WHAT YOU SHOULD KNOW – ARGUMENTS AND DETAILS

EU FUNDS FOR „HUMAN CAPITAL” BUT LESS FOR PEOPLE. WHAT SHOULD YOU DO?

The Operational Program for Human Capital (POCU) is at critical mass, but it is still possible to salvage it, provided we act quickly.
If the POCU fails to target concrete activities in the concept and programming stage, we have only one chance: the year 2019, when, according to the regulations, an analysis of the program’s performance can be made and some changes can be made.

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POCU should have very clear data tracking its beneficiaries: X number of women received screening, Y number of poor children kept in school, Z number of young people employed. Under no circumstances should any administration expenses factor into POCU performance.

What parameters will we use to assess the POCU in 2019? If data including administration expenses is used, it will show that the POCU is a success, despite 2000 women dying of cervical cancer every year and zero women having been tested since its launch. Will the MFE be able to declare the POCU a success based on skewed data?

SYSTEM FAILURE details: Cervical cancer testing and prevention

4,000 new cases registered annually. The highest EU mortality rate from cervical cancer: 2,000 women. Every year.

• These are the circumstances under which the POCU project „Integration of primary HPV screening into the national cervical cancer screening program” has operated for 5 and a half years with a budget of 4 million euros.Project „Integration of primary HPV screening into the national cervical cancer screening program”
• Implemented by the Oncological Institute „Prof. Dr. Ion Chiricuță ”from Cluj-Napoca in partnership with the National Institute of Public Health.
• The total eligible value of the project is 22,811,228.48 lei of which EU funds: 19,260,738.02 lei.
• The project is to be carried out over a period of 68 months, an it began on 11.05.2018.

The project manager is quoted in the media claiming that the over 4 million euros allocated to the project will cover development of methodologies for prevention and specialization programs designed to train 440 people who carry out the early detection, diagnosis and treatment of cervical cancer. A year and a half from the beginning of the project, methodologies were developed and training was completed. The screening activity has yet to occur.

NOTE: the problem does not lie with The Oncological Institute or the physicians on staff. They applied for a financing guide that obliges them to complete methodologies and training. The Ministry of European Funds and the Ministry of Health designed the guide and are obliged to meet the international obligations for use of the funds (alignment with certain standards), not delegate this responsibility to the oncological institute. Rather than assigning blame to the beneficiaries, to participants in the system, any censure for failure to produce must lie with the MFE and their failure to properly administer projects. Ultimately, the responsibility of ensuring funds are used effectively and properly and effect tangible change is incumbent upon the MFE, not applicants and not beneficiaries.

The Oncological Institute has conducted two projects with Norwegian funds (one completed in 2017 and one in progress), carried out in partnership with a sister institute in Norway which focused on testing. Clearly, it’s not outside the realm of possibilities to realise testing focused intervention.

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SOLUTION

The guides made by the MFE and the MS must be reworked.

Consider these 4 simple steps by which European money could actually fund cancer screening:

1. Simplify the costs for testing.
2. Launch a call for projects targeting structures and organizations able to work directly in poor communities (mayors, churches, NGOs – anyone showing previous activity there).
3. Have the MFE require testing
4. The Ministry of Health and subordinate institutes either have separate projects or become partners in the above to carry out the tests AND to administer the cancer cases detected.

In 2016, we proposed a revision of the POCU and the introduction of simplified costs to the Minister of Foreign Affairs. The process was initiated, and discussed with the Ministry of Health and the European Commission. A program review before the mid-budget evaluation (2019) is more difficult to execute, but the Commission was open, provided that Romania comes up with cost calculations based on each operation. We started these calculations, despite the opposition of the bureaucracy in the line ministries. After 2016, the process was not pushed within the government level but rather by the Commission. At the end of his term, the former PSD minister of the MFE announced that he had sent these proposals to the Commission. It took three years.

At the same time, the funds from the health component were mostly contracted on projects like the one above – we see a similar tale with other serious diseases, such as tuberculosis.

What to do NOW

1. SOLUTION Remove the funds that remain otherwise untouched on calls dedicated to cancer detection and prevention

One solution, for the moment (2019) is to capitalize on all the funds that have the potential to be lost, for the 2014-2020 financial framework.

The funds can still be recovered, or in technical terms, re-contracted if the Ministry applies a rapid and responsible analysis and identifies the funds that are in danger of remaining unused.

Where does the money come from? Even if a good part of the European money allocated for health was contracted, from previous experience, only about 75% is put into action. In addition, EC financial corrections are added; and there may be discrepancies.
We propose an open public debate between the Ministry of Health and other relevant actors, in order to make more efficient use of these funds to meet the population’s concrete needs.

