Scaling the mobility of health workers in an enlarged Europe : An open political-economy perspective

Abstract

The enlargement of the European Union in 2004 and 2007 and the marketisation of health care are increasing the mobility of workers and driving a scalar transformation of the sector across Europe. Drawing on questionnaires and interviews in 17 European Union countries, and focusing on two case study New Member States, we analyse inter- and intra-country drivers and impacts of health care labour mobility. The data are analysed from an open political-economy perspective underpinned by an understanding of scale as a socially constructed material entity mediated by national and supranational state institutions, and the collective agency of workers. We emphasise the contradictory and contested nature of rescaling health care and the complex micro-dynamics of mobility. Although absolute outward migration across borders is relatively small, the movement of health care specialists is having a disproportionate effect on sender countries and regions within them.