|  Re: Medical Tourism (ppt) -
September 24th, 2006
Medical tourism promises big bucks. But not before the basics are taken care of, finds Amitabh Baxi
The healthcare industry in India is expected to grow in size to Rs 200,000 crore by 2012 from Rs 86,000 crore in 2001, while the total health tourism market is expected to go up to Rs 10,000 crore by 2012 — up from Rs 1,518 crore in 2004, registering a sharp growth of 20-25% per year.
READS good, feels better, promises big business! And why not? An estimated 1.75 lakh international patients came to India for treatment in 2005, about 30% more than 2004.
But forget the hype and grandiose figures for a while and you’d be tempted to ask: Is the Indian healthcare scenario geared for this growth in medical tourism? Does India have appropriate infrastructure? Are other imperative services such as hospitality, aviation and others prepared for this boom?
Opinions vary. In fact, while no one is discounting the potential, there’s a definite word of caution. Dr Narottam Puri, medical director, Max Healthcare, says though medical tourism is the current flavour, and for good reasons, there’s a lot of ground work to be done to arrive at credible figures. “We have, at best, rough estimates and we need to set our priorities considering the huge domestic healthcare challenge we have,” he reasons.
So is it too early to uncork the bubbly? Dr Naresh Trehan, executive director of Delhi-based Escorts Heart Institute and Research Centre, has a different take. “Take, for instance, the coup in Thailand — one of the preferred healthcare destinations. The present instability there may deter medical tourists and, in turn, present a good opportunity for India. As a matter of fact, compulsions around the world are getting worse and more people today are travelling for their medical needs. But the key issue here is how professionally and efficiently will we seize the opportunity. We have to go ahead step by step, consolidate our ground position and deliver what we promise,” he points out.
Even Kolkata’s private healthcare industry is sceptical about the glorious dream of a Rs 10,000-crore medical tourism industry. “Popular healthcare tourism destinations in Asia such as Thailand and Singapore first promoted their tourism potential and then healthcare tourism. India is doing both simultaneously, which might take some time to work,” says Mr Sajal Dutta, president, Association of Hospitals of Eastern India (AHEI), a body of Kolkata’s corporate hospitals.
AHEI also feels several infrastructure issues need to be sorted out. “Starting from facilities in airports to faster customs clearances for foreign patients to better roads leading to the hospitals — unless these are improved, medical tourists will still prefer hospitals like Bumrungrad in Bangkok as their first option,” Mr Dutta points out.
These apprehensions are shared by Vishal Bali, CEO, Wockhardt Hospitals, who feels there’s a long road ahead, as he argues for better visa procedures and improved facilities at airports. R Basil, managing director, Manipal Health Systems, Bangalore, too says the government should actively approach other countries with concrete proposals on collaborations in medicine, medical education and research that could lead to concrete policy measures in favour of Indian healthcare providers.
Undeniably, India can boast of highly-skilled doctors and world class machinery and equipment. But the picture isn’t that rosy at the ground level. “Postoperative care, quality of nursing, skillsets of ward boys and the lack of professionalism at hospitals leave much to be desired,” says Delhi-based neurologist J Kumar who is also working on getting patients from abroad. He blames the casual approach of Indians for the lack of efficiency and feels that the service culture will take a long way to evolve.
Another issue that merits immediate attention is accreditation and quality standards. “To become a preferred healthcare destination, India needs to set uniform parameters across the country — both in terms of price and quality of services,” Dr Kumar observes.
FLIP SIDE VIEW
Point taken, doc. But on a broad level, all this is not going unnoticed. Already, the government has developed a strategy to position India as a global hub for the quality-conscious medical tourist. In fact, the health ministry has already formulated stringent quality parameters for hospitals’ accreditation and is introducing international standards to the healthcare supply chain.
Working in tandem, the external affairs ministry has come out with a special ‘M’ category visa for those seeking medical treatment in India, while the civil aviation ministry is opening special counters at airports to facilitate a hassle-free entry. The tourism ministry, on its part, is pushing medical travel as part of its ‘Incredible India’ campaign and intends to showcase India as the emerging healthcare destination in the global arena.
Not surprisingly then, the healthcare industry is already seeing the beginning of a new era. The Apollo Hospitals group, that treated 7,000 foreign patients in 2005,
feels the government is taking the right steps and “this level of facilitation will definitely put India on the top of healthcare map,” says Dr Anupam Sibal, group medical director at Delhi’s Indraprastha Apollo.
Mr Bali of Wockhardt too feels that “the government is doing its bit — with the tourism industry taking some very positive steps.” Wockhardt has seen a steady growth in the number of patients from the US and the UK in the past 6-8 months.
