Policy & Politics Journal Blog

By José Nederhand and Ingmar van Meerkerk

“The place where we organize care, how we provide care, and those who provide the care will change” – Dutch Ministry of Care (2013), Vision on Care and the Welfare Labour Market.

The Dutch Ministry of Health has announced extensive reorganization of the care system. Just like in many other Western countries with ageing populations, the welfare state is subject to major reforms. In parallel with academic debates, the idea of co-producing and self-organizing public services seems to have penetrated the discourse of politicians and governors all over the world. Politicians state that in order to keep care provision affordable, accessible and in line with societal demands, responsibilities should be shifted ‘back’ to society. Through volunteering, citizens are expected to shoulder tasks formerly performed by the state, either by partnering and co-production with the state or by self-organization. Our systematic content analysis shows that citizens are now generally framed as active service producers which are, and should be, part of the general system of care service delivery. This activation of citizens has considerable implications for the roles, competences and responsibilities of care professionals. In fact, government is calling for a new public service ethos of professionals, see our recent article in Policy and Politics.

So what new co-production roles and competences do care professionals need to master according to national government?

Activation: professionals should play a pivotal role in activating people and their social network. They should examine the opportunities for self-reliance and the deployment of the social network of people. The idea here is that if more people become activated, the total amount of care that is necessary becomes more diluted and therefore manageable.

Supporting: professionals should advocate for the needs of people as informal carers and support them. They could for instance capacitate and facilitate people in taking specific care measures.

Partnering: professionals should see informal carers as equal partners in service provision and engage in teamwork with them. They should act as back-up care providers when informal care is insufficient and collaborate with informal carers in the drafting of a care plan.

Today’s professionals should not only continue their traditional responsibility for care provision to citizens, but should also have incorporated the above-mentioned roles. While this hybridization of roles may sound ideal, the practical implications have to be established. Tensions may arise between these new roles and traditional, provider-centered roles of public professionals. Furthermore, the extent to which citizens identify with, and are able and willing to enact co-producing roles in the delivery of care provision is far from clear.

If you enjoyed this blog, read a related article on Conceptualising the active welfare subject: welfare reform in discourse, policy and lived experience by Sharon Wright.