Reconceptualizing regulation: Formative evaluation of an experiment with System-Based Regulation in Dutch healthcare

Abstract

The Dutch Healthcare Inspectorate has recently tried out a new form of inspection: System-Based Regulation (SBR). This article explores how SBR was situated in the healthcare context through a process of ‘experimentalist governance’. A qualitative formative evaluation was undertaken involving two years of participative observation, numerous iterations between data gathering and feedback in order to orient the next steps of the process. The evaluation found that SBR could fit into the existing supervisory regime, but notwithstanding positive outcomes SBR was controversial and further implementation was delayed. The process of ‘experimentalist governance’ was strengthened by qualitative formative evaluation that documented and reflected on the process as it progressed. The evaluation also helped to translate and communicate learning so as to better understand regulation and to reform and reconceptualize SBR in today’s healthcare context.