“Last year, we received more than 3,000 patients from 20 countries. This year we expect the foreign patient business to grow by another 50% at least. This surely makes the future of medical tourism look very good,” says Mr Basil of Manipal Health Systems.
CUTTING AN EDGE
There can’t be two opinions on this. India is now being recognised as a quality destination for medical value travel and patients from over 55 countries are treated at Indian hospitals. Medical value travellers come seeking both quality and costeffective healthcare and India now offers the latest techniques such as robotic surgery, gamma-knife treatment for brain tumours and other cutting medical procedures. “The efficacy of treatment compares with that in the West, with death rate from coronary bypasses at 0.8% compared with 2.35% in the US,” according to Dr Trehan of Escorts.
Arguably, much of the advantage lies in low costs — India offers the same world class procedures and surgeries at about one-fifth to one-tenth of what is charged in western countries. In fact, medical procedures in India are even cheaper than in Thailand, the other main medical tourism destination in the region.
For instance, bone marrow transplants cost $30,000 in India and $62,500 in Thailand.
Another reason why India is strategically placed to attract patients is that healthcare systems in Europe and the US are under severe pressure, with patients having to wait for over a year for surgery. According to estimates, there are 50 million people in the US without medical insurance for whom domestic treatment costs are prohibitive.
Their medical treatment in India is now being facilitated by tie-ups between the insurance companies in the US and private Indian hospital chains. Security hassles in the western countries post-9/11 is further bringing in a new set of patients from Gulf countries to India.
What’s interesting, the western countries’ fascination with fitness and alternative therapies for health maintenance and healing is also aiding the momentum. In fact, Americans reportedly spend around $25 billion on non-traditional medical therapies and products alone. Also, consumers today are well travelled and seek something new and different in a holiday experience. In fact, rejuvenation, including yoga, and alternative therapies now form an integral part of health tourism in India.
This, actually, translates into a big opportunity for the traditional healthcare system — comprising Ayurveda, Homeopathy and Sidha — that has about 7 lakh practitioners. In fact, realising their importance, the government has launched a Rs 125-crore project for the scientific validation of these.
Melting technology barriers and the proven lead in IT have helped sharpen the edge and showcase the medical prowess better. Improved telecommunications and air transport are already being used in exchanging medical information and diagnostic images, while the time zone differentiation is actually working to its advantage in giving instant medical opinions.
THE ROAD AHEAD?
Quality in capital letters. In fact, healthcare circles in Kolkata feel the process of accreditation will provide a new thrust to the medical value tourism. Apart from eyeing the coveted Joint Commission International (JCI) accreditation, hospitals are also eyeing the National Accreditation Board for Hospitals and Healthcare Providers (NABH) accreditation. These standards are expected to raise the standard in healthcare, set benchmarks and create a level-playing field at the global level.
“NABH accreditation will provide a fillip to inbound medical tourism and also showcase to the world India’s healthcare standards,” says Dr Y P Bhatia, chairman of NABH Accreditation Committee.
Indeed, as more foreign patients go down on the quality route, the defining parameter in healthcare will be accreditation — JCI or NABH — which will help dispel much of the concern in the international community about the standards of India’s private healthcare. “Singapore and Abu Dhabi have made it mandatory for all hospitals to have JCI accreditation. That’s the way to go for Indian hospitals too if they want to join the action building around medical tourism,” argues Dr Sibal of Apollo.
“Don’t forget, for every good story, there are 10 takers. But for every bad story, there are 100 takers,” sums up Dr Trehan.
Well you wouldn’t want to disagree with that.
OUR PROBLEMS
India is still a developing country and has several inherent problems
There is a negative perception about the country because of poor hygiene and sanitation
No uniformity of quality and accreditation is now becoming a reality
Medical insurance is still in its infancy and has a very low penetration Flight connectivity needs attention Infrastructural woes continue to affect the airports, roads and power Save for the initiatives taken by a few organised players, there has been no focused marketing till now
THEIR PROBLEMS
LACK OF KNOWLEDGE
The knowledge about medical tourism is mostly shared by word-of- mouth or by persons who are internet savvy
LACK OF TRUST
Patients from developed countries are still sceptical of the quality of medical care abroad, and doubly sceptical of ventures that have no personal or local contacts
LACK OF FOLLOW-UP
Continuity in health care is a major cause for concern. There are many stories on the internet about the people who opted for treatment abroad, but returned home without follow-up care and suffering complications
LACK OF MEDICAL LIABILITY
Patients from developed countries know that they have legal recourse to medical malpractice for healthcare in their countries. This is often not true of procedures that take place overseas, and are not under their legal jurisdiction
There are 10 kind of people. Those who know to read binary, and those who don't!!!
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