From “major decisions” to “everyday life”: Direct accountability to clients

In this chapter we will discuss two models for democracy: the “Major Decisions Model” and the “Everyday Life Model”. In the Everyday Life Model, citizens involved in an accountability process can say whatever bothers them in their dealings with a health care organization. In the Major Decisions Model, citizens involved in an accountability process have to disregard their personal experiences and are rather asked to discuss major strategic plans and decisions on the organizational agenda. In the literature, the Major Decisions Model is generally seen as preferential, because it directly connects citizens to crucial decision-making. However, in some circumstances the Everyday Life Model might be wiser to adopt as it builds directly on the genuine daily experiences of clients in health care settings.