Institutionalizing professional conflict through financial instruments: The case of DBCs in Dutch mental healthcare

Abstract

Earlier in this book Van der Veen already briefly discussed NPM-related changes in the Dutch healthcare system. His overall conclusion was that these changes appear to limit the autonomy of professionals, but not their discretion. In this chapter, a specific far-reaching change in the Dutch care system � most specifically in Dutch mental healthcare � will be discussed. I will examine how the use of financial instruments creates pressures for professional conflict and change. This chapter describes the introduction of Diagnostic Treatment Combinations (in Dutch Diagnose Behandel Combinaties or DBCS) in the mental healthcare field, and analyzes the challenges this financing system presents to the profession of psychiatry.