Living as water

Reseña del libro

De kwaliteit van de WMCZ als medezeggenschapswet

In dit proefschrift is onderzoek verricht naar de kwaliteit van de in 1996 in werking getreden Wet Medezeggenschap Cliënten Zorginstellingen (WMCZ). Deze wet kent medezeggenschapsrechten toe aan cliënten van collectief gefinancierde zorginstellingen. In dat kader verplicht zij zorgaan-bieders tot het instellen van een cliëntenraad bij iedere zorginstelling die zij in stand houden. Reeds ten tijde van haar totstandkoming riep de WMCZ echter nogal wat vragen op. Bestaat er in deze tijd onder de cliënten bijvoor-beeld nog wel behoefte aan een wettelijke medezeggenschapsregeling? Past het ‘cliëntenraadsmodel’ voorts wel bij algemene ziekenhuizen en extramu-rale zorginstellingen waarmee cliënten maar weinig contact hebben? En laat de WMCZ tot slot niet teveel aan zelfregulering over, of regelt de WMCZ juist teveel en werkt zij daardoor bureaucratie in de hand? Om deze vragen te kunnen beantwoorden is de WMCZ getoetst aan de kwaliteitseisen voor de regelgeving, zoals die zijn opgenomen in de nota Zicht op wetgeving en de ‘Aanwijzingen voor de regelgeving (Ar.)’. In het kader van deze toetsing is gekeken naar de werking van de WMCZ in de praktijk en is bovendien de vergelijking getrokken met de Wet op de ondernemingsraden (WOR) en de Wet Medezeggenschap Onderwijs (WMO). Het proefschrift is afgesloten met een aantal aanbevelingen.The thesis is about an act named the ‘WMCZ’. This act, which became law on 1 June 1996, contains co-determination rights for clients of collectively financed organizations in the fields of social care and health care. During its period as a bill, as well as after it became law, there was a lot of criticism of the WMCZ. The criticism concerned in general: (a) the necessity of the WMCZ (b) the scope of the WMCZ and (c) the contents of the WMCZ. This gave cause to examine if the realization of the WMCZ has been in agreement with the Dutch criteria for the quality of regulation and, if so, to what extent. The results of several evaluation researches regarding the WMCZ were used for this particular examination, as well as the experiences that had already been acquired with two other laws on co-determination rights, namely the ‘WOR’ (which creates co-determination rights for employees and their works councils) and the ‘WMO’ (which creates co-determination rights for teachers, pupils and/or their parents). The assessment led to the conclusion that most criticism of the WMCZ is well-founded. Although a legal prescription for clients’ participation appears to be necessary, the form of participation that is prescribed by the WMCZ – that of co-determination through a clients’ council – does not in any case appear to be an effective and efficient way to achieve the goals of the WMCZ, i.e. strengthening the legal position of the clients on a collective level and improving the match between the supply and the demand of care. The legislator also did not succeed in finding the right balance in the WMCZ between the things that need to be regulated by law and the things that can be left to self-regulation

Decision-Makers’ Generation of Policy Solutions amidst Negative Performance: Invention or Rigidity?

Behavioral theory proposes that decision-makers engage in search to identify satisfactory policy solutions to organizational problems. For complex problems, required solutions cannot be identified merely through search, but must be created and designed. While behavioral theory suggests that negative performance will spur creative solution generation, threat-rigidity theory provides a competing view that decision-makers’ creative efforts are ultimately thwarted through restricted information processing and constriction of control. We test these competing expectations through a survey-experimental comparison of the creativity of policy solutions in response to negative budgetary performance, generated by a nationally representative sample of local government decision-makers. The findings indicate that negative performance decreases the creativity of policy solutions as rated by policy experts, and reveals that key mechanisms of threat-rigidity theory are at play. This reduced generation of creative policy solutions amidst negative performance places limits on public organizations’ capacity to adapt to adverse circumstances

Cumulative Exposure Assessment of Triazole Pesticides

In the EFSA opinion on identification of new approaches to assess cumulative and synergistic risks from pesticides to human health a tiered approach for cumulative risk assessment has been proposed. The first tier is a deterministic approach using average and large portion consumption statistics. The higher tiers include probabilistic exposure assessment and Benchmark Dose (BMD) modeling. The aim of this study is to demonstrate the feasibility and applicability of a higher tier assessment of cumulative exposure using probabilistic modeling in combination with the relative potency factor (RPF) approach. The RPFs are used to weigh the toxicity of each pesticide relative to the toxicity of a chosen index compound (pesticide). In this report the authors address both the short-term and long-term cumulative exposure to triazoles using different statistical model