This editorial offers an introduction to the current issue.

The Dutch Municipal Personal Records Database is an IT-innovation that enables the use of the civil registry by hundreds of (semi-)public organisations. Literature review and a case study show how this ‘basis registration’ creates a deep tension between system and lifeworld: citizens who do not fit the system’s criteria lose their access to the major part of public services. The instrumental rationality of the system simplifies the use of addresses for service delivery to one single definition, turns the consequences of address mutations into a black box, and reduces the discretionary space of street-level bureaucrats to handle with social complexities and unintended consequences of the system. This type of IT-innovations can, therefore, come to resemble a ‘digital cage’: a highly disciplining system that hinges on hardware and software design instead of Weberian rules and procedures.

This article analyses the transformations of the Dutch civil service over the last 15 years, during which numerous cutbacks and reorganizations took place. While existing research predominantly focused on changes in the total number of civil servants, we examine how the distribution of civil servants changed in terms of rank, gender and age. We theorize four methods for shrinking the government apparatus, and for each method, we identify the possible consequences for the composition of the central civil service in terms of hierarchical make-up and of age. Our results indicate that the total number of civil servants only slightly decreased, but the decrease affected differentially the various ranks of the civil service. While at the lower ranks the number of civil servants decreased strongly, at the upper ranks the number actually increased slightly. The number of women in the civil service increased, also in the higher echelons. Regarding the age distribution, we found considerable changes, with the modal age shifting upwards with up to ten years. Altogether, the civil service has become slightly smaller, more gender-balanced, and significantly more senior (both in terms of ranks and age). The results of this study show that it is important for researchers and practitioners to look beyond the trends in the total number of civil servants and explore the deeper changes within the civil service.

In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.

In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.
We calculate and describe profits obtained by health organizations in The Netherlands in the years 2014 and 2015. We distinguish between profit and not-for-profit organizations. We find that on average net profits amount to about 2 percent on turnover with a peak of more than 3 percent for mental-healthcare organizations. If we take the size of organizations into account, we find that for-profit organizations with a turnover of less than 1 million euro tend to have on average net profit rates of 4 percent to more than 5 percent with peaks amounting to more than 50 percent. We are not yet able to come up with explanations for these excessively high profit rates in parts of the Dutch health care sector. On the other hand, the highest losses can be found in small-sized organizations as well. We delved deeper into the financial accounts of a few for-profit organizations and found indications of misreporting of turnover or number of treatments. On the other hand, bad management and unhealthy cost structures might explain why some organizations incur excessive big losses. The sector does not appear to be well monitored by the government.

In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.
Systematic research on societal responses to profit in healthcare is scarce. It is a highly complex topic, with many tensions in the public and political debate. In a recent Dutch publication on profit, authors use a ‘lifeworld’ perspective to assess profit in their research, while their assessment could have been different using a ‘system’ perspective. Both perspectives have their merit, and debate on the role of profit in health care should separate the two perspectives. We describe both perspectives and use them to clarify whether making a profit is different from paying that profit to shareholders. We conclude that in healthcare, the general tension between the perspectives can be summarized as ‘profit for one actor may feel – but isn’t always – someone else’s loss’. Recognizing these tensions and searching for a strategy to align interests in which everyone gains may help the current stagnated debate on this issue in the Netherlands.

In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.

Reflection and debate initiates academically inspired discussions on issues that are on the current policy agenda.

Reflection and debate initiates academically inspired discussions on issues that are on the current policy agenda.

Reflection and debate initiates academically inspired discussions on issues that are on the current policy agenda.

In this feature authors review recently published books on subjects of interest to readers of Beleid en Maatschappij.

The most relevant part of a discussion is not what is discussed but what cannot be spoken of. The real taboos are those for which it is taboo to call them taboos. The status quo defines itself as non-ideological while denouncing any challenge to itself as radical.
Therefore the column ‘De Blinde Vlek’ (The Blind Spot) frames the framers, politicizes the status quo and articulates what is not heard of.