Aruna Thuriarajan, 50, was in acute pain as her spinal problem
was getting worse by the day. Her doctor in Alberta, Canada
said she would have to wait for three years for a corrective
surgery. Unwilling to wait for so long, she decided to trawl
the net to look for an alternative option. She came across a
hospital in India which not only promised her a world-class
treatment at almost one fourth of the cost but also offered
her a vacation at the Taj Mahal. Six weeks later, she could
lift her arm, and endorse a cheque from Alberta reimbursing
her for almost the entire cost of the surgery despite the fact
it was done in a foreign private hospital. "I’m glad
that I went over to India for the surgery," Aruna says
and makes it a point to tell others of her ilk to look to India
as a healthcare destination.
Similar is the story of Flaine Ackrill, a Buckingham Palace
employee, who decided to come to India for an operation at
the Apollo Hospital in Chennai for uterine cancer. Cyril Parry,
a 50-year-old man from Birmingham also underwent a successful
hip replacement at the same hospital.
Traditional destination spots still attract foreigners by
the hordes to India, but lately, medical tourism is proving
to be one of the most lucrative and viable options. Word to
mouth publicity about the top-class facilities available is
augmenting the flow.
Figures speak for themselves. About 1.5 lakh ‘medical
tourists’ visited the country last year and their number
is expected to almost double this year. A research by international
consultancy major McKinsey revealed that medical tourism industry
in the country is growing by 30 per cent every year. It observes
that if medical tourism were to touch 25 per cent of the private
up-market players, up to Rs 10,000 crore will be added to
their revenue. With internationally recognised healthcare
professionals, holistic medicinal services and low cost of
treatment, India can earn $ 5 billion every year and attract
over one million health tourists every year, according to
industry body Confederation of Indian Industry (CII).
What has led to this sudden change in attitude towards a
country which is still perceived to be lacking in healthcare
infrastructure? The reasons are not far to seek. While a heart
surgery costs $30,000 in the US, it costs $6,000 in India.
A hip replacement could be done at one of the best hospitals
in India for $ 10,000 while the same would cost $50,000 in
the US. Similarly, a bone marrow transplant costs $26,000
here compared to $250,000 in the US.
Though medical treatment is free in the UK under the National
Health Service (NHS), the long waiting period prompts many
to opt for private treatment, sometimes at an astronomical
cost. There are around one million people waiting for an orthopaedic
surgery in the UK. Labour MP Frank Field recently described
India as the cheapest place in the world to have a cataract
operation. "For 50 pounds one can have an operation at
an Indian hospital with an international reputation,"
he famously said.
Adding to India's attractiveness as a low-cost medical destination
is a group of super speciality hospitals like the Apollo,
the Escorts Heart Institute, the Jaslok Hospital, and the
Hinduja Hospital in Mumbai. "We have well equipped, state-of-the-art
hospitals and we can offer the same level of care as anywhere
else in the world," Apollo Group chairman Dr Prathap
C Reddy said. "There is no reason why we shouldn’t
become the healthcare destination of the world," he adds.
The Apollo group alone has so far treated 95,000 international
patients, many of whom are of Indian origin. Dr Reddy is awaiting
a response to his proposal for sub-contracting
work from NHS in Britain to carry out operations at a fraction
of the cost.
Market-savvy hospitals like the Apollo and the Escorts also
offer add-ons like pick-up and drop facilities from the airport,
swank suites at the hospitals, complete with office set up,
and a post-operative vacation at almost no extra cost.
Apollo Hospitals Group is even scouting about for partnering
with hospitals in other countries. "We’ve just entered
into a partnership to provide operational management services
to Lagos-based Hygeia Nigeria , one of the largest healthcare
groups in west Africa. We’ve also bagged a project consultant
job for a 100 bed multi-speciality hospital in Ghana . Projects
in Kuwait , Yemen , Sudan , Ethiopia , UAE, and even Bangladesh
, Nepal and Malaysia are also at various stages of association,"
revealed group
vice-president Dr Hari Prasad.
