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British way of doing things and British products. We did ourselves great harm, especially in Malaysia, by our handling of changes in the overseas students fee Quite! structure in the 1980s. As a result we lost the best part of a generation of students. In consequence the younger doctors, unlike their seniors, now start with a preference for US or other non UK products. We have, at least in part, recovered from that but I have asked officials to be sure that we put no unnecessary obstacles in the way of those vital educational and training links.
Fourth, the reputation of the NHS as an economical provider of high quality health care remains extremely high. Those companies that can say their products are well used by the NHS have a quality assurance of great value. We need to build on this. All countries are striving to improve services within budgetary constraints. The NHS provides an excellent model of how to do so. The value of the NHS in demonstrating what the UK can offer is seen clearly in the Malaysian adoption of our NHS nucleus hospital concept. This has provided substantial export opportunities for a number of firms. The ODA has been extremely helpful in making a success of this initiative.
Finally, we need to be sure that we do make the most of trade missions. This mission focused on health care industries. Generally these are smaller companies - though there are important exceptions like BOC, Vickers and Smith Industries. These smaller companies particularly welcome the support and opportunities such a mission can bring. For example, we included a company called Laundry Installations which has expanded into hospital business following our contracting out of NHS laundry work. It has now been expanding vigorously overseas. These smaller companies are our health care equivalent of the German "Mittelstand" and should be strongly encouraged. At the same time, the overall impact of such a mission is enhanced by the presence of our biggest companies.
I am exploring the potential of joint missions which cover both health care and pharmaceutical companies. If we follow this route, we must be sure though that we get the right people to make the most of high level contacts. In considering the way forward we here can learn from FCO and DTI experience on the management of these missions.
I am asking my officials to get in touch with your officials and those of the President of the Board of Trade to compare notes on how to get the most from trade missions and to develop proposals for my next mission in the light of those discussions.
I am copying this to the Prime Minister, the Chancellor of the Exchequer, the President of the Board of Trade and Sir Robin Butler.
12 October 1993
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V.B.