International Trade in Services.pdf - DSpace at Khazar University

Health without Borders 131
Box 4.10: Seizing Opportunities in the United Kingdom: The Case
of South Africa
South African hospital companies have been successful in winning health care
contracts abroad, particularly with the U.K. National Health Service. Netcare, an
investment holding company based in South Africa, began operations in the United
Kingdom in 2001. An early project of the group involved taking part in helping
reduce waiting lists in selected areas. Surgical centers in Greater Manchester and
Stracathro in Angus, Scotland, performed 8,000 procedures in one year; cataract
centers have performed 20,000 procedures to date; and walk-in centers have so far
treated 30,000 patients. In 2006, Netcare led a consortium that acquired General
Healthcare Group, the owner of the largest independent hospital operator, BMI
Healthcare. This has increased the business by 89 percent, transformed Netcare into
one of the world’s largest health care groups (119 hospitals and almost 11,000 beds),
and given Netcare an outstanding platform for enhancing its relationship with the
U.K. National Health Service. As part of this contract, Netcare will send teams of
medical personnel from South Africa for fixed, short-term periods in the United
Kingdom. These personnel are prohibited from employment with the U.K. National
Health Service for a period of two years. Netcare has also piloted a project that allows
nursing employees to work in foreign countries for four to six weeks at a time. The
objective is to expose South African doctors and nurses to opportunities in U.K.
hospitals and enable them to supplement their incomes through fixed-term contracts
abroad. Staff turnover has been significantly reduced as a result, and the group could
retain skilled staff in South Africa.
South African health care groups are also targeting patients in Africa. Netcare has
set up a network of referral agents in a number of African countries to attract patients
to the group’s hospitals and doctors in South Africa. They also arrange transport,
accommodation, and recuperative care for these patients. Competitors have
established centers in Johannesburg to assist foreign patients and their families with
transport, visas, accommodation, and medical treatment. They employ English-,
French-, and Portuguese-speaking interpreters and clearly target African patients.
Source: http://www.netcare.co.za/live/netcare_index.php.
of the development of new technologies and medical procedures or packaging
health services differently (for example, health tourism packages, airport pickup
services, translation services, and facilitated billing, etc.).
There are a number of success stories that should be examined carefully by new
entrants. The cases of Cuba and South Africa illustrate successful export promotion
strategies under Mode 3 (establishment abroad) and Mode 2 (health
tourism) (boxes 4.10 and 4.11).
Reforming the institutional framework to promote trade
The example of Cuba shows that a successful export promotion strategy in the
health sector is fully compatible with significant state involvement and the preservation
of a predominantly public health sector. Indeed, experience shows that