Bureaucracy, power, and conflict: the politics of managing a transcultural community mental healthcare clinic in the Netherlands

Abstract

This thesis investigates the ways in which a transcultural mental healthcare clinic in the Netherlands faces various challenges. Using rhetoric culture theory as the main theoretical framework, it looks at aspects of the organisation and its quality control system through examples derived from participant observation. The research shows that the quality control system is open to interpretation and that culture is an important aspect of the organisation. It also shows that there is disparity in power between both insurance companies and the state on the one hand, and the healthcare providers on the other. In this thesis, further attention is given to the particular way the clinic was organised, whereby people close to the board were given management positions thanks to kin-like relationships. This led to a division among staff which came to the fore during frequent conflicts and arguments. Another aspect that is highlighted in the thesis is the way audits produce stress, anxiety and even panic among staff and have not significantly increased the quality of care at the clinic.