N. V. GALISHCHEVA

Candidate of Economic Sciences, MGIMO University, Russian Foreign Ministry

India Keywords:, South Asia, export of services, import of services, education, medicine

Due to the liberalization of the education sector in India in the 2000s, and, above all, higher education, the country's position in the world market for the export of educational services is gradually strengthening.

As of mid-2011, India had 17,625 colleges1 and 90 private and 512 public universities2.

INTERNATIONAL STUDENTS AS A TYPE OF SERVICE EXPORT

All universities in India are certified by a special state commission (University Grants Commission), which has been functioning since 1956. In addition, 16 Educational Councils monitor their activities. At the same time, private universities do not have the right to organize colleges or other educational structures under them. State universities are divided into 42 federal, 275-local subordination (with 170 of them also receiving funding from the federal budget), 130 - having the status of a branch of a university assigned by the Ministry of Higher Education, 47 agricultural universities under the jurisdiction of the Indian Council for Agricultural Research, 18 institutes equated by the Ministry of Higher Education. educational institutions by university status (for example, Indian Institute of Technology, National Institute of Technology, Indian Institute of Management, etc.).

The National Policy on Education, which was adopted in 1968, 1986, 1992 and 2005, played a significant role in the development of this area in India. The main objectives of these documents were to raise the educational level in the city and in rural areas, introduce compulsory education for children under 14 years of age, implement the "three languages" formula in schools everywhere-local, English as an official language (to bridge the gap between the intelligentsia and the majority of citizens in rural and urban areas) and Hindi as a national language. In addition, in the light of the increasing demands of scientific and technological progress in education, emphasis was placed on technical disciplines, improving the educational level of women, correcting the regional and social imbalance of primary and secondary education (creating schools in each locality, expanding their material and technical support), continuing to encourage the development of backward castes and tribes. In this regard, spending on education has steadily increased, amounting to 3.05% of GDP in FY2009 / 10, 3.25% of GDP in FY2010 / 11, and ^3.11%in FY2011 / 1233 (in t.h. spending on higher education -0.37% of GDP)⁴. In 1976, by an amendment to the Constitution of India, education was transferred from the exclusive jurisdiction of the States to the Federal Government as well. This made it possible to introduce uniform educational standards throughout the country, increase control over the implementation of the National Education Policy, improve the financing of the industry and the quality of teaching.

After 1992, the emphasis was placed on universalizing secondary education in the country, standardizing textbooks and manuals, improving the educational level of the adult population through large-scale educational programs, establishing the so-called Open University in each state, giving greater autonomy to higher education institutions, increasing the number of technical subjects studied in the curricula of colleges and universities, and increasing state funding for education in overall.

Government measures have also increased the number of international students studying in India (their expenses are included in the export of educational services). The number of so-called international students increased from 7 thousand in 2001.5 to ¹³ thousand in 2004-2005 academic year, 21 thousand in 2008-2009 academic year b (more recent data are not available). Most of them came from Asian countries, especially from South Asia, and several thousand Africans appeared.

Foreigners are attracted by the very high educational level of Indian universities, moderate tuition fees and teaching in English.

However, these figures pale in comparison to some other Asian countries. In 2006, Singapore had 80,000 international students; the total number of students in the country is estimated to be-

Ending. For the beginning, see: Aliyah and Africa Today, 2013, No. 2.

It is planned to increase this number to 150 thousand in 2015, while in China these figures were 190 thousand in 2007 and approximately half a million are planned in 2020.

The National Education Commission, which operates under the auspices of the Ministry of External Affairs of India, seeks to increase the number of international students, considering them as a means of intellectual enrichment of the academic environment, improving the level of education and as an additional source of income. To this end, measures are being taken to facilitate obtaining a student visa, expand English language development programs, take Internet entrance exams, build new dormitories, etc.

INCREASING THE SHARE OF MEDICAL SERVICES

India, along with other countries (and there are more than 50 of them), positions itself as a center of so-called medical tourism. In this regard, during the post-reform period, the share of medical services in the Indian basket of exports of other commercial services has been steadily increasing.

