Leroi Henry

Networks as transnational agents of development

The term network has become a hallmark of the development industry. In principle networks have the potential to provide a more flexible and non‐hierarchical means of exchange and interaction that is also more innovative, responsive and dynamic, while overcoming spatial separation and providing scale economies. Although the label ‘networks’ currently pervades discourses about the relationships between organisations in development, there has been surprisingly little research or theorisation of such networks. This article is a critical evaluation of the claims of developmental networks from a theoretical perspective. While networks are regarded as a counter‐hegemonic force, we argue that networks are not static entities but must be seen as an ongoing and emergent process. Moreover, theory overlooks power relationships within networks and is unable to conceptualise the relationship between power and values. These observations open up a research agenda that the authors are exploring empirically in forthcoming publications.

Difference and Distinction? Non-migrant and Migrant Networks

In recent years the role of social networks and of social capital in shaping migrants’ lived experiences and, particularly, their employment opportunity has increasingly come to be recognized. However, very little of this research has adopted a relational understanding of the migrant experience, taking the influence of nonmigrants’ own networks on migrants as an important factor in influencing their labour market outcomes. This article critiques the alterity and marginality automatically ascribed to migrants that is implicit in existing ways of thinking about migrant networks. The article draws on oral history interviews with geriatricians who played an important role in the establishment of the discipline during the second half of the 20th century to explore the importance and power of non-migrant networks in influencing migrant labour market opportunities in the UK medical labour market.

A perverse subsidy: African trained nurses and doctors in the NHS

Published without an abstract. From the introduction: What would constitute an ethical policy towards the recruitment of African-trained health professionals for the NHS? The story goes that there are more Malawian doctors in Birmingham than there are in Malawi. Gareth Thomas (international development minister) and Rosie Winterton (health minister). They say we don’t need to hire overseas any more. We have trained enough British doctors and nurses and they have to have jobs. NHS manager, in conversation, 2006 In recent years there has been increasing concern about the ‘poaching’ of African doctors and nurses by UK health services. The scale of emigration undermines health care in very poor countries with very severe health problems. 2 The UK government’s response was to institute an ‘ethical’ recruitment policy that banned active recruitment by UK health service employers in staff-short African countries. Public debate about this policy response, including commentary from politicians, journalists, trades unions and also the World Health Organisation (see the latest World Health Report 2006: Working Together for Health WHO, Geneva), has thrown up some complicated ethical and political issues. In this extremely unequal world, there are conflicts between the human rights of African health workers, of British health services users and the African populations who need health services. Migration undermines health services in African countries of origin. Blocking migration by African health professionals however undermines their right to move away from their country of origin; it also plays into the prejudices of anti-immigration lobbies in Britain. Employment by the NHS of doctors and nurses trained in Africa constitutes a ‘perverse subsidy’ to British health service users - that is, a flow of subsidy from poor to rich. The movement from Ghana to the UK alone subsidises the UK health services to the order of £39 million per year. Yet ‘ethical recruitment’ policy solutions lack a sound ethical basis and are potentially discriminatory in their effects, since they focus on restricting mobility rather than ensuring equality of health care. A recent sharp and unheralded switch in immigration policy that phases out training opportunities for migrant overseas-educated doctors and limits entry of all but the most highly qualified doctors has been the latest (and perhaps the most significant) change in this respect. And it has been played out in the fertile territory of debates around ethical health provision. In this article we unpack some of the ethical, political and economic issues that surround this debate and map out some possibilities for picking our way through this troubled terrain.

The co-marking of aged bodies and migrant bodies: migrant workers’ contribution to geriatric medicine in the UK

This article sits at the nexus between two bodies of work, gerontology and migration research, both of which have theorised the body as the locus of stigma. Gerontologists, while acknowledging the significance of perceptions of the ageing body for engagement and participation in society, have often evaded direct engagement with physical and medical understandings of older bodies. In parallel, research which focuses on migration, race and the body has focused on how the migrant body is stigmatised both because of its somatic markers and because of the status of the frail older people whom they tend. Drawing on oral history interviews with UK born and South Asian overseas-trained geriatricians, the article argues that the two bodies, which are usually seen in negative ways, came together in meaningful ways in the development of the specialty of geriatric medicine. Thinking of the body as an assemblage with many elements, some of which are stigmatised but which can nevertheless be recuperated, helps us to think beyond stigma in the context of body work.