Ready for revival

The pandemic has snuffed out the medical tourism boom in South-east Asia, leaving the once-thriving sector ailing. TTG Asia reporters examine how the industry is fighting to nurse the sector back to financial health.

By Pamela Chow
While medical and wellness is not a current focus of her tourism strategy, Singapore may find ample opportunity in this sector, thanks to her effective clampdown on the spread of Covid-19, as well as her egalitarian distribution of vaccines since December 2020. The island nation’s speedy turnaround during the pandemic has earned her global recognition that could benefit her status as a hub for treatment and restoration.

This potential lifeline is not overlooked by hospitality brands in the country, which have stepped up their offerings to tap this niche segment.

One Farrer Hotel & Spa, Singapore

Boldly entering the scene is Singapore’s first licensed confinement luxury hotel, Kai Suites, which offers pre- and post-partum care for mothers and their newborn. Its services include a three-month prenatal programme, a seven-day stay and a three-month postnatal programme that provides education, nourishment, nutrition and rejuvenation.

One Farrer Hotel & Spa is also joining the game. After serving as a testing facility for medical staff, followed by a stay-in facility for Malaysian long-term pass-holders, the hotel embarked on a refurbishment to redesign most of its property and processes in consultation with medical experts. Corridors and rooms are now lined with antimicrobial materials, while a new housekeeping protocol implements UV lamp disinfection for every room. Plus, an upcoming Pillow Lab will use an Ultraviolet-C Chamber to disinfect its new menu of pillows.

It has also rebranded its previous “hotel in a hotel” concept into Mint Hotel, a room category that features intelligent and hygiene-focused design. Under the advice of medical professionals from the connecting Farrer Park Hospital, Mint Hotel’s 176 rooms feature antiviral wall coverings, moveable furniture, antimicrobial blinds and custom gapless vinyl flooring replacing its carpets.

One Farrer Hotel & Spa’s general manager, Gilbert Madhavan, told TTG Asia: “One of our target markets (for 2021) will be medical tourism. While travel demand will come back slowly in some ways, medical tourism will always remain quite stable. Indonesia, Vietnam and Bangladesh are some of the (country’s) key (sources) for medical tourism, and they always come accompanied by family.”

To capture this crowd, the hotel has launched Farrer Concierge, a one-stop service that takes care of guest needs, from scheduling medical appointments to making tour and transport arrangements.

By S Puvaneswary
2020 was poised to be a banner year for Malaysia’s medical tourism industry, which had been enjoying a major boom in recent years. With more than one million medical tourists flocking to Malaysia annually, the country harboured bold ambitions to become a medical tourism hub in South-east Asia.

On a roll, the sector closed 2019 at a record high, with some 1.3 million medical tourist arrivals, making the country the top favourite for medical tourists around the world.

Enter the pandemic. Malaysia Healthcare Travel Council (MHTC) anticipated 2020 would see a 70 per cent reduction in hospital receipts to between RM500 million (US$122.3 million) and RM600 million, as compared to 2019’s performance. Border controls and stricter processes that medical travellers must comply with have led to a slump in foreign patients at Malaysia’s private hospitals. Sherene Azli, who was the CEO of MHTC until her term ended on January 15, projects it will take at least three years for the medical travel sector to return to 2019 levels.

In a desperate bid to revive the sector, the government has allocated RM35 million to the MHTC this year to promote the country’s medical travel sector, and extended income tax exemption for export private healthcare services until 2022.

On its part, MHTC is driving a rebound in the sluggish sector through a three-pronged strategy, namely, aggressive publicity and branding campaigns showcasing Malaysia’s excellence in healthcare and building confidence in Malaysia as a healthcare travel destination; providing support and facilitating end-to-end infrastructure including digital adoption; and cementing Malaysia as a thought leader in medical travel.

Sherene stressed: “We need to engage medical travellers in the continuity of care as well as ensure they remember Malaysia as among the best in the world for healthcare. We do this by amplifying our expertise through social media. Players in the medical travel sector also give talks and participate in medical travel related webinars.”

While Malaysia’s border remains closed to leisure foreign tourists, it is open to foreign medical travellers entering Malaysia via chartered flights since July 1, 2020 and by commercial flights since October 5, 2020.

However, hospitals have to get clearance from the government, which MHTC helps to facilitate, before foreign patients are allowed to enter the country.

