc phi nh nc v ci cch vic cung ng dch v cng ca cc c quan nh nc, th hiu qu cung ng dch v cng v tng th s b gim st, nh hng tiu cc n i sng ca ngi dn v s pht trin chung ca ton x hi. I.3. Tc dng ca dch v cng trong tin trnh pht trin v vai tr qun l, iu tit ca nh nc trong cung ng dch v cng I.3.1. Tc dng ca dch v cng trong pht trin kinh t- x hi Tnh u vit ca mt x hi c phn chiu mt cch r rng qua cht lng cung ng dch v cng, bi v dch v cng l nhng hot ng phc v cc li ch ti cn thit ca x hi, m bo cho x hi pht trin bn vng v c k cng, trt t. Mi x hi u c nhng vn chung, lin quan n cuc sng ca tt c mi ngi. l cc vn nh trt t tr an, phn ha giu ngho, gio dc, y t, dn

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s, mi trng, ti nguyn, gii quyt thnh cng cc vn ny, cn c s gp sc ca c nh nc, cng ng v cc t chc x hi thng qua vic cung ng cc dch v cng. Nu cc dch v cng b ngng cung cp hoc cung cp khng y , cht lng thp th s dn n nhng ri lon trong x hi, nh hng nghim trng n i sng ca mi ngi dn, ng thi tc ng tiu cc n s pht trin ca mi quc gia. Nhn chung, dch v cng p ng nhng nhu cu chung ca x hi v cc lnh vc sau y: duy tr trt t cng cng v an ton x hi nh quc phng, an ninh, ngoi giao. bo v trt t kinh t, trt t mua bn trn th trng thng qua vic xy dng v thc thi th ch kinh t th trng. cung cp cc tin ch cng cng cho ton th thnh vin trong x hi nh bo v sc khe, gio dc o to, giao thng cng cng, thng tin, th vin cng cng... qun l ti nguyn v ti sn cng cng nh: qun l ti sn nh nc, bo v mi trng, ti nguyn thin nhin. bo v quyn cng dn, quyn con ngi.

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cp su hn ti tc dng ca vic cung ng dch v cng, chng ta c th ly th d trong lnh vc hnh chnh cng. Hnh chnh cng c lin quan n mc tho mn cc nhu cu cng cng ca x hi, lin quan n tin b kinh t, x hi ca mt quc gia. Theo cc nh nghin cu Trung quc1, tc dng ca hnh chnh cng ch yu l tc dng dn ng, tc dng qun ch, tc dng phc v v tc dng gip . Ni v tc dng qun ch, tc l nh nc pht huy nng lc qun l cng cng mang tnh quyn uy, cng ch x l, iu ha cc quan h x hi v li ch x hi, m bo cho x hi vn hnh tt; cn v tc dng gip , chnh l s gip ca nh nc i vi cc a phng ngho, nhng ngi c hon cnh kh khn, nh gip ngi ngho, cu t x hi, phc li x hi, bo him x hi, y t, Vic cung ng dch v hnh chnh cng cn c tc dng trc tip n s pht trin kinh t -x hi ca t nc. Khi cung cp cc dch v ny, nh nc s dng quyn lc cng to ra dch v nh cp cc loi giy php, ng k, chng thc, th thc... Tuy xt v mt hnh thc, sn phm ca cc dch v ny ch l cc loi vn bn giy t, nhng chng li c tc dng chi phi quan trng n cc hot ng kinh t- x hi ca t nc. Chng hn, giy ng k kinh doanh ca doanh1

Hnh chnh cng v qun l hiu qu chnh ph.- H.: NXB Lao ng x hi, 2005

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nghip th hin vic nh nc cng nhn doanh nghip ra i v i vo hot ng, iu ny dn n nhng tc ng v kt qu ng k v mt kinh t - x hi. Ngoi ra, thng qua vic cung ng dch v cng, nh nc s dng quyn lc ca mnh m bo quyn dn ch v cc quyn hp php khc ca cng dn. Nguyn tc nh nc phi chu trch nhim cao nht v cng l trch nhim cui cng i vi vic cung ng y v s lng, cht lng, c hiu qu dch v cng cho d l nh nc tin hnh thc hin trc tip hay thng qua cc t chc v c nhn khc l mt l chn bo v an ton cho cuc sng ca mi ngi dn. Vi vic nh nc bo m s cng bng, bnh ng cho cng dn, nht l nhm dn c d b tn thng, trong vic tip cn v hng th cc dch v cng thit yu lin quan trc tip ti i sng nh y t, gio dc, an sinh x hi, ngi dn c hng cc quyn sng c bn ca mnh, trn c s hc tp, lm vic nng cao mc sng ca bn thn v ng gp nhiu hn cho x hi. Nh vy, dch v cng c tc dng cc k to ln i vi s pht trin ca t nc v tng ngi dn, v l yu t quan trng gp phn n nh x hi. I.3.2. Vai tr qun l v iu tit ca nh nc i vi cung ng dch v cng Chng ta u bit rng, nh nc ca bt k ch no cng bao gm hai chc nng c bn: chc nng qun l (hay cn gi l chc nng cai tr) v chc nng phc v (hay cn gi l chc nng cung cp dch v cho x hi). Hai chc nng ny thm nhp vo nhau, trong chc nng phc v l ch yu, chc nng qun l xt n cng cng nhm phc v. Vi chc nng phc v, nh phn tch cc phn trn, nh nc c trch nhim cung ng cc dch v cng thit yu cho x hi. Bn cnh , vi chc nng qun l, nh nc phi thc hin vai tr qun l v iu tit x hi ni chung, trong c vn dch v cng. Nh nc bng quyn lc ca mnh, thng qua cc cng c qun l v m nh php lut, quy hoch, k hoch, chnh sch, qun l v iu tit hot ng cung ng dch v cng, qua lm tng hiu qu cung ng dch v cng trong ton x hi. - Nh nc h tr, khuyn khch, to iu kin thun li cc t chc phi chnh ph, cc t chc t qun ca cng ng tham gia cung ng dch v cng Vai tr ny vt ra khi phm vi qun l nh nc thun ty, xut pht t vic xc nh trch nhim cao nht v n cng ca nh nc trong lnh vc dch v cng khng c ngha l nh nc phi trc tip cung ng ton b cc dch v ny. Thc hin vai tr ny, nh nc cn hon thin c ch, chnh sch khuyn khch t nhn, cc doanh nghip v cc t chc x hi ca ngi dn tham gia cung ng dch v cng. C ch, chnh sch y bao gm: vch r nhng lnh vc dch v cn khuyn khch s tham gia ca khu vc phi nh nc, chnh sch h tr ti chnh, chnh sch thu, cc iu kin vt cht, cc chnh sch o to, kim tra v kim

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sot,... Nh nc cn to ra mt mi trng php l chung cho tt c cc n v cung ng dch v cng, m bo mt sn chi bnh ng cho tt c cc nh cung ng dch v cng. - Nh nc qun l, kim tra, gim st hot ng ca cc c s ngoi nh nc cung ng dch v cng Xt cho cng, nh nc vn l ngi chu trch nhim cui cng trc x hi v s lng cng nh cht lng dch v cng, k c cc dch v cng c thc hin bi cc cng ty t nhn hay cc t chc kinh t-x hi. Trong khi , i vi cc cng ty t nhn, cc t chc, c nhn m nhn cc dch v cng, li ch ca chnh bn thn h khng phi bao gi cng thng nht vi li ch ca nh nc, ca x hi. V vy, nh nc phi to ra c ch cc tc nhn bn ngoi nh nc khi m nhn cc dch v cng thc hin mc tiu x hi. Xy dng h thng ch tiu cht lng dch v cng nh gi hot ng ca cc n v cung cp, gim st v kim tra hot ng ca cc c s ny. Nh nc cn nh hng pht trin i vi khu vc t nhn, hng khu vc t nhn vo nhng lnh vc m t nhn hot ng hiu qu, ng thi to mi trng cnh tranh lnh mnh nhm khng ngng ci tin vic cung ng dch v cng cho x hi. iu ct li l nh nc phi cn nhc, tnh ton v gii quyt tha ng mi quan h gia li ch ca nh nc, ca x hi vi li ch ca t chc v c nhn tham gia cung ng dch v cng. II. I MI CUNG NG DCH V CNG II.1. Nhng chuyn bin trong ch trng ca nh nc v cung ng dch v cng nhiu nc trn th gii, khu vc nh nc tng nm c quyn trong lnh vc cung ng dch v cng v nhn chung cht lng cung ng l vn gy nhiu bc xc. Nhng thp k qua chng kin vic nh nc trc tip tin hnh qu nhiu hot ng, trong c hot ng cung ng dch v cng, m l ra c th chuyn giao mt mc nht nh cho th trng v x hi dn s m nhim. Kinh nghim t cc nc pht trin cho thy mt chnh ph m m qu mc s khng a n mt x hi pht trin. Do vy, mt trong nhng mc tiu ci cch c cc nh nc xc nh r l chuyn mt phn kh ln chc nng qun l x hi ca chnh ph sang cho cc tc nhn khc, v x hi ha dch v cng l mt xu th ln trong tro lu ci cch nh nc hin nay phn ln cc nc trn th gii. Nh nc vn gi vai tr quan trng nht trong m bo cung cp dch v cng, nhng khng nht thit phi l ngi trc tip cung cp tt c cc dch v . Vai tr ca nh nc cn th hin r hn trong y mnh qun l cung ng dch v cng bng lut php, chnh sch v cc bin php mang tnh h tr, kch thch. Cc nh nc tin tin hin nay ang tm cch s dng ti a c ch th trng trong lnh

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vc cung cp dch v cng. Phn ln dch v cng c ton x hi tin hnh, nh nc ch gi li nhng dch v cn thit nht theo hng nh nc nh nh cn thit, x hi ln nh c th.Hp 2: Nhng bin chuyn trong ch trng cung ng dch v cng ca Chnh ph Anh p ng nhu cu ngy cng tng cao ca ngi dn, v trc p lc ca Lin minh Chu u, Chnh ph Anh ang tp trung ch vo vic nng cao cht lng v hiu qu cung ng dch v cng m trc ht l gio dc, y t, giao thng, mi trng. C th l: - Trong t chc v qun l hot ng cung ng dch v cng c s tch bch kh r rng gia nhng lnh vc hot ng do nh nc ti tr hon ton nh y t, gio dc vi nhng dch v c t nhn ha nh v sinh mi trng, cp nc sch, giao thng cng cng.- Phn cp thm quyn v trch nhim gia chnh ph v chnh quyn a

phng trong vic qun l cc dch v cng kh r rng, rnh mch. C nhng lnh vc ch c cp trung ng chu trch nhim thc hin (nh y t, gio dc bc i hc, cung cp nc sch), c lnh vc c cp trung ng v a phng qun l (dch v mi trng). Nhn chung, trong vic t chc v qun l cc hot ng dch v cng, chnh ph ra chin lc, chnh sch, tiu chun cht lng dch v v phn b ngn sch, cn chnh quyn a phng thc hin k kt hp ng vi cc cng ty t nhn v gim st, kim tra vic thc hin. - Ngha v v trch nhim cung ng dch v cng ca cc c quan, t chc nh nc v t nhn cng nh ca cc c nhn, t chc hng th dch v c lut ha mt cch y , chi tit. - Chnh ph tch cc to hnh lang php l v thc y c ch cnh tranh gia khu vc cng v khu vc t cng nh gia cc t chc thuc khu vc cng nng cao hiu qu v cht lng dch v cng. - Quyn t ch v ti chnh v nhn lc ca cc n v trc tip cung ng dch v cng c bo m, ng thi chnh ph v cc chnh quyn a phng tng cng kim tra, gim st v c bin php x l kp thi bo m tnh lin tc ca cc dch v. Bn nguyn tc ci cch dch v cng ca Th tng Anh Tony Blair - Xy dng cc chun mc chung c tnh quc gia p ng nhu cu ca ngi dn v tho mn cc i hi ca EU; xc nh r trch nhim thc hin m bo ngi dn d l ai, u u c quyn nhn c cc dch v c cht lng cao. - Thc hin nguyn tc phn cp, phn quyn v u quyn nng cao tnh ch ng sng to v t chu trch nhim ca cc b phn trc tip tip xc vi dn

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v cho cc c quan chnh quyn a phng trong cung cp dch v cng. Theo , chnh quyn a phng phi chu trch nhim mt phn ng k chi ph cho vic cung ng cc dch v cng nh gio dc, cc dch v x hi, chm sc ngi tn tt v giao thng cng cng. - To iu kin cho cc c s cung ng dch v nh y t, gio dc c kh nng tr thm lng cho cng chc; thc hin nguyn tc khuyn khch tnh nng ng v t ch ca cc c s. T nm 1998 gn mt na gio vin ph thng c tng 25% lng do gn vi kt qu ging dy, lng cho y t mi nng cao trnh tng1/3, cc bnh vin cng ang th nghim tr lng gn vi kt qu hot ng. Theo d kin bnh vin s tr thm 6000 bng/nm cho mi nhn vin nu hon thnh nhim v. - Thc hin nguyn tc m rng kh nng la chn cho khch hng, m bo cho ngi dn c quyn la chn v yu cu cht lng dch v cao hn khng ch t khu vc t nhn m c t khu vc cng. V d nh vic chn trng hc cho tr em, bnh vin iu tr khi m au, hoc h thng cung cp nc sch tt hn v r hn. T thng 7/2002, bnh nhn i m tim nu qu 6 thng s c gii thiu n m mt bnh vin khc trnh tnh trng i qu lu. Ngun: Theo Bo co ca on Cng tc B Ni v kho st, nghin cu hnh chnh cng, dch v cng Anh, 2004

