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The doctoral thesis of Lauri Kuula, MSc. “Managing resources in the Finnish social and health care sector through procurement and international recruitment - Essays on tendering, contracts and ethics” will be publicly examined at the Aalto University School of Business on Friday, March 6, 2026.

Better accounting for the characteristics of procured services during tender design, better monitoring of recruitment partners in international recruitment and a more thorough management of ethical risks to different stakeholders are necessary in managing public resources.

In Finland, public social and health care (SHC) spending is close to third of the national budget. Finland is expected to face a significant shortage of health workers in the 2030’s. Lauri Kuula’s dissertation examines resource management in Finnish social and health care sector, focusing especially on international recruitment and public procurement. International recruitment of health workers is examined from the ethical decision-making and recruitment services procurement point-of-view. Additionally, the dissertation aims to understand how service characteristics impact public tender design.

This dissertation is a combination of three research papers. The first research paper focuses on public procurement of SHC services, especially on how service characteristics (should) impact public tender design. The second paper of this dissertation examines international recruitment of health workers in Finland, more specifically, how are different (potential) ethical implications impacting different stakeholders considered in international recruitment decision-making and practice. In the third paper of this dissertation, the sharing of (ethical) responsibilities between a public employer and a recruitment services provider is examined.

The research finds that the characteristics of procured services should impact how public SHC tenders are designed. The responsibilities of individual organizations in managing ethical risks in international recruitment should be reduced and the division of benefits between different stakeholders ensured. Governance of potential risks and recruitment services providers is lacking. The dissertation proposes recommendations to develop organizational practices and national policy. Developing international recruitment and public procurement practices could have positive implications for managing public resources and ensuring SHC workforce availability and well-being in the 2030’s.

The dissertation is based on a total of 46 interviews, document analysis of 12 public international recruitment contracts and two behavioral experiments (N=265, N=246).

Keywords: Public Procurement, International Recruitment, Health Care, Social Care

Opponent: Professor Alexander Trautrims, University of Nottingham 
Custos (Chairperson): Professor Katri Kauppi, Aalto University School of Business

Contact information: lauri.kuula@aalto.fi

Thesis available for public display 7 days prior to the defence at: