Consumers in charge of care: The Dutch personal budget and its impact on the market, professionals and the family

One of the icons of the Dutch welfare state reforms is the Personal Budget. With the introduction of this budget, care patients now have become consumers. They can manage their own budget and employ a care worker who cares according to the cared-for's wishes. The Personal Budget intends to create a market of care, as well as a shift of balance of power from professionals to care receivers. In practice, the market has not come yet. Instead, the majority of budget holders employ a family member. This is important as it gives recognition to informal carers. On the other hand, this may hamper the employment career of people with care responsibilities as they are likely to be constrained in their care relationship. Another caveat is that the Personal Budget undermines the professionalisation process of care workers. When consumers are in charge, care workers are no longer the custodians of their professional development. This may have unwelcome consequences for the quality of care in the long term.