C nhiu nguyn nhn dn n s thay i nhn thc t pha cc c quan cng quyn v t chnh nhng ngi dn v s cn thit phi c s chuyn bin trong cung ng dch v cng. l, th nht, cng vi s pht trin ngy cng mnh m ca khu vc t nhn v phng din kinh t, nhng thnh tu khoa hc cng ngh lm cho khu vc t nhn c th tip nhn mt s dch v trc y ch thuc v nh nc. Th d, k thut truyn hnh cp pht trin cho php nm c thi gian s dng ca tng my thu hnh, hoc qua thit b t ghi c th o chnh xc lng s dng kh ga, in, nc ca tng h tiu th ( thu tin). Th hai, s thay i v mc sng to iu kin cho c nhn c th t mua sm cho mnh nhng phng tin m trc y ch c th s dng cng cng. C th thy r iu ny trong cung ng dch v cng v lnh vc vn ha; nu nh trc y, ngi dn ch c th xem phim nh ti cc rp chiu cng cng, th nay ngi ta c th xem ti nh qua u my VCD, DVD. Ngoi ra, s thay i v mc sng ca ngi dn theo hng cht lng cuc sng ngy mt nng cao i hi s lng cc loi hnh v cht lng dch v cng cn phi ngy cng tng p ng yu cu ca i sng x hi. Th ba, l do quan trng khin nh nc cn i mi c ch cung ng dch v cng thng qua ci cch v chuyn giao dn vic cung ng dch v cng cho khu vc t nhn l s km hiu qu ca khu vc cng so vi khu vc t nhn trong lnh vc

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ny. Theo J. E. Stiglitz, th cc d n nh cng cng thng tn km hn nh ca khu vc t nhn khong 20%; chi ph thu gom rc thi do khu vc cng cng thc hin thng cao hn khu vc t nhn 20%; chi ph phng chy, cha chy ca khu vc t nhn (nhng do nh nc cp tin) thp hn ca khu vc cng cng 47%. Kho st 58 quc gia ang pht trin cho thy ch c 6% s ngi c hi nh gi dch v cng do nh nc cung cp l c hiu qu cn 36% tr li l khng hiu qu. c bit, dch v xy dng ng s v dch v y t b nh gi l km hiu qu nht2. L do cui cng buc nh nc phi c nhng chuyn bin giao mt s lnh vc cung ng dch v cng cho khu vc ngoi nh nc l v iu s gip nh nc gim nh c gnh nng ngn sch, huy ng c cc ngun lc tim tng ca x hi. Ly v d trong lnh vc y t, mc d hu ht cc nc, nh nc u m nhn vai tr to ln trong cung ng dch v y t v y l mt loi hng ha cng cng rt c bit, song nh nc khng th l ngi cung ng duy nht cc dch v ny do mc chi ph ln ca n. Theo mt ti liu kho st, chi tiu cho chm sc y t trong GDP ni chung tng ln ng k trong giai on t 1965 n 1983 vi mc tng t nht l 50%, trong c nm nc t mc tng trn 70%. Vi mc tng nh vy, ngn sch nh nc kh m chu ni v s tham gia ca khu vc t nhn l tt yu. M, t l chi ca nh nc trong tng chi tiu chm sc sc khe t khong 40% mi nm k t 1974 n nay3. Phn chi cn li n t cc ngun kinh ph ca t nhn, cc t chc x hi hoc tin bo him. thc thi c hiu qu cc chc nng ca nh nc, cc c quan cng quyn phi linh hot, mm do thch ng vi cc iu kin phc tp v thay i nhanh. Kinh nghim t nhiu nc cho thy, nu nh nc t thn thc thi ton b cc chc nng ca mnh m b qua cc nhn t th trng v x hi th s dn ti mt nh nc yu v mt x hi km pht trin. Cng vy, trong lnh vc cung ng dch v cng, nu nh nc ch s dng b my ca mnh cung ng dch v th chc chn s dn ti nhng bt cp c v khi lng v cht lng cung ng. Do , cng vi vic phi i mi hiu qu cung ng dch v cng ngay trong khu vc nh nc, iu quan trng l nh nc phi chuyn giao cc loi dch v cng m x hi c th m nhim i i vi vic kim tra, gim st nhm m bo cht lng v hiu qu cung ng dch v cng. Hp 3: Cc hnh thc chuyn giao dch v cng trn th gii1- Nh nc bn mt phn hoc ton b ti sn ca doanh nghip nh nc cung ng dch v cng cho t nhn hoc mt tp th; Ngn hng Th gii (1998), Nh nc trong mt th gii ang chuyn i, Bo co thng nin nm 1997, NXB Chnh tr Quc gia, H Ni. 3 J. E. Stiglitz (1995), Kinh t hc cng cng, NXB Khoa hc v k thut, H Ni.2

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2- Nh nc bn mt phn c phn ca doanh nghip nh nc cung ng dch v cng ra ngoi x hi; 3- Nh nc cho thu doanh nghip cung ng dch v cng i vi t nhn hoc tp th; 4- Khon kinh doanh cung ng dch v cng cho t nhn hoc tp th; 5- K hp ng hoc n t hng vi cc doanh nghip hoc t chc trong vic cung ng dch v cng theo yu cu ca nh nc; 6- Cho php cc doanh nghip hoc t chc t nhn tham gia vo cc lnh vc cung ng dch v cng v chu s qun l ca nh nc thng qua lut l v quy ch. Ngun: L Chi Mai (2003).

II.2. y mnh s tham gia ca khu vc phi nh nc trong cung ng dch v cng Thc ra, vic khu vc phi nh nc cung ng dch v cng c t thi xa xa. Lch s cho thy rng, hu ht cc dch v y t u c thc hin trn c s t nhn bi nhng b , cc thy lang. Ti cc nc ang pht trin, th ha v cng nghip ha mnh m dn n vic thnh lp cc nhm lao ng v h t t chc cung ng dch v bo him y t thng qua nhng qu phng m au hoc ngh thnh lp cc h thng bo him x hi c nh nc cp kinh ph. Ch n th k XX nh nc mi gi vai tr quan trng trong vic cung cp cc dch v x hi nh gio dc v y t, v ngy nay, trong tro lu ci cch nh nc trn khp th gii, vic cung ng dch v cng li c chuyn tng phn thch hp cho khu vc phi nh nc, v ang tr thnh mt xu th pht trin. Thc t cho thy, khu vc phi nh nc ngy cng thm nhp vo cc hot ng cung ng dch v cng, chng hn nh trong lnh vc lm sch mi trng, cung cp in, nc, Ngay c nhng lnh vc m theo truyn thng ch do nh nc qun l v thc hin, th nay cng tr thnh a bn hot ng ca khu vc t nhn. M hin nay, nhiu nh t ti cc bang c giao cho khu vc t nhn qun l, nhiu loi dch v cnh st c giao cho cc cng ty t nhn m nhim. Ngoi ra, khu vc t nhn cng c php tham gia cung ng dch v gio dc v y t, l loi dch v m nh nc gi vai tr c bn v chng lin quan trc tip n mc tiu pht trin ca mi quc gia. phn ln cc nc trn th gii tn ti song song hai h thng gio dc cng lp v gio dc dn lp. S pht trin h thng trng t thc to iu kin cnh tranh v cht lng ging dy gia hai h thng. Tt nhin, cc trng t phi chu s qun l ca nh nc v ni dung ging dy, bo m theo mt chng trnh chun, thng nht. Vic chuyn dn m hnh trng cng lp sng nh bao cp nh nc vi sc qun tnh sang nh ch hi ng qun tr t doanh thc y tnh nng ng, sng to v cnh tranh ca cc c s gio dc.

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Hp 4: Th trng ha gio dc Anh Theo sch trng ca Chnh ph Anh, vic ci cch gio dc nc ny bao gm vic tin n th trng ho gio dc tng a phng. Qua m hnh ny, cc trng c th trng ho c quyn cnh tranh vi h trng tiu trung hc nh nc hin h . Ni dung th trng ho c th hin nh sau: -Ph huynh, cc c quan phc li x hi, k c doanh nghip c khuyn khch hnh thnh v iu hnh cc trng nh ch t thc;Nhm i tc va nu c quyn xy dng thng hiu ring, xy dng gio trnh thch hp, min khng ra ngoi cc ch tiu v m ca chnh ph lin quan n pht trin kinh t- x hi. c bit khuyn khch ni dung ging dy i mi khoa hc- k thut; -Chm dt s can thip ca cc cp chnh quyn a phng vo vic tuyn sinh, chn gio vin, k c thu mn ban gim hiu. Chnh quyn a phng khng c ngn tr cc k hoch pht trin c s trng c; -Hiu trng hnh x chc nng nh mt gim c iu hnh. Hiu trng gii v c nng lc qun l c khuyn khch tip nhn iu hnh cc trng km. T hnh thnh chui trng di quyn mt hi ng qun tr m hiu trng thc ti tr thnh ch tch; -Cc trng c quyn k hp ng thu mn, thi hi v n nh quy ch lng bng cho cc i tng nhn s phc v ti trng. Ngun: Thi bo kinh t Si gn, ngy 24/11/2005

Bng vic chuyn hot ng cung ng dch v cng cho khu vc t nhn, nh nc c th s dng cnh tranh gia cc nh cung ng dch v vi nhau c c nh cung ng dch v c hiu qu nht. Chnh v th, thc y cnh tranh trong cung ng dch v gia khu vc cng v t ang l mt mc tiu c nhiu nc hng ti nhm nng cao cht lng dch v cung ng. S dng th trng cung ng nhng dch v cnh tranh s gim bt chi ph v ci tin cht lng dch v, san s gnh nng ca nh nc v tin ti xy dng mi quan h hp tc nh nc- th trng. Theo E.X. Xavat, mt chuyn gia hng u ca M v cnh tranh trong dch v cng cng, th u th r rng nht ca cnh tranh l n em li hiu qu ln hn, nhiu hiu qu hn cho ng vn4. Theo mt nghin cu ca Ngn hng th gii, Braxin, vic k hp ng vi cc ch u t t nhn v bo dng4

David Osborne, Ted Gaebler, i mi hot ng ca chnh ph .- H. NXB Chnh tr quc gia, 1997

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ng s tit kim c 25% chi ph so vi vic s dng cc cng ty nh nc. Cng vy, bng cch p dng c ch cnh tranh vo vic sn xut v cung ng dch v cng, nh nc to ra mi trng ganh ua tch cc gia khu vc cng v t. Chng hn, vi vic cho php cc cng ty t nhn tham gia t chc cung ng dch v vn ti ni a, Chnh ph Niu Diln to ra c s cnh tranh gia cc t chc cung ng dch v vn ti, qua nng cao cht lng phc v khch hng, lm gim cc ph vn chuyn. Ngay c cc nh nc phc li nh an Mch, Phn Lan v Thy in, hin nay, vic thc y cnh tranh gia khu vc cng v t ang l mt tiu im ca cc nh hoch nh chnh sch. an Mch, hu ht cc dch v x hi l do nh nc cung cp, c ti tr thng qua h thng thu vi mc thu thu nhp c nhn rt cao, song nc ny ch t ch s cnh tranh v sn xut dch v cng di mc trung bnh. V vy, t nm 2002, mc tiu tng cnh tranh, tng hiu qu, cht lng, i mi v tng s la chn i vi dch v cng tr thnh mi quan tm ca chnh ph an Mch. Chnh ph c sng kin v tng cnh tranh v khuyn khch quan h hp tc cng- t. iu ny cng c th hin r trong trng hp Phn Lan. L mt nh nc phc li, song Phn Lan l nc c truyn thng duy tr h thng bnh vin t t nhiu thp k. S tn ti ca h thng bnh vin t mt mt gy sc p v nng cao cht lng y t ti cc c s cng, mt khc l ngun cung ng thm dch v cho ngi s dng, to cho h quyn la chn dch v rng ri hn. Chnh sch cnh tranh gia cc bnh vin t (v cht lng dch v, v mc ph v nhm tng th phn) tc ng ti h thng y t cng v t khu vc ny vo tnh th phi ci cch. Nh vy, trong vic thc y cnh tranh, hot ng ca nh nc khng n thun l iu tit, m cn khuyn khch v to ng lc th trng. Chnh ph to ra mt sn chi bnh ng cho mi i tng c kh nng cung cp dch v cng to ra s cnh tranh lnh mnh gia cc nh cung cp dch v, v ngi tiu dng cc dch v cng c quyn t do la chn nh cung cp dch v. Nhiu bng chng thc t cho thy khi cc t chc cung ng dch v cng bc vo cuc cnh tranh th mi vic u thay i. Nhng t chc no cung ng dch v cht lng km vi gi c cao th dn b xa b, trong khi nhng t chc cung ng dch v cht lng cao vi gi c phi chng th ngy cng pht trin. Chnh s cnh tranh buc cc t chc cung ng dch v phi lun lun t i mi v iu mang li li ch cho c ngi dn, nh nc v nh cung ng dch v. Mt trong nhng chuyn bin quan trng trong cung ng dch v cng trong nhng nm gn y l s tham gia ngy cng mnh m ca cc t chc x hi dn s, bao gm cc t chc chnh tr - x hi, cc t chc x hi - ngh nghip, cc t chc phi chnh ph, cc c nhnVic m rng s tham gia ca cc lc lng x hi ny cng nh nc vo cung ng dch v cng to ra mt mi trng cnh

