Ministry of Commerce And Supplies - Enhanced Integrated ...

N T I S2010Barriers to Exports of Health Services Political instability in Nepal remains a challenge. The general business environment is not favourablefor doing business, including in health services. This means less flow of FDI and fewer consumers; There is a lack of market integration in the sector. Different health care systems have different coststructures. Information available to the consumers is poor. There is little coordination among thevarious medical institutions. And, there is very little unified marketing of this export. Most consumerswho come to Nepal to receive medical treatment are informed only by word of mouth. This lack ofmarket integration limits Nepal’s potential to market to a larger target population; Nepalese medical institutions tend to emphasize their low costs. While the cost of health services isindeed cheaper than in India, it is not the only factor that generates demand. Other factors, such as timeneeded to receive a service, quality of service, costs and quality of accommodation and transportationalso need to be considered. A survey conducted by SAWTEE shows that there are consumers willing topay a higher price for better quality. However, these other forms of differentiation are very rare andyet to be explored by Nepal’s exporters of health services; Although the development of the health sector has been guided by policies, programmes and planssuch as the National Health Policy of 1991, the subsequent Second Long-Term Health Plan (1997–2017), the Eighth, Ninth, and Tenth Development Plans, and the current TYIP, no concrete strategiesand policies have been delineated for mode-specific export supply of this service; Skilled health care professionals are limited. In order to increase human resources in both quality andquantity, additional spending on training and education is required. However, due to the lack of marketintegration and specific policies, as well as due to political instability, generating more investment fromboth domestic and foreign investors is difficult; Other limitations include, but are not limited to, poor infrastructure, overcharging foreigners, security,language barriers, etc.Labour ServicesAs shown earlier in this chapter, remittances from overseas Nepalese workers have become a major componentof GNP.Export of labour services is governed by the Labour Act of 1992, the Foreign Employment Act and ForeignEmployment Regulations of 2007, and the Immigration Act of 1993 and the Regulations of 1995. Nepal hasnot made any commitment regarding this service under the WTO.A positive step taken by the Foreign Employment Act of 2007, compared to the Foreign Employment Act of1985, is the removal of the need for women to secure permission from a guardian, which had hamperedtheir freedom and restricted their movement and chance to gain overseas employment. Though the Acthas removed this provision, psychological fear and cultural values continue to limit the increase in women’soverseas employment.Barriers to the Export of Labour Services:Barriers to labour export start right from the beginning of recruitment and remain until repatriation andreintegration with the family. Of the two main problems that hamper the export of professional humanresources in developing countries, the first is the lack of distinctions between the temporary and permanent12Maskay, et al (2006). Foreign Investment Liberalization and Incentives in Selected Asia-Pacific Developing Countries: Implications for theHealth Service Sector in Nepal, Working Paper Series, No. 22, Asia-Pacific Research and Training Network on Trade. Quoted from SAWTEE (2008)http://www.unescap.org/tid/artnet.NEPAL TRADE INTEGRATION STRATEGY 2010BACKGROUND REPORT223