Regulators are tasked with monitoring and assessing organizations to safeguard public values. When regulators are faced with more complex and dynamic public values, the more traditional command and control regulation often lacks in providing regulators with the right tools to address the issue at hand. We speak of increasing complexity when regulators are faced with epistemic scarcity and ideological divide. In other words, what regulators consider as valid information does not provide the answer needed, and when there are multiple possible perspectives on the public value at hand. Reflexive regulation may provide a solution for these instances of complexity. It focuses on higher order reflexivity (critical reflection on the regulators’ own methods and assumptions), participatory decision-making with all parties involved and, using the experiences of service users as a yardstick.
In our ethnographic case study, we follow the Dutch Healthcare Regulator in regulating person-centred care and services for people with dementia (PWD) living at home. Because PWD are living at home, a network of professionals is collectively responsible for the provision and quality of person-centred services. During this project, inspectors increasingly divert from their a priori designed regulatory framework. Instead, inspectors start with listening to experiences of PWD and family caregivers and use these experiences as a normative yardstick in a reflective group conversation with all parties involved.
We observe a changing role of inspectors as reflexive regulation requires different skills, overcoming emotional and cognitive barriers and reconfiguring their conceptualization of certain values, like objectivity and legitimacy. In the coming months we will continue our ethnographic work in following the inspectors experimenting with reflexive regulation. During this panel we would like to present and discuss the use of reflexive regulation and its accompanying changing role for inspectors and the regulator.