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tranh lnh mnh, ph v s bt bnh ng, phi th trng do c quyn gy ra trong lnh vc ny, huy ng c cc ngun lc cng ng v pht huy vai tr ca cc i tc x hi trong qun l x hi. Vai tr ca cc tc nhn ny trong cung ng cc dch v cng cho x hi th hin c th cc mt sau y: - L cnh tay ni di ca nh nc nhm pht huy sc mnh ca c nhn, ca c cng ng x hi tng thm ngun lc p ng cc yu cu ca x hi v cc dch v cng; - L mt trong nhng chc nng c bn ca t chc dn s trong hot ng vn ng qun chng v gn b vi li ch c bn ca ngi dn, l cu ni gia nh nc v nhn dn trong cung cp dch v cng; - Thc hin vai tr i din v bo v li ch ca ngi hng th dch v cng, m bo cng bng v ng vi chnh sch ca nh nc; - Tham gia b sung, hon thin chnh sch ca nh nc trong lnh vc dch v cng p ng yu cu pht trin ca x hi v ph hp vi kh nng ca nn kinh t. Thc t cho thy ngy cng nhiu hot ng cung ng dch v cng c m rng cho nhiu nhm li ch trong x hi c kh nng cung ng. l cc hip hi ngh nghip, cc nhm cng ng, cc hp tc x, cc hi t thin, cc t chc ca ph n, thanh nin, v cc t chc phi chnh ph khc, Cc t chc ny tham gia tch cc vo vic cung ng dch v trc tip cho cc c nhn v cng ng, t dch v y t, gio dc cho ti nhng dch v cho vay tn dng nh, hoc o to hng nghip. cc nc pht trin v ang pht trin, nhiu t chc x hi hot ng song song vi nhng c quan cung ng dch v cng ca nh nc. V d, mt s nc giao cho cc nhm cng ng t qun xy dng v khai thc cc cng trnh phc li x hi trong a phn sinh sng ca h. mt s nc khc, chnh ph li y quyn cho cc hip hi ngh nghip cp giy php hnh ngh, iu hnh v kim sot cc hi vin. Nhiu bng chng cho thy cc t chc nh vy thng c nhiu li th khi thc hin cung ng dch v cng v h c c ch hot ng rt linh hot v gn gi hn vi ngi dn. Vic cho php khu vc t nhn v cc t chc x hi tham gia cung ng cc dch v cng ch mang li li ch ng k. Vi vic huy ng cc ngun vn x hi cho s pht trin kt cu h tng, nh h thng ng s, giao thng vn ti, thng tin, v sinh mi trng, hiu qu cung ng cc dch v cng trong nhng lnh vc ny tng mnh, i i vi vic tit kim mt t l ln ngn sch nh nc. i vi cc dch v ng ph nh qut dn, sa cha, xy dng, duy tu v bo dng, chi ph cng gim i khi thc hin phng thc k hp ng vi cc thnh phn

17

kinh t khc. Cng vy, s tham gia ca khu vc phi nh nc vo cung ng dch v cng to iu kin cho nhiu ngi tham gia vo hot ng ny, pht huy c kh nng v ngun lc tim tng trong x hi, khi dy tnh sng to v ch ng ca ngi dn, qua a dng ha v tng cng ngun cung ng cc dch v cng cho x hi. Tm li, ngy nay phm vi cc dch v cng c chuyn giao cho khu vc t nhn v cc t chc x hi ngy cng m rng. Hu ht cc quc gia p dng nguyn tc lnh vc no th trng v x hi c th m nhim c th nh nc chuyn giao dn mt mc nht nh trch nhim cung ng dch v cng lnh vc . nhng lnh vc dch v khng th chuyn giao c cho khu vc t nhn v cc t chc x hi, th nh nc phi gi vai tr cung ng nng ct v phi tin hnh ci cch trong chnh khu vc nh nc ci thin cht lng cung ng cc loi dch v ny. Tuy nhin, cn nhn mnh mt ln na rng, d nh nc trc tip cung ng dch v hay chuyn giao cho cc khu vc khc, th vi vai tr l ngi m bo cng bng x hi, nh nc vn c ngha v quan tm n vic t c nhng mc tiu chnh ca hot ng cung ng dch v cng thng qua kim sot, iu tit v bo h th trng v x hi cung ng cc dch v mt cch thun li. II.3. Ci thin cht lng cung ng dch v cng trong khu vc nh nc Cho d khu vc t nhn v cc t chc x hi ngy cng tham gia nhiu hn vo cung ng dch v cng, song khu vc nh nc vn tt yu l ngi cung ng mt s ln dch v. Chnh v vy, trong i mi cung ng dch v cng, vic ci thin cht lng cung ng dch v ngay chnh khu vc nh nc l ht sc quan trng. Bn cnh chc nng qun l nh nc, chc nng phc v ca nh nc nhm cung cp nhng dch v cn thit cho ngi dn h thc hin tt quyn li v ngha v ca mnh gi y cn c ch trng hn bao gi ht. Nng cao cht lng cung ng dch v cng khng phi l mt vn mi m. Ngay t gia nhng nm 80 ca th k trc, Php a ra cc chu trnh cht lng th nghim trong cc c quan nh nc. Trc yu cu ca ngi dn hin tr thnh ngi tiu dng i hi cao, vn cht lng trong cung ng dch v cng ca nh nc ngy cng tr nn cp bch. Nguyn tc cht lng trong cung ng dch v cng ca cc c quan nh nc chnh thc c cp ti trong Hin chng dch v cng ca Php ngy 18 thng 3 nm 1992 v vn bn ngy 26/7/1996 v ci cch Nh nc Php. Hin chng a ra mt lot cc bin php nhm m bo cung ng dch v thit yu nh trng hc, bnh vin, cnh st, bu in cho nhng ni xa xi. iu quan trng l Hin chng yu cu cc c quan xy dng ch s hiu sut v ch trng s hp tc gia c quan nh nc cung cp

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dch v v ngi s dng. Theo mi c quan nh nc phi c gng lm cho ngi dn bit r mc tiu ca mnh, iu chnh cc ch s cht lng theo nhu cu ca ngi s dng dch v. Cc nh nc cng ang tin hnh nhiu ci cch khc nhau nhm mc ch nng cao hiu qu cung ng dch v cng thng qua cc n v nh nc. Mt s nc pht trin nh Anh, M hin ang th nghim mt s phng php tng cnh tranh trong ni b khu vc nh nc nhm ci thin vic cung ng cc dch v cng khng th chuyn giao c cho khu vc phi nh nc. Ngoi ra, vic phi tp trung ha cung ng dch v cng thng qua phn cp, phn quyn, cng l mt bin php c hiu qu gy sc p cnh tranh nhm nng cao hiu qu cung ng dch v cng ca khu vc nh nc. L do cn bn mang tnh ni ti ca phi tp trung ha cung ng dch v cng l quyn quyt nh sn xut v cung ng dch v cng phi c tr li cho nhng n v thp nht, c kh nng nm bt c tnh hnh mt cch r rng nht. Vic phi tp trung ha to iu kin cho cc chnh quyn a phng linh hot hn trong cung ng cc dch v cng ph hp vi hon cnh ca a phng mnh, ng thi buc h tr nn c trch nhim hn. Vic phn cp ny lm tng hiu qu v hiu lc cung ng dch v cng, qua ngi tiu dng s c hng nhng dch v cht lng cao vi gi c hp l.Hp 5: Phi tp trung ha trch nhim: kinh nghim ca Php, Anh, Ty Ban Nha v Thy in - Php: Theo cc lut v phi tp trung ha nm 1982, Nh nc Php trao thm quyn cho cc khu vc v cc ban, ngnh trong nhiu lnh vc nh pht trin th, cc bin php h tr kinh t v giao thng a phng. Cc lut ny cng phn cp cho chnh quyn khu vc trch nhim v xy dng v bo dng cc trng ph thng trung hc (tng t nh trch nhim ca cc x i vi cc trng tiu hc vn tn ti hng th k), trong khi vn gi trch nhim v hu ht cc chnh sch gio dc khc cp trung ng. - Ty Ban Nha: Ti y, vic thnh lp cc cng ng t qun dn n vic chuyn giao ng k cc trch nhim, k c vic phi tp trung ha h thng gio dc, y t cng nh cc cng trnh cng cng, nng nghip, bo v mi trng, pht trin vng v tr gip x hi. - Anh: vic phn cp thm quyn v trch nhim gia chnh ph v chnh quyn a phng Anh trong vic qun l dch v cng kh r rng, rnh mch, trong chnh ph tp trung ra chin lc, chnh sch, tiu chun cht lng dch v v phn b ngn sch, thc hin kim ton, cn chnh quyn a phng thc hin k kt hp ng vi cc cng ty t nhn v gim st, kim tra vic thc hin.

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- Thu in: C s phn cp r nhng dch v cng m tng cp chnh quyn phim nhim, trong c bit ch cc dch v cng v phc li cng cng hon ton min ph (nh bo him tht nghip, tr cp x hi,). Ngun: Phc v v duy tr: ci thin hnh chnh cng trong mt th gii cnh tranh/ Ngn hng pht trin chu .- H. CTQG, 2003; v cc ngun khc.

V ci thin cht lng cung ng dch v cng trong khu vc nh nc, vn kim sot ti chnh v qun l ng mt vai tr quan trng. Trong nhiu trng hp, do rt kh o lng nhng sn phm u ra ca khu vc nh nc, nn cn c ch kim tra ti chnh v t ch chu trch nhim c nhn, nhm buc cn b qun l phi lm vic ht mnh trnh tnh trng s dng khng hiu qu cc ngun lc cng cng v nhm ci thin vic cung ng dch v. Kho st nhiu nc cho thy mt phn ng k cng qu quc gia c phn b cho cc dch v x hi c bn khng n c cc bnh vin v trng hc nh d kin, nht l cc vng nng thn, vng su, vng xa5. Vi tnh trng nh vy, cho d nh nc c dnh mt phn ngn sch rt ln cho cung ng dch v cng, th hiu qu cng rt thp. iu dn n s mo m trong bc tranh cung ng dch v cng, v nh nc u t rt nhiu vo hot ng ny, song hu qu l ngi dn khng c hng mc xng ng nhng phc li . V vy, tng cng vic kim sot ti chnh v qun l l gii php khng th thiu nhm ci thin cht lng cung ng dch v cng trong khu vc nh nc. Mt vn quan trng cn lu trong vic ci cch nhm nng cao cht lng dch v cng trong khu vc nh nc chnh l yu t con ngi. bt k lnh vc no, con ngi lun ng vai tr then cht quyt nh s thnh, bi ca ci cch, v trong lnh vc cung ng dch v cng cng vy. Chnh v th, nhiu nc tp trung nhiu bin php nng cao nng lc chuyn mn ca cng chc thng qua vic ci tin cng tc cn b v khuyn khch s tham gia ca cng chc vo hot ng qun l, tng cng u quyn v trch nhim c nhn. Phng thc tuyn dng v bt theo phm cht m nhiu nc s dng lm cho b my vin chc c c lc lng cn b, nhn vin cht lng cao. Bn cnh vic nng cao nng lc chuyn mn, i vi i ng vin chc trc tip thc hin cung ng dch v cng, cn c bit ch nng cao phm cht, o c phc v khch hng. Kinh nghim ca nhiu nc ch ra rng mt khi ngi vin chc c thc trong cng vic, c thi tn ty phc v khch hng th hiu qu cng vic s tng ln rt nhiu. C th thy r vn ny qua trng hp Bang Ceara ca Brazin trong hp di y:5

Ngn hng Th gii (1998), Nh nc trong mt th gii ang chuyn i, Bo co thng nin nm 1997, NXB Chnh tr Quc gia, H Ni.

