This thesis is an evaluation of the citizen participation in municipal home based care services for older adults. The implementation of the Principal-Agent model1 wins popularity among the decision makers in the municipally. This model is primarily constructed to make the market organisation more effective and is based on the “New Public Management tradition”. This model is now also used in the public sector. The challenge is whether or not this way of organising can give the same advantages as the traditional organisation. The Principal-Agent model requires more active clients and participation is connected to the right to submit claims. In this thesis participation is used to explain different levels of participation. The thesis analyses what happens to the participation in municipal home based care services with a Principal-Agent organisational model. Qualitative personal interviews are used as a method, using both clients and employees as interview objects. Our results show that the clients are basically satisfied with the services provided; the reason seems to be the treatment received from the employees in the daily contact with the clients. The employees who are in daily contact with the clients give often more and more personal care than those who practise the written decision. The results also show that the definition of citizen participation is different between these groups and also among the employees across the two levels. The citizen participation as it occurs in this municipally is mostly individual; the citizens have not been included in either the planning or the implementation. An important result is that the interviewed clients lacked the competencies needed in order to be active citizens. It also indicates that only a small part of the citizens use their right to lodge complaints. The implementation of the Principal-Agent model changes the citizen’s role from being a user to becoming a consumer. Structures like the Principal-Agent model can be a way of using power at a structural level, particularly in the way it defines the needs of the clients. In the future it is important to adjust the citizen’s participation in a way that gives the users of care service real participation. There is also a need for a broader public debate concerning this subject. The implementation of the Principal-Agent model must be a political decision and not a way of administrating services in a more effective way. The consequences of this organisation are still not fully discovered. Evaluation programs should be planned in parallel to the planning and the implementation when changing structures.