This is a summary of the research paper from Eva Grevinga and Marjolein van Hattem for the course of Social Policy and Social Risks. The authors report that since 2015, the Dutch government has given municipalities the responsibility (i.e. decentralization) to oversee three main services in the social domain, including youth care [1]. This was said to be done in order to move from a collective welfare provided by the state (i.e. classical welfare state) to citizens taking responsibility for their personal well-being (i.e participation state) [2]. When looking at youth care, giving full responsibility to municipalities has been met with resistance and criticism. The research took this into account and decided to look at how policymakers were able to reduce the resistance to achieve the shift from classical welfare to participation state. To understand how this was done, Eva and Marjolein analyzed the youth care plan in the Netherlands between 2000 to 2020. To do so, they first did a review of the literature to identify the important changes that occurred before and after 2015. Then, they looked at reform itself and collect data from the National Youth Institute (NJI), government regulations, press releases and annual reports. The research question of the study is: to what extent have policymakers tried to prevent or minimize the impact of policy feedback and outcomes in the decentralization of youth care in The Netherlands, and have they been successful in doing so?
Who’s responsible?
The literature revealed that before 2015 youth care in the Netherlands included universal policies (e.g. education and child care), preventive services and specialized services (e.g. mental health care and child protection) [3][4]. During this time, municipalities were only responsible for the first two, whilst provinces and national governments were in charge of the third. Since 2015, all responsibilities were given to municipalities [5][6]. As a result of reform, there have been budget cuts [7].
The decentralization of youth care can also lead to providing less than what is necessary, due to the idea that the recipients of the welfare might move to areas in which they receive more benefits [5]. Although this phenomenon can be counteracted through centralized quality control by the government, it is not likely that this will fully reduce the insufficient provision of youth care by municipalities. This is because the original purpose of giving all the responsibilities is to municipalities is to have them adapt their services to individual needs.
The review of the literature also revealed that the main reasons behind the allocation of youth care duties to municipalities were to reduce treatment and waiting times and to improve its quality. This was seen not to be the case in practice, as municipalities often lack the resources and the knowledge to implement new duties.
Avoiding the blame
The analysis of several documents showed that since 2015, youth care spending in the Netherlands has decreased. For politicians, this is not good because the more politicians reduce their social spending, the more likely the public is to mobilize and show their disagreements with such actions, which is something that politicians try to minimize or prevent [8]. The study looked at how this works when it comes to the decrease in youth care spending.
A way in which politicians prevent the public from turning against them after a budget cut is to employ Pierson’s New Politics [8]. The main focus of this practice is to avoid the blame for budget-cutting. This can be done through different techniques such as obfuscation and justification. The first involves avoiding the blame by obscuring the reduction in spending through, hiding who is responsible for such action [9]. A method is by moving the welfare challenges that a government has to municipalities. The second involves avoiding the blame by justifying their actions by convincing their voters that the spending is being reduced to save or to fix policy failures [10]. These two techniques were used to avoid the blame for the budget cuts in youth care after 2015. Issues were transferred to the local authorities and cuts in spending were justified by saying that municipalities are closer to the population than the central governments, which allows them to understand local situations better [11] [12]. Another justification used was that giving all the duties to municipalities would make the system more efficient, effective and coherent [13].
To what extent have policymakers tried to prevent or minimize the impact of policy feedback and outcomes in the decentralization of youth care in The Netherlands, and have they been successful in doing so?
What the analysis uncovered
Through the decentralization of youth care in the Netherlands, the study concluded that since 2015 there has been a shift from a classical welfare state to a participation state. This paper shows that the decentralization of youth care in the Netherlands was used as a blame avoidance technique and that when outcomes are not reached, an increase in resistance to be expected. Meaning that the use of New Politics techniques has actually resulted in the opposite of the wanted outcome. The research also found that due to unintended feedback of the reform and the inability to meet the wanted outcomes such as better quality, and less treatment and waiting time, policymakers have had to reconsider certain actions and place additional budgets. The unintended reform feedback was due to the capability of municipalities to fulfil their duty of prevention, which resulted in the short-term rise in youth care beneficiaries. In addition to this, given the need for local authorities to be better prepared for new responsibilities, there has been an increase in costs, and thus to extra spending needed.
The research suggests that such reforms should not be accompanied by budget cuts to allow for a smoother transition and the minimization of feedback and outcomes, especially with the shift of responsibilities from national to local government.
The study by Eva and Marjolein has also reported some limitations. Firstly, an issue was that finding coherent data after 2015 and information on youth care in the Netherlands was a struggle. Secondly, since no regression analyses were performed, it is unclear what are the causes and the effects. The growth in beneficiaries of youth care could be for other reasons, not necessarily due to decentralization. Lastly, the aspect of eligibility of youth care was not investigated within the study as after the decentralization data on criteria for eligibility have been complicated and limited as every local authority has its own rules.