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Hp 6: Xy dng tinh thn tn ty ca nhn vin: chnh quyn tt ti Bang Ceara ca Braxin Nm 1987, ngoi hot ng hnh chnh km ci, chnh quyn bang Ceara ng Bc Braxin cn phi i mt vi mt cuc khng hong ti chnh gay go. Tuy nhin, ch trong vng 4 nm, cuc khng hong ti chnh c khc phc, v cht lng ca cc dch v c ci thin ng k. Din c tim chng vcxin phng bnh si v bnh bi lit tng gp ba, t 25% ln ti 90% tng s tr em. Chng trnh cng chnh ca bang ny to vic lm cho hn mt triu nng dn khng c vic lm trong thi k hn hn S thnh cng ny phn ln l do cng lao ca b my vin chc. Bng vic khen thng cho nhng ngi lm vic tt, cng khai xt tuyn nhn vin mi, thi hnh cc chng trnh nh hng v loan tin trn cc phng tin thng tin i chng v thnh cng ca mnh, chnh quyn bang to nn mt thc mnh m v s mng trong cc chng trnh ch cht v nhng ngi thc hin chng trnh. Nhng vin chc c ng c tt m ng nhiu phn vic hn bnh thng, v nhiu khi vi thi t nguyn. c trao quyn quyt nh rng hn, cc vin chc cung ng c nhiu dch v theo ng yu cu ring ca cc khch hng. Khc vi nhng ni khc, tuy cho quyn rng hn, nhng c hi lm iu tiu cc khng tng v c nhng p lc i hi nhn vin phi chu trch nhim. Nhn vin mun lm vic tt hn xng ng vi nim tin mi ca khch hng i vi h. V bn thn iu ny l kt qu ca vic sp xp cng vic theo hng phc v ng cc yu cu ca khch hng v chnh quyn bang cng khai t ra tn trng h. Nhng c ch ny to ra mt vng lun hi m trong nhn vin cm thy c qu trng v tha nhn, khng nht thit l bi cp trn, m bi nhng khch hng ca h v nhng cng ng ni h lm vic. V iu ny cng c tinh thn tn ty ca h i vi cng vic. Ngun: Ngn hng Th gii (1998), Nh nc trong mt th gii ang chuyn i, Bo co thng nin nm 1997, NXB Chnh tr Quc gia, H Ni.

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II.4. Tng cng s tham gia v gim st ca cng ng i vi vic hoch nh chnh sch v m bo cht lng dch v cng S tham gia ca ngi dn vo qu trnh hoch nh chnh sch v m bo cht lng dch v cng s gip nng cao hiu qu cung cp dch v ca nh nc thng qua vic ci tin qun l dch v cng v tng cng s minh bch trong quyt nh chnh sch. Qu trnh tham gia ny th hin qua nhiu cch khc nhau, c th t tham kho kin, trao i thng tin, cho ti nhng hnh ng trc tip tham gia ca cng dn, ch ng xut sng kin hoc gp vo chnh sch. Nht l nhng ni vic cung ng dch v cng khng hiu qu th ngi dn c th thng bo cho cc cp chnh quyn v vn ny v thc p h phi ci tin. Do , cc c quan cng quyn buc phi c trch nhim hn trong vic lng nghe ting ni ca ngi dn v phn hi kp thi, y trc cc yu cu . C ch phn hi ny gip cho cc thng tin hai chiu lun thng sut v c chia s. Thng qua , ngi dn v cc nh cung cp dch v c c hi cng nh gi v trao i kin nhm nng cao cht lng dch v. Kinh nghim cc nc cho thy rng s tng tc ngy cng tng gia ngi s dng v nh cung ng dch v cng em li nhng kt qu tch cc. Mt nh gi gn y ca ngi dn v h thng cung cp nc Bacu, Adebaigian cho thy khng ch nhng vn nghim trng v tht thot nc v cht lng nc c hi cho sc khe m c nhng chi ph cao do b my cung cp nc khng ng tin cy ca thnh ph p t cho nhng ngi tiu dng c thu nhp thp. Ngoi ra, nhng ngi tiu dng ny cng cho bit thm l h sn sng tr nhiu hn t 2 n 5 ln s tin thc t m h ang tr cho vic cung cp nc sch v ng tin cy. Nhng thng tin nh vy mt mc nht nh buc nh cung cp phi xem xt li cht lng dch v ca mnh, iu c th dn ti nhng thay i tch cc trong vic cung cp nc thnh ph ny. Singapore, Cc thng tin phn hi ca cng chng tp hp mt cch c h thng nhng bnh lun ca cng dn v nhiu loi chnh sch quc gia, trong c cung ng dch v cng, v mi nhng nhm c quan tm ti d nhng cuc hp bo co vi cc b trng v quan chc cao cp. iu ny lm tng tinh thn trch nhim ca c quan nh nc cung ng dch v cng thng qua vic i hi cc c quan ny phi cng b v tun th nhng nh mc v tiu chun dch v, cung cp thng tin cng cng v tr li khiu ni ca ngi dn. cc thnh ph ca M, chnh quyn cc thnh ph thit lp mt c ch ng b, ng vin cng chng tham gia vo ton b qu trnh qun l th. Do nhng ngi c li ch lin quan c tham gia mt cch rng ri vo qu trnh quyt nh chnh sch, nn qu trnh thc thi chnh sch c thc hin mt cch tng i thun li. Mt l do na khin cho s tham gia ca cng ng vo vic hoch nh chnh sch v m bo cht lng dch v cng tr nn cn thit; l thc t cho

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thy c quan cung ng dch v cng ca nh nc khng th d kin trc v p ng c tt c cc dch v cng m ngi dn mun c. Vic xut hin nhng bin php thay th ca cc t chc x hi v khu vc t nhn c th gip lp i nhng khong trng trong cung ng dch v cng. Do vy, cc t chc x hi c th va l nhng cng s, ng thi l nhng i th cnh tranh trong cung ng dch v cng. V mt khi c ngi dn ng h, cc t chc ny c th gy p lc vi chnh quyn ci thin vic cung ng v nng cao cht lng cc dch v cng. Trong cung ng dch v cng, cc nh nc ang to ra nhng c ch thun li mi ngi dn u c th ng gp, san s gnh nng ti chnh vi nh nc, v qua ci thin c cht lng dch v m chnh h c hng. C th thy r xu hng ny qua h thng bo him y t x hi da vo cng ng. y l mt hnh thc la chn tng bao ph ca h thng bo him y t, c bit mang li li ch cho ngi dn vng nng thn, v cc vng su, vng xa. Xu hng xy dng h thng bo him y t nh vy c nhiu nc ch trng. Th d, i loan v Hn quc rt quan tm n vic xy dng h thng bo him y t theo hng phc v ngi dn ngy cng c hiu qu da trn s ng gp ti chnh t pha ngi dn cng vi s h tr ca nh nc. Chng trnh bo him y t quc gia ca i Loan, sau 3 nm thc hin (1998), thu ht c 97% dn s tham gia. n cui nm 2003, con s ny ln ti 99%6. Chng trnh bo him y t lm cho ngi dn hiu r c quyn v ngha v hp php ca h trong vic cng nh nc v nhng ngi dn khc chia s ngha v ng gp v cng hng nhng li ch t Bo him y t quc gia. Thc t cho thy rng Chng trnh Bo him y t quc gia ca i loan bo v ngi dn khi nhng ri ro ti chnh v c s tip cn cng bng ti cc dch v y t. Bn cnh , Chng trnh tng cng cung cp cc dch v y t vng su vng xa, m bo li ch cho ngi dn sng cc vng kh khn. iu cho thy rng ch trng tng cng s tham gia ca ngi dn vo cung ng dch v cng qua mang li li ch cho c hai pha ngi dn v nh nc l hon ton ng n v cn c nhn rng ra nhiu lnh vc cung ng khc.

Bo him y t quc gia ca i Loan/ Hong-jen, Ti liu trnh by ti Hi ngh quc t: Hng ti bo him y t quc gia bnh ng, hiu qu v cht lng cao- i Loan, 20056

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PHN II THC TRNG CUNG NG DCH V CNG CA KHU VC NH NC V NHNG YU CU I MI CUNG NG DCH V CNG VIT NAMI. MT S THNH TU TRONG CUNG NG DCH V CNG CA NH NC TA nc ta, trc thi k i mi, Nh nc nm gi hu ht cc hot ng, t hot ng kinh t n dch v vn ho x hi, t qun l hnh chnh n gio dc, y t, ngn hng, bu in, giao thng vn ti, du lch Ni chung, Nh nc bao sn tt c. Mt s hot ng kinh t, x hi c tin hnh di hnh thc tp th, chu s chi phi ca nh nc. Cn hot ng ca t nhn ch tn ti trong mt s lnh vc, ch yu l bun bn v dch v nh l, khng c iu kin pht trin. Nh nc u t khng nh vo vic xy dng trng hc, bnh vin, mua trang thit b v t chc cung cp min ph nhng dch v ny, ng thi c nhng chnh sch v bin php tr gip cho ngi ngho c cung ng dch v cng, trc ht l trong hc tp v khm cha bnh. H thng gio dc v chm sc sc khe ban u ca Vit Nam c cng ng quc t nh gi cao. Cc dch v cng khc nh vn ha, thng tin, chiu sng cng cng, dch v nh , cung cp in, nc, thu gom rc thi, u do Nh nc trc tip t chc cung ng cho x hi. Mi ngi dn u c c hi gn nh nhau trong vic hng th cc dch v cng do Nh nc cung ng. Bc vo thi k i mi, Nh nc m ca mt s lnh vc dch v s nghip ( nh gio dc, y t, vn ho, th thao) v dch v cng ch ( nh vn ti cng cng, v sinh mi trng) cho s tham gia ca cc thnh phn kinh t Tuy nhin, do s tham gia ca khu vc t nhn v cc t chc x hi trong cung ng cc loi dch v cng vn cn giai on bc u vi nhng kt qu cn khim tn, nn Nh nc ta vn m nhn vic cung ng phn ln cc dch v cng. Phn ny tp trung gii thiu v nh gi nhng kt qu cung ng dch v cng ca Nh nc trong mt s lnh vc tiu biu trong cung ng dch v s nghip cng, dch v cng ch v hnh chnh cng. I.1. Dch v s nghip cng Trong nhng nm qua, cng vi s tham gia ca nhiu ch th khc nhau trong cung ng dch v cng, Nh nc ta lun c bit quan tm u t cho cc lnh vc s nghip vi ngn sch chi tiu c duy tr mc 30% tng chi tiu ca Chnh ph. Trong hon cnh ngn sch nh nc lun phi chu sc p t nhiu

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pha, c th thy rng chnh ph thc s quan tm n vic cung cp cho ngi dn cc dch v cng thit yu nh gio dc, y t v an sinh x hi. Nhn chung, ngi dn c hng th nhng iu kin gio dc, y t v vn ha, tt hn. iu c chng minh qua bng chng ch s pht trin con ngi (HDI) ca nc ta t c mc cao hn so vi trnh pht trin kinh t. Ch s HDI bao gm mt s yu t c bn ca cuc sng con ngi nh tui th, trnh vn ho v thu nhp thc t theo u ngi. Nu nh trong nm 2004, xp hng v GDP bnh qun u ngi ca Vit Nam ch mc 124, th ch s HDI ca Vit Nam c xp th 112 trong s gn 200 nc trn th gii7. Trong lnh vc gio dc, vi s u t ca Nh nc v truyn thng hiu hc ca dn tc, chng ta hon thnh vic xo m ch v ph cp gio dc tiu hc, ang thc hin ph cp trung hc c s v pht trin mnh cc trng dy ngh, gio dc i hc v chuyn nghip. S tr em trong tui tng cp hc c i hc t t l cao. Nm 2005 t l ny cp tiu hc l 97%, trung hc c s l 80%, trung hc ph thng l 45%. C nc c 17 triu hc sinh ph thng, trong 48% l hc sinh n. Cc trng ph thng hu ht l cng lp. Trng ngoi cng lp cn t, phn ln bc trung hc ph thng v tp trung th. Cc trng cng lp khng thu hc ph bc tiu hc, cc bc hc cao hn c thu hc ph nhng kinh ph u t v hot ng vn da ch yu vo ngn sch nh nc. Trong lnh vc o to (dy ngh, gio dc i hc, cao ng v chuyn nghip), s trng dn lp ngy cng tng, nhng t trng cha cao. Nm 2004 c 1,32 triu sinh vin i hc, cao ng, 465 nghn hc vin trung hc chuyn nghip, trong 10,5% hc cc trng ngoi cng lp. S hc sinh hc ngh mi tuyn nm 2005 l 1,18 triu ngi. Sinh vin, hc sinh ngho c nh nc tr gip thng qua chnh sch hc ph v cho vay di hn; nhiu a phng vn ng nhn dn lp qu khuyn hc gip cho hc sinh ngho v khuyn khch hc sinh gii. Bn cnh vic khng ngng tng t l chi ngn sch cho gio dc, ( t 8,6% nm 1985 tng ln 12,3% nm 2003) Nh nc ta tch cc vn ng, thu ht vn ODA, ti tr ca cc t chc quc t v chnh ph cc nc di hnh thc vin tr khng hon li v cho vay di hn vi li sut u i. u t cho lnh vc gio dc nhm thc hin cc mc tiu v ph cp gio dc, bi dng gio vin v cn b qun l gio dc; pht trin dy ngh v cng c cht lng i hc. Trong lnh vc y t, h thng y t nh nc c xy dng v pht trin tng i rng khp. T cp Trung ng, B Y t v cc bnh vin Trung ng, n cc tnh, huyn, x u c mt mng li cc t chc v cc dch v phng v cha7

UNDP (2005), Bo co Pht trin Con ngi nm 2004.

