Risico’s vermijden door depolitisering

Abstract

In this paper we demonstrate how contemporary politics deals with complex risk issues that emanate from emergent technologies based on the following case study: the implementation of the national electronic patient record (EPR) in the Netherlands. The Dutch Senate unanimously rejected the EPR in 2011. From then on, market playsers have been at the forefront to make the EPR operative in Dutch health care, despite its lack of political legitimacy. This study reports how the relocation of politics to market players and professional arena’s takes place (Hajer and Versteeg 2005; Pierre and Peters 2000; Rhodes 1997; Walls et al. 2005). As we perceive this relocation of politics as a form of governmentality (Foucault 1991), we are able to make visible how power is exerted over professionals and citizens (Rose and Miller 1992) and how they deal with processes of subjectification (Broer 2006). Our analysis of semi-structured interviews with policy makers, implementers and first-line health care professionals, observations of information meetings and a variety of documents shed light on several governmental techniques that aim to allay anxiety regarding the EPR: seduction, emotion management and relieving in combination with strict surveillance of health care professionals. Even though collaboration with the EPR is voluntary we make plausible that these techniques seriously compromise health care professionals’ and citizens’ freedom of choice. We conclude that the technology is strongly depoliticized in order to protect the rollout of the EPR in Dutch health care.