Meanwhile, the UK government has invited tenders to treat
2,50,000 NHS patients a year and this has created opportunities
for a number of Indian players to jump
into the healthcare bandwagon. The Manipal Group, a leading
south-based healthcare player, recently entered into a joint
venture with a British healthcare company, 4 Ways Healthcare
(4WHC), to bid for patient waiting lists of NHS. The current
plan is an attempt at breaking the log-jam.
"The government is making a huge investment in NHS.
But it remains low on capacity. There is a shortfall in facilities
and doctors. The solution was to bring in doctors from overseas,"
says Sanjiv Agarwal, CEO of 4WHC. "We’ve capabilities
in all these areas and we should be able to send our doctors
to the UK as required for short periods," said Rajen
Padukone, CEO, Manipal Healthcare.
SRL Ranbaxy Laboratories, the diagnostic service company,
has also tied up with a healthcare group in the UK to offer
laboratory testing services. Janak Singh Bajwa, director,
SRL Ranbaxy, said the company had started working with some
of the group's private hospitals in the UK on a pilot basis
and is planning to scale up its alliances in the country.
"Wockhardt has an entirely new clinical strategy for
medical tourism plan.
For the moment, we are venturing into markets in West Asia,
Africa and South-east Asia. Next will be the tougher terrains
of the US and UK . We’re already receiving patients from
these markets which would now get a momentum through these
efforts," said Vishal Bali, vice-president of the group.
Along with some of the top hospitals, various industry bodies
like the CII, Federation of Indian Chambers of Commerce and
Industries (FICCI) and the Federation of the Indian Exporters
Organisation (FIEO) are making an orchestrated effort to promote
medical tourism. The CII along with Indian Healthcare Federation
is working with tour operators for promoting packages to attract
more medical tourists. CII healthcare committee member (eastern
region) Tapas Mukherjee opines that West Bengal has the potential
to cater to around 50 crore foreign health tourists from Bangladesh,
Nepal, Bhutan and China. "We are in talks with the Centre
and the tourism Ministry for setting up a separate health
zone in the city which would have facilities for international
treatment along with boarding and lodging facilities for the
patients' relatives. Some of the best hotels in town have
agreed to offer special discounts. We’re especially targetting
patients from the Middle East, trying to convince them that
the total cost of air travel and treatment will be much less
if one comes to West Bengal," he said.
The FICCI recently formed a task force comprising eminent
people from public and private sectors to make recommendations
on promoting medical tourism in the country. "We want
Kolkata to become the healthcare hub of Southeast Asia,"
said Sajal Dutta, president of the Association of the Hospitals
of Eastern India.
Several hospitals like the Apollo Gleneagles, AMRI, CMRI
and the Ruby General have joined hands with Indian Airlines
to offer 30 per discount to patients who come to Kolkata for
treatment. The package includes not only air fares but also
takes into
account a wide range of diagonostic and therapeutic services.
However, lack of accreditation is a major roadblock in drawing
patients from abroad. But most corporate hospitals are already
in the process of upgradation and accreditation. Rating agencies
like Crisil and ICRA have graded a few hospitals for setting
standards, but certification also needs to come from international
agencies like Joint Commission on
Accreditation of International Standards (JCAHO).
While accreditation from an international body such as the
Joint Commission International (JCI) facilitates better response
from Europe and the US, recognition
from the National Health Services (NHS) ensures international
standards in terms of patient care, quality improvement and
patient safety.
However, India is also pitted against Thailand, Singapore
and some other Asian countries which have good hospitals,
salubrious climate and tourist destinations.
There is a flip side to medical tourism as well. Government
and basic medical insurance, and sometimes extended medical
insurance, often do not pay for the medical procedure, meaning
the patient has to pay cash.
There is little follow-up care. The patient usually is in
hospital for only a few days, and then goes on the vacation
portion of the trip or returns home. Complications, side-effects
and post-operative care are then the responsibility of the
medical care system
in the patient’s home country.
Most of the countries that offer medical tourism have weak
malpractice laws, so the patient has little recourse to local
courts or medical boards if something goes wrong.
There are also growing accusations that profitable, private-sector
medical tourism is drawing medical resources and personnel
away from the local population, although some medical organisations
that market to outside tourists are taking steps to improve
local service.
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