Ancient governance lessons for modern public services

GGi had a good friend in Dr. Marius Buiting, who sadly died last year. Marius was perpetually interested in everything and drew on the most unlikely sources of inspiration. He alerted us to the interesting functional governance approach used by Dutch Water Boards. Professor Andrew Corbett-Nolan reflects on whether it's a potential model for community engagement in some of the up-and-coming new NHS structures, such as neighbourhoods.

In an era where democratic participation often feels limited to periodic elections there remains a wealth of inspiration from Europe's vestigial governance systems.

Across Western Europe interesting, ancient but often unknown governance structures have endured for centuries handling specific public functions outside the main national frameworks. I am continually struck by how these relics offer fresh ideas for how citizens can become engaged in services the state provides.

It was my very dear friend and GGi collaborator the late Dr. Marius Buiting (pictured above) from The Hague who drew my attention to one of these examples, the Dutch water boards led by the dijkgraaf, to exemplify this. The Dutch water boards, or waterschappen, are a medieval system that have evolved into a modern, participatory model for managing essential services like flood defence and water quality. Europe is dotted with similar holdovers, from trade guilds to religious administrations, each providing pathways for citizens to influence state-provided services without relying solely on ballots or local authority appointment.

This article explores these systems and then looks at the potential of inspiration from these models to re-boot the legitimacy of public governance in structures such as NHS neighbourhoods or foundation trusts (FTs).

In a time of declining voter turnout and calls for more inclusive democracy, these models remind us that governance can be functional, localised and participatory, empowering individuals beyond the voting booth.

The dijkgraaf

The waterschappen represent one of Europe's most enduring functional governance systems, with roots tracing back to the 12th century when local communities in flood-prone lowlands began organising to protect against the sea and rivers. In a nation where much land lies below sea level, water management was, and remains, a matter of survival, leading to the formation of collaborative boards that predated the centralised Dutch state.

By 1255, the first of these formal ‘hoogheemraadschap’ was established in the Rhine delta, granting locals powers to build dikes, levy taxes and enforce maintenance rules. This system, born from necessity in medieval polders (reclaimed land), emphasised collective responsibility under the principle ‘Whom the water harms stops the water’, fostering a consensus-driven approach that has influenced Dutch culture's Polder model of negotiation.

Over the centuries, the boards have consolidated. In the 19^th century there remained several thousand and 21 remain today. They retain autonomy as public authorities and operate on hydrological boundaries, crossing provinces. The waterschappen handle flood protection (3,600 km of primary dikes), water levels, quality (335 wastewater plants), and climate adaptation. Funding is self-generated through stakeholder taxes (€2.7 billion annually), based on ‘polluter pays’ and ‘beneficiary pays’, ensuring financial independence. Governance is enshrined in the Dutch Constitution (Article 133) as a fourth tier alongside central government, provinces and municipalities with the Water Act (2009) defining their roles.

At the heart is the dijkgraaf, a title meaning ‘dike count’ with feudal origins, evolving from aristocratic overseers to professional chairs. Appointed by the crown for six-year terms on the board's recommendation, the dijkgraaf presides over both the general board (elected legislature) and executive board, blending executive, judicial and ceremonial duties. They represent the board externally, manage crises (e.g., flood emergencies) and ensure stakeholder balance. Backgrounds typically include engineering, public administration or politics, reflecting the role's technical and diplomatic demands.

Recent dijkgraafs illustrate this and it is interesting to see the blend of skills and experienced-based appointments with political connection, perhaps a useful lesson as we approach citizen engagement appointments.

Jeroen Haan, dijkgraaf of Hoogheemraadschap De Stichtse Rijnlanden since 2019, has a background in civil engineering and public administration. Educated at Delft University of Technology, he previously served as alderman in Utrecht and dijkgraaf of another board, focusing on sustainable water management and climate resilience. His leadership emphasizes innovation, such as integrating AI in flood modelling. Luc Kohsiek, dijkgraaf of Hoogheemraadschap Hollands Noorderkwartier since 2021, brings expertise from water engineering and policy. A graduate of Wageningen University, he worked in Rijkswaterstaat (national water agency) on delta projects before leading regional initiatives on sea level rise. Kohsiek advocates for biodiversity in water systems, aligning with EU directives.

Toine Poppelaars, dijkgraaf of Hoogheemraadschap van Delfland (appointed 2022) has a political background as a former CDA party member and municipal councillor. Trained in public administration, he emphasises community involvement in urban water challenges, like Rotterdam's flood defences. His tenure has focused on partnerships with municipalities for green infrastructure. Hein Pieper, former dijkgraaf of Hoogheemraadschap Rijnland (2015-2023) came from politics (PvdA party) and environmental advocacy. A social sciences graduate, he championed sustainable agriculture and water quality, influencing national policy on peatland subsidence. Pieper's background highlights how dijkgraafs often bridge technical and social dimensions.

These examples show dijkgraafs as appointed experts rather than just as elected politicians, selected for six-year terms to provide stability. Their backgrounds - mixing engineering (e.g., Haan, Kohsiek) with politics (e.g., Poppelaars, Pieper) - ensure balanced leadership. The role's vestigial feudal title belies its modern professionalism, with salaries around €100,000-€150,000 annually and accountability to provincial oversight.

Citizen engagement in this system is multifaceted. The general board's elections (turnout ~50% in 2023) allow direct input, but nomination for stakeholder seats (farmers, businesses) enables targeted participation. Boards consult locals on plans, and the Unie van Waterschappen lobbies nationally. This ‘interest-pay-say’ model has proven resilient, as per OECD praise for efficiency, and inspires global adaptations in flood-prone areas.

Other vestigial systems

Europe's functional relics offer varied engagement models. The City of London's livery companies, rooted in 12th-century guilds, engage tradespeople through nomination and apprenticeship, funding education and charity. They echo stakeholder involvement without broad elections. Switzerland's Landsgemeinde, from 13th-century assemblies, enables direct citizen voting in open forums, fostering debate on local issues. They are a model for consultative public service panels.

In Greece Mount Athos's monastic governance (10th century) uses elected representatives for internal affairs, suggesting community nomination for cultural or health services. In Spain the Basque fueros (12th century) allow provincial tax collection via nominated deputations, engaging citizens in fiscal oversight. They offer a parallel for localised public funding boards.

Are there lessons for the NHS?

These systems highlight how functional governance can enhance legitimacy by involving citizens directly in specialised services. For the NHS, facing trust erosion and centralisation critiques, adapting such models could re-boot engagement in neighbourhoods or FTs.

In NHS neighbourhoods, focused local hubs for preventive care, the dijkgraaf-like stakeholder boards could nominate residents, GPs, and charities to oversee plans, mirroring water boards' ‘interest-pay-say’. This would help legitimise decisions, as in Dutch consultations on dikes.

For the new NHS FTs thinking through whether to retain councils of governors, public governors could evolve into neighbourhood-linked structures, with nominations from local groups ensuring diverse voices. Staff governors could be drawn beyond staff in the NHS FT concerned to encompass staff in primary care or local third sector providers, just like Pieper's advocacy in Rijnland. GGi's work shows poorly resourced governors underperform but invested-in ones add value.

Drawing from Landsgemeinde, NHS assemblies for service feedback could empower patients beyond surveys. Basque fueros suggest devolved funding panels for community health budgets.

Imaginative thinking could, for the NHS, help counter ‘democratic deficit’, and the perception that citizen engagement is always an elected-councillor-shaped hole. Learning lessons from elsewhere could help build resilient, legitimate governance amid reforms.