Cross-border mobility of health professionals: contesting patients' right to health

Soc Sci Med. 2012 Jan;74(1):20-7. doi: 10.1016/j.socscimed.2011.02.012. Epub 2011 Mar 3.


Cross-border labour mobility in the health sector is portrayed as both an opportunity for health professionals immigrating to developed countries, and as a challenge for patients remaining in low-income countries with restricted access to health care provision. In policy debate, this problem is articulated as the opposition between, 'the right to freedom of movement' and 'the right to health'. The underlying layers of this dilemma expose competing institutional interests for source and destination countries, international organisations, private recruitment agencies, trade unions and professional organisations. To resolve some of these tensions, a 'soft law' regulation (ethical recruitment policy) was adopted in the UK in the early 2000s. This article argues that this ethical recruitment policy produces an ambivalent effect. The qualitative content analysis refers to documents produced by international organisations, government bodies, professional organisations and trade unions in the UK and source countries. We found that ethical recruitment on the one hand proposes a practical mechanism to the realisation of the right to health in source countries, through encouraging employers' behaviour in accordance with ethical principles in international recruitment. On the other hand, this policy protects the reputation of institutional stakeholders changing rhetoric around international recruitment rather than the practice. The findings of this study contribute to a broader discussion of the international norms diffusion and the ambivalent role of 'soft law' in their implementation.

MeSH terms

  • Emigration and Immigration* / legislation & jurisprudence
  • Health Personnel*
  • Health Services Accessibility
  • Humans
  • Patient Rights*
  • Personnel Selection / ethics*
  • Public Policy
  • United Kingdom