Incoming patients must adhere to strict procedures, including showing a negative Covid-19 test result obtained within 72 hours of departure, undergoing a second Covid-19 test in a local hospital upon arrival, and a two-week quarantine prior to their treatment.

Mohd Nazri Harun, head of international marketing at KPJ Ampang Puteri Specialist Hospital, shared that last year, the hospital saw a significant decrease in medical travellers, especially from its three main source markets: Indonesia, the Middle East and South Korea.

To plug the shortfall, the hospital has shifted its marketing focus to the expatriate population and foreign embassies located in Ampang and its surrounding areas.

Mohd Nazri said: “We have been offering promotional medical packages as well as specially-priced Covid-19 screenings to embassy staff and their families (since last year).”

The pandemic has also hastened the healthcare industry’s shift from paper-based to digitalised processes.

Hospitals in Malaysia have embraced virtual consultations to ensure continuity of care for overseas patients who are unable to travel to Malaysia due to travel restrictions.

Stanley Lam, CEO, Mahkota Medical Centre in Melaka, said the hospital provides teleconsultation services so patients can seek follow-ups remotely. It also delivers prescribed medicines to the patient’s doorstep.

Other digitalisation efforts include an online platform to allow patients to schedule their appointments and a Care Line on the hospital’s website to assist patients with their enquiries.

Medical travellers to Mahkota Medical Centre mainly seek cardiology, oncology, orthopaedic and fertility treatments. Some 30 per cent of its medical travellers are from Indonesia, with other main markets being Vietnam, Cambodia and Singapore.

In the northern state of Penang, Ronald Koh, president and CEO, Penang Adventist Hospital, shared that the medical staff and doctors had made “persistent efforts” to switch to digital to cater to the rising needs of overseas patients who are unable to travel to Penang during this period.

Koh predicts teleconsultation is here to stay even as Covid-19 vaccines roll out, as it provides an “alternative (platform) for foreign patients who face difficulties travelling abroad to continue receiving follow-up care as well as save on travel costs and travel times”.

Sherene agreed with Koh that demand for teleconsultations will continue to grow even after borders reopen and international travel resumes. She said: “If we look at digital healthcare in 2019, its growth was already on an upward trajectory.

“Specialised fields of care were already investing in telemedicine apps and software programmes. New features like AI, predictive analysis, and automatic data collection were being used to lower the cost of care.

“The arrival of Covid-19 boosted the growth of this sector as healthcare systems globally had to adapt rapidly, and it played a critical role in offering patients access to care and more importantly, continuity of care.”

Telemedicine presents convenience and flexibility for both doctors and patients – doctors enjoy flexibility to manage their patient schedules, while patients save on commute, she added.

Sherene also sees healthcare facilitators playing a more important role “as resource banks and sources of credible information” in a post-pandemic world fraught with uncertainty. She said: “Now, more than ever, patients need assistance to plan their healthcare travel, ranging from documentation to accommodation.

“Healthcare facilitators can also play a significant role in assisting patients to adhere to the standard operating procedures for entering Malaysia for healthcare treatments.

“In addition, by keeping tabs on travel bans, country regulations and requirements, healthcare facilitators can bridge the gap between patients and healthcare providers.”

Mövenpick BDMS offers quarantine packages for returning Thais and inbound travellers

By Anne Somanas
As one of the world’s top medical tourism destinations, Thailand’s healthcare sector had been on a winning streak before the pandemic hit.

In 2019, the country was listed as one of the top five destinations of inbound medical tourism spending globally by the World Travel & Tourism Council. In fact, medical tourists accounted for nine per cent, or around 3.15 million, of the country’s 35 million tourists in 2018, with the bulk hailing from China.

As Covid-19 casts a prolonged dry spell on international tourism, Thailand’s hospitals, clinics and agents servicing foreign medical tourists have seen footfall tumble, due to the government’s strict 14-day quarantine requirement on all visitors.

Bumrungrad International Hospital, a private enterprise whose international patients account for 65 per cent of its revenue pre-Covid, has seen foreign visitors drop by 80 per cent in 2020, especially from its top source market of Myanmar.

For major inbound medical tourism agents like Medical Departures, which works with hospitals and clinics across 34 countries, and for which Thailand is a core market, the measures curbing inbound tourism flows have led CEO Paul McTaggart to furlough 30 per cent of his staff, while diversifying to markets that currently have more tourism-friendly climates like Europe and South America.

