Photo: dreamstime

With the vast number of the population in Finland aging, immigrants may just be the answer to the concerning lack of care personnel.

IN the 19th century, Horace Greeley advised the American youth of his time to escape the impoverished and crowded cities of the East Coast and “go west, young man.” In Finland nowadays, while the prosperous southwestern triangle between Helsinki, Tampere and Turku is neither poor nor terribly crowded, officials like Marianne Mäntylehto might advise you to go north. And maybe study nursing.

The land of opportunity

Mäntylehto is project manager for TyöVarma, an EU-supported initiative to bring skilled labour to Pudasjärvi, a small town about 80 kilometres northeast of Oulu. With a population of just under 9,000, this sleepy timber and manufacturing town, whose greatest claim to fame is the downhill skiing spot at Iso-Syöte, might not seem like the most obvious land of opportunity. But as the baby boom generation begins to enter retirement, the demographics of Pudasjärvi, like the rest of Finland and indeed Europe, are beginning to skew dramatically older. “We are going to need a lot of nurses,” Mäntylehto says. And she doesn’t quite know where they’re going to come from.

In this respect, Pudäsjarvi is not that different from any number of Finnish towns, including Helsinki and the rest of the south. The Ministry of Labour’s work and economic development office currently lists more than 3,000 vacancies in the healthcare services field all over Finland, including more than 500 in the capital region – and these are positions that need to be filled today, not just sometime in the future. According to Statistics Finland, in 2010 there were 45,200 vacancies in public administration, education, human health and social work activities, by far the largest amount in any sector of the economy. If trends continue, that figure will rise by seven per cent next year. “It’s a nurse’s market,” says Raili Suojoki, international coordinator in nursing at Helsinki’s Diaconia University of Applied Sciences.

Language skills


“It’s a nurse’s market.”


These might seem like ideal times if you happen to be a healthcare professional, but don’t tell that to Musab Ignaim, a job-seeking nurse from Helsinki. A native Palestinian, he earned a bachelor’s degree in nursing in Jordan and would meet the standards set by European qualification directives to start practicing his trade right away in Finland, where he moved last year for family reasons. But there’s a catch. Although he speaks English fluently and basic Finnish at about the A2 level (“can understand sentences and frequently used expressions related to areas of most immediate relevance,” according to the Common European Framework of Reference for Languages), he remains unemployable. “Everywhere I go, I’m told I have to speak Finnish fluently before starting work,” he says. “Some employers have even told me to pass the language test for the nationality exam before even bothering to apply.” As a result, Ignaim has given up on nursing for now, while negotiating the winding road toward independent fluency.

From a patient’s point of view, while it’s certainly preferable if you can chat with your nurse in your native language, is it really better to go without a nurse at all? Especially if you can still communicate your basic needs anyway? “I suppose under some circumstances, in operating theatres, for example, where there’s not much talking going on, it would be OK,” allows Suojoki, whose nursing programme educates a small number of foreigners, in Finnish. “But in dealing with patients on an everyday level, it’s impossible – all nursing documentation is in Finnish. If you are going to serve patients, you need to speak Finnish and, in a lot of hospitals, Swedish too.”

Finns, however, as they get older and retire in greater numbers, may not be permitted the luxury of demanding a multilingual nurse in their dotage. As much as the Ministry of Labour might prefer unemployed native Finns to retrain as nurses, move to remote towns up north, and even brush up on their Swedish, not all of them will have the aptitude or desire. While there currently is a Labour Market Training scheme available to immigrants trying to transition into professional life in Finland, the daily stipend is modest and the waiting list for the language courses is very long – it can take more than a year in Helsinki. It’s hard to imagine a skilled foreigner with a range of professional options voluntarily choosing Finland, where they can expect to go unemployed, perhaps for years, while attempting to master one or even two new languages at their own expense.

Importing nurses


“The lack of qualified staff is growing.”


Enter Vantaa-based Opteam, an international recruiting firm that sees a business opportunity in finding foreigners to fill looming gaps in the labour market. Its most high-profile project has been the bringing of nurses to Finland from the Philippines – a country where remittances from professionals abroad account for ten per cent of the country’s GDP and nurses, in particular, have become something of an export commodity. Before the nurses come to Finland, Opteam provides nine months of intensive language training in the Philippines that lasts six hours a day, five days a week. Minna Vanhala-Harmanen, Opteam’s CEO, says that many of their nurses “have already reached the language level required for citizenship.”

The company has shepherded 58 nurses to Finland since 2010, and sees more coming in the future. “The number of retiring employees is rising and the lack of qualified staff is growing,” says Päivi Mäenpää, a consultant with Opteam. Healthcare organisations, she notes, “are awakening to the fact that pilot projects are needed now, when the number of existing professionals still makes it possible to give thorough guidance and on-the-job training to new nurses.”

Once the nurses begin working in Finland, the salary rewards are considerable – up to five or six times what they can expect to earn in the Philippines. Living expenses are much higher here, of course, but healthcare and education – sometimes crippling burdens in the Philippines – are free. Finland is thus a pretty attractive proposition to some Filipino professionals, despite having to learn a new language and move to the other side of the world. But not every country is like the Philippines, with the same mix of poor public services, low wages and an unusual surplus of educated workers. Moreover, not every country is like Finland – Filipino nurses can just as easily choose other European countries with similar needs, such as the United Kingdom, where they might have an easier time getting set up in working life.

