As WELLMIG progresses, I recall the words of Socrates: I know that I know nothing. Perhaps I should paraphrase Socrates (no disrespect intended) and say that the more I find out, the less I feel that I know.

by Marie Louise Seeberg

When policies meet people

Like most research projects nowadays, WELLMIG is organized into work packages. One of them delves into what we have called the “regimes” of migration and integration for nurses wanting to come to work in Norway. That these regimes look very different for people coming from our three countries Sweden, the Philippines, and Poland is something we have mentioned before. They are subject to different policies of authorization and recognition of qualifications.

What we have discussed to a much smaller extent is the impact of other Norwegian policies on their opportunities and experiences along the way. This is where it gets really complicated.

Workfare, welfare, and gender

As it says on the tin, WELLMIG brings together two national policy fields that are usually regarded separately: health sector policies, and immigration policies. However, labour market policies also enter the picture and in many ways, constitute a bridge between health and immigration.

“Integration” or “inclusion” policies targeting immigrants emphasize the importance of taking part in the labour market, of “workfare” as a premise for “welfare”.

This, again, is a matter of economy and of ideology: in order to sustain the welfare state (even after petroleum), everyone needs to pull their part, contribute to society, pay their taxes and so on. It also has to do with gender equality: women are expected to be on the labour market in Norway, because this is how gender equality is achieved. Never mind that a huge proportion of women are employed in care work, conducting professionally tasks that are traditionally perceived as “feminine”, and that most men are getting paid to do anything but.

The gender-segregated labour market comes as a surprise to many foreigners expecting a society where gender is not a decisive factor.

A flurry of policies

As we move beyond the question of authorization, there seems no end to relevant policy documents. There are white papers on staff recruitment to the healthcare sector, action plans on boosting the qualifications of people already working in the sector (some of them are the very nurses we are studying, working as semi-skilled carers because they lack authorization as nurses), government strategies on integration, and projects built on government grants emerging from such and other policies.

Again, some of these projects target the very nurses we are studying.

Predicting unpredictable effects in public

It boggles the mind how so many intricate policies and measures co-exist, partly overlapping and partly surely conflicting with one another. The dynamics between them must create so many unforeseen and even unwanted effects. This is well known, and there is even a system in place to try to predict and prevent such effects.

Before new regulations are implemented, there are usually extensive “Hearings” (høringer) or Consultations. This is an important element in the political process in Norway, where legal and policy changes likely to have a significant effect are explained by the government in a “Hearing note”, whereupon a large number of stakeholders is invited to respond to the note, in order to bring to light any unwanted effects.

Anyone else may also respond and very often, uninvited organizations and individuals do submit responses. We have studied some of these notes and responses, and it makes for interesting reading. We also note that the government does not need to change course in the aftermath of a “Hearing”. However, all responses must be easily available on the government website, so anyone can read them and find out what the government may have chosen not to listen to.

Narrow focus, wide context

After implementation, many plans and projects are studied and evaluated. My own workplace, NOVA, is often commissioned to carry out and report from such studies and evaluations – usually in competition with other research institutes. The reports also make for interesting reading.

However, a general challenge in such studies is that one has been commissioned to focus narrowly on the one measure or policy, whilst knowing that there is so much going on in its environment, not least in the form of other measures and policies that cannot fully be taken into consideration.

Wide focus, narrow context

In a word, we find complexity. Everything is connected. Saying that is not adding anything new to existing knowledge – it is a banal truism.

Our job in WELLMIG is to find out specifically how complexity plays out in forming the lives, experiences, and opportunities of nurses from Sweden, Poland, and the Philippines who want to work as nurses in Norway. It is no simple task.