Granting Healthcare to the Unwanted. Professional Ethos and Daily Practices of Social Workers Assessing Medical Assistance Requests from Undocumented Migrants

Based on ethnographic fieldwork within welfare administrations in Brussels and in Wallonia, this contribution will focus on the implementation of healthcare policies for undocumented migrants in Belgium. Starting from the daily practices of social workers within welfare bureaucracies, where undocumented migrants’ requests for medical care are decided on, we explore the place of professional commitments, affects and administrative guidelines in providing public healthcare to “the unwanted” (Agier 2005). We aim to contribute to existing studies on street-level bureaucrats, particularly those focusing on immigration desks, by showing that civil servants’ de facto discretion does not always restrict migrants’ access to public services (Spire 2009; Brodkin & Majmunder 2010; Gabarro 2015): welfare workers indeed regularly give their “clients” the benefit of the doubt, sometimes even write reports that can help advance their claims. Drawing from insights from the sociology of work, we analyze the daily practices of social workers within the wider context of their professional training, values and ethical commitments and explore how they manage to strike a balance between professional ethos, administrative guidelines and duty to control. We also show that affects and emotions can play a crucial role in tipping the bureaucratic scale in favor of the user, hence bringing new insight into the often-assumed rationality of bureaucracy.