Zoekresultaat: 183 artikelen

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    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.

    Welke kennis is nodig om zicht te krijgen op de te verwachten effecten van beleid? Hiervoor moet worden ingeschat of een beleidsinterventie effectief zal zijn en binnen een bepaalde context zal uitwerken zoals beoogd. Twee typen kennisclaims zijn hierbij van belang, namelijk die over de verklarende mechanismes tussen interventie en uitkomst, en die over de ondersteunende factoren die voorwaardelijk zijn voor de uitkomst. Dit standpunt wordt geïllustreerd aan de hand van twee voorbeelden van beleidsinterventies in de praktijk: de inzet van kleinere schoolklassen en de publieke registratie van zedendelinquenten.


Gerdien van Eersel
Gerdien van Eersel is universitair docent Interdisciplinaire Sociale Wetenschap aan de Universiteit Utrecht. Ze was daarvoor onderzoeker bij de lokale overheid en heeft een achtergrond in de wetenschapsfilosofie.
Article

Morality in the Populist Radical Right

A Computer-Assisted Morality Frame Analysis of a Prototype

Tijdschrift Politics of the Low Countries, Aflevering Online First 2021
Trefwoorden Populist radical right, morality, frame analysis, word2vec, crimmigration
Auteurs Job P.H. Vossen
SamenvattingAuteursinformatie

    This article provides a computer-assisted morality framing analysis of Vlaams Belang’s 2019 manifesto. The VB is regarded in the literature as a prototypical example of the Populist Radical Right (PRR). We first concisely review what PRR politics is and what it consists of, tentatively distinguishing four elements that we hypothesise will materialise in corresponding subframes running throughout the manifesto. We point to a mismatch between the omnipresent role of morality in all PRR subframes and the little attention devoted to the concept in the PRR literature. We introduce a useful theory from social psychology into framing literature to create a novel methodological approach to frame analysis that builds a bridge between a qualitative content and a quantitative context approach. The results support our hypothesis that populism, nationalism, nativism and authoritarianism can be distinguished from one another. Additionally, we detect a fifth PRR subframe, crimmigration, by its unique role of morality.


Job P.H. Vossen
Job Vossen is a PhD candidate at the University of Antwerp. His research investigates (im)morality in political discoursing and its interacting with fear, solidarity and gender and sexuality. The corresponding author states that there is no conflict of interest.
Article

Opposition in Times of COVID-19 – To Support or Not to Support?

Tijdschrift Politics of the Low Countries, Aflevering 2 2021
Trefwoorden minority government, rally-around-the-flag, COVID-19, mainstream parties, challenger parties, opposition, party goals
Auteurs Britt Vande Walle, Wouter Wolfs en Steven Van Hecke
SamenvattingAuteursinformatie

    COVID-19 has hit many countries all over the world, and its impact on (party) politics has been undeniable. This crisis situation functions as an opportunity structure incentivising opposition forces to support the government. Not much is known about what drives opposition parties to (not) support the government in crisis situations. This article integrates the literature on rally-around-the-flag, political opportunity structures, party types and party goals. More specifically, we focus on the behaviour of opposition parties towards the government’s crisis response to the COVID-19 pandemic. We analyse whether and how the party type influences the position of the party vis-à-vis the governmental coalition, focusing on the case of Belgium. We categorise the seven opposition parties in Belgium as challenger or mainstream parties and explain their behaviour on the basis of policy-, office- or vote-seeking motives. Our analysis is based on party voting behaviour, elite interviews and an analysis of the main plenary debates.


Britt Vande Walle
Britt Vande Walle is PhD Researcher at the KU Leuven Public Governance Instituted, funded by a FWO fellowship ‘Fundamental Research’. Her research focuses on comparative politics, political parties, and political party think tanks. ORCID: https://orcid.org/0000-0002-9594-9897.

Wouter Wolfs
Wouter Wolfs is Senior Researcher at the KU Leuven Public Governance Institute. His research interests include the European Union, political finance, legislative studies and political parties. ORCID: https://orcid.org/0000-0002-6214-5972.

