Over the last thirty years, welfare states have witnessed a considerable number of debates concerning the identity and power of clients of social and care services. Criticism of the authoritarian and paternalistic practices of professionals and a call for democratisation have stimulated changes in services delivery. Western countries have witnessed a trend towards more user-based services, with increased attention towards clients’ wishes and demands. The clients’ position towards services delivery has strengthened. This shift in power was initiated by the assumption of new roles as citizens and consumers. These roles were carved out against the older idea of clients as patients (in health care) or underprivileged (in welfare and social work). The three roles of patients, citizens, and consumers respectively correspond to the three logics of services delivery: professionalism, bureaucracy, and marketisation (Knijn 2000; Freidson 2001).

In the process of turning patients into citizens or consumers, the positions of professionals were hardly ever taken into consideration. Professionals were simply seen as the problem, as the opponents. Ironically, professionals themselves have played a prominent role in this attack on professionalism. Social workers, for instance, were the first to argue that they themselves were too powerful and paternalistic towards clients and should step back (Duyvendak 1999). Health care professionals were the main force behind the strong wave of criticism of psychiatry and mental health professionalism (Tonkens 1999). Social professionals reinforced guiding notions like autonomy and independence that fundamentally changed the client-professional relationship.

But even while professionals played a crucial role in the process that resulted in new roles for patients, such as citizens and consumers, little attention has been paid to what the corresponding new roles of professionals should be. What is the new identity of professionals and what are their tasks when clients are turned into consumers or citizens? What defines good professionals in the eyes of clients as consumers and/or citizens? Are they expected to wait passively and refrain from using their powers unless asked to by the client? Or do powerful clients need powerful professionals? While the clients have changed, no explicit new role has been defined for the professionals.