Bureaucracy and ‘red tape’ are seen as a main annoyance in healthcare practice. ‘Rules’ like guidelines and performance indicators would withdraw professionals from their real work, that is, helping patients. However, rules may also improve quality of care if they foster high quality practices. In this research, we explore how healthcare rebels deal with rules in their everyday work: how rebels ignore, engender and bend rules to build new environments for doing good care. Drawing on ethnographic research in three hospitals in the Netherlands (2017-2018), we reveal how rebels build and care for clinical microsystems containing their own clinical unit and related contexts (e.g. pharmaceutical suppliers, ICT companies, primary care) to evoke alternative and situated practices of good care delivery – i.e. focusing on quality of life and person-centred care. Rebels enact mechanisms of decoupling and recoupling to disconnect rules that embark on good care in specific patient situations, and build new routines that foster good care. However, such caring practices are hard to generalize as they often occur ‘under the radar’ and hence remain hardly noticed to the outside world. We argue that through revising accounting processes, and paying more attention to narratives of good care, more convenient quality systems could be found.

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.

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

Both education and housing are highly regulated sectors in the Netherlands. According to various stakeholders, regulations and formal and informal rules hinder the development of new initiatives aimed at providing attention to personal needs and wishes of children (in education) and older people (in housing). This article focuses on founders of initiatives in both sectors that, despite institutional obstacles, dare to do things differently. We adopt a rebellion perspective, which focuses on how individual and collective actors aim to create favorable circumstances for providing better services, even if this means they have to disrupt existing institutions. In-depth interviews were conducted with 22 founders of rebellious initiatives in education and housing for older people. According to the founders, what makes them different from others is having a dream, learning by doing, and critically assessing rules and regulations. Founders in both sectors not only interpret rules differently, but also try to change them. In order to do so, they need supportive internal and external contexts, which they create through personal contacts and social media. Although rebellion in both sectors has many similarities, sector-specific institutional settings and past events do shape its appearance.

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 discuss recent research findings that are of interest to readers of Beleid en Maatschappij.

Combatting the coronavirus politicians and policy makers have to continuously make a trade-off between public health and democratic rights. How do citizens’ attitudes towards democracy develop in a pandemic? In this study we test whether changes in the information environment affect citizens’ trust in the local and national government. Moreover, we study whether changes in the information environment are associated with the perceptions about the extent to which democratic processes are under pressure. We address these questions using a five wave panel study in the Netherlands conducted between April and September 2020. We find that during this period media use and political trust decreased. Moreover, Dutch citizens are worried about the effects of the corona crisis on local and national democracy. When it comes to the effects of media use on political trust and attitudes towards democracy, we find that media use has a limited effect on attitudes towards democracy. If anything, consuming news via the public broadcaster has a positive effect on political trust. To conclude, our study provides descriptive evidence about the development of attitudes towards democracy in the Netherlands during a major public health crisis. Dutch citizens are worried about democracy but media play a limited role in amplifying or reducing these worries.

In this feature authors discuss recent research findings that are 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’ frames the framers, politicizes the status quo and articulates what is not heard of.

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

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.

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

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

Municipalities play an important role in the Dutch energy transition. Therefore, they are expected to deal both sufficiently and timely with their tasks. The question is whether they have the capacity to do so (governing capacity). This study aims to assess whether improving governing capacity can be used to improve the policy performance. We operationalized governing capacity and built a model to assess the relation between several conditions for governing capacity and policy performance for three domains of the energy transition: built environment, mobility and renewables. We found no direct relationship between perceived governing capacity and energy transition policy output. However, we found relationships between conditions for governing capacity, and the policy output. About 25 percent of the total variance in policy performance could be attributed to population size. This percentage levels up to 55 to 60 percent if the motivation of the local administration, cooperation between municipalities and other governmental organisations and the participation of citizens and businesses are also taken into account. This contradicts the idea that enlarging municipalities is the most important way to achieve a higher policy performance.

In the past decade, large infrastructure projects in the Netherlands have often been implemented through Public-Private Partnerships (PPPs), specifically using Design-Build-Finance-Maintain (DBFM) contracts. While the decision to implement projects through PPPs is based on expected advantages for internal parties – the public and private partners in the PPP –, there is a call for more focus on the advantages and disadvantages of PPPs for external stakeholders. External stakeholder management in DBFM projects is based on a contractual division of risks and responsibilities between the partners. However, it is clear from the literature that the contract does not guarantee successful stakeholder management. Relational aspects are important. Little research has been done, however, into the interplay of contractual and relational aspects in achieving successful stakeholder management. This article addresses this research need. A comparative case study was conducted into the PPP projects A9 Gaasperdammerweg and A16 Rotterdam. The study first shows that sanctions, when combined with a relational approach, have a positive effect on the relationships with stakeholders. Second, external stakeholder management cannot be simply outsourced to the private partner and continuous involvement of the public partner is important for success.