2. SOLUTION Rapid changes to the POCU, together with the conclusions that can be derived from the evaluation of the performance framework in 2019. The reorientation of the funds towards the aforementioned priorities – those urgent and concrete.

What do we learn in the long term?

The MFE launched a public debate for the future budget (2021 – 2027)

Let’s not repeat history. Let’s get it right from the start.

3. INNOVATIVE SOLUTION for the future

In order to recover from the delay in monitoring and testing the entire female population of Romania, the current bureaucratic and ineffective programs must be scrapped. We need a more immediate solution, and we can look to a number of member states with more efficient and advanced health systems. We can follow their examples by investing in personalized medicine systems.

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How can we fight the disease of absorption without impact? Concrete cases

In 2016, right before the end of the mandate, we acted to repair the programming defects of the POCU through guides and to direct the funds towards those indicators that show a real impact on communities.

The POCU had been thought of separately and segmented – the axis for jobs, the axis for education, the axis for social issues, the axis for health – each with a multitude of specific objectives divided not on the logic of intervention – „why do we do this,” but on the types of beneficiaries or other restrictive criteria.

There is a bureaucratic reason why ministry employees prefer this segmentation, it helps them manage projects; however, the allocation of funds on completely separate financing lines and specific objectives, which also involves the separation of budgets, applicants and final beneficiaries, makes it difficult to create projects that really solve social problems.

Poverty is not organized in real life and does not follow the axes of the POCU

To give an example, let’s take a look at school dropouts. Why do some children drop out or not start school at all? Obviously, there is not a single cause. Poverty, lack of education of parents, lack of training or empathy of staff, distance from school – can all contribute and the list doesn’t end there. In most cases, addressing just one of these issues and ignoring the others will not keep kids in school.

How did those who programmed the POCU approach this situation?

They created priority axis 6 – Education and skills with six specific objectives, each with specific indicators allocated on a separate financing line; one for social intervention, one for teachers, one for preschoolers, one for schoolchildren, one for adults who did not complete their education. In rural areas with the highest risk of dropout, the respective schools could not apply to the POCU because the students did not qualify according to the guide. To effectively combat school dropouts, you must allow for more students to be eligible for more projects and for students to be able to benefit from multiple projects. As one student could drop out of school because of poverty, lack of parental education, and (not or) lack of staff empathy, so should that same student be able to benefit from multiply projects that tackle all of these factors.

In addition, the tendency was that only county or central public institutions were taken on as project partners – even the those with the least contact with the community. As in the previous SOPHRD, public institutions proposed projects with activities where absorption was easy and employees materially benefitted: developing methodologies, going to trainings and seminars. The kind of activities that are easy to do and verify, but with minimal impact for the children who drop out of school.

In this case study we see absorption for the sake of absorption. As a general rule the system tends towards the activities that are easiest to do, and officials also prefer this model because of its convenience (shuffling papers are easier than visiting communities).

Already defective due to extreme fragmentation of interventions, the POCU computer system was designed to remain segmented, to suit the way in which the management of European funds had been conceived. Each with its own square, in its domain, with its money and with its computer module.

What have I done?

We correlated the measures in the Integrated Poverty Reduction Package (which I launched when I was at the Prime Minister’s Chancellery) and expedited the disbursement of funds from the Human Capital Operational Program (POCU) for urgent measures in the fields of employment, education, health and social services. We prioritized the issues in such a way that would allow Romania to reach its assumed indicators for 2018 and avoid the risk of disengagement.

Some examples of our vision and what we changed.

These, exemplified below, are the solutions already tested to make the Human Capital Program truly feel its effects for people.

1. SOLUTION. INTEGRATED APPROACH.

Example: School for all

Continuing with the above example of school dropouts – is this a question strictly about why you teach and how good the teachers or students are? Or it is also about meeting the basic needs of students. Making sure they arrive at school school regularly and on time (a school bus when school is difficult to access), have appropriate materials (school supplies, clothing and footwear for an impoverished family) and have the necessary conditions to learn (sufficient teachers, appropriate classrooms, functioning buildings)? There are separate measures for kindergarteners, children in primary and secondary school, and for those who have left the traditional education system and are learning in Second Chance programs, and trade schools. When the same schools administer to all of these programs and when many parents have children from all these categories, is it more logical to maintain separate projects (with bureaucracy and the additional costs involved) to solve each part of the whole issue separately, or is a comprehensive project allowing all the interventions that are needed in a school from the same project more appropriate?

School for all was the first „combined call” that we launched at the Ministry of European Funds in 2016. The call put 193.2 million euros into the market and in some ways revolutionized the traditional way of approaching European funds. I had to make a few choices – not without a fight with my own ministry and with officials from the Ministry of Education.

