Seminar Voice & Choice

Department of Health Policy and Management (ESHPM)

Central to policy reform in healthcare is repositioning the role of the patient. From passive recipients of care, patients are expected to change into active and critical consumers. Choice of care providers and ensurers as well as active participation of patients in care delivery are thought to enhance the quality and efficiency of health care. At the same time, policy makers realize that patients do not automatically behave as critical health care users who make informed choices concerning their care. Instruments to equip’ patients for this active critical role – to give them voice and choice – are therefore developed and implemented. This construction of the active patient is discussed in this seminar which focuses on the processes of creating critical consumers in health care. The main questions of the day are:

  • What kind of constructing work is done to create consumers of care?
  • Can we classify the introduction of choice and voice mechanisms as a new governing mentality – as new attempts to govern the behaviour of citizens?
  • Do patients now perceive and experience themselves as consumers?
  • What are the consequences for care? Does it change the relationship between providers and receivers of care?
  • Are voice and choice mechanisms working for everybody? Can non-users take advantage of the efforts of users, or does choice produce inequities?
  • Is there a tension between voice and choice mechanisms or do they reinforce each other?


All presentations and some comments are available in pdf by clicking on the respective titles.

Chair: Roland Bal

Welcome and Introduction (pdf)
Roland Bal (ESHPM, Rotterdam)

Good patients (pdf)
Dick Willems (University of Amsterdam)
Commentator: Sam Adams (ESHPM, Rotterdam)

Strengthening the individual and collective influence of patients (pdf)
Atie Schipaanboord (NPCF, National Patient and Consumer Federation)
Commentator: Jeroen Crasborn (AGIS, healthcare insurer)

Creating the citizen consumer: beyond voice and choice (pdf)
Janet Newman (The Open University, UK)
Commentator: Mark Leys (Free University Brussels, Belgium)

Public reporting of performance indicators: why and for whom? (pdf)
Diana Delnoij (CKZ, Dutch Centre for Consumer Experience in Health Care)
Commentator: Hester van de Bovenkamp (ESHPM, Rotterdam)

Instruments for creating health care consumers (pdf)
Kor Grit (ESHPM, Rotterdam)
Commentator: Kees Molenaar (Dutch Ministry of Health) (pdf)

Bringing Patient and Staff Experiences to Healthcare Improvement: Experience-Based Co-
Design (pdf)

Glenn Robert (King's College London, UK)
Commentator: Maria Mul (Academic Medical Centre Amsterdam) (pdf)