Steven Van Hecke
Steven Van Hecke is Associate Professor in Comparative and EU Politics at the KU Leuven Public Governance Institute. His research focuses on Europarties, EU institutions and European integration history. ORCID: https://orcid.org/0000-0003-0215-5463.
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.
Vrij artikel

Permanent falen

Het (niet-)gebruik van kwaliteitssystemen in de GGZ

Tijdschrift Bestuurskunde, Aflevering 3 2021
Trefwoorden performance measurement, quality control, mental health care, institutional theory
Auteurs Marieke Van Geffen, Taco Brandsen, Christiaan J. Lako e.a.
SamenvattingAuteursinformatie

    In this article we present the results of research into quality control systems in Dutch mental health care (GGZ). So far, little is known about the efficacy of quality control systems in this sector. A mix of qualitative and quantitative research methods has been applied (interviews, focus groups, questionnaires and document analysis) to find out how these systems were applied in mental health care and how their use could be explained.
    The findings show that the implementation of quality control systems was limited and highly selective. The system appears to be permanently failing, a fact recognized by most parties, yet mistrust prevents change. This confirms the assumption from institutional theory that some parts of organizations can have a symbolic rather than a real effect. In this case, it seems that the presence of quality control systems is valued over the actual improvement of quality.


Marieke Van Geffen
Dr. M. van Geffen is gastonderzoeker aan de Radboud Universiteit, manager innovatie bij de Viersprong en specialist in persoonlijkheid, gedrag en gezin.

Taco Brandsen
Prof. dr. T. Brandsen is hoogleraar bestuurskunde aan de Radboud Universiteit Nijmegen.

Christiaan J. Lako
Dr. C.J. Lako is hoofddocent bestuurskunde aan de Radboud Universiteit Nijmegen.

Odette M. Brand-de Wilde
Dr. O.M. Brand-de Wilde is klinisch psycholoog en psychotherapeut aan de Universiteit van Amsterdam, afdeling klinische psychologie.
Thema-artikel

Tweebenig besturen binnen zorgnetwerken

Besturen tijdens de ‘hamer’ en de ‘dans’ in zorgregio west

Tijdschrift Bestuurskunde, Aflevering 3 2021
Trefwoorden network management, health care managers, innovation, consolidation, health care networks, COVID-19, crisis management
Auteurs Jelmer Schalk, Eduard Schmidt, Suzan van der Pas e.a.
SamenvattingAuteursinformatie

    Crisis management requires health care managers to simultaneously innovate, i.e. to adjust – and to consolidate, i.e. to provide stability. COVID-19 was no exception in this respect. In this study, we ask to what extent multi-actor and multi-level health care networks stimulate or hinder balancing innovation and consolidation. We present the results of a qualitative case study, drawing upon 29 interviews with health care managers in one region in the Netherlands. Our analysis chronologically follows the crisis management response and differentiates between ‘the hammer’ phase (the ‘lockdown’) and the ‘dance’ phase (learning to live with the virus). We show that, especially in the hammer phase, formal networks can contribute to consolidation, yet innovation comes mostly from informal and personal networks. While the hammer phase should help organizations prepare to live and dance with the virus, we show that multi-actor and multi-level networks focus more on idiosyncratic organizational interests, although some of these are in fact productive. We conclude with recommendations for practice.


Jelmer Schalk
Dr. J. Schalk is universitair hoofddocent bij het LUMC.

Eduard Schmidt
Dr. J.E.T. Schmidt is universitair docent bij de Universiteit Leiden.

Suzan van der Pas
Dr. S. van der Pas is universitair hoofddocent bij het LUMC.

Sietse Wieringa
Dr. S. Wieringa is huisarts bij het LUMC.

Sandra Groeneveld
Prof. dr. S.M. Groeneveld is hoogleraar Publiek Management bij de Universiteit Leiden.

Jet Bussemaker
Prof. dr. M. Bussemaker is hoogleraar Wetenschap, beleid en maatschappelijke impact bij het LUMC.
Article

Performing the COVID-19 Crisis in Flemish Populist Radical-Right Discourse

A Case Study of Vlaams Belang’s Coronablunderboek

Tijdschrift Politics of the Low Countries, Aflevering 2 2021
Trefwoorden populism, COVID-19, crisis, discourse
Auteurs Jens Meijen
SamenvattingAuteursinformatie

    In June 2020, the Flemish populist radical right party Vlaams Belang (VB) published the Corona Blunder Book (CBB; Coronablunderboek in Dutch), detailing the government’s mistakes in handling the COVID-19 crisis. Populist parties can ‘perform’ crisis by emphasising the mistakes made by opponents (Moffitt, 2015) and may use a specifically populist discursive style, consisting largely of aggressive and sarcastic language (Brubaker, 2017). This paper takes the CBB as a case study in the populist performance of crisis and the populist style, finding that the book is, first, a clear example of populist ‘everyman’ stylistics and the performance of crisis, and, second, that VB uses the book to shift the COVID-19 crisis from a public health crisis to a crisis of governance, seeking to blame Belgium’s federal structure for the government’s alleged mismanagement of the COVID-19 pandemic and hence arguing for Flemish independence, one of the party’s main agenda points.