1.1 SOLUTION. UNIT PROJECTS Instead of launching a grant for each measure and each target group of children, as understood in the POCU logic ministries, we chose to launch unit projects (which combined several specific objectives – one for preschoolers, one for students, one for second chances and one for teachers), which allows a school to support all its students with one project. To do this we had to innovate, and we launched the concept of „combined calls”, which united several specific objectives (OS 6.2, 6.3, 6.4 and 6.6) from the POCU, and reconfigured the previously been stratified IT SMIS system.

1.2 SOLUTION. EDUCATIONAL MEASURES alongside the SOCIAL ones

There is a flawed logic in the Romanian bureaucracy in which each ministry sees only its own piece. For example, the Ministry of Education occupies itself solely with the children who are in school. In 2016 we were explicitly told that if the issue does not concern school, it is simply not within the MEN’s purview. A question of poverty, even within school, must be the job of the Ministry of Labor. All things related to the nursery, must fall to the Ministry of Health. This is an explanation of the fragmentation of European funded projects. The MFE must pursue and impose integrated, not separate, interventions on the line ministries. In 2016, I was threatened with public criticism of funding guides by the MEN directors due to the inclusion of social measures. In their opinion, social aid measures for poor children have nothing to do with schools. They did not go public, but they propagated rumors that we refused to work with the Ministry of Education. Such an attitude must be amended at the political level – although ministers change, directors remain. The Directorates of the Ministry of Education and the Ministry of Labor are filled by a disproportionate number of insensitive, racist leaders, indifferent to the problems of poor children. This is not a blanket condemnation of directors, there are some exceptions, but the overall atmosphere of these agencies is derelict.

Instead of funding only strictly educational measures (standard educational activities, teacher training, grants for schools), we chose to fund socio-educational measures to facilitate the access of children to kindergarten and school and to help them not to drop out THROUGH THE SAME GUIDE. Some of the measures included hot meals, clothing and shoes, supplies, and access to a school bus if that made the difference between the presence or absence of children. To make this possible, an interpretation of the POCU guide that acted in the interest of the final beneficiaries and allowed the integration of two lines of intervention managed by different state institutions was necessary.

1.3 SOLUTION. I EXTENDED ELIGIBLE APPLICANTS from only school inspectorates to schools and town halls.

Instead of leaving the funds available only to school inspectorates and county institutions, as in the POSDRU (with huge amounts per project, lots of money for consultants, low impact on the ground), we chose to give the money to the organisations unequivocally able to help the intended beneficiaries. Schools and town halls are most familiar with local problems and their most likely solutions. These smaller, more targeted, more flexible projects were more able to impact local communities. Because of this, we allowed the realization of two types of projects – simple projects (smaller, local projects with budgets between 350,000 and 1.4 million euros) and combined (large projects – county, regional, national with complex activities and budgets between 450,000 and 2 million euros). About a third of projects were simple projects – applications made by schools, mayors and NGOs interested in solving problems in their communities, through small projects in one or two schools.

1.4 SOLUTIONS I gave precedence to schools with serious situations

Instead of launching targeted funds, at the risk of very little money actually reaching problematic schools, we chose (stubbornly) to direct them to schools with the most children at risk of dropping out, where the impact could be much higher.
We decided to attack the issue head on by creating a list of schools with educational risk – the interventions in these schools received additional scores in the evaluation. Criteria for prioritization included: a high number of students with a volatile school situation or children who repeat grades, a high percentage of unprepared (unqualified) teachers, a high percentage of 8th grade students who did not sit for the national assessment, the school average from the national assessment and the high degree of marginalization of the locality (according to the World Bank). The Ministry of Education balked at the label of an „educational risk school”, so the list was made by the MFE team (experts in socio-educational programs), along with two statisticians from the Prime Minister’s Chancellery and with help from specialized NGOs. More than 400 schools with the highest degree of educational risk, have received funding based on the evaluation grid. The list is not perfect because the data is difficult to integrate and has errors, but it was the first attempt of its kind and was generally received positively by the applicants. We will see the effects in a few years.

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CONCRETE EXAMPLE

Results for „School for All”

The appeal allowed the financing of practically any educational measure (after school activities, priority areas of education, second chance, extra-curricular and non-formal education, etc.), supplemented by social measures designed to increase the access of children to school (material support like hot meals, supplies, hygiene products, transportation), with support measures for schools (hiring support teachers or other specialists such as speech therapists, psychologists, and school counselors; and renovating classrooms and providing equipment) and encouraging school-family-community partnership. During the mandate of 2016, we organized public debates, worked for the development of the database of disadvantaged schools, debated the guide, then launched the call for projects.

By the end of 2016, 317 projects were submitted, totalling 1.9 billion lei.