Zoekresultaat: 170 artikelen

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Kroniek

Public private partnerships in the Netherlands: a love that’s here to stay

Tijdschrift Bestuurskunde, Aflevering 1 2022
Trefwoorden Public—private partnerships, Public procurement, DBFMO, Public Management, Contracting
Auteurs Anne-Marie Reynaers
SamenvattingAuteursinformatie

    Public-private partnerships (PPS) are often used by public procurers. This article evaluates the application of PPS in the Netherlands by reflecting on the findings on a recently published report “Learning from 15 years DBFM-projects at the Directorate-General for Public Works and Water Management” (or “Leren van 15 jaar DBFM-projecten bij RWS” in Dutch).


Anne-Marie Reynaers
Dr. A. Reynaers is werkzaam als universitair hoofddocent aan de Universidad Autónoma de Madrid (Spanje). Dit stuk is mede geschreven op basis van het rapport Leren van 15 jaar DBFM-projecten bij RWS, dat uitkwam op 12 oktober 2020.
Artikel

Access_open Lokale beleidsvrijheid: geven en nemen?

Over de relatie tussen formele beleidsvrijheid, ambtelijke capaciteit, schaal en politieke verandering

Tijdschrift Bestuurs­wetenschappen, Aflevering 1 2022
Auteurs Jolijn De Roover, Jan Wynen, Wouter Van Dooren e.a.
SamenvattingAuteursinformatie

    Local policy freedom is often equated with the formal policy freedom of municipalities and thus with the formal boundaries that determine the local playing field. In this article, we question this approach. It is not clear to what extent formal policy freedom is a good measure for the ‘real’ policy freedom of municipalities, and thus for the policy freedom that municipalities use in policy implementation. Does more formal policy freedom necessarily lead to more used policy freedom? Moreover, not every municipality uses formal policy freedom in the same way. To indicate variance in policy discretion used, reference is often made to official capacity, scale and political changes. However, it is unclear to what extent these variables have an impact on local policy freedom. The authors investigate the link between formal and used policy freedom, official capacity, scale and political change on the basis of Flemish policy reform. Based on an analysis of financial data, they conclude that more formal policy freedom can be an incentive for more used policy freedom, but also that the explanatory power of administrative capacity, scale and political change is limited. In both research and policy, we need more attention for the value of social interaction, soft skills and networking.


Jolijn De Roover
Dr. J. De Roover is postdoctoraal onderzoeker aan de Universiteit Antwerpen en freelance docent ‘Good Governance’ aan de Universiteit van Tilburg.

Jan Wynen
Prof. dr. J. Wynen is onderzoekshoogleraar aan de Universiteit Antwerpen. Zijn onderzoek richt zich op de relatie tussen organisaties en veranderende omgevingen.

Wouter Van Dooren
Prof. dr. W. Van Dooren is hoogleraar bestuurskunde aan de Universiteit Antwerpen en daarnaast voorzitter van de Vlaamse Vereniging voor Bestuur en Beleid.

Jan Boon
Dr. J. Boon is postdoctoraal onderzoeker aan de Universiteit Antwerpen bij het departement Politieke wetenschappen.
Artikel

De veranderende rol van provincies bij de ­uitvoering van hun beleid voor maatschappelijke betrokkenheid bij natuur

Tijdschrift Beleid en Maatschappij, Aflevering Online First 2022
Trefwoorden nature policy, governance strategies, Province, social engagement, Grants
Auteurs Tineke de Boer, Didi van Doren, Dana Kamphorst e.a.
SamenvattingAuteursinformatie

