ABSTRAKSecara umum, Disertasi ini bertujuan untuk mengetahui seberapa jauh birokrasi di bidang kesehatan di Kotamadya Ambon memang telah membuka diri terhadap peluang partisipasi publik. Secara khusus, tujuan dari Disertasi ini adalah untuk mengetahui seberapa jauh partisipasi publik terhadap pelayanan publik di bidang kesehatan di Kotamadya Ambon, secara riil telah dilaksanakan oleh pelaku pelayanan publik.
Lokasi penelitian adalah di Puskesmas Rawat Inap X dan Puskesmas Non Rawat Inap Y di Kota Ambon. Pemilihan Puskesmas dengan perbedaan Rawat Inap dan Non Rawat Inap didasari oleh asumsi penulis bahwa besar kemungkinan perbedaan status tersebut membawa dampak pada kualitas pelayanan publik.
Disertasi ini menggunakan metode kualitatif dengan beberapa langkah pengumpulan data sebagai berikut :Pertama, studi sekunder dan wawancara dengan peneliti dalam topik penelitian sejenis untuk mendapatkan gambaran awal masalah Disertasi; Kedua, wawancara mendalam yang dilakukan kepada beberapa informan kelompok pengunjung/pasien baik di Puskesmas Rawat Inap maupun Non Rawat Inap kemudian dijadikan informan dalam kegiatan wawancara mendalam. Ketiga, Selain melakukan wawancara mendalam, penulis dalam upaya menggali data lebih dalam, juga melakukan FGD dengan peserta yang mencakup wakil dari Kantor Dinas Kesehatan Ambon, Pejabat Puskesmas (Rawat Inap dan Non Rawat Inap) Karyawan Puskesmas (Rawat Inap dan Non Rawat Inap) Dokter Puskesmas (Rawat Inap dan Non Rawat Inap). Keempat, terkait dengan tujuan yang ingin dicapai dalam penelitian ini, yakni melihat realita pelayanan publik di Puskesmas sebagai salah satu sentra pelayanan publik di bidang kesehatan, maka diperlukan data kuantitatif melalui survei.
Melalui penelitian Disertasi ini, terungkap bahwa reformasi birokrasi di Kotamadya Ambon juga sudah banyak direalisasikan. Namun demikian, semua upaya realisasi reformasi birokrasi tersebut belum sepenuhnya berjalan. Beberapa aspek yang telah dicapai dalam derajat tertentu, antara lain adalah : Pertama, birokrasi pelayanan publik di Kotamadya Ambon dalam derajat tertentu telah mengembangkan keterbukaan (transparency). Kedua, berkaitan dengan keterbukaan adalah kebertanggungjawaban (accountability). Ketiga, birokrasi pelayanan publik di Kotamadya Ambon, khususnya dalam pelayanan publik bidang kesehatan, dalam batas-batas tertentu sudah mulai membangun aksesibilitas partisipasi publik melalui mekanisme pengaduan. Keempat, birokrasi pelayanan publik di Kotamadya Ambon, khususnya di bidang kesehatan,telah berupaya untuk tidak berorientasi kepada yang kuat, tetapi harus lebih kepada yang lemah dan kurang berdaya. Sementara itu, mengacu pada hasil penelitian Disertasi ini maka agen atau pengguna pelayanan masih belum mampu berpartisipasi secara aktif. Mereka hanya berpartisipasi secara pasif dan belum mampu mewujudkan diri mereka secara aktual sebagai ?active society?. Protes sosial (terbatas pada penyampaian keluhan dan pengaduan) memang ada tetapi hasil penelitian Disertasi ini hanya mengungkap bahwa protes-proses sosial itu hanya dilakukan secara sendiri-sendiri oleh individu-individu yang tidak puas terhadap pelayanan publik yang diterimanya.
ABSTRACTIn general, this dissertation aims to know how far bureaucracy in area of health in Municipality of Ambon had been exposing to opportunities of public participation. Specifically, the purpose of this dissertation is to know how far the public participation to public service in health in Ambon Municipality, actually have been carried out by the person responsible for public service.
The observation was done at the Inpatient health center X (Puskesmas Rawat Inap X) and non-Inpatient health center Y (Puskesmas non-Rawat Inap Y) in Ambon City. Health center election with a difference Inpatient and Non Inpatient based on the author?s assumption that the most likely of that status differences have an impact on the quality of public services.
This dissertation uses qualitative methods of data collection with a few steps as follows: First, secondary studies and interviews with researchers in similar research topics to get a preliminary description of the problem Dissertation; Second, in-depth interviews are conducted to some informants group visitors/ patients both in the Inpatient and Non-Inpatient Health Center and then made the informant in-depth interviews. Third, the addition in-depth interviews, the authors in an effort to dig deeper into the data, also conducted FGDs with participants including representatives from the Office of Health Office of Ambon, Officer Health Center (Inpatient and Non Inpatient) Employee Health Center (Inpatient and Non Inpatient) Medical Doctor Health Center (Inpatient and Non Inpatient). Fourth, related to the objectives to be achieved in this study, that seeing the reality of public service at the Health Center as one of the center of public services in health, we need quantitative data through surveys.
Through this dissertation research, it was revealed that the reform of the bureaucracy in Ambon also been many realized. However, all attempts at bureaucratic reform has not yet been realized fully operational. Some aspects that have been achieved in some degree, among other things: First, the public service bureaucracy in Ambon has developed a certain degree of openness (transparency).
Ambon Municipal Government considers that the public is the main stakeholders in the service. Second, openness is associated with accountability. Ambon Municipality has succeeded in increasing the accountability reporting responsibility to realize the various budget responsibilities, achievement in the development of public services by exploiting the role of mass media and other public information. Third, the bureaucracy of public services in the Municipality of Ambon, especially in public services in health, within certain limits, have started developing the accessibility of public participation through the complaint mechanism. Fourth, the public service bureaucracy in Ambon, particularly in the areas of health, has been oriented to try to be as strong, but must be more to the poor and less powerful.
Meanwhile, referring to the results of this dissertation research, then the agent or service users are still not able to actively participate. They only participate passively and not yet able to realize their actual self as ?active society.? Social protest (limited to the submission of grievances and complaints) do exist but the results of research in this dissertation reveal that the protest-social process is only done independently by individuals who are dissatisfied with public services received.