Despite the country reopening to medical tourists since July 2020, the programme has enticed few visitors. “The limitation that they have to stay in the hospital for two weeks (as part of the quarantine protocol), even for a two-day surgery, led many to stay in their own countries. The programme is still open, but the market potential is limited,” explained Bruno Huber, general manager at the Mövenpick BDMS Wellness Resort.

“For any medical business in Thailand, it’s (almost) 100 per cent domestic (clients) at the moment. You can have world-class facilities, but it doesn’t matter if the patients can’t get here, so we’re not relying on foreign patients at this point,” said McTaggart.

To entice the domestic crowd, health and wellness operators are launching promotions and packages to capture rising demand for wellness and preventative care treatment.

RAKxa’s VitalLife clinic, initially geared toward foreign visitors, has quickly pivoted to the domestic market and launched a one million baht (US$33,200) per year membership programme. More than 40 memberships have been sold since the resort’s opening at the end of 2020, said its medical director, Narinthorn Surasinthorn.

In the alternative state quarantine (ASQ) market, Mövenpick BDMS – Thailand’s first hotel to offer ASQ last April – is seeing “above average” profits, with returning Thai young working professionals and expats, mainly Japanese, being their top client base, shared Huber.

While its core business is now ASQ, the resort also offers packages that pair quarantine with an extended stay and access to medical services.

Bumrungrad has also launched local-targeted offers, and fixed its rates for 2021 to make its services more accessible to domestic patients.

At the same time, the hospital continues to bring in critically-ill patients who require treatment into the country, but it is a process involving “high coordination” between multiple parties, according to Nipat Kulabkaw, its chief international business development officer.

Still, experts and industry professionals anticipate that Thailand’s excellent track record with managing Covid-19 will be a future boon for local medical tourism.

“Covid-19 showed our level of public health management and built further credibility for Thailand as a medical tourism and wellness destination,” said Runjuan Tongrut, executive director of the Americas region at Tourism Authority of Thailand (TAT). “The TAT is building on that to keep Thailand top-of-mind for foreign visitors.”

These efforts include the Amazing Thailand Health and Wellness Virtual Trade Meet held last December to match both well-established and new health providers in the Thai market with travel operators abroad, as well as a strong social media strategy, with the TAT head office in each country regularly pushing health and wellness related content, such as beach yoga in Thailand, on their Facebook and Instagram accounts.

With Covid-19 vaccine rollout now underway across the globe, Bumrungrad is in talks with the Ministry of Public Health for medical tourists from Middle Eastern countries with proof of vaccination to be exempted from quarantine or serve a reduced quarantine, as it “could help to boost our medical tourism numbers this year,” stated Nipat.

Asked how Thailand could elevate its medical tourism sector, Nipat shared that to compete with regional players such as Singapore and India, as well as emerging global competitors like South Korea and Turkey, Thailand needs to make it possible for foreign health professionals to practice in the country.

“If we want medical tourism to become one of the country’s key strategies, we need support in terms of manpower. The main barrier to medical personnel and specialists practising in Thailand is that they need to attain a Thai license. This requires an ability to speak Thai, so right now, high-end medical specialists from abroad cannot practice here,” he explained.

“Also, in terms of pricing, Thailand is currently benchmarked against Singapore, Germany and the US. We can easily compete with those countries, but if we look at the next pricing tier down which is 30 to 40 per cent cheaper, India is a very scary competitor when it comes to pricing. Reducing the high import taxes on medical equipment would allow Thailand to be able to offer more affordable medical procedures.”

McTaggart sees this lull for Thai medical tourism as temporary.

He elaborated: “Thailand offers great value-for-money, immediate accessibility and access to alternative treatments such as stem cell treatments that may not be authorised in patients’ home countries – these are the three things that draw medical tourists to Thailand. Thailand is the oldest player, and the most well-known. When travel resumes, I’m certain the country will rebound as a medical travel destination.”

Pre-pandemic, plans were in place for many internationally-geared hospitals and wellness centres to launch. Now, despite the heavy blows to medical tourism in 2020, many of those in the pipeline have either already opened or are building ahead.

Medpark Hospital, aiming to become a hub for super tertiary care in South-east Asia, soft-opened in Bangkok in October 2020.

Near Suvarnabhumi, The Forestias – Thailand’s largest mixed-use real estate development that is projected to complete in 2022 – is also integrating an elderly home, and a large medical centre geared toward international visitors.

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