Samenvatting

This article describes and explains the development of the regional construct for the coordination of medical assistance in accidents and disasters, the emergency medical services in the region (GHOR), in the Netherlands in the period 1996 to 2020. The authors distinguish four stages of organisational development, which they analyse from a multi-actor perspective consisting of three elements: the impact of disasters and (negative) evaluations, the institutional context and the bureaucratic battle surrounding the GHOR. The GHOR was a solution for a perceived insufficiently coordinated functioning of all parties involved in medical assistance. The GHOR was positioned in a complex way. This made it predictable that the multidisciplinary GHOR process would gradually be integrated within the ‘nearby’ regular mono-disciplinary acute care process and the structures for it. This article gives policymakers involved in disaster and crisis management more insight into the history and development of the GHOR over the last two decades. This insight is important now that the added value of the GHOR has come under discussion, partly due to the doubts of the Evaluation Committee for the Security Regions Act, and decisions about its future have to be taken. For administrative scientists, this case study shows that public administration’s ability to foresee and break through known organisational development patterns is still inadequate.