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Young EU citizens are encouraged to enhance their ‘employability’ by taking advantage of intra-EU mobility, but, for many, moving to another EU country can instead generate disadvantages in the labour market. Drawing on a qualitative study on the experiences of university-educated young Nordics and southern Europeans working in precarious jobs in Brussels, we examine how their access to income support in the context of mobility shapes their access to financial independence. We argue that the variation in European welfare models regarding young peoples’ social entitlements impacts this access in multiple and complex ways. The article advances a tripartite approach that looks at the regulation and enforcement of conditionality of social entitlements on the levels of EU, their country of origin and their country of destination. The analysis shows how, in Belgium, precarious EU migrant citizens are denied access to income support due to the interplay between general welfare conditionality for all claimants and recently reinforced conditionality affecting EU migrant citizens in particular. In these situations, the de-familialising Nordic welfare models showed an aptitude for shielding their young citizens. The young southern Europeans, on the other hand, often had no access to income support in any country, which forced them to choose between family dependency and unfiltered exposure to precarity.

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.

PurposeRecent scholarship reveals the imagery of the professional as the “ideal citizen”. The linkage between professionalism and citizenship is here approached from the perspective of democratic social justice in order to examine the persistence of gendered inequalities in the health care system. The paper aims to examine the ideas framing professionalism, both in sociological theory and historically, asking what gendered hierarchies mean in modern health care systems, and why and how they persist in the conditions of liberal democracy.Design/methodology/approachThe question is approached through both sociological literature and an analysis of historical framings of professionalism; the Finnish health care system is employed as a case. The reason for keeping the discussion close to a specific case is that different professional fields, countries and historic contexts differ from each other in democratically relevant respects.FindingsTraditional sociological theory assumed that professional privilege was based on essentially neutral expertise that benefits democracy only if protected from bureaucracy and politics. The recent theoretical turn reframes professional knowledge as socially defined, but the destabilisation of professional knowledge claims is not without problems. The paper refers to the persisting tensions between changing governance and gendered hierarchies in health care and argues for new approaches that suggest ways through which professional expertise can be democratically represented in politics.Originality/valueThe interdisciplinary framework uses political theory on social justice to examine how health care politics frame professionalism.

Governments play a crucial role in defining what is ‘maternal health’ and decid- ing what services are included in maternity care delivery. State policies also shape the roles of formal and informal care providers, families, the public, and commercial and voluntary sectors in providing maternity as well as newborn and reproductive healthcare services. Reducing health inequities for pregnan women and increasing their access to quality maternity services have been foci of global efforts to realize the right of every woman to the best possible mater- nity care. In the last half century, most high-income countries have publicly invested in universal healthcare (UHC) coverage for their respective popula- tions, which has included comprehensive maternity care. More recently, several low- to middle-income countries have likewise been investing in universal healthcare coverage.

The market for professional services is increasingly international but comparisons have not been made between different professions nor on how state policies affect opportunities for mobility. This article considers three professions: engineers, physicians and psychologists and explores the similarities and differences in international labour market demand for occupations. It examines how state policies in four countries, Canada, Finland, France and the UK, aim to promote and control professional labour mobility and migration, and the differences across the three professions. Engineering is an international profession and the extent to which states encourage inward migration differs. Medicine is highly regulated in all four countries but inward migration of physicians varies depending on national policy. Psychologists are less mobile, and the extent of state sponsorship and regulation varies across countries. In all three professions, international organizations are a force encouraging global standards. The conclusion is that state policies reflect state interests and have a strong influence on patterns of mobility.

Purpose – This chapter critically examines the purportedly growing phenomenon of Maternal Request Caesarean Sections (MRCS) and its relative contribution to the rising caesarean section (CS) rates. Methodology – We apply a decentred comparative methodological approach to this problem by drawing upon and comparatively examining empirical data from Canada, the US, the UK and Finland. Findings – We find that the general argument that has emerged within the obstetric community, evidenced in particular by a recent “State of the Science” conference, is that the reduced risks and benefits of MRCS are evenly balanced, thus ethically it could be seen as a valid choice for women. This approach, taken in particular in the North American context, negates the problematic nature of accurately measuring, and therefore assessing the importance of maternal request in addressing rising CS rates. Moreover, although some of the blame for rising CS rates has focused on MRCS, we argue that it has a relatively minor influence on rising rates. We show instead how rising CS rates can more appropriately be attributed to obstetrical policies and practices. Originality – In presenting this argument, we challenge some of the prevailing notions of consumerism in maternity care and its influence on the practice patterns of maternity care professionals. Practical implications – Our argument also calls into question how successful efforts to address MRCS will be in reducing CS rates given its relatively minor influence.

Welfare policies in the Nordic countries have been restructured, due to economic and demographic constraints, and claims for efficiency, but also with respect to the competence required. The authors discuss the crisis in care work, its recruitment problems, educational models and care work cultures. They show that values and the ethos of welfare policy affect the care for both the clients and the workers. This book is of interest to students, researchers, professionals, and policymakers.

The professional terms for occupations that provide welfare services are changing, and here the introduction of new public management in the Nordic countries since the 1990s is indicative of wider developments. The article explores professional projects in welfare service work from both conceptual and empirical perspectives. The aim is to produce a gender-sensitive analysis of the professional projects at the lower levels of the occupational hierarchies in health care. The first part reviews the literature conceptualizing the societal and institutional embeddedness of professional projects. The institutional matrix of welfare states emerges as a key context in shaping the welfare service work performed by women-dominated professional groups. The second part examines the case of Finland and suggests that recent reforms have created new inequalities in the system of professions, in which occupational groups in welfare service work are becoming marginalized. This signals a move away from ‘democratic professionalism’ towards a revival of ‘old professionalism’.

Theories of professions and healthcare organisation have difficulty in explaining variation in the organisation of maternity services across developed welfare states. Four countries - the United Kingdom, Finland, the Netherlands and Canada - serve as our case examples. While sharing several features, including political and economic systems, publicly-funded universal healthcare and favourable health outcomes, these countries nevertheless have distinct maternity care systems. We use the profession of midwifery, found in all four countries, as a 'touchstone' for exploring the sources of this diversity. Our analysis focuses on three key dimensions: (1) welfare state approaches to legalising midwifery and negotiating the role of the midwife in the division of labour; (2) professional boundaries in the maternity care domain; and (3) consumer mobilisation in support of midwifery and around maternity issues.