Professionals often have problems with governmental policies they have to implement. This can lead to diminished legitimacy and lower policy performance. The goal of this article is to identify the main reasons why professionals resist implementing new policies. An interdisciplinary approach is taken. From public administration literature, I use the policy alienation model, which consists of five dimensions: strategic, tactical and operational powerlessness, societal meaninglessness and client meaninglessness. These are possible reasons why professionals resist public policies (‘resistance to change’, a concept drawn from change management literature). I test these assumptions using a survey among 1,317 healthcare professionals. The results show that when professionals experience that a policy is meaningless for society or for their own clients, they show strong resistance. A lack of perceived influence is much less important in explaining resistance, although this is partly dependent on the particular profession someone belong to. The policy alienation model can help policy makers and managers to develop policies which are accepted by professionals. The article ends with practical recommendations for policy makers, managers and professionals.

Over the last decade educational regulation has changed dramatically. Attempts to develop more cost-efficient regulation and to reduce the regulatory burden paralleled an increased focus on student achievement and sanctioning of failing schools. Additionally, the Inspectorate of Education holds school boards (instead of school principals) accountable for the quality development of their schools. Also, a change in legislation now requires schools to establish an internal supervisory board and improve their accountability to stakeholders.

These changes greatly impact the role of the Dutch Education Inspectorate as they are placed in a polycentric, instead of a monocentric, steering context. This article discusses the new position and role of the Dutch Education Inspectorate and evaluates the extent to which the educational sector and the Inspectorate of Education meet the requirements of such a polycentric context.

In recent decades, professionals in the public sector have been faced with increasingly detailed demands concerning accountability and performance. It is often argued that this increased accountability and its bureaucratic pressures limit professionals’ discretionary space and autonomy. However, this critique is hardly based on empirical research on the experiences and perceptions of professionals themselves. In this article we present an investigation into these perceptions and experiences with accountability in one particular brand of the public sector, namely youth care.
Our research indicates that professionals in youth care are hardly interested in greater autonomy or discretion. They rather want clarity, security and options for learning. Moreover, we found ‘bureaucratic attachment’: attachment to bureaucratic procedures particularly as a reaction to increased fears to be sued when something goes wrong with clients. In the recurrent arguments for reduction of bureaucracy, this other face of bureaucracy is often disregarded.
Regarding working conditions however, the professionals we interviewed do want more discretion. Especially concerning occupation of beds, as the requirement for permanent occupation is viewed to augment risk. We therefore argue for better backing of professionals in youth, for a more precise battle against unnecessary bureaucracy, and for professionalization in order to handle more discretion.

In order to facilitate the creation of a regulated market, Diagnostic Treatment Combinations (DBC’s in Dutch) have been introduced in Dutch mental health care in 2008. DBC’s are developed to distinguish and price the ‘products’ of health care, in order to make comparison and competition between health care providers possible. In this qualitative study we analyzed mental health care professionals experiences with the DBC-system. We focused on two questions: (1) what does the DBC-system and the related introduction of marketization of mental health care mean for professionals? and (2) how do professionals cope with the DBC-system in their daily practices? We found that the logics of the market and bureaucracy, both incorporated in the DBC-system, often conflicted with the values and ethics of mental health care professionals. Mental health professionals experience deterioration of professionalism and quality of care. They were coping with conflicting values by non-compliance with rules and pragmatic use of the DBC-system. It is argued that the efforts of professionals to protect the quality of their work might actually lead to invisibility of the problems they encounter, which reinforces the policy they criticize.

Demand-steering policies in healthcare are understandable but problematic answers to the desire for democratization that dates from the seventies of the former century. Prominent critics such as Achterhuis and Illich were very critical of the undemocratic character of health care. Yet their romantic idea of society excused them from the need to articulate democratic alternatives. The empty space that they left was filled by the concept of demand-steering. Demand-steering, however, rather than strengthening democratic practices, merely undermines them, by preferring exit above voice, by putting up new bureaucratic barriers between clients and professionals and by undermining the quality of the relationship between clients and professionals.

