Since 2015, Dutch municipalities are responsible for all youth care. Most Dutch municipalities have made limited progress in achieving the main goals of the reform while also struggling with endemic budget deficits. The city of Utrecht has managed a relatively successful transformation. What can we learn from this success?
Jonathan Zeitlin (University of Amsterdam), Jan-Kees Helderman (Radboud University Nijmegen) and Charles Sabel (Columbia Law School, Columbia University) analysed the institutional innovations and development opportunities in the Utrecht youth care system as a case from which other municipalities can benefit.
The Dutch Youth Act
In 2015 the Dutch Youth Act was introduced, shifting the responsibility for youth care from the national to the municipal level. The guiding principles of the youth care transformation are:
- one family, one plan and one coordinator through an integrated, multidisciplinary and coordinated approach;
- customization, and treating every child and their family as unique needing a unique constellation of help or support;
- the pursuit of normalization and de-medicalization, by focusing on prevention and early detection.
Next to care-related tasks, local and regional levels had to develop new organizational arrangements and systems to support these tasks, making the transformation a very complex one.
’The decentralization of youth care to the municipal level is one of the farthest reaching reforms of the welfare state undertaken in any country in recent years’, tells Zeitlin. ’Today, more than five years after the decentralization, evaluations have shown that most Dutch municipalities have made limited progress in achieving the main goals of the reform - providing integrated, customized support to children and families - while also struggling with endemic budget deficits.’
’Yet one large municipality - Utrecht - has managed not only to provide help to the highest proportion of children in the country while avoiding major budget deficits, but also to make an ever-expanding set of specialist care services accessible in each neighbourhood.’
What made the youth care transformation in Utrecht successful?
Zeitlin et al conclude that the Utrecht youth care system is largely the result of an accumulation of institutional decisions and design choices that build logically and consistently upon each other.
One of the most important decisions is that Utrecht chose to give the responsibility for basic youth care to one organization set up solely for this purpose (Lokalis), uniting all general basic care teams. Through a constant exchange about the aims of all different care teams, a shared vision could emerge. Next to facilitating this exchange, Lokalis supported continuous clarification and cultivation of guiding principles within and between the different teams. As a result, Lokalis in fact became the ’specialist’ in providing general basic care in Utrecht.
Another crucial choice is that Utrecht developed a model of lump-sum funding for specialized youth care services. This allowed a shift in focus from traditional thinking in products to the specific support and care needs of individual youth care clients and the skills and competencies needs of care professionals.
A third explanatory factor is the creation of an institutional infrastructure through which care professionals, municipal officials and other local partners, could discuss and deliver customized solutions in a coordinated manner. Utrecht organized a series of joint review forums, like the Appropriate Alternatives Committee, the Customization Round Table and the City Deal meetings, that brought general and specialized knowledge and skills together to find solutions to difficult cases and uncover the deeper problems behind them.
Lessons for other municipalities in the Netherlands and beyond
’Our report analysed the key institutional innovations and methods underpinning the success of the Utrecht ’model’. The most important is joint review of concrete cases by social workers in neighbourhood teams, specialist care providers, municipal officials, and other local partners, in order to clarify conflicting perspectives, improve front-line practices, and identify systemic problems that require higher-level action.’
’These institutional innovations and working methods are not at all specific to Utrecht youth care, but can and should be adapted by other municipalities in the Netherlands and beyond’, concludes Zeitlin.
About the authors
Jan-Kees Helderman is associate professor Public Administration, and chair of the faculty research group (hot spot) on Governance and Innovations in Social Services (GAINS) at Radboud University.
Charles Sabel is a professor of law and social science at Columbia Law School.
Jonathan Zeitlin is Professor of Public Policy and Governance, and Distinguished Faculty Professor in the Department of Political Science and the Faculty of Social and Behavioral Sciences (FMG) at the University of Amsterdam. He is also founding Academic Director of the Amsterdam Centre for European Studies (ACES).
Faculty of Social and Behavioural Sciences
Programme group: Political Economy and Transnational Governance