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Customized or arbitrary care at the kitchen table? An ethnography of situated judgements in public encounters

Funder: Netherlands Organisation for Scientific Research (NWO)Project code: 016.Veni.195.015

Customized or arbitrary care at the kitchen table? An ethnography of situated judgements in public encounters

Description

In the transition from welfare state to participation society, frontline workers and citizens are expected to adopt new behaviour. Frontline workers have to conduct ‘kitchen table talks’ with citizens in their homes rather than applying eligibility checklists behind the office desk. Citizens are expected to behave as responsible partners rather than as passive welfare recipients. The starting points of the conversation are citizens’ own responsibilities rather than legal entitlements to care. The policy metaphor of the ‘kitchen table’ symbolizes a paradigm shift in resource allocation in changing welfare regimes: from impartial bureaucratic procedures that treat like cases alike to participatory encounters that enable ‘customized’ arrangements. Yet, this shift has generated much discussion. Patient organizations argue that the allocation of care has become ‘arbitrary’ due to increasing differences between and within municipalities. A sharp rise in lawsuits filed by citizens against municipalities is another matter of concern. This project is a timely response to calls by scholars and practitioners to investigate and improve the quality of local allocative decision-making in care. To date, research has focused on the role of frontline workers from a bureaucratic perspective (street-level bureaucracy). This project develops an interactional approach called “Situated Judgements in Public Encounters” that provides insights into a) how citizens and frontline workers in interaction make situated judgements about needs, responsibilities and the allocation of public and private resources, and b) which strategies contribute to fair allocative decision-making. I will conduct a multi-sited ethnography of public encounters in a large (Rotterdam), medium (Amersfoort) and small (Woudrichem) municipality to gain an in-depth understanding of public welfare encounters and the distribution of public health resources between and within different municipalities. The analysis will contribute to a training module on value judgements for frontline workers and a municipal decision-making framework for allocation of care.

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