The private healthcare sector is one of the most successful cases of liberalisation in Tunisia. With 73 clinics and a strong basis of complementary services, Tunisia is one of the top North Africa and Middle East providers of healthcare services.
The sector has been liberalized since the 90s, which has allowed the growth and development of exports particularly to Europe. Patients from France, England and other countries come to Tunisia to receive special treatments and medical interventions. In 2002 more than 3000 English flew to Tunisia, driven by the low cost of the services and the possibility to reduce the long list of patients waiting for assistance . For example, interventions in Tunisia can cost up to half of the cost (including the flight) compares to the English’s healthcare system- the NHS. Each year Tunisia has more than 600 new medical personnel arriving to the sector.
| |
Numbers of centres |
Number of beds lits |
| Clinics |
73 |
2129 |
| Haemodialysis centers |
99 |
984 |
| Medical imaging centers |
122 |
|
In spite of the successful liberalization policy put in place by the government and which has attracted a great number of private investors, many challenges still remain. The sector is facing some structural impediments, mainly due to the lack of coordination between private and public healthcare sectors. For example, the reform of healthcare insurance regime is having some delays due to divergence between the stakeholders.
From the liberalisation point of view, the healthcare sector is a good example of how the development of one sector is limited by the weak supply of its supporting sectors. According to one recent workshop about the liberalisation of the healthcare sector , the sector is going through a second development phase, where reinforcement of the offer/quality and operational efficiency are the main focus of attention for the years to come. Within them, some of the critical areas to be developed are:
- Quality of service (certification)
- Supply chain management
- Management of Healthcare Information Systems
- Finance capability
- Training capability
Looking at the requirements needed to develop these areas, supporting service sectors play an important role as sources of local knowledge, products and expertise. For example, to improve the level of quality of their services, clinics have to increase the quality of care offered across different healthcare services, as well as enhance the evaluation procedures for medic and paramedic practices. Consulting firms specialised in organisational management can provide the know-how required to implement quality certifications and accreditation programs.
This dependency between Healthcare sector and supporting sectors is seen in many other areas: patient traceability and information warehousing depend of IT firms, training is an area in which private and public educational institutes are important, etc.
| Future challenges |
Development areas |
Supporting service sector |
| Heamlthcare mangement information system |
increase the qualité of care across the différent services to respond to EU standards
Accreditation and certification according to international norms(ISO,CLIN,...etc)
Enhance the evaluation of medic and paramedic pratcices |
Specialist consulting firms in healthcare organisational and mangement |
| Healthcare Management information system |
increase the traceability acros the entire care services chain integration of data and information between different services |
Information technology apply to healthcare sector |
| Fincancing upgrade of the sector |
Acces to finacial ressources to upgrade facilities and develop of healthcare services (tourism de de santé) |
Finance |
| Human ressources training and development |
the adaptation of local offer to modern requirements and competances improve the training to parmedic personnel Raqualification of healthcare proffesional |
Education and training for halthcare sector |
This link, which in Europe is very strong, in Tunisia is still weak. Most of Tunisian secondary service sectors are underdeveloped. Healthcare, together with Tourism, is an exception in an economy characterized by a incomplete offer of services. In other words, there is a gap between the service demand from the leading export-driven service sectors and the local offer from supporting service sectors. For example, the weakness found in consulting and IT sectors affects the healthcare sector in two ways. Firstly, leading clinics have to look for help abroad to carry out specialized IT and organisational management projects due to the lack of local suppliers with the expertise required. This fact jeopardises the Healthcare sector’s low-cost competitive advantage, since clinics will have to pay higher prices than if it were provided locally. Secondly, only few leading institutions have the resources to bring this expertise from abroad, affecting the adoption of sector-wide initiatives necessary to strengthening the exporting capabilities of the whole sector.
The important point is to recognise that the liberalisation of services goes beyond the deregulation of one particular sector. It involves a coherent development policy simultaneously apply to inter-related sectors on the economy, in such a way that synergies among them provide the offer/demand elements necessary for a stable and long term growth. |
