Drawing on a mix-methods study comprised of an online questionnaire and semi-structured interviews, this article presents findings about the complexity and development in time of health service use by Polish migrants living in the United Kingdom. The article contributes to the analysis of transnational healthcare practices by operationalising a framework that considers service access within and beyond national borders, and between private and public sectors. By categorising engagements with healthcare providers based on their occurrence in time it argues for an understanding of transnational healthcare as a process. It finds that Polish migrants manage their health by accessing a variety of different providers. This complexity is also reflected in the multiple ways in which access to services with regards to specific health issues unfolds in time. By focusing the analysis on specific health issues rather than individuals the article finds that multiple ways to access healthcare services coexist for the same participant, who does not necessarily move towards particular healthcare providers unitarily, but adopts ad hoc solutions on the basis of their experiences within specific medical areas. Understanding migrants' patterns of accessing healthcare can contribute to more effective policy solutions supporting migrants in the UK today.

No abstract

Background: Polish people are the biggest migrant group in the UK and the scholarship shows that they are attentive to their healthcare needs and seek to fulfil them by using various services both within and outside the British public healthcare system. This article explores the role of junctures within healthcare systems in the connections migrants realize between healthcare systems and sectors. The article argues that in a transnational context, migrants enact these junctures by joining different levels of care within the same sector, between sectors and across national borders. In particular, the article explores how Polish migrants’ healthcare seeking practices within and beyond national borders are enacted given the features, availability and relationship between primary and specialist care for how they are articulated between private and public sectors. Methods: This article is based on the second phase of a mixed-methods study on how Polish people in the UK manage their health transnationally. The participants were purposefully sampled from survey respondents (first phase) who identified as having a long-term health condition or caring in a non-professional capacity for someone who is chronically ill. Thirty-two semi-structured audio-call interviews were conducted with Polish migrants living in England between June and August 2020. Transcripts were analysed by applying thematic coding. Results: Key findings include a mix of dissatisfaction and satisfaction with primary care and general satisfaction with specialist care. Coping strategies consisting in reaching specialist private healthcare provided a way to access specialist care at all or additionally, or to partially complement primary care. When Polish private specialists are preferred, this is due to participants’ availability of time and financial resources, and to the specialists’ capacity to fulfil needs unmet within the public healthcare sector in the UK. Conclusion Polish migrants join with their practices systems which are not integrated, and their access is limited by the constraints implied in accessing paid services in Poland. This shapes transnational healthcare practices as relating mostly to routine and ad-hoc access to healthcare. These practices impact not only the wellbeing of migrants and the development of the private market but also the public health provision of services.

No abstract

This article focuses on the autonomy of construction workers informally employed in Belize City, Belize, as emerging from the labor processes and material conditions that characterize construction work in this ethnographic setting. I argue that the notion of ambivalence can be fruitfully applied in order to understand how autonomy acts in contradictory ways in reproducing the relationships amongst workers, and between them and their contractors. In a context characterized by personal relationships, minimized managerial control, and flexible employment, the article employs an ethnography of the workplace which focuses on the role of trust, status and tactics used by builders to their own advantage, in order to show the relevance of their autonomy for how they meaningfully engage with their work, with each other and their employers. The article asks how workers differentially positioned within the skills‐based hierarchy of the workplace act ambivalently, simultaneously reinforcing and negating their unequal place within it while striving to make their conditions less precarious.