Jens Meijen
Jens Meijen is a PhD candidate at Leuven International and European Studies (LINES) at KU Leuven. His research focuses on nationalism, populism, and diplomacy.
Article

The Praise for a ‘Caretaker’ Leader

Gendered Press Coverage of Prime Minister Sophie Wilmès in a COVID-19 Context

Tijdschrift Politics of the Low Countries, Aflevering 2 2021
Trefwoorden political leadership, crisis, care, Belgium, gendered media coverage
Auteurs Clémence Deswert
SamenvattingAuteursinformatie

    Studies on media coverage of women politicians have underlined how the media contribute to the association of the figure of the political leader with masculinity. Yet, the social construction of leadership seems to evolve towards a more ‘femininity-inclusive’ definition. Research on the ‘glass cliff’ phenomenon suggests that stereotypical feminine attributes might be expected from political leaders in a time of crisis. We investigated the gendered construction of political leadership in the press in a COVID-19 context through the case of former Belgian Prime minister Sophie Wilmès. In line with the ‘think crisis-think female’ association, our discourse analysis shows an appreciation of traditionally feminine traits, and particularly care-related qualities, in the evaluation of what a ‘good’ leader should be in pandemic times, although some characteristics traditionally associated with masculinity are still considered valuable assets in the journalistic portrayal of Wilmès’ leadership.


Clémence Deswert
Clémence Deswert is a PhD candidate at the Political Science Department of the Université libre de Bruxelles (ULB). Her research interests include political communication and political representation of women. Declaration of interests: I confirm that this article was not submitted to or publicised in another journal. No conflict of interest exists.

Luana Russo
Luana Russo is an assistant professor in quantitative methods at the Faculty of Arts and Social Sciences (FASoS) of Maastricht University. Her research focuses on two main connected branches: political and electoral behaviours and quantitative methods. Her substantive research interests are in comparative politics, electoral and political behaviour, polarization, political participation, electoral geography and quantitative methods. She holds a PhD from Scuola Superiore Sant’Anna (2011).

Min Reuchamps
Min Reuchamps is professor of political science at the Université catholique de Louvain (UCLouvain). His teaching and research interests are federalism and multilevel governance, democracy and its different dimensions, relations between language(s) and politics and, in particular, the role of metaphors, as well as participatory and deliberative methods.

    Dutch social policies are aimed at the integration and participation of all people. This creates challenges for persons with a mental vulnerability and their neighbourhoods. Five municipalities in the province of Flevoland asked us to help them improve the move from protected living to living in the neighbourhood. We used an arts-based participatory action research design and we followed ‘hot topics’, topics that sparked people’s energy and emotion, and which led to empowerment and participation. Focusing on these topics, which initially might not seem to be closely connected to the main research topic, might produce more information, and energy to take action on it, rather than rigidly sticking with the initial research topics. In this article, we focus on the first phases of the project. The emotions that people with mental vulnerabilities expressed when talking about their dogs, led us to the core of what really mattered to them in terms of inclusive living and participation. The dog functioned as an unexpected ‘hot topic’. In a symbolic sense, ‘the dog’ stands for a diverse range of lifeworld topics that can act as a creative catalyst for social change.

    Vooraf

    Participatief actieonderzoek en responsieve evaluatie staan volop in de belangstelling bij beleidsmakers en onderzoekers. Dit type beleidsonderzoek en -evaluatie beoogt democratisch, inclusief én impactvol te zijn. Het gaat om onderzoek mét in plaats van óver mensen. En het is actiegericht: onderzoek wil bijdragen aan concrete oplossingen door met betrokkenen gezamenlijke (verbeter)acties te ontwikkelen in de praktijk, en daarop te reflecteren en van te leren. Dit alles met het oog op sociale inclusie. Het zijn mooie idealen, maar wat betekent dit in de alledaagse, vaak weerbarstige onderzoekspraktijk?

