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Globally spreading neoliberal doctrines regarding the need to ‘flexibilise’ the allegedly bureaucratic welfare states have been shown to contribute to the ‘flexibilisation’ of care work, involving austerity measures and reliance on migrant labour. Focusing on public eldercare in Finland, this chapter adds to the literature a close intersectional examination of the exploitative ‘coping management’ that the neoliberal discourse underpins. This management style fails to challenge inadequate resources and instead extorts nurses, treating them as disposable routine workers. We argue that coping management is expressed through ‘flexibility talk’ that emphasises personal characteristics rather than formal skills, and that there is an inherent affinity between ‘flexibility talk’ and ‘migrant flexibility talk’. We maintain that the re-articulation of care work as work requiring ‘flexibility’ and therefore particularly fitting for migrants has problematic gendered and racialised implications in the workplace. Our analysis draws on interviews with managers in public eldercare and observations from eldercare units in Finland. We show how the practices and discourses of flexibilisation help care managers to reconcile the practical and ethical dilemmas they face in ways that appear morally and locally sustainable to them. We have observed that care managers do not currently recognise migrant nurses as stakeholders worthy of equal recognition.

OBJECTIVE: In recent decades, governments around the globe have been under pressure to create more efficient and effective health care systems. Research shows, particularly in middle- and low-income countries, that many of these neo-liberal policies that have been enacted have had a largely negative effect with regard to equitable health services for lower-income populations and dignified working conditions for health providers. In this paper we highlight recent reforms in health care in Canada, focusing on formal care during pregnancy and childbirth, and compare these to parallel developments in two Nordic countries–Finland and Iceland. METHOD: We draw upon secondary data sources and primary research findings. RESULTS: Our comparative analysis pays close attention to barriers in access to primary care services across the childbearing period for lower-income women in the three countries, as well as the factors that create poor working conditions for the predominantly female maternity care labour force. DISCUSSION: As Canada struggles to deal with the crisis in its maternity care system, it could learn from developments in Finland and Iceland that promote teamwork among primary health care professionals and high-quality care for lower-income populations.