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bnh. Nh nc c quy hoch tng th pht trin s nghip chm sc, bo v v nng cao sc khe ngi dn. Ngn sch nh nc dnh cho ngnh y t (nm 2003 chim 3,1% tng chi ngn sch) c phn b theo hng u tin cho y t d phng, hon thin mng li c s, pht trin bo him y t cho cc i tng chnh sch, hin i ho cc trung tm y t chuyn su v pht trin y hc c truyn, Cc chnh sch tr gip ca nh nc cng vi cc hnh thc h tr ca cng ng qua cc qu t thin, lm vic ngha ...th hin s quan tm v c gng ca c nh nc v x hi trong vic chm sc sc khe ngi ngho, ngi gi c n, ngi tn tt,Cc chng trnh mc tiu y t quc gia c thc hin c hiu qu. C th thy r thnh cng ny thng qua vic thc hin tt cc d n tim chng m rng, phng chng dch bnh. Nh vy, nhiu dch bnh nguy him c khng ch; s ngi mc v cht do cc bnh truyn nhim ngy cng gim. Tui th bnh qun ca ngi Vit nam nm 2005 t 71,3 tui, thuc loi cao ng Nam . Nh nc cng c cc chnh sch nhm m rng v nng cao cht lng h thng khm cha bnh bng y hc c truyn t trung ng n c s, tng cng u t nhm y mnh nghin cu khoa hc, c bit l cng ngh sinh hc, cng ngh thng tin trong hot ng y t; y mnh sn xut thuc cha bnh v ci tin qun l th trng dc phm. Vic i mi chnh sch vin ph c thc hin i i vi chnh sch tr cp cho ngi ngho, khm cha bnh min ph cho tr em di 6 tui, pht trin bo him y t. Ngun nhn lc cho ngnh y t c quan tm u t pht trin, k c vic gi cn b y t ra nc ngoi o to. i ng cn b ngnh y c hng cc chnh sch i ng, ph cp c th (nh ph cp phng chng dch; ph cp chm sc bnh nhn lao, tm thn, phong, HIV/AIDS). Nh nc cng ng vai tr nng ct trong vic cung ng cc dch v vn ho- thng tin... v t c nhiu thnh tch ng k. Bn sc vn ha dn tc c gi gn, ng thi nhng tinh hoa vn ha ca nhn loi c tip thu. Mc tip nhn, hng th vn ha ca ngi dn qua cc knh khc nhau c ci thin r rt. c nhiu cng trnh vn ha c cc ngnh, cc cp quan tm u t gi gn, tn to, cc di sn vn ha phi vt th c bo tn v pht huy. Ti cc a phng, cc cng trnh, thit ch vn ha c xy dng rng khp, nht l phong tro xy dng nh vn ha thn, bn. Tnh n nm 2004, c nc c 5.126 nh vn ha, trung tm vn ha. Mng li th vin t cp tnh, huyn, cho ti x, thn c xy dng mi v nng cp, to iu kin cho ngi dn tip cn ngun tri thc qua sch, bo, ti liu. Nhng thnh tu gp phn nng cao i sng tinh thn cho ngi dn.

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I.2. Dch v cng ch i vi vic cung ng cc dch v cng ch, cho n nay, Nh nc vn l ngi chu trch nhim cung ng hu nh ton b cc dch v in, nc, v sinh mi trng. i vi dch v in v chiu sng cng cng, trong c ba qu trnh ca vic cung ng in, cc cng ty nh nc nm hu ht khu pht in, truyn ti v phn phi in. Nh nc u t nhiu vo vic nng cp v pht trin h thng c s h tng. Trong 5 nm (2001-2005) xy dng mi v nng cp 69.600 Km ng t; hu ht cc x trong c nc c ng t n trung tm x, c in ti cc gia nh, c trng hc, trm x y t, 62% dn s nng thn c dng nc sch v 90% c xem truyn hnh. Lnh vc cung ng dch v vn ti thu ht s tham gia ca cc thnh phn kinh t, ch yu l vn ti ng t v ng sng, cn vn ti ng hng khng v vn ti bin vn tp trung ch yu trong tay cc cng ty ca nh nc. Trong tng khi lng lun chuyn hng ho nm 2003 ca c nc, cc cng ty nh nc chim 64% v hng ho v 37,3% v hnh khch. Nhn chung, nhu cu i li v kinh doanh ca ngi dn c p ng tt hn; song cht lng dch v cha cao. Tnh trng tc nghn giao thng cc th ln cha c khc phc. Tai nn giao thng tip din nghim trng. Vic cung ng dch v bu chnh vin thng c bc pht trin mnh. Trc thi k i mi, dch v vin thng ch yu nhm phc v cho cc c quan, doanh nghip nh nc v mt s c s sn xut. i vi ngi dn, my in thoi khi cn l mt th xa x. n nm 1990, c nc mi c 114 nghn my in thoi, vi mt 0,17 my/100 dn. Cng vi chnh sch ci cch kinh t v m ca, ngnh bu chnh vin thng trong mt thi gian ngn thay i cn bn t mt h thng lc hu sang mng k thut s hin i m rng c cho cc vng nng thn, min ni, bin gii v hi o, m bo thng tin ni a v quc t thng sut. Tnh n cui nm 2005, trong c nc c 14 triu my in thoi (17 my/100 dn), 2,4 triu thu bao Internet8. Mng in thoi di ng pht trin nhanh vi s xut hin ca mt s cng ty thay cho tnh trng c quyn kinh doanh trc y. Vit Nam l nc c tc pht trin vin thng ng th hai trn th gii my nm qua, gp phn tch cc thc y s pht trin kinh t - x hi, bo m an ninh- quc phng, phc v dn sinh v nng cao dn tr.

Cc s liu ly trong bo co ca B K hoch v u t thng 10-2005 v k hoch pht trin kinh t - x hi 5 nm 2006 -2010.

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I.3. Dch v hnh chnh cng Dch v hnh chnh cng gn vi chc nng phc v v qun l ca nh nc, do cc c quan hnh chnh nh nc thc hin phc v cc quyn v ngha v c bn ca cc t chc v cng dn. Trong nhng nm qua, Nh nc ta ch trng i mi v nng cao cht lng cung ng dch v hnh chnh cng, coi l mt khu quan trng trong vic thc hin chng trnh ci cch nn hnh chnh c v th ch, th tc, t chc b my v cn b. Nh nc bt u p dng cc phng tin k thut in t, tin hc nng cao cht lng dch v hnh chnh cng, nh trong vic cung cp thng tin v th ch, t chc, u thu cc d n chi tiu cng, ng k cp php kinh doanh, cp php u t, hi p php lut hay ng k xe my Nhn chung vic cung ng dch v hnh chnh cng c mt s tin b, nhng khng u. Ngi dn v doanh nghip c to thun li v d dng hn trong mt s vic cn gii quyt vi c quan nh nc, nh ng k kinh doanh, lm th tc h tch, tm hiu lut php, song cn gp nhiu rc ri, phin h trong nhiu lnh vc khc, nh cp giy chng nhn quyn s dng nh, t, cho thu t, cp php xy dng nh, cng chng, h khu Ngi dn v doanh nghip vn tip tc l nn nhn ca tnh trng phin nhiu, bt hp l, chm tr, thiu hiu qu trong t chc v hot ng ca b my hnh chnh cc cp. II. NHNG VN TN TI TRONG CUNG NG DCH V CNG Vit nam, vi c ch bao cp trong nhiu thp k qua, Nh nc hu nh m nhim tt c vic cung cp cc loi dch v cng, di cc hnh thc khc nhau, nh thng qua cc doanh nghip nh nc cng ch, h thng trng hc, bnh vin cng, cc t chc ph n, on thanh nin hot ng bng ngn sch nh nc, Hu qu l Nh nc phi chu gnh nng v bin ch, chi ph hnh chnh, ng thi b my ca cc b, ngnh v a phng rt cng knh v km hiu qu. II.1. Hiu qu cung ng dch v cng thp Hiu qu thp trong cung ng dch v cng ca Nh nc khin cho ngi dn khng tha mn vi cc dch v cng m Nh nc ang cung cp hoc c quyn cung cp. Cc dch v ny nhn chung khng ch thiu v s lng, m cht lng phc v cng cn thp, do khi lng dch v cng do Nh nc m nhn cung ng trc tip cn qu ln v h thng cung ng dch v cng cn nhiu hn ch v nng lc qun l, iu hnh v t chc thc hin. S c quyn ca cc c quan nh nc trong vic cung ng mt s loi dch v cng l mt nguyn nhn quan trng dn n hiu qu cung ng dch v cng thp. Tnh trng c quyn lm tng tnh quan liu, ca quyn ca b my nh nc. Hot ng di s bao bc ca Nh nc, cc c quan nh nc chu trch nhim cung ng dch v cng cha thc s phi i mt vi cnh tranh v nguy c

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ph sn, nn h cha c ng lc gim chi ph, h gi thnh v nng cao hiu qu cung ng dch v cng. i vi nhng dch v thu tin, gi c dch v khng phn nh ng chi ph b ra; trong mt s trng hp, quy nh gi ca Nh nc thp hn chi ph, trong khi c nhng dch v do n v cung ng t nh gi li nng ln qu cao. C th thy r vn ny trong ngnh in, mt ngnh thuc nh nc c quyn trong vic cung ng dch v. Ngi dn v doanh nghip bt bnh v gi in tng lin tc, lm nh hng khng nh n i sng v sn xut. Trong khi , ngnh in a ra rt nhiu l do tng gi. Gi in c th khng tng, hoc tng mt mc hp l nu ngnh in ci tin phng thc qun l, trnh tht thot in nng, v gim bt tham nhng, lng ph trong vic xy dng, vn hnh cc nh my pht in v mng li phn phi in. V tiu cc trong vic lp t in k in t Thnh ph H Ch Minh m cng lun ln n gay gt trong thi gian va qua l mt minh chng cho s thiu trch nhim v km hiu qu ca c quan nh nc trong cung ng dch v cng. Cc loi tr cp v u i ca Nh nc i vi cc c quan cung ng dch v cng nh tr gi, tn dng u i, min thu s dng t,trong nhiu trng hp li em n cc kt qu tiu cc. Vic c hng nhng u i khng lm cho cc n v ny hot ng hiu qu hn, m thay vo li nui dng t tng li, da dm vo Nh nc, v trit tiu tnh nng ng, sng to ca cc n v . Trong cung ng dch v cng ca cc n v nh nc, s bao cp v cung ng dch v cng cng c th dn n tnh trng tiu dng qu mc cn thit, lm tng gnh nng ngn sch trong khi s lng v cht lng ca vic cung cp dch v vn khng c bo m. Mt hn ch na trong vic cung cp dch v cng ca Nh nc l s thiu vng cc dch v p ng nhu cu ngy cng cao v a dng ca ngi dn. Cc hot ng cung cp dch v cng mang tnh co bng khng cn kh nng p ng y , kp thi v tt cc nhu cu khc nhau ca cc b phn dn chng trong x hi. Ngi dn hin nay khng cn l nhng ngi th ng cu xin dch v ca Nh nc, m h tr thnh nhng khch hng, do vy h c quyn s dng dch v v i hi c phc v mt cch tt nht. C ch cung ng dch v cng hin nay ca Nh nc ta cha thch ng vi thc t ny.

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Hp 8 : S yu km ca h thng gio dc cng lp nc ta, gio dc c coi l quc sch hng u nn ngn sch u t mi ngy mt tng. Nm 2005, s tin u t vo lnh vc ny ln ti 4 t USD (2 t ca Nh nc v 2 t ca dn), cng vi s tin khong 900 triu USD vay ca nc ngoi v 3.000 t ng tin cng tri gio dc. y l s tin tng i ln so trong hon cnh ngn sch chung ca Vit Nam hin nay9. Cng cuc ci cch gio dc cng c tin hnh t nhiu nm nay, v bc u t c mt s kt qu nht nh. Tuy vy, h thng gio dc ca Vit Nam vn ang trong tnh trng ng bo ng v nhiu phng din dn n cht lng gio dc b gim st, mt nguy c ln i vi s pht trin chung ca ton dn tc. Qun l gio dc Vit Nam mang tnh tp trung. Cc chnh sch gio dc u do B Gio dc v o to ch th t Trung ng. iu dn n vic a ra cc chnh sch xa ri thc t ca mi a phng, lm chm s pht trin ca tng vng ni ring v c nc ni chung. Khc hn vi h thng gio dc nhiu nc khc l va cung cp cho sinh vin nhng kin thc c bn, va to cho h mt kh nng t duy phn tch v tng hp s kin, th gio dc Vit Nam c tnh t chng v nhi nht vo u cc sinh vin cng nhiu s kin cng tt, khng to cho h c tnh t ch v t lp sau ny c kh nng t gii quyt cc vn 10. Trong lnh vc gio dc, cha c s pht trin cn i gia gio dc ngh nghip, gio dc i hc v gio dc ph thng; quy m, cht lng v hiu qu gio dc ngh nghip cha p ng yu cu cng nghip ho, hin i ho t nc; i ng gio vin cn thiu, cht lng cha p ng yu cu ca i mi gio dc; cng tc qun l gio dc cn hn ch, nht l i vi gio dc khng chnh quy v gio dc ngoi cng lp; nhiu gio vin, nh trng cha tch cc i mi phng php dy v hc; cc iu kin bo m pht trin gio dc cn nhiu bt cp; gio dc vng su, vng xa cn gp nhiu kh khn; vic phong hc hm, hc v khng t ln hng u tiu chun cht lng lm xu i hnh nh v uy tn ca ngi thy trong x hi. c bit, mt trong nhng vn nn ca ngnh gio dc Vit Nam l vic chy theo bng cp, mua im, s tha ha v o c ca mt s gio vin. Tnh trng dy thm, hc thm trn lan v ang gy ra nhiu hu qu tiu cc, lm nh hng khng nh ti cht lng o to, uy tn ca cc thy

9

Chi tiu cho gio dc Vit Nam nm 2005 chim 8,3% GDP, vt c M ch c 7,2%. Thi bo kinh t Si gn, ngy 25-11-2004

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c gio, sc khe v kh nng tip thu ca cc em hc sinh. Mt yu t khc lm nh hng nghim trng ti cht lng gio dc chnh l vic thiu trang thit b dy hc. Tnh trng dy chay, hc chay ca thy v tr vn ang din ra khng ch nhng vng nng thn, vng su, m cn c nhng thnh ph ln.

