Globalisation and Health Service Provision The British

1
Globalisation and Health Service Provision
2
The British Context

• Expansion of NHS Funding
• More Private / International Providers
• Primary Care Trusts / Care Trusts
• Foundation Hospitals / Franchises
• Private Finance Initiative
• Non-Commercial Basis ?

3
World Trade Organisation

• TRIPS
• GATS
• - Most Favoured Nation
• - National Treatment

4
Modes of Supply

• Cross Border Trade (e.g. Tele-health)
• Consumption Abroad
• Commercial Presence
• Presence of Natural Persons

5
Article 1.3

• Government services are exempt where they are
• supplied neither on a commercial basis, nor in
  competition with one or more service suppliers.

6
Summary

• Services are Internationalising
• Governments are Privatising
• GATS Facilitates Both
• Watch the Doha Round Carefully!

7
International Organisations

• WHO / GPPPs
• International Monetary Fund (IMF)
• World Bank
• World Trade Organisation (WTO) / GATT

8
A Typology of Healthcare Companies

• Providers of Services
• Producers of Goods
• Suppliers of Services
• Health Insurers
• Premises Companies