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Bureaucracy and fragmented social care system mean people do not receive the help they need

In his PhD research in the field of public administration, Mark Reijnders looked at why people do not receive the help they need. They lose their way in the labyrinthine support system or become bogged down in bureaucracy. In public administration this is known as non-take-up of social care. PhD defence on 17 June.

Reijnders conducted his research in The Hague. ‘The research arose from a practical need in municipal policymakers to find out more about non-take-up, or how people find it difficult to access the help they need.’ We do not know the exact size of this group, but Reijnders thinks it is considerable in size.

Different types of help

Non-take-up can relate to very different types of help: home help, contact with peers, help with life admin (for example with your tax return), good-neighbour schemes, meals at home (meals on wheels), buddy schemes, support for carers, transport services, help with debt, day care and home adaptations.

Mark Reijnders: ‘Policymakers are too quick to focus on individual responsibility and self-sufficiency.’ (Photo Hanna Radstake)


For his thesis, Reijnders looked at reasons for non-take-up and its consequences for social policy in the Municipality of The Hague. ‘My main conclusion is that the policy shows too little awareness of the many problems and obstacles that people who need help may face. Policymakers are too quick to focus on individual responsibility and self-sufficiency. The reasons for non-take-up are in part due to the individual, but are also related to the structure of the social system. All that red tape and the labyrinthine nature of the system often causes people to lose their way. They come up against unintelligible rules or face a language barrier.’

Qualitative research

Reijnders used qualitative research methods, which included talking to people who had had difficulty asking for help. A single woman, for instance, whose tax return was too late because she didn’t know how to file it, an elderly man who didn’t use a free meals service in his neighbourhood, a Chinese carer who had been stretched to the limit but had not asked for help because of a language barrier, and a woman with arthritis who didn’t want to ask for home help.

He also consulted focus groups of volunteers from Stichting Kompassie, an organisation that gives free advice to people who need help. They had hands-on experience and were able to reflect on the difficulties people have with finding help from a different perspective. ‘That was a very interesting supplement to the individual interviews.’

Elusive group

It wasn’t easy to find people who don’t receive the support they are entitled to, says Reijnders. They are by definition difficult to reach. ‘But we managed nonetheless, thanks to the good collaboration with different organisations in The Hague. I spoke to people via the Food Bank, an organisation for carers and a hospital.’ Reijnders is also calling on researchers to pay more attention to this elusive group. ‘Non-take-up creates a disparity in society that is very difficult to bring into the open. My thesis provides some pointers on how to include this hidden group of people in further academic research.’

More empathy

Reijnders’ advice to policymakers is to show more empathy to people who do not use the help they are entitled to, and to draw on this when developing and implementing social policy. ‘Make an effort to find them, talk to them, discover their needs and learn from this.’ And at the same time help must be offered in a more accessible way: ‘Remove the bureaucratic barriers, get organisations to work together more and be realistic about whether people are likely to ask for the help they need.’

With his colleagues Trui Steen and Jelmer Schalk, Mark Reijnders previously conducted research into why people do not seek help. ‘I became fascinated by the topic and decided to devote my PhD research at the Institute of Public Administration to this. What spurred me on was how little academic knowledge there is about the subject. I could see that it was of great academic and social value.’

Reijnders now works as an independent researcher and adviser on non-take-up.

Text: Corine Hendriks
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