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162 QUANTIFICATION OF BENEFITS FROM ECONOMIC COOPERATION IN SOUTH ASIA • However with regard to nursing and dental, there is no information on whether other SAARC countries have recognised degrees from each other. • There are no explicit requirements for citizenship or residency to register with the relevant authorities for practicing the profession of medicine or dentistry in the relevant SAARC member. CONCLUSIONS AND RECOMMENDATIONS Overview The inclusion of services within the SAFTA framework presents several challenges and opportunities for the SAARC countries. Such an inclusion holds potential not just for ensuring greater intra-SAARC trade, but also holds the potential of raising the levels of competitiveness in the South Asian region as a whole. It has been estimated that the availability of services (especially tourism, health, education, and labour) within the SAARC region will help to attract consumers from other parts of the world, and that an advanced services infrastructure within the region will boost the regions’ share in global services trade. 60 For facilitating this, several developments to liberalise both within each country, and at the regional level, will be necessary. With respect to health services, as already discussed, there are very few regulatory constraints in the SAARC countries in respect of investments in the health sector. The regulatory framework in each country is also conducive to arrangements for recognition of foreign medical and dental qualifications. There are no regulatory constraints on movement of patients from one country to another for treatment. However, there are several other issues pertaining to supply of services under each mode, which need to be addressed as part of the negotiations. These are summarised below. Recommendation 1: Investment Related Aspects Affecting Health Services, i.e. Mode 3 Service Delivery • Address upgrading commitments to autonomous levels: One of the aspects that comes out from the discussions in this chapter is that while none of the SAARC countries have committed Mode 3 in ‘hospital services’ as an area for complete liberalisation under the GATS framework, each of the countries has achieved significant autonomous liberalisation in this Mode, and there are practically no regulatory impediments to Mode 3 in the regulatory framework of these countries. Only Maldives and Bhutan require specific government approval for joint ventures in the hospital sector. In all the other countries, 100% FDI is allowed. As part of the SAARC negotiations, the upgrading of the GATS commitments to the autonomous levels achieved in the member countries, should, therefore, be an aspect for discussion. • Address Investment-related operational constraints at national and regional levels: Operational constraints to investment need to be dealt with at the national level as a matter of legal and institutional reform. While this process needs to be undertaken at both the national and regional levels, investment related provisions investment related provisions under SAFTA could provide certain obligatory provisions offering special protection for foreign investors. • Constitution of a working group to address FDI related barriers: The SAFTA currently does not envisage a chapter on Investment. It however mandates the SAFTA members to consider removing barriers to intra-SAARC investments. 61 Constraints to FDI as identified above could therefore be studied and attempt to be addressed under a joint working group of the SAARC members. Recommendation 2: MRAs for Recognition of Medical and Dental Degrees between SAARC Members There are a number of similarities in the regulatory frameworks for recognition of qualifications and licensing of professionals in medicine, dentistry and nursing. Reciprocal arrangements for recognition of medical degrees exist among India, Bangladesh, Sri Lanka, Nepal and Pakistan. With respect to Maldives and Bhutan, these countries seem to recognise medical degrees at least from India and Sri Lanka. Internship and other work experience requirements for qualification are also similar in all the countries. There are no constraints in terms of citizenship and residency requirements in the regulatory framework. 60 See, Shivraj Bhatt, “Services under SAFTA: How to make it work for South Asia?” Nepalnews.com, September 6, 2006, available at http://www.bilaterals.org/article.php3?id_article=5780 61 Article 8, Agreement on SAFTA.
H EALTH AND RELATED SERVICES 163 To formalise the movement of doctors across SAARC countries, therefore, it may be desirable to have mutual recognition agreements (MRAs) on recognition of qualifications for doctors, dentists and nurses. Such MRAs will have a positive impact in facilitating service delivery through both Modes 1 and 4. At a minimum, such MRAs should address the following aspects: • Ensure that the relevant medical, dental and nursing councils from each SAARC country recognise medical and dental qualifications provided in other SAARC countries. As a first step, such recognition may be confined to degrees awarded only by specific institutions in each of the countries, and may subsequently be reviewed and expanded to a larger list of institutions • Recognition of qualifications needs to be accompanied by streamlining the process of application for registration with the relevant councils. An aspect to be explored is whether recognition by a medical, dental or nursing council in any SAARC member can be automatically recognised by the relevant council in another SAARC member. This would mean, for instance, that a doctor qualified and registered with the medical council of India need not go to each SAARC member and complete the registration formalities in such member; but will be automatically recognised in such member by virtue of his/her membership of the medical council of India. • Such an MRA should also address standards of service delivery. Recommendation 3: Measures to Encourage Mode 2 in Health Services Delivery As discussed in this chapter, there are no regulatory constraints for mode 2 delivery of services. However, factors such as lack of insurance portability limits access for a service consumer. This needs to be addressed at the level of each member state. • Ensure portability of insurance coverage and recognition of foreign medical degrees by insurance companies: This aspect needs to be addressed at the national level in each SAARC member. The agreement between the SAARC members should recognise this as a key factor for development of Mode 2 supply of service. Each member should also undertake to ensure that health insurance service providers within their territories extend the coverage for treatment in any SAARC country. • Provide expedited Medical Visas: ‘Medical visas’ as a separate category is recognised under the Indian regulations pertaining to Immigration and Visas. Expedited mechanisms for consideration and grant of medical visas between all SAARC members needs to be considered.
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QUANTIFICATION OF BENEFITS FROM ECO
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QUANTIFICATION OF BENEFITS FROM ECO
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Preface Our consultations with seni
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viii CONTENTS 7. Revenue and Welfar
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Executive Summary OBJECTIVE This st
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EXECUTIVE SUMMARY xiii Table 1 EAMA
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EXECUTIVE SUMMARY xv India A full S
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EXECUTIVE SUMMARY xvii indicates th
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EXECUTIVE SUMMARY xix ments on basi
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Part I BENEFITS FROM TRADE, INVESTM
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4 QUANTIFICATION OF BENEFITS FROM E
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2 Literature Review and Rationale f
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4 Effective Additional Market Acces
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6 Impact of SAFTA on Member Countri
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7 Revenue and Welfare Implications
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8 Impact of SAFTA on Inward and Out
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Part II BENEFITS FROM DEEPENING INT
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11 Construction and Related Enginee
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Appendix 8 Intra SAARC FDI Collabor
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Appendix 11 Table A11.1 On an Emplo
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Appendix 12 Original Commitments/In
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Appendix 14 Table A14.1 Telecommuni
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Appendix 15 REFERENCE PAPER Scope T
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Bibliography Abelson, P. (1996),
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BIBLIOGRAPHY 241 Cuba (2002), Negot
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BIBLIOGRAPHY 243 (2004), Impacts of
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BIBLIOGRAPHY 245 Silva, Patricia an
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BIBLIOGRAPHY 247 (1998), Tourism Se
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