Suchergebnisse

AbstractThe literature on responsive regulation argues that citizens should be involved in regulatory practices to avoid capture between regulator and regulatee. It also argues that including citizens can add an important perspective to regulatory practices. However, we know little about how citizens' perspectives are brought into regulatory practices. This paper draws on existing qualitative research to compare and analyze four cases of experimental participatory regulation in Dutch health care, focusing on the theoretical assumptions that citizen involvement (a) prevents capture, and (b) stimulates the inclusion of new perspectives. Our results show that involving citizens in regulation can increase transparency and trust in regulatory practices and familiarizes regulators with other perspectives. It is, however, up to the regulator to work on deriving benefits from that involvement—not only the practical work of organizing participatory regulation, but also the conceptual work of reflecting on their own assumptions and standards. We do find evidence for weak forms of capture and argue for the need to extend capture to involve multiple actors. We reflect on these results for theory development and regulatory practice.

This paper uses the metaphor of the dance to envision how hospitals in the Netherlands engaged in organizing and delivering care during the first months of the COVID-19 outbreak. Drawing on an ongoing ethnographic study in a Dutch university study and interviews with nurses in various hospitals, we show how hospital actors (nurses, physicians, managers, directors, patients) engaged in different dances following the changing rhythms of the virus outbreak and related policy measures, as well as mutual interactions driven by 'old' and 'new' private and collective interests. We discern three dance patterns in the unfolding crisis—learning to dance; the dance marathon; dancing to a cacophony—each requiring a new choreography of organizing and caring, rearranging personnel, spaces, and materials to adapt to (the consequences of) the virus outbreak. We argue that dance is a powerful metaphor to provide an affective narrative of how hospitals operate at different levels and in various ways to accommodate a new group of patients while flexibly finding alternative ways of organizing and caring in a highly political and uncertain context.

In this paper, we explore how multiple accountability (MA) can enable an independent regulatory agency to deal with multiple conflicting public values in a complex and politically salient decision-making process. We examined the decision-making process of the Dutch National Health Care Institute on quality regulation of emergency care in the Netherlands. Using insights derived from ethnography, document analysis, and interviews, we show that MA resulted from strategic interactions between the Institute's vertical and horizontal accountability forums. We argue that MA impeded efficiency but also enabled the Institute to deal with multiple conflicting public values.

In this paper, we explore how multiple accountability (MA) can enable an independent regulatory agency to deal with multiple conflicting public values in a complex and politically salient decision-making process. We examined the decision-making process of the Dutch National Health Care Institute on quality regulation of emergency care in the Netherlands. Using insights derived from ethnography, document analysis, and interviews, we show that MA resulted from strategic interactions between the Institute's vertical and horizontal accountability forums. We argue that MA impeded efficiency but also enabled the Institute to deal with multiple conflicting public values.