    Promoting societal engagement with nature is an important policy ambition of Dutch nature policy. This article provides an overview of how the provinces together with stakeholders have shaped their policy to increase the societal engagement of citizens with nature in recent years. The goals and governance modes embedded in the policy programs were analyzed, and results and experiences of the various involved parties with the policy were reviewed. Based on a national review and in dept study of three cases, this article describes different regional approaches for increasing societal engagement. In addition it discusses the recent developments within this policy field.
    The analysis shows that provinces pursue different goals with societal engagement. It is both a policy goal in itself – provinces would like to increase the number of citizens involved – as well as a means of achieving a broader range of other goals (welfare, health, quality of life, shared responsibility, funding, support for nature policy). Provinces use different governance modes; they act as responsive and increasingly networking government. They use various policy instruments; financial support for initiatives and intermediaries, network building and communication. Furthermore, the analysis shows that past experiences have shaped provinces’ governance mode and that these are adapted accordingly. A shift is noted from leaving the initiative with communities to more direct facilitation by the government. Also governing based on performance, linked to new public management, is on the rise, as there is increasing demand for accountability of provincial expenditure.


Tineke de Boer
Tineke de Boer is onderzoeker aan het onderzoeksinstituut Wageningen Environmental Research van de Wageningen University & Research.

Didi van Doren
Dr. Didi van Doren is wetenschappelijk onderzoeker bij het Planbureau voor de Leefomgeving, Sector Natuur en landelijk gebied.

Dana Kamphorst
Dr. ir. Dana Kamphorst is onderzoeker aan het onderzoeksinstituut Wageningen Environmental Research van de Wageningen University & Research.

Irene Bouwma
Dr. ir. Irene Bouwma is onderzoeker aan het onderzoeksinstituut Wageningen Environmental Research van de Wageningen University & Research.

    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.


Bernadette Holtkamp
Mr. B.J. Holtkamp BN is hoofddocent/onderzoeker Safety & Security Management aan de Saxion Hogeschool in Enschede.

Ira Helsloot
Prof. dr. I. Helsloot is hoogleraar Besturen van Veiligheid aan de faculteit Managementwetenschappen van de Radboud Universiteit Nijmegen.
Essay

Met vreemde ogen kijken

Gemeentelijke visitaties met behulp van bestuurskrachtmetingen: opzet, uitkomsten en benutting

Tijdschrift Bestuurs­wetenschappen, Aflevering 3 2021
Auteurs Jean Schutgens
SamenvattingAuteursinformatie

    This study examines the quality of visitation in three government sectors in the Netherlands: academic education (training), urban policy (urban municipalities) and municipal authorities. The focus is mainly on the visitation of municipal authorities in the Dutch province Limburg. The assessment of the visitation quality of university study programmes and of major cities policy must yield hypotheses to determine the quality of the visitation of municipal authorities that have been visited. The object of study is therefore ‘visitation’, in particular ‘visitation quality’. The visitations of university studies were viewed from four quality perspectives, namely on the design quality, the process quality, the assessing and the concluding quality, and usability or utilisation. This is also the case with the visitation of the major cities’ policy and of the Limburg municipal authorities. The question is, of course, what the analysis of the quality of all the assessments in three sectors yields, with special attention to the assessment of municipal authorities. Is it clear after that analysis how this quality inspection should be carried out? The study provides a wealth of insights and shows the state of the administrative strength of the inspected Limburg municipal authorities. A publication of this study has been postponed for more than five years, because the author wanted to investigate whether the administrative strength measurements were used in the longer term.


Jean Schutgens
Dr. J.M.L.R. Schutgens is bestuurskundige en in 2014 bij Arno Korsten gepromoveerd aan de Open Universiteit. Hij was gemeentesecretaris van Landgraaf in de periode 1992-2008.

    Local political parties are an important factor in local politics in the Netherlands. These parties, which participate in municipal elections but are not affiliated with national political parties, are currently the largest ‘political family’ in the municipal councils. Yet surprisingly little is known about these parties. The existing research indicates that this ‘party family’ has a protest character. But at the same time, more precise analyses indicate that this party family is more diverse: and that the label ‘local party’ describes all kinds of different movements. However, a comprehensive analysis of the programmatic positioning of all parties in this family in relation to national parties is lacking. That is the purpose of this article. For this research, all election manifestoes of the departments and parties that participated in the municipal elections in November 2013, March and November 2014, November 2017 and March and November 2018 were collected. On this basis, the positions of all these parties are estimated on the left-right dimension, a scale that measures anti-elitist rhetoric and a scale that measures localism, based on modern quantitative text analysis techniques (bag-of-words approaches). In this way, for the first time, a picture is obtained of the programmatic cohesion and diversity of this party family as a whole.


