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linguistic ties to France, proximity to Europe (2.5-hour flight from Paris), and the quality of the service provided (because of highly trained medical professionals and efficient travel operators.).
Lack of Scale and Poor Telecommunications The small size of businesses is a feature of professional services in the developing world. Tunisia is an extreme case, however, with a predominance of family-owned businesses. This often results in management and marketing problems. Access to credit (including export credit) is limited, because these enterprises lack physical collateral. For the professional service sector as a whole, credit represents just 5 percent of output (the figure is 10 percent in tourism or manufacturing). Lack of sufficient scale characterizes all professional services in Tunisia: • In the medical services sector, the number of beds per clinic is limited. As a result, clinics cannot offer a complete range of services, and they often lack the size needed to become major exporters of medical services. By contrast, some private hospitals in Thailand are listed on the stock exchange. • In the engineering sector, only three firms provide services to international markets, and even they are relatively small (hundreds of employees compared with thousands in other countries). There are about 2,000 microfirms that will never reach the critical size to become significant exporters. • In the accounting sector, only the Big Four are large enough to export services. • In the legal sector, the number of specialized law firms is very limited (about a dozen), each with a maximum of 40 lawyers. By comparison, Morocco has attracted a dozen foreign law firms, each employing up to 250 lawyers. In the ICT sector, the government has made substantial efforts to promote computer and Internet use by households and in the public sphere (schools, government agencies). As a result, IT penetration has increased steadily, reaching 15 Internet subscriptions and 50 computers per thousand inhabitants in 2005. In comparison with high-income countries, however, the level of IT use remains low, and IT spending per capita is only a fraction of that in most Organisation of Economic Co-operation and Development (OECD) countries. The private domestic market for IT products is thus small.