Authority, Trust, Knowledge and the Public Good in Disarray

Abstract

Over the last thirty years, welfare states have witnessed a considerable number of debates concerning the identity and power of clients of social and care services. Criticism of the authoritarian and paternalistic practices of professionals and a call for democratisation have stimulated changes in services delivery. Western countries have witnessed a trend towards more user-based services, with increased attention towards clients' wishes and demands. The clients' position towards services delivery has strengthened. This shift in power was initiated by the assumption of new roles as citizens and consumers. These roles were carved out against the older idea of clients as patients (in health care) or underprivileged (in welfare and social work). The three roles of patients, citizens, and consumers respectively correspond to the three logics of services delivery: professionalism, bureaucracy, and marketisation (Knijn 2000; Freidson 2001).