    Op 20 januari 2020 organiseerde prof. Abma daarover een symposium, getiteld ‘Responsive, Participatory Research: Past, Present and Future Perspectives’ (Vrije Universiteit, Amsterdam). De rode draad op het symposium was de vraag wat goed en ethisch verantwoord participatief onderzoek is, en wat dit vraagt van onderzoekers en beleidsmakers. Drie lezingen op deze conferentie zijn nadien omgewerkt tot essays om lezers van Beleidsonderzoek Online vanuit verschillende perspectieven beter kennis te laten maken met deze vorm van onderzoek:

    Prof. Weerman en haar team focussen in hun bijdrage op het zich in de praktijk ontwikkelende onderzoeksdesign en het inzetten van creatieve methoden om participatie te bevorderen. Ze gaan na welke kwaliteitscriteria aan participatief actieonderzoek worden gesteld en hechten daarbij met name aan eisen ten aanzien van participatie, samen leren en verschil maken (zie BoO juli 2021). Ze benadrukken het belang van creativiteit en flexibiliteit.

    Prof. Abma bespreekt in haar artikel de normatieve dimensies en de ethiek van participatief actieonderzoek (zie BoO september 2020). Ze illustreert met een voorbeeld uit de crisishulpverlening aan GGZ-cliënten dat participatief actieonderzoek niet slechts een methodisch-technische exercitie is, maar een sociaal-politiek proces waarbij bestaande machtsverhoudingen verschuiven om ruimte te geven aan nieuwe stemmen en kennis. Dit omvat het zien van en stilstaan bij ethisch saillante dilemma’s en morele reflectie.

    De bijdrage van prof. Cook (zie BoO februari 2021) gaat over de weerbarstige praktijk van participatief actieonderzoek. Het doel is samen leren en voorbij geijkte oplossingen komen. Zij laat zien dat dit uitdagend is voor professionals die geconfronteerd worden met burgers die feedback geven en vragen om het (deels) loslaten van vaststaande professionele kaders. Er ontstaat dan ongemak en onzekerheid, maar zo beoogt en laat Cook overtuigend zien, deze ‘mess’ (niet meer goed weten wat goed en nodig is) is productief om te komen tot hernieuwde inzichten en innovaties.

    (Introductietekst opgesteld door prof. T. Abma)


Alie Weerman
Alie Weerman is professor of Mental Health and Society at Windesheim University of Applied Sciences. Her PhD focused on the use of experiential knowledge of professional social workers and caretakers. She practices Participatory Health Research in several organizations in healthcare and social work. She always uses experiential knowledge as a valuable ‘third source of knowledge’ in the process and results of studies.

Rosalie Metze
Rosalie Metze is associate professor of Mental Health and Society at Windesheim University of Applied Sciences. Her expertise lies in topics such as outreach work, experiential knowledge, self-efficacy, and strengthening the voice of those less heard. Her goal is to always work according to the PAR principles, and gain the necessary acknowledgement for this type of research.
Thema-artikel

Wat motiveert burgers tot coproductie en burgerinitiatief?

Wetenschappelijke reflectie op ‘Waarom burgers coproducent willen zijn’ (2013)

Tijdschrift Bestuurskunde, Aflevering 2 2021
Auteurs Mirjan Oude Vrielink
Auteursinformatie

Mirjan Oude Vrielink
Dr. M.J. Oude Vrielink is onderzoeker bij Oude Vrielink Dienstverlening – Partner in kennis.
Article

Interest Representation in Belgium

Mapping the Size and Diversity of an Interest Group Population in a Multi-layered Neo-corporatist Polity

Tijdschrift Politics of the Low Countries, Aflevering 1 2021
Trefwoorden interest groups, advocacy, access, advisory councils, media attention
Auteurs Evelien Willems, Jan Beyers en Frederik Heylen
SamenvattingAuteursinformatie

    This article assesses the size and diversity of Belgium’s interest group population by triangulating four data sources. Combining various sources allows us to describe which societal interests get mobilised, which interest organisations become politically active and who gains access to the policy process and obtains news media attention. Unique about the project is the systematic data collection, enabling us to compare interest representation at the national, Flemish and Francophone-Walloon government levels. We find that: (1) the national government level remains an important venue for interest groups, despite the continuous transfer of competences to the subnational and European levels, (2) neo-corporatist mobilisation patterns are a persistent feature of interest representation, despite substantial interest group diversity and (3) interest mobilisation substantially varies across government levels and political-administrative arenas.


