Budgetary Reforms in the Non-profit Sector: A Comparative Analysis of Experiences in Health Care and Higher Education in the Netherlands

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Abstract

This study reports on budgetary reforms in the Dutch health care and higher education sector in the last twenty years. Comparisons between the two sectors reveal that not all reforms adhere to the principles of New Public Management. New budget systems in both sectors are mixed systems, with university budgets developing from input to more output based systems and hospital budgeting systems from output to more input oriented systems. More output-based budget systems appear to stimulate production, contradicting government's policy of cost reduction. The most effective reform measures turn out to be those who are best aligned with opinions and attitudes of medical and academic professionals.

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