Bound between care and control: Institutional contradictions and daily practices of healthcare for migrants in an irregular situation in Italy

Abstract

On the books, the inclusiveness of the Italian framework regulating healthcare access for migrants is indisputable. However, we might wonder how access takes shape on the front-line of the healthcare system, particularly in times of increasingly hostile institutional and discursive environments. By focusing on Italian migration and healthcare policies and the practices of health workers during their encounters with migrants in an irregular situation, this contribution analyses how health workers deal with institutional tensions in the field and how these, in turn, shape their narratives and actions. It suggests that individual positioning plays a major role in favouring the adoption of discretional practices of care or control. Nonetheless, practices are also mediated by the wider institutional and discursive landscape, which has been exponentially characterized by a tension between a medical-humanitarian logic that legitimates providing healthcare to vulnerable migrants, and a control-oriented logic targeting immigration and health expenditure.