Mc d theo B Gio dc v o to, Vit Nam c ti 94% dn s bit ch, v xa xong nn m ch, ph cp gio dc tiu hc v ang thc thi ph cp trung hc c s, song trn thc t, c khong 6,8 triu ngi trn 10 tui cha tng n trng v trong s c 5,3 triu ngi hon ton cha bit ch. Mt trong nhng nguyn nhn ca nn m ch l chi ph trc tip cho gio dc Vit Nam kh cao so vi thu nhp ca cc h ngho. Bn cnh , Vit Nam hin nay, s lao ng c o to ngh ch t 25% so vi tng s lao ng, c ngha l cn 75% lao ng khng c o to. Tt c nhng yu t trn lm suy gim nghim trng cht lng gio dc Vit Nam, y nn gio dc Vit Nam tt hu xung hng thp nht khu vc ng Nam . Thc trng trn ca ngnh gio dc t ra vn phi tin hnh ci cch nng cao cht lng gio dc. D lun x hi cho rng n lc phi nhn thng vo s tht m x tn gc nguyn nhn ca s tr tr trong ngnh gio dc. Ci cch gio dc phi su rng ch khng n thun l tng thm kinh ph cho cc trng hay nhng gii php chp v mi khi c s phn ng ca x hi. i vi gio dc cp i hc, cn thit phi ch trng ti phng thc qun l, quyn t ch, trc tin l t ch v o to ca cc trng, thay i ni dung chng trnh v phng php dy v hc, o to li v sng lc i ng ging vin v xy dng nhng chnh sch x hi tho ng trong gio dc. Trong nhng nm gn y, B Gio dc v o to cho php cc trng trng im quc gia c xut mt s chng trnh o to hin i da trn c s tham kho cc chng trnh o to nc ngoi m khng b rng buc bi chng trnh khung ca B. Hy vng rng, vi s chuyn bin mi ny, cht lng o to trong cc trng i hc s c s ci thin ng k. nc ta hin nay, cu hi nn hay khng nn coi gio dc l mt loi hng ha c bit ang l mt vn cn gy tranh ci. Song mt iu r rng l nu cho khu vc t nhn chim v tr ch o trong vic cung ng dch v gio dc th s xy ra tnh trng nhiu ngi c nng lc khng iu kin i hc. X hi s b tn tht to ln do khng tn dng c tr tu ca nhng ngi ny. V vy, to ra s cng bng, Nh nc c trch nhim cung ng loi dch v ny cho tt c ngi dn ca mnh mt mc nht nh, to tin cn thit cho mi cng dn pht huy c ht kh nng ca mnh. Vi ngha nh vy, th Nh nc phi gi mt vai tr ct yu trong pht trin gio dc, v vic ci cch gio dc hng ti mt h thng gio dc ton din c cht lng v khc phc nhng khim khuyt hin nay trong h thng ny phi l trch nhim chnh ca Nh nc. Vi ch

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trng mi ca ng v Nh nc v x hi ha gio dc, vic cho php khu vc t nhn v cc t chc x hi dn s tham gia vo lnh vc ny s gp phn thc y s nghip gio dc, o to ln mt bc mi.

Thc t cho thy rng, trong lnh vc cung ng dch v cng, Nh nc ta c gng rt nhiu nhm p ng cc yu cu ca x hi. mt mc nht nh, Nh nc m bo c vic cung ng cc dch v cng thit yu cho ton x hi. Trong mt s lnh vc nh gio dc, y t, chng ta t c nhng kt qu ng k. Tuy vy, bn cnh nhng thnh tu ni trn, hot ng cung ng dch v cng ca Nh nc cn nhiu thiu st. hot ng cung ng dch v cng c tt hn na, chng ta cn tng bc ci tin hot ng ca nhng c quan nh nc cung ng dch v cng, i mi c cu t chc v quy trnh cung ng dch v. iu quan trng l phi thc y s cnh tranh trong lnh vc cung ng dch v cng thng qua vic chuyn giao mt phn cc dch v cng cho khu vc t nhn v cc t chc x hi dn s. chnh l nhng yu cu v i mi cung ng dch v cng c cp n trong phn sau. II.2. B my hnh chnh nh nc cn nhiu bt cp C cu b my hnh chnh nh nc ang bc l nhiu im yu, khng ph hp vi chc nng ca nn hnh chnh nh nc trong iu kin kinh t th trng v do khng c kh nng cung ng nhng dch v m thc t i hi. Nn hnh chnh vn cn mang nng du n ca c ch tp trung, quan liu bao cp, cha p ng c nhng yu cu ca c ch qun l mi cng nh yu cu phc v ngi dn trong iu kin mi, hiu qu qun l cn thp. Cc b, ngnh, a phng vn theo m hnh qun l c, mang nng tnh quan liu, hnh thc. C nhiu loi dch v m dn c nhu cu khng c quan tm gii quyt ng mc, th d nh dch v cung cp thng tin, t vn, h tr vic lm, Ngoi ra, chc nng, nhim v qun l ca b my hnh chnh cha c xc nh ph hp; s phn cng, phn cp gia cc ngnh v cc cp cha tht rnh mch. Vic quy nh thm quyn, phn cng trch nhim khng r rng cng vi s thiu phi hp gia cc c quan nh nc trong nhng cng vic c tnh cht lin ngnh lm gim cht lng cung ng dch v cng ca Nh nc. Mt vn nghim trng na l h thng th ch hnh chnh cn cha ng b, cn chng cho v thiu thng nht; th tc hnh chnh trn nhiu lnh vc cn rm r, phc tp; trt t k cng cha nghim. Phng thc t chc b my hnh chnh cha khoa hc, cn cng knh, va tp trung quan liu, va phn tn; cha c nhng c ch, chnh sch ti chnh thch hp vi hot ng ca c quan hnh chnh, n v s nghip, t chc lm dch v cng. Vic cc n v nh nc cung ng dch v cng chu s qun l ca c quan ch qun tng t nh n v hnh chnh, dn n tnh trng cc c quan

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ny khng pht huy c tnh t ch, t chu trch nhim trong hot ng v pht trin ca mnh. Tt c mi k hoch v chng trnh hot ng thng c cp trn giao c th, nh ch tiu tuyn sinh, s ging bnh, s phim pht hnh trong nm, V ti chnh, n v s nghip l n v d ton nh c quan hnh chnh, ch da vo mt ngun u vo t ngn sch nh nc, chi v thu u theo d ton c cp trn duyt. V t chc cn b, cp trn quyt nh nh bin, tuyn chn cn b nhn vin; vic sp xp lng bng, c cn b i nc ngoi, thnh lp n v trc thuc, v.v. u phi c cp trn ph duyt. iu dn ti s tr tr trong nng cao tnh sng to v ci tin hiu qu cng vic ca cn b, nhn vin trong cc c quan nh nc. Vi c ch vn hnh nh hin nay ca b my hnh chnh, ngi dn kh c th tham gia v gim st mt cch c hiu qu, qua ci thin cht lng cung ng dch v cng ca khu vc nh nc. Tnh trng thiu trch nhim gii trnh v v thc trch nhim t pha cc c quan cng quyn v vic cung cp thng tin cho cng chng cn tr ng k vic tham gia v gim st ca ngi dn i vi hot ng cung ng dch v hnh chnh cng. Ngoi ra, nhiu kin ng gp tch cc ca ngi dn khng c cc c quan hu quan n nhn. Nghim trng hn, vic gii quyt khiu ni, t co ca ngi dn cn nhiu vng mc, khng dt im, v khng tun th php lut. Hin tng n trnh gii quyt hoc gii quyt khng ng cc yu cu ca ngi dn din ra ph bin, lm cho ngi dn mt dn lng tin vo cc c quan cng quyn, yu t v lu di c th gy ra nhng bt n x hi nghim trng. Bn cnh , phng thc v th tc cung ng dch v cng cn rm r, nng v to ra s thun tin cho bn cung ng ch cha nhm p ng tt nhu cu ca ngi dn. C th thy r iu ny nht trong lnh vc dch v hnh chnh cng. nhn c mt giy php no , ngi dn phi i n nhiu c quan nh nc khc nhau; thi gian gii quyt cng vic ko di, lm mt c hi kinh doanh ca doanh nghip, hoc tn thi gian ca ngi dn. V nhng l do nh vy, mt thi gian v cng sc, nhiu ngi phi chn cch khon trn gi cho cc c dch v thay mnh i lm cc th tc. Ngoi ra, th tc hnh chnh cn thiu r rng, thiu thng nht, khng cng khai v ty tin thay i, thin v x l cc gii php tnh th, b ng trc yu cu pht trin nhanh ca thc t. iu nguy him l mt s ni cn xy ra tnh trng thng mi ha cc loi dch v do Nh nc m trch. Mt yu t c bn khc lm nh hng xu n cht lng cung ng dch v cng ca Nh nc l i ng cn b, cng chc cn nhiu im yu v phm cht, tinh thn trch nhim, nng lc chuyn mn v k nng hnh chnh; phong cch lm

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vic chm i mi, t quan liu, tham nhng, sch nhiu dn tip tc din ra nghim trng trong mt b phn cn b, cng chc. Trong cc c quan cung ng dch v cng, c bit l cc c quan c trch nhim tip xc trc tip vi ngi dn, thi ca nhiu cng chc cn mang nng tnh quan liu, ca quyn, gy rt nhiu phin h cho ngi dn. C th thy rng, vi nhng tn ti trong b my hnh chnh nh phn trn cp, th cht lng cung ng dch v cng do khu vc nh nc cung cp s b nh hng nghim trng. Do vy, trc nhng yu cu i mi v pht trin kinh t - x hi trong thi k mi, i hi Nh nc, m trc tip l b my hnh chnh phi hon thin th ch v nng cao hiu lc qun l theo c ch mi nhm phc v tt hn nhng yu cu chung ca ton x hi. II.3. Thiu ht ngn sch trong cung ng dch v cng Mc d ngun kinh ph t ngn sch cho hot ng s nghip tng nhanh hn cc lnh vc khc, song vn mc rt hn ch, khng bo m c chi ph cn thit ca cc n v nh nc cung ng dch v cng. Th d, mc ngn sch dnh cho ngnh y t cn kh thp vi mc chi nm 1997 l 3,8%, v nm 2001 l 3,2%. S eo hp v ngn sch chi cho vic cung ng dch v cng gy nhiu kh khn cho cc n v nh nc chu trch nhim cung ng loi dch v ny. Khi Nh nc giao cho n v thc hin nhiu hot ng dch v cng min ph hoc thu ph rt thp, nhng li khng bo m cho cc n v ny cc iu kin thc hin cn thit v nhn lc, cng ngh, ti chnh,th vic hon thnh cc nhim v c giao ca cc n v ny l cc k kh khn. Mc ngn sch hn hp nh vy nh hng rt ln n hiu qu cung ng dch v cng, lm thu hp din dch v c cung ng cng nh cht lng dch v, trc ht l khng tr lng tha ng cho cn b, nhn vin trong cc ngnh cung ng dch v cng, nht l cc gio vin, cn b y t, cng nhn v sinh mi trng, tip l khng p ng c yu cu pht trin. Trong khi y, nhu cu ca nhn dn v cc lnh vc ny ang tng ln nhanh chng vi i hi cao hn v cht lng khi mc sng ngy mt ci thin. Thc trng ny dn n nhng bt cp trong vic cung ng dch v cng ca Nh nc, ng thi lm pht sinh nhng hin tng tiu cc, ph hu nn tng o c ca x hi. C nhiu nguyn nhn dn n s eo hp ca ngun ngn sch nh nc. Xt trn bnh din v m, do Vit Nam l mt nc ngho, vi mc thu nhp bnh qun u ngi thuc nhm thp nht trn th gii, nn ngn sch nh nc dnh cho cc dch v cng hn hp cng l iu d hiu. Trong khi , vic phn b cng nh vic huy ng cc ngun thu cho ngn sch li khng hp l. Trng hp cung ng dch v cng cng vy. R rng rng, thu nhp ca cc tng lp trong x hi hin