Simon Otjes
Dr. S.P. Otjes is onderzoeker bij het Documentatiecentrum Nederlandse Politieke Partijen (DNPP) van de Rijksuniversiteit Groningen en universitair docent aan de Universiteit Leiden.
Thema-artikel

De verleiding van bestuurlijke blikvernauwing: schuld en tijd in ­COVID-19-crisisbeleid

Tijdschrift Bestuurskunde, Aflevering 4 2021
Trefwoorden crisis management, blame avoidance, COVID-19, crisis communication, time
Auteurs Joram Feitsma en Marij Swinkels
SamenvattingAuteursinformatie

    As public institutions seek to come to grips with the crisis of COVID-19, they risk getting trapped in a unilateral here-and-now crisis management style that overlooks other long-term societal issues. We raise the question how and why this is the case. What makes here-and-now crisis management so ‘attractive’ from a political-administrative perspective? Through which strategies is this style being promoted? Guided by the literature on blame management, we empirically analyze the Dutch COVID-19 crisis communication. We specifically zoom into a pivotal yet underexposed facet: the role of time. Three time-related blame management strategies are empirically explored and interpreted: 1) playing with the time horizon; 2) organizing self-reinforcing institutional rhythms of monitoring and decision-making; 3) selectively naming uncertainties and risks. All three subtly add to a short time horizon in managing the ­COVID-19 crisis, revealing how interwoven time and blame are in public decision-making.


Joram Feitsma
Dr. J.N.P. Feitsma is universitair docent bij het departement Bestuurs- en Organisatiewetenschap van de Universiteit Utrecht.

Marij Swinkels
Dr. E.M. Swinkels is universitair docent bij het departement Bestuurs- en Organisatiewetenschap van de Universiteit Utrecht.
Thema-artikel

From National Lockdowns to Herd Immunity: Understanding the Spectrum of Government Responses to COVID-19 (2019-2021)

Tijdschrift Bestuurskunde, Aflevering 3 2021
Trefwoorden COVID-19, Health Policy, Policy Strategies, Policy Capacity, Leadership
Auteurs Michael Howlett
SamenvattingAuteursinformatie

    Governments around the world responded at roughly the same time but in several different ways to the emerging threat of COVID-19 in early 2020. This article sets out the nature of the different strategies that emerged over the course of the pandemic, focussing on the policy tools deployed. Some of these efforts were successful in containing the coronavirus while others were not, in some cases due to poor initial choices and in others due to poor implementation of the chosen strategy. Although the initial understanding each government had of the nature of the disease was the same, different state capacities and different levels of preparedness and effective leadership can be seen to have resulted over time in the emergence of six distinct approaches to the pandemic which, once deployed, proved difficult, although not impossible, to change as the pandemic unfolded.


Michael Howlett
Dr. M. Howlett is professor at the Simon Fraser University in Vancouver, Canada.
Thema-artikel

Naar een politiek-bestuurlijke herdefinitie van pandemische paraatheid

Sturing van de COVID-19-respons in Azië en Europa

Tijdschrift Bestuurskunde, Aflevering 3 2021
Trefwoorden pandemic preparedness, COVID-19 governance, welfare state failure, mitigation and control, political economy
Auteurs Marleen Bekker en Ivo ten Have
SamenvattingAuteursinformatie

