Professionals Assessing Clients’ Needs and Eligibility for Electric Scooters in the Netherlands: Both Gatekeepers and Clients’ Advocates
Frederike Jörg is senior researcher and research coordinator at the GCZ Friesland, a mental health organisation in the Netherlands. Her research interests are elderly care and needs assessment. Hennie Boeije is assistant professor at the Department of Statistics and Methodology of the Utrecht University, The Netherlands. Her interest fields are qualitative research, informal care and care for chronically ill patients. Guus Schrijvers is professor at the Julius Center for Health Sciences and Primary Care of the University Medical Center Utrecht, The Netherlands. His research interest is integrated care.
Correspondence to Frederike Jörg, CGZ Friesland, PO Box 932, 8901 BS Leeuwarden, The Netherlands. E-mail: fjorg{at}tiscali.nl
Independence and maintaining social contact are important factors of elderly persons’ quality of life. An electric scooter may support people with mobility problems to achieve these goals. In the Netherlands, needs assessors have been appointed to evaluate clients’ eligibility for electric scooters. They have to cope with a twofold job assignment: allocating services to only those clients who are eligible according to predetermined criteria, but also acting in their client’s best interest, for the system of needs assessment should be client oriented. This paper examines how needs assessors apply eligibility criteria and act in the client’s interest at the same time. A qualitative study was performed, observing twelve house calls of clients requesting an electric scooter. Interviews were held with needs assessors and a document analysis was made. We found that needs assessors used their discretionary room to create their own policy regarding who deserves an electric scooter and who does not. They did this by concealing or emphasizing certain information. Especially when needs assessors sympathized with their clients, they did their best to sustain the case. The paper concludes with the suggestion that needs assessors would benefit from discussing their personal values, not only to agree on their norms as a professional group but also to avoid illegitimate arguments influence the decision. Furthermore, needs assessor should try to influence local social policy, gearing it towards the needs of the local community.
Keywords: needs assessment, qualitative research, professional autonomy, deservingness