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nay c s phn ha r rt, nhng Nh nc vn duy tr ch thu ph mang tnh cht bnh qun, khng phn bit mc thu nhp. Chnh iu ny gp phn dn ti tnh trng khng ngun lc trang tri cc chi ph cn thit m bo cht lng cng nh s lng v cung ng dch v cng.Hp 7: Nhng tn ti trong cung ng dch v y t ca Nh nc Trc y, Nh nc bao cp phn ln trong vic cung ng dch v y t vi ch khm, cha bnh khng mt tin v mang tnh bnh qun. S dn tri dn n nhiu kh khn cho ngn sch nh nc ni chung v ngnh y t ni ring. Vi khon bao cp qu ln nh vy, Nh nc khng tin tr cp y cho hot ng chm sc sc khe v khin cho ngnh y t lun trong tnh trng thiu thn ngn sch kinh nin. Cc c s y t a phng khng kinh ph cho xy dng, nng cp kt cu h tng, trang thit b, thuc men v o to. Kt qu l cc bnh vin b xung cp nghim trng, tin lng ca y, bc s qu thp khin h khng cn ng lc lm vic, v iu tt yu xy ra l cht lng dch v chm sc sc khe ngy mt yu km. Do nhng kh khn v kinh ph t ngn sch, k t nm 1989 Nh nc p dng ch thu mt phn vin ph lm gim nh gnh nng i vi Nh nc trong lnh vc ny. Song, nhn chung cc c s y t cng vn ch yu da vo ngun chi t ngn sch nh nc, m trn thc t s tin ny ch p ng c khong 40% nhu cu chi tiu ca ngnh y t. S thiu thn v kinh ph nh vy dn n hiu qu chm sc sc khe cn thp; l t l suy dinh dng tr em cn cao, t l ngi mc cc bnh truyn nhim nh st rt, HIV/AIDS, st xut huyt, vim phi v nhng bnh lin quan n nc sinh hot gia tng. Bn cnh , s chnh lch v tnh trng sc khe gia cc vng min v cc nhm dn c cng l mt vn ng bo ng, m theo nhm ngi ngho d b tn thng nht. Theo Ngn hng th gii, ch mt ln i khm bnh vin trung ng vo loi tt c th phi chi mt khon tin bng na s chi tiu cho cc khon chi ph lng thc mi nm ca mt c nhn trong nhm ngho nht. iu e da sc khe ca nhng ngi ngho, do chi ph cho vic chm sc sc khe vt qu kh nng ti chnh ca h. Cc chnh sch y t khng hp l cng dn n nhiu hin tng tiu cc trong ngnh y t. Bnh nhn i khm, cha bnh cc c s cng lp hin nay, ngoi mc ph chnh thc, thng phi chi nhiu khon khc mt cch khng chnh thc, thiu minh bch. Mc lng thp cng vi cc khon ph cp khng thch ng khin cho mt s cn b, nhn vin ngnh y t tc trch trong cng vic, v c thi vi vnh, hch sch bnh nhn, iu by lu nay gy nhc nhi cho ton x hi; vic thu mt phn vin ph to ra nhiu phc tp trong mi quan h gia thy thuc v bnh nhn, ngi giu- ngi ngho v kh khn trong cng tc qun l cc c s y t. c bit, tnh trng qu ti hin nay nhiu bnh vin tuyn tnh v trung ng to nn nhiu bt cp v nhn lc v ti chnh cc bnh vin ny

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mt cch trm trng, lm nh hng khng nh n cht lng khm, cha bnh v chm sc bnh nhn. Ngoi ra, vic ngn sch nh nc cp theo ging bnh tr nn thiu cng bng gia bnh vin qu ti v bnh vin c cng sut s dng ging bnh thp. Bnh vin cng b qu ti th ngn sch cp cho mi ging bnh cng thp. Thc t ny y cc bnh vin c cng sut s dng ging bnh cao vo tnh trng kh khn trm trng gia ngn sch c cp v chi ph thc t cho ging bnh, yu t dn n cht lng dch v km ca cc bnh vin. Tnh hnh trn cho thy vic cho php t nhn tham gia vo lnh vc chm sc sc khe l cn thit v cp bch. Tt nhin, chng ta khng th khu vc t nhn ton quyn trong lnh vc ny, nu nh vy th s dn n tnh trng nhng ngi giu c chm sc sc khe y , cn nhng ngi ngho th phi chu ng bnh tt, m au. Chnh v vy, cng vi vic chuyn giao mt phn vic cung ng dch v trong ngnh y t cho khu vc t nhn, Nh nc phi bo m cho mi cng dn ca mnh c hng mt mc chm sc y t ti thiu nh nhau (mc ti thiu ny c nng dn theo pht trin ca t nc).

III. NHNG YU CU V I MI CUNG NG DCH V CNG Lin quan n nhng bt cp trn y c th k n mt s nguyn nhn ch yu sau y: Mt l, Nh nc qu bao sn trong lnh vc cung ng dch v cng dn n: + Tnh trng c quyn trong lnh vc ny, th tiu cnh tranh trong ni b khu vc cng cng nh gia khu vc cng v khu vc t. Trong kinh t hc ni chung, v mt l thuyt cng nh trn thc t, trng thi c quyn lm trit tiu ng lc i mi ca t thn t chc c quyn. H khng thc s ch n nhu cu i mi nng cao cht lng sn phm cung ng v bn thn h khng chu bt k mt sc p cnh tranh no. Dch v cng khng phi l mt ngoi l. Vic nh nc m nhim cung ng phn ln dch v cng, mc nhin quyt nh mi kha cnh lin quan n dch v cng, c ch th trng khng c ting ni tt yu dn n cht lng hng ho v dch v cng cung ng ra khng c quan tm ng mc. + Gnh nng chi tiu cho dch v cng chc chn vt qu gii hn ngn sch hn hp ca nh nc. Khng ch vy, ngun lc cn b (v s lng cng nh cht lng, nng lc chuyn mn, nng lc qun l, phm cht o c) cng nh

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k thut ca khu vc nh nc cng khng p ng ht cc nhu cu dch v cng trong x hi, nh hng n cht lng v s lng ca dch v cng cung ng. Hai l, kh nng cung ng dch v cng thch hp cho tng cng ng a phng ca chnh ph l hn ch. Bi l, chnh ph trung ng thng khng hiu r nhu cu, th hiu ca cng ng dn c a phng bng cc t chc c nhn hay chnh quyn a phng, do hn ch n tnh thch ng v hiu qu cung ng dch v cng. Ba l, cho n nay, dch v cng vn c xem l dch v thit yu mt chiu do Nh nc cung ng v qun l, cn ngi dn th c trch nhim tip nhn v s dng khi cn thit. V vy, ting ni ca cng ng, phn hi ca khch hng v dch v cng cha tht s c ch trng, cha c nhn nhn ng mc trong hon thin cung ng dch v cng. y cng l mt l do gp phn vo nhng tn ti nu trn trong lnh vc dch v cng. Bn l, mt nguyn nhn quan trng v in hnh ca khu vc cng l b my nh nc cng knh, th tc hnh chnh phin h, t quan liu, ca quyn lm cho cc cng ty nh nc cung ng dch v cng thiu kp thi, tn km ngun lc v gy kh khn cho dn chng trong tiu dng cc dch v cng. Hin nay, chng ta ang sng trong mt thi i ca nhng s thay i nhanh chng, trong mt th trng ton cu c sc p cnh tranh rt ln i vi nn kinh t v cc ch th kinh t, trong mt x hi ca thng tin, mt nn kinh t da trn c s tri thc. Trong c ch th trng , khch hng tr nn quen vi cht lng cao v s la chn rng ri cc sn phm hng ha dch v. V vy, ci cch vic cung ng cc dch v cng gii quyt nhng bt cp trn y l iu tt yu, v cn tp trung vo cc vn sau y: Mt l, m rng p lc cnh tranh hay vn dng thch ng c ch th trng vo lnh vc dch v cng. Cnh tranh lm nng cao hiu qu v lnh mnh cc t chc cng thng qua nhng gii php gim s can thip ca nh nc nh t nhn ho, gii iu tit v u thu hp ng. Chnh lc lng th trng s l cc cng c t nhin iu tit cung cu, lm cn bng th trng. V l , cnh tranh c xem l mt trong nhng ng lc quan trng trong cung ng dch v cng, khuyn khch s i mi trong cung ng dch v cng. Cnh tranh l mt hnh thc o thi t nhin. c bit, trong lnh vc cung ng dch v ni chung v dch v cng ni ring n to iu kin cho "s tn ti ci c ch". n lc, Nh nc cn nhn thc li vai tr ca mnh. Cc cp chnh quyn cn thay i li nhn thc v vai tr ca Nh nc trong cung ng dch v

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cng, mnh dn i mi phng thc qun l, khng m m nhng vic m cc ch th thuc cc thnh phn kinh t khc c th thc hin c trong tm kim sot ca Nh nc. Tinh thn chung l nhng dch v cng no khu vc t nhn c th m nhn c th Nh nc ch ng vai tr l ngi qun l v gim st cht lng, cn i vi cc dch v cng khng th v khng nn giao cho khu vc t nhn, th nh nc s l ngi cung ng trc tip. Nh nc ch nn m nhn cc dch v cng thun tu mang tnh qun l nh nc m khng ai lm thay c. Tnh cnh tranh trong cc dch v ny gii hn trong cnh tranh ni b ca cc c quan nh nc. Cc doanh nghip nh nc cng c khuyn khch cnh tranh vi nhau v c php tham gia u thu ni b nh mi i tc trong nn kinh t. Ngc li, i vi cc dch v cng khng thun tu, Nh nc nn m rng i tng cung ng cho th trng. Chnh ph da vo c ch th trng hon thin cung ng dch v cng, to ra mi trng cnh tranh thng qua cc bin php m rng th trng hay hp ng u thu. Thc cht y l hot ng x hi ho vic cung ng dch v cng. Cch tip cn ny cho php nh nc gim gnh nng v ti chnh v gim s cng knh trong t chc thc hin cung ng cc dch v cng. M rng th trng y c hiu l a dng ho nh cung ng dch v cng, to iu kin cho nhiu i tng tham gia vo cung cp dch v x hi nh gio dc v y t. Tt nhin l, nhng nh cung cp ny phi tun th cc tiu chun ca nh nc. Bn cnh , hnh thc hp ng u thu cnh tranh cng lm tng trch nhim v hiu qu cung ng dch v cng. Th nht, hai bn c phn nh r rng trch nhim ca mnh trong vic cung cp dch v g v tiu chun cht lng dch v ra sao. Theo hp ng, bn ch thu thit lp h thng tiu chun - ch s kim tra, nh gi hot ng v bn thu phi tun th, chu s gim st. y l c s quan trng nh gi kt qu ca hp ng v l do iu chnh hp ng cho thch hp vi iu kin. Th hai, hp ng thu nh hng tch cc ti hiu qu v tit kim chi ph. Cc nh thu c quyn t ch cao hn trong hot ng, hon thin v n gin ho b my qun l. T , kh nng nng cao nng sut lao ng c tng ln. Quyn t ch cao cho php cc nh thu linh hot trong vic cung cp dch v cng cho khch hng. Mt gii php khc trong vic m rng cnh tranh trong khu vc cng l s phn quyn v u quyn cho khu vc t cung ng hng ho v dch v cng. Vic u quyn ny thng xy ra khi cc cng ty nh nc khng kh nng (k thut v nhn s) hoc cung cp cc dch v khng hiu qu. Cc cng ty t nhn c k vng s thc hin cc nhim v hiu qu v nng sut hn.

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Vic u quyn cung ng dch v cng cn m rng cho nhiu nhm li ch trong x hi. Cc nhm li ch ny c th k n cc hip hi ngh nghip, cc nhm cng ng, cc hp tc x, cc hi t thin, cng on, t chc ca ph n hay thanh nin, cc t chc phi chnh ph. c bit, lin quan n tnh thch ng v hiu qu ca mt s loi dch v cng, trong nhiu trng hp, c quan cung ng dch v cng ca nh nc cp trung ng khng th hiu r c nhu cu ca ngi dn a phng. Trong iu kin , chnh quyn a phng (chnh quyn tnh, thnh ph) hay cc t chc a phng s cung cp cc dch v c th cho ngi tiu dng hiu qu v thch ng hn. Ni cch khc, phn quyn v trch nhim ph hp trong cung ng dch v cng ng vai tr quan trng trong vic nng cao hiu qu v thch ng ca dch v cng. Cho php khu vc t nhn tham gia cung ng dch v cng cng l mt trong cc gii php vn dng c ch th trng vo khu vc cng, v iu c chng minh l rt thch hp cho vic nng cao hiu qu cung ng dch v cng. y, Nh nc v t nhn tr thnh i tc hp tc thc s trong kinh doanh. Vic chuyn giao cho khu vc t nhn cung ng dch v cng bao gm nhiu gc , t vic chuyn quyn s hu t liu sn xut ca doanh nghip nh nc sang tay t nhn cho ti gii iu tit. Gii iu tit c ngha l tho g hay ni lng s iu tit y l cc quy nh (php lut) cho php t nhn hay cc t chc phi chnh ph tham gia cnh tranh cung cp dch v cng cho cng chng vi cc doanh nghip nh nc. Bng cch ny, cc doanh nghip t nhn v cc t chc phi chnh ph gip Nh nc gim bt gnh nng thm ht ngn sch, ng thi c th tham gia tch cc vo p ng cho nhn dn mt cch tt hn v hiu qu hn (Hughes 1998).Hp 9: Li ch ca vic i mi cung ng dch v cng - To mi trng cnh tranh gia cc t chc t nhn nhn cung ng dch v cng. Cc t chc c nhn thu cung ng c quyn mt loi dch v cng no lun c nguy c b xa b hp ng nu lm n km hiu qu; To ra hiu qu cung ng dch v cng cao hn; - Nng cao hiu qu cung ng dch v cng thng qua ci cch hng ti cht lng v hiu qu phc v ca cc c quan cng quyn; - To iu kin cho mi ngi tham gia tch cc vo hot ng cung ng dch v cng, pht huy c kh nng v nng lc tim tng trong x hi, khi dy tnh ch ng sng to v tch cc ca ngi dn; - ng vin s ng gp kinh ph ca mi ngi dn vo hot ng cung ng dch v cng ca nh nc;

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- L gii php cn thit gp phn to ra s cng bng trong tiu dng cc dch v cng.