    Despite the highest ranks on pandemic preparedness assessments European welfare states encounter great difficulty in responding effectively to the COVID-19 outbreak. In this article we compare the governance of COVID-19 response in 48 Eurasian countries and a selection of European and SARS (2003) exposed Asian countries during the first wave of the COVID-19 outbreak until 1 June 2020, using data from the COVID-19 Health System Response Monitor and the Oxford COVID-19 Government Response Tracker, recent scientific literature and policy documents.
    Pandemic preparedness during the first wave of COVID-19 evolved from specialist infectious disease control to a broad governance of population mitigation, which in at least half of Eurasian countries lacked appropriate authority and capacity. In the directly operational response in Asian countries, preparedness encompasses a whole of government approach, an engaged and active community and private actors. Preparedness requires and reflects both vertical and horizontal coordination as well as policies that fit with the political economy of a country and region.


Marleen Bekker
M.P.M. Bekker, PhD is universitair docent in de leerstoelgroep Health and Society (HSO), in het Center for Space, Place and Society (CSPS), aan Wageningen University and Research (WUR).

Ivo ten Have
I.L.F. ten Have, MSc heeft recent zijn master Communication and Health Sciences aan Wageningen University and Research afgerond met een thesis waarvan in dit artikel verslag wordt gedaan.
Research Note

Peer Assessment in Parliament

Promises and Pitfalls of a Marginalised Method in Parliamentary Research

Tijdschrift Politics of the Low Countries, Aflevering 3 2021
Auteurs Richard Schobess
SamenvattingAuteursinformatie

    Peer assessment is a rather marginalised method in political research. This research note argues that the collective expertise of MPs can complement other data to contribute to more comprehensive evaluations of MPs’ parliamentary work. Yet, this method is potentially flawed by low survey participation and rater bias among MPs. The experience with a peer assessment survey among members of three Belgian parliaments shows that participation does not necessarily need to be problematic. However, the empirical analysis suggests that scholars should control for various forms of rater bias.


Richard Schobess
Richard Schobess is a PhD candidate at the Department of Political Science of Ghent University. His research focuses on parliaments and elections.
Article

Cancelling proposed debates

Agenda Setting, Issue Ownership and Anti-elitist Parliamentary Style

Tijdschrift Politics of the Low Countries, Aflevering 3 2021
Trefwoorden agenda-setting, parliaments, anti-elitism, issue-ownership
Auteurs Simon Otjes en Roy Doedens
SamenvattingAuteursinformatie

    The Dutch Tweede Kamer is unique among parliaments because here the agenda is actually determined in a public, plenary meeting of all MPs. In the Dutch Tweede Kamer 30 members of parliament (MPs) can request a plenary debate. Many opposition parties request these debates, but only 23% of these are actually held. We examine the question ‘under what conditions do political party groups cancel or maintain proposals for minority debates?’ as a way to gain insight into the black box of parliamentary agenda setting. We examine two complementary explanations: issue competition and parliamentary style. We trace all 687 minority debates that were proposed between 2012 and 2021 in the Netherlands. This allows us to see what proposals for debates MPs make and when they are retracted. We find strong evidence that anti-elitist parties maintain more debate proposals than do other parties


Simon Otjes
Simon Otjes is assistant professor of Dutch Politics at Leiden University and researcher at Documentation Centre Dutch Political Parties. His research focuses on political parties, legislative behaviour and interest groups in Europe and the Netherlands specifically. He has previously published on legislative behaviour in West European Politics, the Journal of Legislative Studies and Party Politics.

Roy Doedens
Roy Doedens studied Philosophy and International Relations and International Organizations at Groningen University and Political Science at Leiden University. Currently, he works as a public affairs advisor at Erasmus University.

Benjamin de Vet
Benjamin de Vet is a postdoctoral researcher (FWO) at research group GASPAR, Department of Political Science, Ghent University. His main research interests are parliaments and political parties. He has published on these topics in Parliamentary Affairs, Party Politics and The Journal of Legislative Studies.