Evelien Willems
Evelien Willems is a postdoctoral researcher at the Department of Political Science, University of Antwerp. Her research focuses on the interplay between interest groups, public opinion and public policy.

Jan Beyers
Jan Beyers is Full Professor of Political Science at the University of Antwerp. His current research projects focus on how interest groups represent citizens interests and to what extent the politicization of public opinion affects processes of organized interest representation in public policymaking.

Frederik Heylen
Frederik Heylen holds a PhD in Political Science from the University of Antwerp. His doctoral dissertation addresses the organizational development of civil society organizations and its internal and external consequences for interest representation. He is co-founder and CEO of Datamarinier.
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

Regels breken in het belang van de burger

Van rebelse leidinggevende naar rebelse professional?

Tijdschrift Beleid en Maatschappij, Aflevering 2 2021
Trefwoorden leadership, pro-social rule breaking, red tape, purpose-driven work, professionals
Auteurs Bernard Bernards en Eduard Schmidt
SamenvattingAuteursinformatie

    The recent decentralization of many healthcare and welfare responsibilities from the national to the municipal level in the Netherlands was aimed at reducing unnecessary bureaucracy and giving discretion to the professional. However, this is not (yet) fully achieved. Therefore, calls have been made for more purpose-driven organizations. Pro-social rule breaking, which refers to acts of rule breaking motivated by the benefits that this creates for citizens, might be a way to make organizations more focused on their organizational purpose. Since little is known about the antecedents of pro-social rule breaking, this article looks at the possible effects of red tape and supportive leadership on pro-social rule breaking behavior of professionals. Based on a quantitative large-n study of professionals in the social domain, the results show that red tape significantly affects pro-social rule breaking. Stimulating leadership does not affect pro-social rule breaking behavior, which may be caused by the fact that intended leader support is not be perceived that way by the professional. The article concludes with a discussion on the desirability of rule breaking in a public sector context, followed by practical implications and further avenues for researchers.


Bernard Bernards
Bernard Bernards, MSc MA is promovendus bij het Instituut Bestuurskunde, Universiteit Leiden.

Eduard Schmidt
Dr. Eduard Schmidt is universitair docent bij het Instituut Bestuurskunde, Universiteit Leiden.
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.

Marianne van Bochove
Dr. Marianne van Bochove is universitair docent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam en senior onderzoeker aan De Haagse Hogeschool.

Katja Rusinovic
Dr. Katja Rusinovic is lector grootstedelijke ontwikkeling, faculteit Bestuurskunde, Recht & Veiligheid aan De Haagse Hogeschool.

Suzanna Koops-Boelaars
Suzanna Koops-Boelaars, MSc, is promovendus, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.
Artikel

Access_open ‘We gaan het gewoon doen!’

Rebelse initiatieven in onderwijs en ouderenhuisvesting

Tijdschrift Beleid en Maatschappij, Aflevering 2 2021
Trefwoorden rebellion, housing for older people, education, rules and regulations, room to manoeuvre
Auteurs Marianne van Bochove, Katja Rusinovic, Suzanna Koops-Boelaars e.a.
SamenvattingAuteursinformatie

    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.


Marianne van Bochove
Dr. Marianne van Bochove is universitair docent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam en senior onderzoeker aan De Haagse Hogeschool.

Katja Rusinovic
Dr. Katja Rusinovic is lector grootstedelijke ontwikkeling, faculteit Bestuurskunde, Recht & Veiligheid aan De Haagse Hogeschool.

Suzanna Koops-Boelaars
Suzanna Koops-Boelaars, MSc, is promovendus, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Joost van Hoof
Dr. ir. Joost van Hoof is lector urban ageing, faculteit Sociaal Werk & Educatie, aan De Haagse Hogeschool.

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


Yvonne La Grouw MSc
Yvonne La Grouw MSc is PhD-candidate bestuurskunde en politicologie aan de Vrije Universiteit Amsterdam en redactielid van Beleid en Maatschappij.
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