The Global Biopolitical Economy of Needs

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Linna building, Väinö Linna auditorium, address: Kalevantie 5

Tiina Vaittinen

Doctoral defence of M.Soc.Sc. Tiina Vaittinen (née Kanninen)

The Global Biopolitical Economy of Needs: Transnational entanglements between ageing Finland and the global nurse Reserve of the Philippines

The field of science of the dissertation is Peace and Conflict Research.

The opponent is Associate Professor Anna Agathangelou (York University, Canada). Professor Tarja Väyrynen acts as the custos.

The language of the dissertation defence is English.

In the governance of nurse migration the left hand of the state does not know what the right hand is doing

The Philippines is known as the global labour reserve, especially in the field of social and health care. In Finland, big transnational care companies now utilise the Filipino nurse reserve, as they prepare to compete with the public sector for clients. Tiina Vaittinen’s (M.Soc.Sc) PhD Dissertation examines the ethical dimensions of this phenomenon, from the perspectives of both the migrant nurses and the elderly Finns in need of care.

In 2007–2008, the Finnish media reported about Filipino nurse recruitment in Finland. The aim was to bring “thousands” of registered nurses (RNs) from the Philippines, which, it was argued, would solve the growing labour deficit in Finnish elderly care. The employers were mainly big, transnationally owned care companies, which hired Filipino RNs as practical nurses in elderly care homes. In addition, in 2008–2010, two groups of Filipino nurses were recruited to public hospitals as registered nurses.

In 2017, the recruitment of Filipino RNs to Finnish elderly care continues, hidden from the headlines. Over the last ten years, some 400–500 Filipino RNs have been recruited, to work as practical nurses or nurse assistants, in transnationally owned care homes across the country. The process of recruitment begins in the Philippines with a Finnish language course. After completing the course, the recruits remain waiting in the Philippines, until the recruiters’ client companies are in need of workforce somewhere in Finland. When the time comes, Finnish speaking Filipino nurses relocate to Finland, usually in groups of two to three nurses at a time.

- The big care companies operating in Finland are in a position, where they can build a flexible, mobile and skilful labour reserve in the Philippines. Due to past mistakes in educational policies, there are over two hundred thousand unemployed or underemployed registered nurses in the Philippines, waiting to migrate abroad for work, Vaittinen explains.
According to the Finnish law, registered nurses who come from outside the European Union cannot gain the Finnish RN qualifications through apprentice. For this reason, the Filipino nurses in Finland are first recruited as nurse assistants. Through apprentice, they can eventually gain the Finnish practical nurse’s qualification, which is a lesser training compared to the recruits’ education as registered nurses. The care companies have sometimes hired Filipino RNs also as care home cleaners, without providing a qualification path even to practical nursing.
There are international ethical guidelines for transnational nurse recruitment. The most important of these is the World Health Organization (WHO) Global Code of Practice for the International Recruitment of Health Personnel, which also Finland should follow.

According to the WHO Global Code of Practice, states have the responsibility to oversee that the ethical guidelines are respected by the different actors operating in the field. Vaittinen’s research shows, however, that in Finland these questions are mainly left to the market actors, i.e. the recruitment companies as well as the care companies, which employ nurses internationally. In this regard, Finland does not follow the WHO guidelines.

- In the governance of nurse migration, the left hand of the state does not know what the right hand is doing. Instead, knowledge is scattered across various regimes of governance, without a single state body possessing a holistic view of the recruitment practices and their consequences, Vaittinen elaborates.

- In Finland, health care professions are strictly regulated – and they must be, for reasons of patient safety. Against this background, it is strange that the market actors, which recruit health care personnel to Finland, are barely regulated at all. This is ethically problematic, since the state cannot abide by its responsibility to oversee the rights of its internationally recruited workforce, if it does not follow how the recruitment business operates and develops.


The dissertation is published in the publication series of TAPRI Studies in Peace and Conflict Research; 103, Tampere Peace Research Institute TAPRI, Tampere 2017. The dissertation is also published in the e-series Acta Electronica Universitatis Tamperensis; 1805, Tampere University Press 2017.

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