Niels Uenk (Faculty of Law) will defend his dissertation called ''Commissioning of Social Care Services. Municipal commissioning approaches for social care services – evidence from a countrywide live experiment' on 6 September.
Governments face challenges in the organization and outsourcing of social care services, for example related to costs and quality. In this research Niels Uenk first explores EU and Dutch legislation concerning the outsourcing of social services by governments. This legal perspective is then combined with an empirical study on the outsourcing practices of Dutch municipalities in the advent of the 2015 reform of the AWBZ to Wmo 2015 and in the first years after this reform. Combining both a public management perspective and a purchasing and supply management perspective, this research analyses how each of the Dutch municipalities commissioned services such as personal assistance and day care for adults. The analysis also includes the procurement procedures and reimbursement methods used by municipalities. The research combines theoretical lenses of agency theory and service triads.
After the decentralization, most municipalities abandoned the commissioning of a limited number of care providers on the basis of annual (maximum) budgets and nationally standardized services. Most municipalities adopted open contracting schemes, contracting every qualifying care provider in a framework agreement with ‘ex post’ competition over every new client. At the same time, municipalities demonstrate more relational dialogue-based procurement procedures. Also a move towards more outcome-based contracting of social care is visible, although this seems to conflict with legal certainty for social care clients. A study comparing regulations and outsourcing practices between Finland and the Netherlands evidences that Finland adopted open contracting schemes in their legal system much earlier, although Finnish municipalities (still) provide the majority of social care services in house. Finally, a study combining the commissioning data with data on the satisfaction of care clients demonstrates that clients in municipalities that adopted open contracting schemes are more satisfied with social care compared to clients in municipalities that stuck to the former ‘AWBZ’ system of contracting care providers.