In the face of thousands of Finnish vacancies, Opteam’s 58 nurses may be a good first step. However, private enterprise alone may be insufficient to meet Finland’s needs. Statistics Finland projects increased vacancies in not just the healthcare sector, but across the board of Finland’s economic life, from timber and manufacturing to media, IT and clean tech. Small northern towns like Pudasjärvi already also face shortages in the agriculture, transportation and logistics fields. “There are no skilled people to help during holidays and sick leaves,” Mäntylehto says. She’s also worried about a lack of entrepreneurs. “All the shop owners are getting old, and no one’s going to replace them. We need these services.”

While Pudasjärvi’s TyöVarma programme does all it can to enhance commuting possibilities from Oulu and Kuusamo and operates a rigorous recruiting operation in partnership with the region’s universities, it’s obvious not all of the community’s needs will be met from within the region, from within Finland or even from within the European Union. “I know that there is a need, and that our organisation has to learn to do things differently,” Mäntylehto says. But funding for efforts to attract skilled workers from abroad has stalled since the economic crisis hit in 2008. TyöVarma’s immigrant outreach has since been limited to running occasional articles in the local newspaper, trying to educate local public opinion about the need for more foreign workers.

Fierce competition

Without a fundamental rethink in Finland’s approach to immigration, fully trained, dedicated professionals fluent in Finnish and perhaps Swedish too are unlikely to materialise en masse on the horizon – not without actively promoted, managed immigration, with intensive, fully paid-for language instruction on a large scale. “The competition for skilled workers is only going to grow more fierce in the future,” says Mäenpää. “Not only in Finland but in Europe and globally, too. It is of vital importance for Finland to develop administrative practices and services so that the process of moving to Finland and starting to work here goes much more quickly and smoothly than it does today.”

Pudasjärvi, more promisingly, is one of ten pilot cities in the Ministry of the Interior’s new Osallisena Suomessa (“Involved in Finland”) project, a three-year experiment conceived at the University of Jyväskylä in taking a more holistic approach to promoting immigrants’ integration into Finnish society. Yet it remains to be seen how the lightly funded programme’s seemingly modest goal – “to enable more flexible integration training without long waiting lists” – will be met. The pilot programme, furthermore, is set to end in 2013, and its fate will depend on how the Jyväskylä group’s final recommendations are received in the political climate at large.

At a time when the mainstream political parties are running scared from the True Finns’ populist wave of xenophobia, however, that might be not be pretty. And it goes without saying that services for immigrants – who constitute less than three per cent of the population and usually can’t vote anyway – are vulnerable in any budget fight. “Finns like to point to certain grey-market employment practices, like what one sometimes sees in construction – where subcontractors pay Russians or Estonians less than they might pay a Finn – and say that immigrants are stealing jobs,” says Opteam’s Vanhala-Harmanen. “But that’s just illegal, and we’re against that too, because we, as a recruiter, can’t compete against someone breaking the law.”

Need for expertise

Where the jobs are:
Current vacanci es in Fin land by sector

Service work: 3,451
Healthcare and social services: 3,215
Sales: 3,194
Scientific, technical, or humanitiesbased
work: 2,843
(clothing, machinery, wood, electronics): 1,019
Administrative, office, tourism and IT: 1,868
Transportation and logistics: 643
Construction and mining: 598
Other manufacturing: 381
Agriculture, forestry and fishing: 262

Source: Ministry of Labour, April 2011

The real long-term issue facing Finnish employers is not so much wages – which are relatively low in Finland anyway – but a dearth of expertise. “If our clients could hire a Finnish metalworker, nurse or cook, they would. It would be simpler and less trouble,” explains Vanhala-Harmanen. “But some Finns just don’t get it, that employers are looking for certain skills, and they are not always available in Finland. Welders and engineers from Slovakia or nurses and cooks from the Philippines earn exactly the same wages as a Finn doing the same job would. It's not about the salaries, it's about skills.”

As Finland ages and fewer active workers support ever growing numbers of retirees, it is perhaps immigrants who hold the key to the country’s prosperity down the road. Given the general demographic trend in Europe – the International Monetary Fund projects that by 2050 there will be two workers for every retiree in the EU, down from today’s already low figure of four workers per retiree – Finland, a country with one of the lowest levels of immigration in the EU, could find itself facing an especially dangerous dilemma, with an impoverished elderly population in conflict with a resentful younger class stewing in economic stagnation. “Well-managed international recruitment,” Opteam’s Mäenpää says, “is a means for Finland to be able to maintain the level of welfare we have reached.” Outi Taivainen, CEO of HR House, another company seeking recruits from abroad, warns that Finland won’t attract that help without a “more open and liberal atmosphere and attitude.”

Whatever happens, it’s clear that Finns must begin to look for more ways to perpetuate their cherished, hard-won Finnish nation, language and values – just as Americans did in their transformative 19th century, with the help of “huddled masses” from all kinds of countries, including, it’s worth noting, Finland. Nowadays, though, the frontier isn’t so much about going west, north, south or east. It’s more about looking inward, about opening the frontier of what it means to be Finnish. It’s up to Finns to decide whether that isn’t too existential a question to be contemplated in the current climate.

Joseph Knowles