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1. Steinmann, Petra Lamberdina Maria. Stelselwijziging forensische zorg: Verklarend onderzoek naar een centralisatie van sturing in de zorg.

Degree: 2019, University of Twente

In 2007 a regime change took place in Dutch forensic care. The budget and the political accountability for this type of care were transferred from the Ministry of Health, Welfare and Sport to the Ministry of Justice, insofar these were not already entrusted there. Forensic care entails mental health care, addiction care and care for mentally-handicapped adults in the criminal law framework. Internationally, it is recommended that the government ministry responsible for prison health should, where possible, be the ministry responsible for public health services (WHO, 2007; CPT, 2017). The problem studied in this thesis is therefore: How does the change in control of forensic care following the regime change in 2007 lead to changes in quality, accessibility, costs and efficiency of this care and how do these changes relate to the equivalence principle? Based on a literature review of economic, constitutional and administrative perspectives, the property rights theory (PRT), the principal agent theory (PAT) and the administrative network approach (NWB) have been selected to study the change in control. An important similarity between the three theoretical frameworks is that these, although in different words, focus on the ceteris paribus reduction of transaction and production costs and thus on efficiency as the variable to be explained. In addition, the NWB concentrates on the legitimacy of the actors’ collective actions. While the economic frameworks (PRT and PAT) focus on reducing uncertainties in the relationships between actors, the NWB concentrates on reinforcing mutual trust. Based on the theoretical insights, propositions have been formulated and tested (Yin, 2014). To exclude rival explanations, developments in the size of the (potential) forensic population, comparable regular health care, wage and price adjustments, and registration and implementation effects have been studied. The research period covers the years 2006 to 2015. By combining quantitative and qualitative data the research findings are based on the actual forensic care procurement, 33 semi-structured interviews with 41 managing and implementing actors who are familiar with the situation prior to and following the regime change, public data and data requested from organisations. Analyses have been carried out on system level, and on types of forensic care and target groups within. By comparing the empirical pattern between variables to the theoretical expected patterns, conclusions were drawn with regards to the acceptance or dismissal of the propositions. This confirms that case study is not only applicable in an explorative research phase, but also in an explanatory one. Following the regime change there is a stronger, more central control from the Ministry of Justice, which respondents candidly point out as its strongest point. The number of principals has declined and the difference in objectives between actors has been reduced. Dependent on (the absence or presence of) instructions to the managing actors to save costs, their stronger rights… Advisors/Committee Members: Groenendijk, Nicolaas Stijn, Public Administration.

Subjects/Keywords: Forensic mental health; Mental healthcare; Property rights; Principal agent model; Network effectiveness; Governance; Regime shifts; Dutch; Public Administration; Public management; Public policy; Addiction care; Forensic psychiatry; Forensische zorg; Stelselwijziging; GGZ; Bestuurskunde; Case study; Public Administration

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APA (6th Edition):

Steinmann, P. L. M. (2019). Stelselwijziging forensische zorg: Verklarend onderzoek naar een centralisatie van sturing in de zorg. (Doctoral Dissertation). University of Twente. Retrieved from https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; 00022c88-583b-4e1e-802b-adc9be57f702 ; 10.3990/1.9789036547963 ; urn:isbn:978-90-365-4796-3 ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html

Chicago Manual of Style (16th Edition):

Steinmann, Petra Lamberdina Maria. “Stelselwijziging forensische zorg: Verklarend onderzoek naar een centralisatie van sturing in de zorg.” 2019. Doctoral Dissertation, University of Twente. Accessed August 05, 2020. https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; 00022c88-583b-4e1e-802b-adc9be57f702 ; 10.3990/1.9789036547963 ; urn:isbn:978-90-365-4796-3 ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html.

MLA Handbook (7th Edition):

Steinmann, Petra Lamberdina Maria. “Stelselwijziging forensische zorg: Verklarend onderzoek naar een centralisatie van sturing in de zorg.” 2019. Web. 05 Aug 2020.

Vancouver:

Steinmann PLM. Stelselwijziging forensische zorg: Verklarend onderzoek naar een centralisatie van sturing in de zorg. [Internet] [Doctoral dissertation]. University of Twente; 2019. [cited 2020 Aug 05]. Available from: https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; 00022c88-583b-4e1e-802b-adc9be57f702 ; 10.3990/1.9789036547963 ; urn:isbn:978-90-365-4796-3 ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html.

Council of Science Editors:

Steinmann PLM. Stelselwijziging forensische zorg: Verklarend onderzoek naar een centralisatie van sturing in de zorg. [Doctoral Dissertation]. University of Twente; 2019. Available from: https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; 00022c88-583b-4e1e-802b-adc9be57f702 ; 10.3990/1.9789036547963 ; urn:isbn:978-90-365-4796-3 ; urn:nbn:nl:ui:28-00022c88-583b-4e1e-802b-adc9be57f702 ; https://research.utwente.nl/en/publications/stelselwijziging-forensische-zorg(00022c88-583b-4e1e-802b-adc9be57f702).html

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