Tom Louwerse
Tom Louwerse is associate professor of Political Science at Leiden University. His research focuses on legislative politics, political representation and elections. He has published in many international journals, including West European Politics, Party Politics, The Journal of Legislative Studies and Political Science Research and Methods.
Article

Access_open The Resilience of Democracy in the Midst of the COVID-19 Pandemic

Democratic Compensators in Belgium, the Netherlands and France

Tijdschrift Politics of the Low Countries, Aflevering 2 2021
Trefwoorden COVID-19, crisis-management, democratic compensators, exceptionalism
Auteurs Tom Massart, Thijs Vos, Clara Egger e.a.
SamenvattingAuteursinformatie

    Since January 2020, European countries have implemented a wide range of restrictions to contain the COVID-19 pandemic. Yet governments have also implemented democratic compensators in order to offset the negative impacts of restrictions. This article aims to account for the variation of their use between Belgium, the Netherlands and France. We analyse three drivers: the strength of counterpowers, the ruling parties’ ideological leanings and political support. Building on an original data set, our results distinguish between embedded and ad hoc compensators. We find that ad hoc compensators are championed mainly by counterpowers, but also by ideology of the ruling coalitions in Belgium and the Netherlands and used strategically to maintain political support in France. Evidence on the link between embedded compensators and counterpowers is more ambiguous.


Tom Massart
Tom Massart is a PhD candidate at ULB / CEVIPOL. His research mainly focuses on European economic governance.

Thijs Vos
Thijs Vos is a political scientist and research assistant at Groningen University.

Clara Egger
Clara Egger is assistant professor in international relations at Groningen University. She is currently leading the Exceptius project on Covid19 containment policies in Europe.

Claire Dupuy
Claire Dupuy is professor of comparative politics at UCLouvain. She specializes in comparative public policy with a focus on multilevel governance, federalism and regionalization processes.

Constance Morel-Jean
Constance Morel-Jean is a master’s student at Grenoble-Alpes University. She specialises in the study of political behaviour.

Raul Magni-Berton
Raul Magni-Berton is professor of political science at Grenoble-Alpes University, PACTE research unit. His research mainly focuses on democracy, its institutions and norms.

Sébastian Roché
Sebastian Roché is CNRS Research Professor at Grenoble-Alpes University, PACTE research unit. He specializes in policing and legitimacy studies.

    Dutch municipalities and provinces have been obliged to have an audit office or audit office function for about 20 years. How does the audit office work nowadays and what contribution does it make to decentralized administration? That is the question at the center of this article. To this end, the authors list the available knowledge about audit offices or committees and present the results of their own analysis of 982 audit reports from 234 audit offices or committees from 308 Dutch municipalities. The audit office or committee has been institutionalized in the vast majority of municipalities and in all provinces. Council members are increasingly less likely to (also) be members of this board and the output has increased slightly from approximately one to an average of one and a half surveys per year. Where initially mainly business management-oriented subjects were examined, some broadening to more policy-related themes has taken place. Municipal councilors are quite satisfied with their audit office or committee. At the same time, the actual social effects of policy are rarely measured in audit institutions. Moreover, council members make little use of audit reports in controlling the municipal board, and audit offices or committees also add little to their framework-setting role. Little is known about the extent to which the research of the audit offices makes a more objective contribution to the administration and strengthening of the functioning of the municipal council, which is also a theme for future research.


Klaartje Peters
Prof. dr. K. Peters is zelfstandig onderzoeker en publicist en bijzonder hoogleraar Lokaal en regionaal bestuur aan de Universiteit Maastricht; zij is voorzitter van de Rekenkamer Venlo en rekenkamerdirecteur in Beuningen, en redactielid van Bestuurswetenschappen.

Sabine van Zuydam
Dr. S. van Zuydam is onderzoeker bij Necker van Naem en is verbonden aan de Universiteit Twente; daarnaast is zij (plaatsvervangend) voorzitter van verschillende rekenkamercommissies en redactielid van Bestuurswetenschappen.

