Over the last decades an increasing number of mergers and acquisitions between Dutch healthcare organizations has taken place (up scaling). More recently there is a rise in the numbers of new small-scale healthcare organizations and small-scale care facilities (down scaling in the numbers). The wide variety of scales, each with its pros, cons and (historical) contexts, makes the existence of one optimal scale an illusion. Our research question is: when, and on the basis of which values, is scale of healthcare organizations legitimate? We answer this question by analyzing 650 newspaper articles from fourteen national newspapers. By using theory about legitimacy and values, we argue that five values underlie the public discussion on scale: governance, the human size, quality of care, market power and efficiency. We conclude that achieving legitimate scale involves dealing with those five values, which are not always commensurable and sometimes conflicting. With this article we contribute to the scientific debate about scale and values. We also give recommendations to policy makers and executives that can be used to improve the legitimacy of scale decisions.

The recent scholarly debate on policies and discourses with regard to citizenship in the Netherlands point to a moralization or culturalization of citizenship. This article aims to contribute to this debate by zooming into the current contents of citizenship education. We make a comparative analysis of the contents of textbooks for citizenship education that are used for civic integration courses for migrants and for primary and secondary school students in the Netherlands. Our findings show that citizenship has indeed gained a moral content in both contexts but that the difference lies in the norms that are stressed and how they are conveyed to the target population of future citizens. Whereas civic integration books for migrants emphasize the importance of learning local procedures and habits in order to belong to the Dutch national community, primary and secondary school books underscore the importance of dealing with cultural diversity in the multicultural society.

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.

Currently the Dutch government funds dozens of social interventions designed to tackle polarization and radicalization issues. It is still unknown whether the assumptions underlying these interventions are valid. This article puts the theories of change of such interventions to the test. Underlying causal assumptions of four dominant Dutch social policies were confronted with scientific evidence: (1) the system-based approach, (2) peer mediation, (3) intergroup contact and (4) self-esteem enhancement. System-based approaches – comparable to multi-systemic therapy (MST) – seem effective in reducing extremist behaviour in radical youth, but do not necessarily lead to an ideological change. In peer mediation, the causal link between the deployment of young people and the positive outcomes of such methods remains unclear. Peer mediation is also more likely to contribute in conflicts that have not yet escalated. Intergroup contact reduces prejudices about other groups, but has a limited effect. There is also no evidence for a long term effect and positive outcomes of intergroup contact do not automatically apply to adolescents. Finally, it is questionable that enhancing the self-esteem of (moslim) youth makes them more resilient against radical tendencies. In the same vein, the scientific evidence is ambiguous about whether increasing self-esteem results in social desirable behaviour or improved social relations.