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Abstract      

Present paper highlights the issues surrounding trade in health services in India and other developing countries. As it is a well-established fact that in the modern era of globalization, the contribution of services to the global economy is increasing in comparison of the contribution of tangible goods. The paper gives an insight to the shortage of healthcare professionals in developed countries, which is the main cause of migration of health sector workforce from developing to developed countries. The economic impact of such migration on Indian economy has also been analysed in the paper. Today, heath sector is among the most rapidly growing service sectors in the world economy, which has been estimated at $4 trillion yearly in the OECD countries alone. As per the World Trade Report, 2008, the annual percentage change in the trade in commercial services was reported to be 18 percent while the annual percentage change in trade in merchandise goods was 15 percent. The sector has seen new and rapidly evolving forms of cross-border transactions, spurred by factors such as wide-ranging technology, demographic transition, increasing costs of medical care, skill up gradation, growing private sector participation, natural endowments etc. An effort has been made in the present paper to assess the various trade related barrier which are creating hurdle for free and transparent movement of healthcare professionals under Mode-IV of GATS. Besides, the paper shows that economic contribution of Indians working abroad in terms of remittances is more that of total FDI in the economy. The main object of the present paper is to assess barriers to trade in health services particularly in Mode–IV i.e. movement of natural persons abroad. The paper is based on secondary data collected from various sources like Reserve Bank of India (RBI), websites of various international agencies and Governments, data from Ministry of Health & Family Welfare, Government of India. Besides, data from World Health Report, 2006 was also used for preparation of present paper. It has been highlighted in the present paper that among the various categories of health care professionals, nurses are in acute shortage in developed countries mainly OECD member countries. This severe shortage has resulted in to recruiting nurses from countries like Philippines and India. However, there are a number of barriers for recruitment of healthcare professionals which mainly pertain to stringent requirements of qualification. Multiplicity of tests for practicing in destination country is another problem faced by these professionals. For example, in order to become a registered nurse in United States (US), a candidate has to go through minimum three tests- Commission on Graduates of Foreign Nursing Schools (CGFNS), National Licensure Exam (NCLEX) and mandatory language tests. Apart from this, the main problem is of recognition of home country’s qualification in destination country. Lack of recognition of professional qualification remains a major obstacle for developing country professionals willing to provide their services abroad. Therefore, Mutual Recognition Agreement (MRA) on qualification is the only solution for free movement of healthcare professionals because this agreement enables the qualification of professional service providers to be mutually recognized by signatory member countries. Therefore, it may be concluded that unnecessary quantitative as well qualitative restrictions on movement of healthcare professionals should be removed so that the availability and accessibility of global public goods and services towards universal access to health care may be promoted.