The powerful social anxieties surrounding ageing and death in society also permeate the organisation of social care and the reform processes that it has been recently subject to in many European states. This article reports on research undertaken in two Dutch care organisations after the introduction of market oriented reforms. The research used psycho-social methods to explore the lived experience of care workers and their managers in this rapidly changing environment. It is argued that reforms that separate the provision of care from the purchasing/funding of care create a new kind of triangulation in the care sector. Drawing on psychoanalytic discussions of “thirdness” it is argued that such triangulation could provide the basis for a more creative approach to caring but if, as in the Netherlands, it is driven primarily by market imperatives such reforms can lead to a persecutory relationship that gets “passed down the line” from funders to providers to carers to residents.