    The impact of audit office reports has received little attention in the scientific literature. In this article, various forms of impact have been distinguished with the help of Public Administration literature and factors that promote the use of evaluations have been distinguished. This theoretical framework was subsequently used for empirical research into the effect of audit office research. The extent to which the recommendations have had an impact was investigated in 20 Dutch municipalities with the aid of impact reports from audit institutions. Out of 176 publications, 94% of the 1216 recommendations were adopted by the city council. This means that the procedural impact is high. Of the 731 recommendations that could be checked at 17 municipalities, the local audit offices report that 58% had been fully implemented, 19% partially and 15% not or not tackled differently. The three categories of success factors from the scientific literature were visible in the practice of the audit offices. This applies most strongly to impact factors related to evaluation quality, in particular the factors related to communications standards, clear recommendations, timeliness and relevance to the decision maker. As far as research and decision-making factors are concerned, the commitment of the organization and the political climate are the most important factors for audit institutions. Finally, the involvement of stakeholders promotes the impact as a catalyst. The article concludes with practical lessons for promoting the processing of audit reports.


Sjoerd Keulen
Dr. S.J. Keulen is specialistisch adviseur bij de Algemene Rekenkamer. Daarnaast is hij extern lid van de Rekenkamer Utrecht.
Thema-artikel

Geen naïef optimisme meer over digitalisering in de publieke sector: sadder but wiser

Wetenschappelijke reflectie op ‘Big data, grote vragen’ (2016)

Tijdschrift Bestuurskunde, Aflevering 2 2021
Auteurs Elise Renkema en Albert Meijer
Auteursinformatie

Elise Renkema
E.A. Renkema, BA is masterstudent in de onderzoeksmaster Public Administration and Organisational Science aan de Universiteit Utrecht. Daarnaast is ze onderzoeker bij de Datawerkplaats, onderdeel van de Universiteit Utrecht. Prof. dr. A.J. Meijer is hoogleraar Publiek Management aan de Universiteit Utrecht, Departement Bestuurs- en Organisatiewetenschap.

Albert Meijer
Article

Access_open An Actor Approach to Mediatization

Linking Politicians’ Media Perceptions, Communication Behaviour and Appearances in the News

Tijdschrift Politics of the Low Countries, Aflevering 1 2021
Trefwoorden mediatization, politicians, news media, media perceptions, news management
Auteurs Pauline Ketelaars en Peter Van Aelst
SamenvattingAuteursinformatie

    In the light of the broader debate on the mediatization of politics, this study wants to better understand how the media perceptions and media behaviour of politicians are related to their appearances in the news. We opt for an innovative actor-centred approach to actually measure the views and actions of individual politicians. We combine surveys conducted with 142 Belgian representatives with data on politicians’ external communication behaviour and on their appearances in television news, newspapers and news websites. The results show that media behaviour is not so much related to beliefs of media importance. We do find a significant positive relationship between strategic media behaviour and media attention suggesting that politicians who put in more effort appear more often in various news media. However, this positive relationship depends on the specific form of strategic communication and the political position of the legislator. Our study adds to the mediatization literature by showing how and when politicians are successful in obtaining media attention.


Pauline Ketelaars
Pauline Ketelaars was a postdoctoral researcher of the Fonds Wetenschappelijk Onderzoek (FWO). Her main research interests are political communication and social movements.