Factors that stimulate the export of medical services in India are: their relatively low cost compared to developed countries; sometimes long waiting times for surgery or other treatment in the countries of residence of potential patients; ease and accessibility of obtaining medical care in India due to the development of international air transportation; standards of medical services provided comparable to advanced countries.

In particular, in Indian clinics, the most complex operations are performed within ^8-10 days from the moment of the first patient's visit, ⁷ and the cost of surgical operations is significantly lower than in the United States8 and the European Union, and the level of their execution, as well as the provision of modern medical equipment in Indian hospitals is comparable to foreign ones. In addition, medical tourists from English-speaking countries are attracted to India by the lack of a language barrier.

Among the disadvantages of Indian medical tourism are long - distance flights, which may be contraindicated for some categories of patients, the complexity of organizing follow-up examinations of patients after surgery, as a rule, returning to their homeland, as well as the lag in the level of sanitation in the country as a whole compared to developed countries in Europe and North America.⁹

Indian exports of medical services have been growing by about 25-30% annually in the last decade, and even despite the global financial crisis in 2008-2010, more than 100 thousand foreign citizens visited India annually for medical purposes.¹⁰ As a result, the industry generated revenue of approximately $310 million in FY2009 / ¹⁰¹¹. At the same time, the most attractive types of medical services for foreigners in India are alternative medicine, bone marrow and skin transplantation, cardio - and ophthalmic operations, orthopedic surgery.

India's share of the global medical tourism industry is expected to grow to 3% by the end of 2013, according to a report by RNCOS ^{12, a market research firm} that has been involved in research since 2002. At the same time, its average annual growth in 2011-2013 will be about 26%, and the number of foreigners visiting India for medical purposes will increase by 19% ^.13

THE PRIVATE SECTOR OUTSTRIPPED THE PUBLIC SECTOR

Indian healthcare consists of private and public sectors. In addition, the country has hospitals under the patronage of charitable organizations, as well as developed traditional medicine (Ayurveda*, yoga, unani**, Siddha*** and homeopathy), which is administered by the Department of Traditional Medicine (The Department of AYUSH - abbreviation for the first letters of the relevant practices - Ayurveda, Yoga, Unani, Siddha and Homeopathy) of the Ministry of Health and Family Affairs.

Until the early 1980s, Indian healthcare was dominated by the public sector. The state system of medical services consists of several levels: outpatient primary health care facilities * * * * locally - paramedic stations (146036), first aid stations (23458), polyclinics (4276); inpatient facilities and laboratories at the district level-hospitals (usually with 150 beds) located in administrative districts. district centers, as well as hospitals (with several dozen locations) and medical laboratories in small towns in each district ¹⁴.

* Ayurveda is one of the oldest medical systems. The goal of Ayurveda is to achieve health by establishing balance and harmony, not by fighting diseases. Prevention plays a more important role than therapy. From the point of view of Ayurveda, general health requires physiological balance, freedom of expression of emotions, harmony in thoughts, attention to the environment and spiritual development.

* Unana-medicine is based on the teachings of the great ancient Greek physician Hippocrates. He believed that, whenever and wherever possible, the drug should be mild and safe.

* * * Siddha yoga is the development of "mystical" or "magical" powers.

**** Primary health care - the primary link in the health care system. It includes the provision of basic medical services at the patient's first visit to a medical institution and is the basic link where the need for further medical services is determined and their coordination is carried out.

Government spending on medicine in FY2009 / 10 amounted to 1.38% of GDP, and in FY2010 / 11 -1.27% of GDP 15, in FY2011 / 12 -0.9%¹⁶. By the end of the 12th five-year plan (2012-2017), it is planned to increase this indicator to 2-3%¹⁷.

One of the most vulnerable areas of the public sector, especially in rural areas, is insufficient funding and, as a result, weak technical equipment of medical institutions and relatively low salaries of medical and service personnel, which negatively affects the influx of qualified medical personnel into the public sector.

