In the current discussion about the public domain, the focus often turns to how we can address persistent problems like health inequalities. Citizens can be crushed in the wheels of bureaucracy, as the recent childcare benefits affair has shown, for example. At the same time, professionals complain about the number of rules they have to comply with. How can we organise the public domain so persistent problems can be addressed without this action leading to an increase in the number of rules? In a theme issue of the journal Beleid & Maatschappij, researchers from Erasmus School of Health Policy & Management (ESHPM) delve into these questions.
They examined how the notion of the ‘rebel’ can contribute to another perspective on public organisations like care and education institutions. The rebel is the figure that ‘does it a bit differently’ and thus primarily pays attention to his/her contribution to the solution of problems. Solution-oriented is more important than rule-following in this case, even if it clashes with the applicable frameworks. Dr Marianne van Bochove and Suzanna Koops-Boelaars MSc looked at the rebelling administrator. How does she know how to arrange her organisation so the interest of the citizens takes priority? Iris Wallenburg and others examined the role of professionals and how they search for – and find – space within centralised organisations to work in a patient-oriented manner. And Dr Annemiek Stoopendaal and Dr Wilma van der Scheer examined an entire sector – that of care for the handicapped – that has successfully resisted externally imposed quality frameworks and developed its own forms of accountability.
The entirety of the articles in the theme number show that the concept of a rebel is an alternative way of looking at the public sector from the viewpoint of citizens and professionals and offers possibilities to promote quality and personalised care. Thus, it is important that the work of rebels does not remain under the radar, as is often the case now; it should be discussed to encourage discussion of the quality of public service provision.
The figure of the ‘rebel’ seems a good way to look differently at the public sector; rebels show what is really involved for professionals and public organisations, and they work on redesigning the meaning of good conduct.