Peter Van Aelst
Peter Van Aelst is a research professor at the department of political science at the University of Antwerp and a founding member of the research group ‘Media, Movements and Politics’ (M2P). His research focuses on political communication. Corresponding author: peter.vanaelst@uantwerpen.be.
Research Note

Caretaker Cabinets in Belgium

A New Measurement and Typology

Tijdschrift Politics of the Low Countries, Aflevering 1 2021
Trefwoorden caretaker government, Belgium, cabinets, political crisis
Auteurs Régis Dandoy en Lorenzo Terrière
SamenvattingAuteursinformatie

    Belgium is probably the world’s best known case of where caretaker governments reside. Yet a clear scholarly definition and measurement of this concept is missing. Based on a detailed analysis of the Belgian federal cabinets, this research note explores the main characteristics and measures the length of the various caretaker periods. We find that Belgium was governed for no less than 1,485 days by a caretaker government between 2007 and 2020, which equals more than four full calendar years. This research note also presents a novel typology of caretaker periods based on the institutional and political practice within the Belgian legislative and executive branches. This typology can be used to assess caretaker periods at other levels of government as well as in other countries in order to improve our understanding of the many ‘faces’ that a caretaker government can take on.


Régis Dandoy
Régis Dandoy is professor in political science at the Universidad San Francisco de Quito in Ecuador and visiting research fellow and guest lecturer at the University of Brussels, Belgium. His main research interests include comparative politics, federalism, voting behaviour, election results, electronic and internet voting and election observation.

Lorenzo Terrière
Lorenzo Terrière is a PhD candidate and teaching assistant at Ghent University. His doctoral research is focused on how (regionalist) parties deal with the strategic issue of government participation.
Artikel

Rebel-leren: hoe een rebelse sector tot lerend verantwoorden komt

Tijdschrift Beleid en Maatschappij, Aflevering 2 2021
Trefwoorden quality of care, rebels, accountability, organization/sector learning
Auteurs Annemiek Stoopendaal en Wilma van der Scheer
SamenvattingAuteursinformatie

    Healthcare is often dominated by the curative domain. Yet, for a new way of improving of and accounting for quality of care, we have to shift our focus to the care for people with disabilities. Since long, quality of care is translated into performance indicators and standards. This reductive way of measuring quality was pursued for the entire healthcare sector. Where this might fit in with hospital care, it was experienced as constraining in care for the disabled. In this sector it was seen as a poor representation of the plurality of healthcare provision. A number of ‘quality rebels’ aimed to create a more suitable and rich Quality Framework for the sector, with attention for objective, subjective and intersubjective dimensions of care. In this article, we analyze the way in which the sector has realized this aim, and we show how this rebellious sector succeeded in transforming the idea of accountability for quality of care, by emphasizing on the reflection and learning processes that take place at all levels of the sector, and beyond. A new approach which requires a continuous cycle of disrupting, creating, and maintaining institutionalized patterns of thinking and doing. It requires ‘rebel learning’.


Annemiek Stoopendaal
Dr. Annemiek Stoopendaal is organisatieantropoloog en universitair docent/senior onderzoeker, Erasmus School of Health Policy & Management, sectie Health Care Governance aan de Erasmus Universiteit Rotterdam.

Wilma van der Scheer
Dr. Wilma van der Scheer is gezondheidswetenschapper, directeur van het Erasmus Centrum voor Zorgbestuur en leider van de academische werkplaats zorgbestuur, Erasmus Centrum voor Zorgbestuur aan de Erasmus Universiteit Rotterdam.
Artikel

Rebellerende zorgprofessionals

Improviseren met regels, passie en verantwoording

Tijdschrift Beleid en Maatschappij, Aflevering 2 2021
Trefwoorden healthcare rebels, administrative burden, quality of care, etnography, accountability
Auteurs Iris Wallenburg, Hester van de Bovenkamp, Anne Marie Weggelaar-Jansen e.a.
SamenvattingAuteursinformatie

    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.


Iris Wallenburg
Dr. Iris Wallenburg is universitair hoofddocent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Hester van de Bovenkamp
Dr. Hester van de Bovenkamp is universitair hoofddocent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Anne Marie Weggelaar-Jansen
Dr. Anne Marie Weggelaar-Jansen, MCM is universitair docent, sectie Health Services Management and Organization, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Roland Bal
Prof.dr. Roland Bal is hoogleraar beleid en bestuur van de gezondheidszorg, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.
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