The private sector consists of private hospitals, medical laboratories, private practitioners (internists, dentists, veterinarians, pharmacists, etc.) and service personnel. In the last two decades, private medical institutions have been equipped with advanced equipment from the United States, Germany and other countries that have proven themselves in the global medical equipment market, as well as Indian equipment that has become very competitive in recent years. The medical staff of Indian private clinics has, in addition to Indian ones, as a rule, diplomas and certificates of advanced training from Western universities and, often, work experience abroad. As a result, India now has first-class specialists in cardiology, transplantology, neurosurgery, ophthalmology, dentistry and other medical fields, ¹⁸ which further encourages the influx of foreign citizens coming here for treatment and, consequently, increases the growth of medical services exports.

In total, over 75% of advanced medical technologies, 68% of inpatient medical institutions and 37% of hospital places are concentrated in the private sector. At the same time, the share of the private sector in inpatient treatment of Indian citizens in FY2009 / 10 was about 60%, and in outpatient treatment-about 80%¹⁹. Among private inpatient medical institutions equipped with state-of-the-art equipment, there are 583 large hospitals of various specializations that were certified at the end of September 2011.20 ^The dominance of the private sector in healthcare leads to the fact that different social strata of the population have different degrees of access to medical services. For example, the hospitalization of wealthy citizens is 6 times higher than that of the poor. The location of private clinics and hospitals, mainly in cities, creates certain difficulties for rural residents in terms of access to quality medical services.

The private sector has grown quite rapidly in recent decades, thanks to government-subsidized medical education, as well as preferential taxation, very favorable government loans issued to Indian doctors to open a private practice, and so on. Currently, the private sector is also actively working in the sectors related to medicine: development of medical technologies and diagnostic devices, production and sale of medicines and medical preparations, construction of hospitals, medical education. To attract foreign investment, India has fully opened up the healthcare industry to foreign direct investment (up to 100% of the authorized capital of companies without prior permission from the Reserve Bank of India).²¹. In addition, at the state level, private companies are provided with such benefits as: discounts when buying land for medical institutions, exemption from certain taxes, including the excise tax on electricity for up to 7 years, or their reduction - up to 50% on stamp duty and 50% on sales tax for transactions with natural gas. real estate, etc. ²²

More than 25,000 medical professionals, including doctors, and the same number of specialists in the field of Indian medicine and homeopathy graduate annually from Indian universities and colleges.²³ At the same time, a significant part of graduates go abroad or get a job in private medical institutions in India. The following system has been introduced as several ways to solve the problem of medical personnel leakage from the country and their employment in remote rural areas: 50% of places in medical universities are paid from the state budget for those bachelors who are ready to continue their education on a budget basis. At the same time, upon completion of their studies, these graduates will be required by the direction of the Ministry of Health and Family Affairs to work for three years in state medical institutions in rural areas.

Another way to solve the problem of staffing "hunger" in the public medical sector was to provide bachelor of medicine students with an additional bonus for each year of work in rural areas after completing their master's degree when passing the entrance exams for continuing education.²⁴ As a result, the number of medical personnel in the public sector has increased significantly. Thus, as of March 2010, it included 11084 doctors, 7692 specialists in the field of traditional medicine, and others. ²⁵

At the international level, improving the system of providing medical services to foreign citizens with an eye to protecting the rights of patients, creating high conditions for the safety of treatment, and ensuring adequate insurance payments in case of failures in the implementation of the project.

A number of international and national structures are actively involved in operations, including the World Health Organization (WHO), under whose auspices the World Alliance for Patient Safety ^{26 program has been implemented in a number of countries since 2004; the Medical Tourism Association; the Joint Commission on Accreditation of Health Organizations (in the USA), etc}. In India, health tourism safety is the responsibility of the Ministry of Health and Family Affairs, which is actively involved in many WHO programs, including The Global Patient Safety Challenge.

One of the main centers of medical tourism and the "medical capital" of India is considered to be Chennai (Tamilnadu), where many well-known clinics in the country and abroad are located. Up to 45% of the total number of foreign citizens receive the necessary treatment in Chennai, as compared to other cities in India that specialize in medical tourism, very competitive prices are provided along with first-class hospitals.²⁷

Manappuram Health Care Ltd., a member of The Manappuram Group, stands out among the most active investors in the medical services sector in India, including their subsequent export. In 2011 -2016, the company plans to invest $222.27 million in developing a network of diagnostic centers and dental clinics in 15 large and 50 small cities in the south of ^the country28.