Waiting to see
During the writing of the paper, another coalition agreement was published [14]. Although there has been confirmation of additional budgets for local authorities, over cuts will be made. There has been an introduction of the copay, which has been met with some disagreements [15]. By also introducing the central purchasing of specialized youth care, a form of re-centralization can be seen. As for outcomes, budgets cuts are intended, like the standardization of treatment times.
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References
[1] Youth Care Act 2015. (2014, March 1). Retrieved December 2021, from https://wetten.overheid.nl/BWBR0034925/2021-11-06.
[2] Van Gerven, M. (2019). The Dutch Participatory State: Shift from a welfare system of collective solidarity towards individual responsibility in a participatory society. In: Blum, S., Kuhlmann, J. & Schubert, K. (Eds). Routledge Handbook of European Welfare Systems. London: Routledge. Retrieved December 2021, from https://www-taylorfrancis-com/chapters/edit/10.4324/9780429290510-22/dutch-participatory-state-minna-van-gerven
[3] Ronis, S.T., Slaunwhite, A.K. & Malcom, K.E. (2017). Comparing Strategies for Providing Child and Youth Mental Health Care Services in Canada, the United States and The Netherlands. Administration and Policy in Mental Health and Mental Health Services Research, 44, 955-966. doi:10.1007/s10488-017-0808-z.
[4] Bosscher, N. (2014). The decentralization and transformation of the Dutch youth care system. Retrieved from http://www.youthpolicy.nl/yp/downloadsyp/Publications-The-decentralisation-and-transformation-ofthe-Dutch-youth-care-system.pdf.
[5] Vermeulen, W. (2015). Decentralisation of social policy in the Netherlands. In: Kim, J. & Mau, N.J. (Eds.), Decentralisation of Education, Health and Social Protection: Issues and Challenges (pp. 127-139). Retrieved December 2021, from https://pure.vive.dk/ws/files/1927788/copenhagen_workshop_2015.
[6] Kroneman, M., Boerma, W., van den Berg, M., Groenewegen, P., de Jong, J. & van Ginneken, E. (2016). The Netherlands: Health System Review. Health Systems in Transition, 18(2), 1-239. Retrieved December 2021, from https://apps.who.int/iris/bitstream/handle/10665/330244/HiT-18-2-2016-eng.pdf?sequence=5&isAllowed=y.
[7] Van der Voet, J., Steijn, B. & Kuipers, B.S. (2017). What’s in it for others? The relationship between prosocial motivation and commitment to change among youth care professionals. Public Management Review, 19(4), 443-462. doi:10.1080/14719037.2016.1183699.
[8] Pierson, P. (1996). The new politics of the welfare state. World Politics, 48(2), 143-179. https://doi.org/10.1353/wp.1996.0004
[9] Pierson, P. (1994). Dismantling the welfare state? Reagan, Thatcher and the Politics of Retrenchment. Retrieved December 2021, from books.google.com/books?isbn=1316583538.
[10] Green-Pedersen, C. (2002). A framework for government choice on retrenchment. In The Politics of Justification: Party Competition and Welfare-State Retrenchment in Denmark and the Netherlands from 1982 to 1998 (pp. 31–42). Amsterdam University Press. http://www.jstor.org/stable/j.ctt46n1h4.7
[11] Hoekman, R., van der Roest, J.W. & van der Poel, H. (2018). From Welfare State to Participation Society? Austerity Measures and Local Sport Policy in The Netherlands. International Journal of Sport Policy and Politics, 10(1), 131-146. doi:10.1080/19406940.2017.1381636.
[12] Dijkhoff, T. (2014). The Dutch Social Support Act in the shadow of the decentralization dream. Journal of Social Welfare and Family Law, 36(3), 276-294. doi.org/10.1080/09649069.2014.933590.
[13] Van Gerven, M. (2016). Beyond the Dutch Miracle? Challenges to and Responses of the Dutch Welfare System. In: Schubert, K., Blum, S. & Kuhlmann, J. (Eds). Challenges to European Welfare Systems. New York: Springer. doi:10.1007/978-3-319-07680-5_24.
[14] Volkspartij voor de Vrijheid en Democratie, Democraten 66, Christen Democratisch Appèl & ChristenUnie. (2021). Omzien naar elkaar, vooruitkijken naar de toekomst. Coalitieakkoord 2021 – 2025. Retrieved December 2021, from https://www.parlement.com/id/vloreou0m8t6/regeerakkoord_2021.
[15] Kleijne, I. (2021, December 17). ‘Wie bepaalt wat passende zorg in de GGZ is?’. Medisch Contact. Retrieved December 2021, from https://www.medischcontact.nl/nieuws/laatste-nieuws/nieuwsartikel/wie-bepaalt-wat-passende-zorg-in-de-ggz-is-.htm.