Tuy nhin, cn phi lu l, thc hin tt vic chuyn giao dch v cng cho cc t chc, c nhn, th bn thn cc c quan nh nc phi t chc tt vic cung ng cc dch v cng do mnh m nhim, bo m tin ch v hiu qu cho nhn dn. Nu Nh nc khng lm tt c vic ny th khng th thc hin tt vic chuyn giao v qun l dch v cng cho t chc v c nhn. Bi l, m hnh cung ng dch v cng ca cc c quan nh nc chnh l c s, l thc o nh gi cht lng, hiu qu cc dch v cng sau khi chuyn giao cho cc t chc, c nhn. Mt yu cu na l, Nh nc cn hon thin cc vn bn php quy v quy trnh chuyn giao cung ng dch v cng cho khu vc t nhn. Hai l, tng cng ting ni v vai tr i tc ca cng dn, cng c c ch ln ting. Dch v cng khng phi l hot ng thuc chc nng qun l ca Nh nc m thuc chc nng phc v x hi ca Nh nc. Do , y, Nh nc ng vai tr l ngi phc v cn cng ng l ngi c phc v. Xt trn gc dch v, th ngi dn l khch hng. Chnh v vy, mi cng dn u c quyn by t kin ca mnh v cht lng cc hng ha v dch v cng c cung cp. Chnh p lc t cc kin phn hi bn ngoi s cho php kim sot v i mi vic cung ng dch v cng. "C ch ln ting" ny c bit c nh hng trong vic hon thin khu vc cng ct li v m rng. thc hin c c ch ny, Nh nc c th p dng cc bin php nh khuyn khch s tham gia ca cng dn vo hoch nh chnh sch cng, iu tra khch hng, tham kin ngi tiu dng C th, Nh nc cn pht huy dn ch trong quy trnh hoch nh chnh sch, cho php, khuyn khch v to iu kin cng chng tham gia ng gp kin vo cc d n nh nc lin quan ti li ch ca cng ng, gim st hot ng ca cc t chc nh nc trong cung ng dch c cng, ng thi xut kin ngh, thc mc ti cc c quan chc nng v cc vn ny sinh lin quan n dch v cng trong x hi. n lt mnh, cc c quan cng quyn c trch nhim lng nghe ting ni ca cng dn, tip thu, x l v phn hi kp thi, y cc kin ngh ng thi iu chnh hot ng cung ng dch v cng ca mnh. C ch phn hi nng cao tnh minh bch, cng khai v thc hon thin kt qu hot ng ca tng c nhn v t chc. Thng qua c ch ny, ngi tiu dng c c hi nh gi v ng gp kin v thc trng cung cp dch v cng hin ti. Ngc li, t nhng kt qu phn hi , nh cung cp rt kinh nghim v hon thin mnh hn. Hin nay, cc nc pht trin v ang p dng nhiu cch thc khc nhau hon thin hot ng cung ng dch v cng, c t pha cc t chc nh nc

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cng nh cc t chc t nhn. Mt trong nhng cch thc c cc nh qun l khu vc nh nc quan tm l cch tip cn nh hng khch hng, c cc t chc t nhn p dng thnh cng. Cch tip cn ny, v thc cht l tp trung vo nhu cu, i hi ca ngi s dng hn l kh nng ca nh cung cp c th cung ng nhng g. Trong iu kin , c ch ln ting hay tng cng ting ni v i tc ca cng dn cng cn c ch trng. Bi l, li ch ca knh thng tin hai chiu l cho php cc nh cung cp nm r ci g dn chng cn v thc t cc dch v cung cp c hiu qu hay khng. Ba l, cng khai ho cc tiu chun cung ng dch v cng. iu ny cho php to ra mi trng lm vic minh bch, dn ch v cng bng trong ton x hi. Cc tiu ch c cng khai gm th tc hnh chnh, tiu chun cht lng dch v v ph dch v cng. Vic cng khai ho, mt mt, to iu kin thun li cho ngi tiu dng trong vic tit kim thi gian v chi ph giao dch, hiu c mnh cn phi lm g v c hng nhng g, trnh c nhng phin h, sch nhiu, thi quan liu, ca quyn ca cn b n v cung cp dch v cng i vi khch hng. Mt khc, cng khai cc tiu ch c vai tr nh i chng php quy trong vic cung cp dch v cng c th, m bo vic cung cp dch v cng c thc hin ng theo cam kt v do , ngi tiu dng c cn c tin tng vo dch v cng h s dng. Bn l, kin ton b my qun l khu vc cng. Khng th cung ng dch v cng tt vi mt b my qun l khu vc cng hot ng km hiu qu. Vic i mi ny c thc hin theo hng: - Lm tinh gn b my nh nc, tch c quan cng quyn vi cc t chc s nghip, tng cng nng lc cho cn b, cng chc nhm nng cao hiu qu cung ng dch v cng. Bn cnh nhng iu kin cn l cnh tranh, minh bch th iu kin c th hon thin cht lng dch v cng l i ng cng chc c trnh chuyn mn cao, trung thnh v tm huyt vi s nghip. Bi l, mt trnh chuyn mn cao s bo m cho cc hot ng trong b my vn hnh khoa hc, chuyn nghip v c h thng. Mt s trung thnh, tm huyt v o c ngh nghip s cho php ngi cng chc theo ui mc tiu ca t chc, sn sng chu trch nhim v mi hnh vi ca bn thn v m bo s chnh xc, cng minh trong thi hnh cng v. Vi mt i ng cng chc phm cht o c tt, nng lc chuyn mn cao, b my nh nc c th tinh gin gn nh n mc ti a m vn m bo c trch nhim cung ng dch v cng y v hiu qu cho x hi. V vy, t chc b my phi c sp xp li mt cch khoa hc, hp l theo hng a ngnh, a lnh vc, v chuyn mn ha, tiu chun ha cng thc. Gn vi n l

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cng tc o to v bi dng nhm khng ngng nng cao nng lc, k nng tc nghip cho i ng cn b cng chc. - Ci cch th tc hnh chnh theo nguyn tc cng khai, n gin, v thc hin c ch mt ca, gim bt thi gian, cng sc ca ngi dn, gip cng chc gii quyt cng vic thun tin d dng; gim bt s cng knh ca b my, hn ch tnh trng tham nhng, hi l, ca quyn khi gii quyt cng vic ca dn. - Khon chi hnh chnh v qu lng cho cc c quan hnh chnh nh nc to ra s ch ng cho cc c quan ny trong b tr cng vic v nhn s. Cho php tr cao hn vi nhng ngi c nng sut lao ng cao. ng thi, ci cch bng tin lng cng chc, m bo tr lng tng xng vi ng gp ca mi ngi, xy dng ch nng lng sao cho khuyn khch nhng ngi lm vic c hiu qu, ng vin, nng cao trnh , nng lc trong cng vic. - M rng p dng h thng qun l cht lng ISO trong cung ng cc dch v cng ni chung cng nh dch v hnh chnh cng ni ring, to ra mt h thng tiu chun nh gi cn b cng chc, nh gi cht lng ca hot ng cung ng dch v cng cho cc t chc v cng dn. - Nng cao trch nhim v o c ca ngi cng chc thng qua mt lot cc bin php nh xy dng s cam kt trch nhim ca cng chc, lp hp th gp , ng dy nng nhn thng tin phn hi t dn, nh gi cng chc thng qua kin nhn dn, c c ch khen thng v x pht tha ng i vi cng chc. - Tng bc hin i ha cc phng tin cung cp dch v, c bit s dng rng ri cng ngh thng tin trong cung ng dch v cng, gim ng k thi gian v cng sc. T nhng phn tch trn, c th thy rng yu cu i mi cung ng dch v cng l ht sc bc thit. t c thnh cng trong cng cuc i mi ny, Nh nc s phi thc hin ng b nhiu gii php lin quan n tt c cc kch chiu cung ng dch v cng, t nhng ci cch ni ti trong chnh cc c quan nh nc chu trch nhim cung ng dch v, n nhng gii php mang tnh v m nh ci cch c ch, phng thc vn hnh ca b my hnh chnh nh nc, hoc thay i c vai tr ca Nh nc trong cung cp dch v bng vic chuyn giao mt mc nht nh trch nhim cung ng cho khu vc phi nh nc thng qua qu trnh x hi ha cung ng dch v cng. Vit Nam, vn x hi ha cung ng dch v cng c th ch ha bng ch trng, chnh sch ca Nh nc. Vi ch trng ny, ngha vic x hi ha khng n thun l s chuyn giao cc hot ng cung ng dch v cng cho cc t chc ngoi quc doanh, m cn c ngha ng vin v t chc s tham gia rng ri, ch ng v tch cc ca ngi dn vo

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pht trin cc dch v cng, a dng ha cc hot ng cung ng dch v trn c s pht huy tnh sng to v kh nng ng gp ca mi ngi dn.

PHN III QU TRNH X HI HO CUNG NG DCH V CNG VIT NAMNhng phn tch cc phn trn cho thy yu cu i mi cung ng dch v cng ang c t ra ht sc cp bch. nc ta, cng vi qu trnh pht trin nn kinh t th trng, th vic Nh nc bao cp i vi hu ht cc dch v cng trong x hi vp phi nhng mu thun ngy cng nan gii. C th l: - Mu thun gia khon kinh ph bao cp qu ln v dch v cng vi ngn sch nh nc cn rt hn hp. Do nn kinh t nc ta cn trnh pht trin thp, thu nhp bnh qun u ngi nm 2005 mi t gn 640 USD, thu ngn sch hn 210 nghn t ng, chim khong 25% GDP. Vi mc thu nh vy, vic Nh nc bao cp hu ht cc hot ng cung ng dch v cng l gnh nng qu ln i vi ngn sch nh nc. - Mu thun gia khi lng dch v cng c Nh nc cung ng v nng lc thc thi ca b my nh nc. Mt mt, khi lng dch v cng do Nh nc trc tip cung ng l qu ln, bao trm nhiu lnh vc; mt khc, b my nh nc ni chung v h thng cc t chc cung cp dch v cng ni ring cn nhiu hn ch v nng lc qun l, iu hnh v t chc thc hin vic cung ng, nn nhn chung cht lng dch v cng thp, khng p ng tt nhu cu ca ngi s dng. S c quyn trong vic cung ng cc dch v cng lm tng tnh quan liu, ca quyn ca b my nh nc. - Mu thun gia dn s tng nhanh vi kh nng cung ng dch v cng c hn ca Nh nc. Trong nhng nm qua, dn s nc ta tng vi tc ng k, trung bnh t 2,1% trong giai on 1980-1995 v 1,46% trong giai on 19962005. Trong iu kin ngun thu ca ngn sch vn hn hp, nhu cu chi cho pht trin kinh t ngy cng ln, th tc tng dn s ni trn lm lng chi cho dch v cng tnh theo u ngi gim st. Nhng mu thun trn cng vi nhng tin b khoa hc v cng ngh trong lnh vc dch v, vic tng ng k nhu cu s dng dch v cng mt b phn dn c c thu nhp cao trong x hi, tnh cht cnh tranh ca c ch th trng, xu hng phi tp trung ho cc hot ng ca Nh nc, khin cho Nh nc khng th tip tc bao cp hon ton i vi cc dch v cng c na. Nh nc

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thc hin i mi c ch cung ng dch v cng theo hng khuyn khch mi thnh phn kinh t, mi ch th trong x hi cng tham gia vo hot ng cung ng dch v cng (hay cn gi l x hi ho cung ng dch v cng). I. QUAN NIM V X HI HA CUNG NG DCH V CNG I.1. Quan nim v x hi ho Trong nhng nm qua nc ta, c mt thc t l thut ng x hi ho c cp trong nhiu vn bn quan trng ca ng v Nh nc cng nh trn cc phng tin thng tin i chng, nhng cho n nay cha c mt khi nim (nh ngha) thng nht v x hi ho, hoc ch t l cha c s gii ngha tng i y v ni hm ca thut ng ny. Thc t, iu ny tr thnh mt thch thc ln trong vic qun trit v thc hin ch trng x hi ho cung ng dch v cng nc ta do c nhng cch hiu khc nhau, thm ch mu thun nhau v x hi ho. Cch hiu thng thng nht l dng ngha ca t x hi cng vi ngha ca hnh v ho, nh cc cch gii thch di y cho x hi ho l chung: (1) hot ng sn xut- kinh doanh l hot ng khng th t mt ngi hay mt gia nh lm c, m l mt hot ng c t chc v c tnh tp th c