Contractual governance, a term introduced by Yeatman (1994), is gaining ground in the social services. The concept refers to a fundamental change in the governing of social services. Governance implies a new way of directing and controlling the provision of services; the well-known expression ‘steering, not rowing’ means that governments are withdrawing from the direct responsibility of providing services themselves or from directly subsidising on an input basis non-profit organisations that are responsible for providing such services:

Complexity, dynamics and diversity has led to a shrinking external autonomy of the nation state combined with a shrinking internal dominance vis-àvis social...

Between the years 1980-1990, the Osheroff case aroused the emotions of many psychiatrists (Kaasenbrood 1995: 10-15). Osheroff suffered from serious depression. Following the failure of treatment with medication, he was admitted to Chestnut Lodge,¹ where he was treated for seven months using clinical psychotherapy without medication. His condition deteriorated to such an extent that his family requested a different treatment. When this request was not honoured, the family decided to have Osheroff transferred to another clinic. Here he was treated with medication. Osheroff’s condition quickly improved, and after three months he was discharged completely free of symptoms. However, this is...

In 1994, Michael Power, a chartered accountant and lecturer in accounting and finance at the London School of Economics, published an intriguing essay, entitled The Audit Explosion. Power argued that the growing multitude of audit procedures had changed the nature of service delivery. People and organisations that were consistently being audited – such as hospitals, schools, water companies, laboratories, and various industries – start thinking differently about their own activities; they start looking at their work from an auditor’s point of view. They focus on the measurable and quantifiable aspects of their work. Auditors generally do not see what is...

Since the days (1917) that Calvinists and Catholics were allowed to manage their own schools with full funding by the central government, Dutch society has valued the relative autonomy of ethnic and religious groups. The accommodation of immigrant cultures and religions fits with this picture, so it is not surprising that many commentators have labelled the Netherlands a multicultural society (Favell 1998; Joppke 2004; Koopmans & Statham 2000; Koopmans et al. 2005; Soysal 1994; De Zwart 2005). However, developments in recent years have cast doubts upon this image of the Netherlands as a ‘multicultural paradise’ (Duyvendak et al. 2005; Uitermark 2005)....

Picture this: An elderly police inspector who knows the tricks of his trade. Serial killers, ordinary murderers, drug dealers, rapists, and thieves will no longer walk free as long as he is around to catch them. Accompanied by one or two faithful assistants, he visits crime scenes, interviews witnesses, looks for clues, studies his files, and hunts down the villains until they are safely behind bars. That is, if it is up to him, but usually it isn’t. The elderly police inspector whom we know from so many police series on television is very often pestered by the high and...

Human service organisations are confronted with a culturally plural clientele. This study intends to unravel the everyday practices of social workers in dealing with cultural diversity. Assuming diversity has an impact on both the general repertoire and the everyday work of professionals, the question of this chapter is: How do professionals deal with diversity? I will focus mainly on what social workers experience in the providing of social services to a culturally diversified clientele: How do social workers talk about cultural diversity and how do they relate these issues to their professional attitude and competence in their own words?

Following...

In the 1990s, active citizenship and community involvement spread as core concepts in social policies across post-welfarist North-western Europe. Active citizenship has been promoted as an indispensable tool for the regulation of society, in policing and safety policies, provision of social services, welfare and health policies, and local economic development (Body-Gendrot 2003; Mayer 2003; Uitermark 2003; Cruikshank 1999; O’Malley & Palmer 1996; Rose 1996), but it has been particularly prominent in politics for the regeneration of – often urban – public space (Giddens 1998; Imrie 2004). These days, involvement, consultation, and participation are pervasive notions that emerge as a new specialisation...

Over the last thirty years, welfare states have witnessed a considerable number of debates concerning the identity and power of clients of social and care services. Criticism of the authoritarian and paternalistic practices of professionals and a call for democratisation have stimulated changes in services delivery. Western countries have witnessed a trend towards more user-based services, with increased attention towards clients’ wishes and demands. The clients’ position towards services delivery has strengthened. This shift in power was initiated by the assumption of new roles as citizens and consumers. These roles were carved out against the older idea of clients as...

Not so long ago, a dozen or so people were gathered together at an invitation dinner hosted by one of Britain’s think tanks and health policy research funders. As the meal drew to a close, the host invited one of the academics present to open the discussion with some prepared remarks. A lively informal discussion ensued. Among those who had remained silent for a while was a senior doctor who had been invited to participate. His comments then became a point of reference for several others in the discussion. Not long after this event, I found myself at another dinner,...

The German health care system is undergoing various changes due to what is known as the third health care reform (Gesundheitsreform), initiated by the Social Democratic and Green Party coalition government. Obviously, one of the aims is to reduce the general cost of health services. With the slogan ‘Rationalisation without Rationing’ (Rationalisierung statt Rationierung), a transformation process is currently taking place which influences the work of medical personnel in different ways.

This particularly affects hospital doctors, who will no longer be ‘captains of the ship’. New members of hospital boards will be increasingly recruited from the administrative elites. In this...

Professionals in public service do not have it easy. They suffer under the constraints of government, market and managers, and are confronted with ever-higher demands that threaten their discretionary space. Freidson (2001) sees an advancing market logic in which citizens present themselves as vocal and demanding consumers who do not want to hear about the considerations and assessments that professionals normally make on the basis of their professional standards. Administrators, civil servants and managers are also constantly making higher demands on professionals that have little to do with the work itself. Standardisation and protocols resulting from this bureaucratic logic also...

Health care and welfare provision have always been complex phenomena – people who tend to be professionals who are caught between private situations, community interests and public values deliver soft services to vulnerable, weak, or powerless individuals. Over time, various types of governance have been introduced in order to organise and provide complex care and welfare. These governance systems have unavoidably been hybrid. Because health care and welfare are service delivery issues; because they involve vulnerable clients and professional providers; and because individual, community and collective interests collide – or conflict – it has proven difficult to leave care and...