A very healthy prognosis

Medical tourists are flocking to India as it offers quality care at little cost

Syringe with medicine. Bubbles in the liquid. Isolated on White. Close-Up

MEDICAL tourism in India is flourishing. According to the Federation of Indian Chambers of Commerce and Industry (FICCI), some 600,000 medical tourists arrived in India in 2010 (up from 150,000 in 2005). This is estimated to have grown to 720,000 by end-2011.

FICCI expects the medical tourism industry to earn US$2 billion in 2012 and the healthcare industry in the country to generate US$69 billion or 8.5 per cent of GDP. The Indian medical tourism industry is growing at the incredible rate of 30 per cent annually and is expected to generate US$3 billion by 2015.

India’s attractiveness as a medical hub can be attributed chiefly to its ability to offer overseas patients exceptional value for money. Treatments in India cost half, and sometimes even a third, of what other medical tourism hubs in Asia such as Singapore, Malaysia and Thailand charge, and about a tenth of that in the US. Generally, bigger hospitals in major Indian cities are equipped with state-of-the-art facilities helmed by highly trained and experienced doctors.

The principal source markets of medical tourists to India are East African nations, the Middle East, the UK, Canada, Afghanistan, Bangladesh, Pakistan, Sri Lanka, Myanmar, Nepal and the US. Arrivals from the CIS countries are also increasing.

Africans, including those from Nigeria, Zimbabwe, Uganda, Tanzania and Kenya, come to India seeking treatment as medical facilities in these countries are often woefully inadequate and there tends to be a shortage of medical expertise.

Individuals from developed nations such as Canada, the UK and the US on the other hand, head to India not only to alleviate costs but to also save time.  For instance, in the UK, a patient might have to wait for around six months for a knee-replacement before the publicly funded National Health Service can offer a slot. Indian  hospitals conversely, can carry out the procedure immediately at a fraction of the cost – US$9,500 versus US$24,000 at a private hospital in the UK.

In the case of war-ravaged Afghanistan, Congo or Burundi, no facilities for even the most basic medical procedures exist.

Surgeon Dr Naresh Trehan of Delhi National Capital Region (NCR)-based Medanta Medicity said: “Afghan hospitals can no longer provide basic treatments and in the Gulf no specialised procedures can take place so we have Iraqis and Iranians coming to India for specialised treatments.”

Major hospital groups in India include Fortis Escorts, Apollo, Medanta-The Medicity, Max and Manipal.

Apollo, the largest healthcare provider in Asia, treated an estimated 60,000 foreign patients in 2010, generating US$77 million. They have also opened clinics in Oman, Kenya, Tanzania, Ethiopia and Nigeria.

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Max Hospital, has seen the number of foreign patients grow by 500 per cent over the last three years and, according to a spokesman, some 20,000 foreigners were treated in its hospitals in 2010, accounting for about 20 per cent of patients treated by the group each year.

Fortis Escorts, the third biggest player in India, has a 20-member international marketing team that travels to the depths of Africa and the Middle East to set up local doctor referrals and sourcing centres. It treated about 6,000 foreigners in 2010.

The escalating demand for medical tourism in India has spawned a new breed of entrepreneurs hoping to cash in on this lucrative segment.

Medical facilitators, who are essentially medical tourism experts, work in tandem with Indian hospitals and foreign patients.

Sourav Mukherjee, CEO of New Delhi-based Longfield Management, a medical tourism facilitator, explained: “We have our own team of medical professionals who conduct risk assessments on patients before we commit them to any hospital.

“We assess quality vis-a-vis costs, and offer packages for all budgets so the patient is not solely dependent on the prices quoted by the hospitals. The whole gamut of ancillary services like airport transfers, hotel check-ins, services of translators, choice of cuisines, healthcare escorts, currency exchange and local sightseeing are also provided.”

However, the surge in foreign patients has brought its own unique set of challenges.

“Understanding  foreign patients’ requirements and problems is the overriding challenge Indian medical staff face while cultural differences and dietary habits also have a bearing on the speed of recovery of patients,” said Dr Atul Bhatnagar, general surgeon, Sant Parmanand Hospital, New Delhi.

Despite the immense potential of medical tourism, there has been little government steering  or intervention to bolster the sector.  Developments in the industry have been led primarily by the private sector.

Even though the Indian government has introduced fast-track “M” visas to attract foreign medical tourists, this has proven to be more of a hassle than a boon. Holders have to register within a few days of arrival at the local police station personally.

This is especially difficult for critical care patients who are often transferred to hospitals by ambulances from the airport. So, many opt for tourist visas instead. Industry experts agree that to compete with Thailand and Singapore, India must introduce visas-on-arrival and revise its restrictive re-entry rules (not allowing re-entry within 60 days of exit) to ensure repeat visits for post-operative care.

Nonetheless, the government has had a hand in ensuring that medical tourists are guaranteed high-quality medical services. It currently runs an accreditation system for hospitals and provides a list of recommended prices. The Indian Ministry of Tourism publishes brochures highlighting various treatments provided by 45 hospitals that have been designated as ‘Centres of Excellence’, most of which are based in Delhi NCR.

The Confederation of Indian Industry (CII) introduced a certification system in 2008 and so far, has approved 30 of its 120 member hospitals. Under this regime, hospitals must agree to limit charges made to foreign patients under the dual pricing system now in practice.

To attract patients from the US and Canada, hospitals must be sanctioned by the Joint Commission International (JCI), a healthcare accreditation agency with stringent quality parameters. Some 19 hospitals in India now have JCI accreditation.

Key facts on medical tourism in India

• Unlike mainstream leisure tourism, medical tourism is sold on a needs basis. Consequently, packages can only be bought when patients need it. The final cost of a medical package can never be fully determined until some diagnostic tests are done on arrival at the hospital and the patients’ condition has been accurately assessed

• The average price for common medical procedures in India according to corporate hospitals are: US$13,000 for an angioplasty; US$11,000 for a heart bypass; US$10,000 for a single heart-valve replacement; US$10,000 for a hip replacement; US$9,500 for a knee replacement; US$12,000 for a gastric bypass; US$7,500 for a spinal fusion and US$17,000 for a mastectomy. These fees are about 20 per cent to 30 per cent more than those charged to Indian patients as they inculde priority admission, surgical consumables and service charges.

• Routine procedures carried out by Indian hospitals on  foreigners include cardiac care, joint replacements, cancer care, kidney and liver transplants, neurological ailments, minimal access surgery, dental implants and cosmetic surgery. Patients also visit India for naturopathy and ayurvedic cures, stress-busting treatments, detoxification and rehabilitation therapies.

This article was first published in TTG India, February/March issue, on page 18. To read more, click here to subscribe.

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