* * *

Thus, over the past two decades, India's foreign trade in services has shown high growth rates, significantly exceeding global indicators. This is due, on the one hand, to the rapid development of high - tech industries, the significant liberalization of the Indian economy as a whole, its rapid growth against the background of improving the well-being of the population, and on the other hand, to the growing integration of knowledge-intensive sectors of the Indian economy into the world economy.

At the same time, it is noteworthy that India has succeeded in successfully penetrating foreign service markets to a much greater extent than in commodity markets. This is evidenced by the fact that India's share in global exports of services in recent years has reached almost 3%, while in global exports of goods - just over 1%.

The dynamic growth of knowledge-intensive industries also had a significant impact on the change in the structure of the export basket of services: the share of tourism and transport services decreased, while the percentage of other commercial services (mainly related to ICT)decreased. increased. Thus, unlike most emerging and developing countries, whose integration into world trade in services is determined by a surplus of labor resources, mainly low-skilled ones, the growth of Indian exports of services in the 1990s-2000s was largely provided by the category of high-quality knowledge-intensive services.

The rapidly expanding service sector and increasing trade reflect the dynamism of the Indian economy, where an efficient tertiary sector has a significant impact not only on economic growth, but also on improving its competitiveness in the world.

¹ http://findarticles.eom/p/articles/mi_7058/is_3 - 4_18/ai_n4871 1614/

² http://en.wikipedia.org/wiki/List_of_universities_in_lndia

³ Chapter 12. Human Development, Equity and Environment // Government of India. Union Budget and Economic Survey 2011/12, p. 304 - http://indiabudget.nic.in/es2011 - 12/echap-13.pdf

⁴ http://findarticles...

⁵ http://aserf.org.in/bulletinl/fdi.htm; http://www.indembassy. com.vn/tabid/83/default.aspx

^{Mishra Alya.} 6 India: Reforms to attract more international students // University World News, 27.03.2011 - http://www.university-worldnews.com/article.php?story-20110326095903447; Project-Atlas. Partner; Association of Indian Universities - http://www.iie.org/en/ Services/Project-Atlas/India

⁷ http://www.recoverdiscover.com/healthcare_system.php

⁸ India Economy Guide. Investor Opportunity in Health Care Sector - http://theindiaeconomy.blogspot.com/2008/06/investment-opportu-nity-in-health-care.html; Kirmani Aazeen F. India is the Emerging Global Health Destination - http://www.chillibreeze.com/articles/ medicaltourism.asp

⁹ http://www.economywatch.com/business-and-economy/tourism-industry.html

¹⁰ http://www.healthdeskindia.com/blog/category/medical-tou-rism-india/

¹¹ http://www.ibef.org/artdispview.aspx?in=74&art_id-29511&cat Jd=120&page-2

¹² http://www.aboutus.org/RNCOS.com; http://www.rncos.com/

¹³ http://www.ibef.org/industry/healthcare.aspx

¹⁴ Annual Report to the People on Health. Ministry of Health and Family Welfare. Government of India. September 2010 -http://mohfw.nic.in/showfile.php71id-121

¹⁵ http://indiabudget...

¹⁶ Annual Report to the People on Health... December 2011 -http://mohfw.nic.in/WriteReadData/1892s/6960144509Annual%20Rep ort%20to%20the%20People%20on%20Health.pdf

¹⁷ Ibidem.

¹⁸ http://www.recoverdiscover...

¹⁹ Annual Report to the People on Health... September 2010...

²⁰ http://dme.ap.nic.in/Recognizedhosolist.pdf

²¹ India Economy Guide...

²² http://www.indianmba.com/Occasional_Papers/OP169/opl69. html

²³ http://www.searo.who.int/LinkFiles/India_CHP_india.pdf

²⁴ Annual Report to the People on Health... September 2010...

²⁵ Ibid.

²⁶ http://www.who.int/patientsafety/en/brochure_final.pdf

²⁷ http://www.wealthnext.com/2011/medical-tourism-and-indian-companies

²⁸ http://articles.economictimes.indiatimes.com/2011 -06 - 18/news/ 29674281_l_big-plans-diagnostics-small-towns

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