Doing more justice to the democratic impulse is possible and desirable. A new step towards this aim is being taken by a fourth logic of steering, (next to the familiar logics of the market, bureaucracy and professionalism) that centers on improving the dialogue between clients and professionals. The one variant, democratic professionalism, starts from the position of the professional and aims at intensifying democratic control, while the other variant, collaboration, starts from the client and aims at providing him with more influence and responsibility for the health care process. This fourth logic however can only provide a new impulse to democratization when the vague notion of the dialogue is elaborated more thoroughly.

Since the 1980s, there has been a rise of managers and executives in public domains. Especially in domains like education, this development was accompanied by sharp controversies and 'clashes' between managers and professionals, who would be 'alienated' from each other. The classic nature of professional and managerial loyalties would seem to strengthen this alienation. Professionals would primarily be loyal to their profession, whereas managerial loyalties would mainly focus on organisations. Although research has criticized the one-sidedness of professional loyalty, managerial loyalty has hardly been studied up till now. In this article, managerial loyalties are analyzed theoretically as well as empirically. The article rests upon a qualitative study among school leaders in Dutch secondary education. It shows that management reforms in education did not result in the adoption of a new, primary loyalty to organizations, management or performance by school leaders. Instead, long-standing relations, for example with teachers, remain meaningful, also because most school leaders have a professional background as teacher. Consequently, assumptions about managers who alienate from professionals, and managers who do not value their relationships with professionals must be criticized, at least in (secondary) education.

'Demand-based organising' has become popular throughout public domains, sometimes complementing, sometimes working against 'fact-based' and 'market-based' organising. This raises critical questions, about ways in which 'customer' and client demands are and can be known, and how multiple demands can be aggregated. In addition, it is difficult to link demand-based strategies to public service contexts, full of professional practices. How do public managers cope with such contradictory conditions? How can they organise in demand-based ways, amidst contradictory demands? This article, firstly, explores how demand-based rhetoric and instruments have been introduced. Secondly, it explores how public managers really (can) work in demand-based settings. Thirdly, it explores how demand-based practices can be organised, so that public service contexts can be managed 'professionally'. This leads to a paradoxical conclusion. Professional public managers organise in demand-based ways by not handing-over or 'outsourcing' content to customers and clients, but by substantiating demands themselves.

The recent decline in professionalism has frequently been explained as a result of the rise of New Public Management (NPM). As will be shown in this article, however, NPM does not automatically result in a decline in professionalism; its effects differ in various professional contexts. In a case study of the work of social insurance doctors and labor specialists the authors demonstrate that NPM structures the technical aspects of professional tasks, that are the verifiable elements of the professional's judgment. NPM proofs to have strong influence on the techniques for quality insurance (performance of production, time and lawfulness). On the longer term this influence can undermine professional self-regulation. NPM has little impact on the indeterminate task aspects, the professional judgment itself, even though this part has become more 'technical' in years. The case study shows however that this is not due to NPM but to the impact of bureaucratization of the professional task. Furthermore it becomes clear that this impact is stronger in the case of the labor specialist than with respect to the social insurance doctor.

Over recent years, we have seen a steady increase in the number of security officers and city supervisors in Dutch urban areas. However, despite the mounting presence and visibility of these auxiliary patrols, little is known about how citizens perceive and value them. A questionnaire held among a sample of 761 residents of Amsterdam shows that citizens have mixed opinions. Many people are accepting or neutral about the occurrence of security officers and city supervisors in urban space, but at the same time lack a clear idea of their quality and professionalism. This somewhat ignorant and laconic attitude raises the question whether people underestimate the potential consequences of omnipresent quasi-police. It is argued that more repressive approaches may generate substantial conflicts with the general public. Furthermore, safety and security may become 'consumer goods' in the sense that people are quite happy to leave their responsibilities to paid policing professionals – a position which promotes the rise of a 'culture of control'.