Medical tourism set to take off in a big way

Shardul Nautiyal and Sapna Dogra Mumbai/New Delhi

With world class healthcare professionals, nursing care and treatment cost almost one-sixth of that in the developed countries, India is witnessing 30 per cent growth in medical tourism per year. According to a CII-McKinsey study, medical tourism can contribute Rs 5,000-10,000 crore additional revenue for up-market tertiary hospitals by 2012.

India is the most touted healthcare destination for countries like South-East Asia, Middle East, Africa, Mauritius, Tanzania, Bangladesh and Yemen with 12 per cent patient inflow from developing countries. And the most sought-after super-specialties are cardiology, neuro-surgery, orthopaedics and eye surgery.

The government has woken up to realise the potential of medical tourism, with tourism minister Renuka Chowdhury recently promising that she would put policies in place to help hospitals promote medical tourism by seamless integration of healthcare delivery with tourism and travel related facilities in the country.

The concept of medical tourism is gaining significance for India with both Indian and foreign insurance companies looking at India as a prospective healthcare destination, with corporate hospitals which can compete globally.

Realising the potential, hospitals have now started tying up with facilitating agencies like tour operators and have taken to marketing and advertising their sevices in the form of treatment packages for foreign patients to give a fillip to the health tourism sector.

Experts feel that Indian healthcare institutions should tie-up with multinational insurance companies to offer healthcare services to patients from abroad in order to improve medical tourism. They advocate accreditation of healthcare institutions by a foreign agency, marketing and advertising of healthcare institutes, the facilities and treatment packages they offer to the patient from abroad, as some of the components that need to be given a serious thought, if medical tourism has to really take off in a big way.

A provision for room-sharing facilities and special wards for patients from abroad, proper visa facilities and preferential treatment at immigration are other subjects which need to be addressed. The healthcare institutions are tying up with tour operators to tap the potential of medical tourism. “Other ways of exploring this sector is through seminars and exhibitions, which helps feature the healthcare industry and the medical sector globally,” points out Anupam Verma, director, administration, Hinduja Hospital.

Experts pinpoint that the other big advantage about the need to improve medical tourism is that it is non-seasonal. National Health Policy also encourages the supply of services to patients of foreign origin on payment.

According to Dr Keval Jain, consultant internal medicine, Sir HN Hospital, “Medical tourism can be improved, if we have a good infrastructure in place to deliver quality healthcare to the foreign tourists. Now, big and large hospitals in small towns and cities have a good set-up to offer treatments to foreign patients..”

To which Dr Atul Marwah, head, nuclear medicine, Bombay Hospital, adds, “Medical tourism can be promoted by marketing the medical expertise and facilities to the American and European countries. Some accreditation programmes need to be devised by the Medical Council of India (MCI) to ensure that General Medical Council, UK could accreditate the healthcare institutions in the country.”

Packages of treatments offered by Indian healthcare institutions should be advertised in the foreign country after being certified by an accreditation agency, suggests Dr Marwah.

According to Dr Gustad B Daver, director, professional services, Hinduja Hospital, “A good set-up in a hospital like pre-operative evaluation, an extensive lab set-up and operation theatre facilities, good post operative, intensive care and radiological facilities will be of major help to boost health tourism. A provision for room sharing facilities and special wards is also a prerequisite for an ideal set up.”

Opines Dr B K Goyal, dean, Bombay Hospital and Medical Research Centre, “Medical tourism can improve, if our healthcare institutions have a set up, which is on par with the West. Our doctors have the expertise, which needs to be marketed through a proper system set up in the healthcare institution, that of a special department to look after the requirements of patients from abroad.”

“Having a system to give proper accommodation and pick up facility from the airport for the relatives of the patient are some of the value addition to the treatment packages offered to the foreign patients,” Dr Goyal adds.

Medical tourism can be improved by creating awareness among the global community about the facilities rendered by Indian healthcare institutions. “The cost, quality and infrastructure of the Indian healthcare institution need to be advertised. Besides this, a proper civic infrastructure need to be in place like airports and good roads. There should be proper visa facilities and preferential treatment at immigration,” opines Verma.

Experts cite that medical insurance, alternate wellness concepts and BPO in diagnostics are other upcoming businesses which will give a boost to medical tourism in the coming years.

In the Capital, corporate hospitals like Apollo hospitals, Escorts Heart and Research Institute, Rockland hospitalare aligning themselves to capitalise on this trend.

The Apollo Hospital Enterprises, which treated an estimated 60,000 patients between 2001 and 2004 is the front runner in this field. Apollo’s business began to grow in the 1990s, with the liberalisation of the Indian economy. Apollo now has 37 hospitals, with about 7,000 beds. The company is in partnership in hospitals in Kuwait, Sri Lanka and Nigeria.

According to Anjali Kapoor Bissel, head, international marketing, Apollo Hospitals, there’s a team of eight people looking after medical tourism in Delhi and at the moment they are focussing on attracting patients from East Africa, Gulf (Oman and Yemen) and South Asia (Nepal, Bangladesh and Nepal).

She also informs that Apollo Hospitals has entered into a tie-up with Sita, to launch a jointly developed project, Sita Care, which will market hospitals packages abroad. There are several other small travel companies, which guide the tourists to avail health services (viz. dental check-up, whole body check-up etc). Majority of the patients contact the hospital directly via their web site and they usually get a package deal that includes flights, transfers, hotels, treatment and often a post-operative vacation.

According to a CII-McKinsey study, medical tourism can contribute Rs 5,000-10,000 crore additional revenue for up-market tertiary hospitals by 2012.

Apollo is steadily making progress in the field of medical tourism and developing methodologies to attract foreign patients, says Anne Marie Moncure, MD, Indraprastha Apollo. According to Moncure, every 5th doctor in the world is an Indian and their expertise is already acknowledged world over therefore, patients from abroad don’t hesitate to come to India and have treatment here.

It is about setting the expectations and nurturing the outcomes, she adds. For follow-ups of the medical tourists, Apollo has set the telemedicine centres, where through video-conferencing patients get in touch with their patients, informs Anjali. Last year in November, the group opened a telemedicine centre at the Om Hospital in Nepal.

Incidentally, Apollo is opening its first international Apollo health and lifestyle Ltd (AHLL) clinic at Doha on the January 26, 2005. The move is another initiative in developing medic al tourism because these international clinics will be telemedicine and information centres in international markets. According to Ratan Jalan, CEO, AHLL, these clinics will highlight the standards Apollo hospitals’ abroad. Apollo is looking to branch in South-east Asia, West Asia, Africa, UK and USA through this model, informs Mr Jalan Along with follow-ups these clinics will take care of initial investigations and day-to-day health services that patients may have to undergo, adds Mr Jalan.

Talking about challenges, Anjali says, the biggest challenge that they face is of connectivity with no direct flights from many places. Talks are going in with the ministry of aviation in this regard. Another challenge is that of competition from Singapore and Thailand. However, the cost in India is one fifth of Singapore and half of Thailand, elaborates Anjali and adds that we have brand India and we should cash in on that. Earlier, westerns were wary of coming here but now that perception has changed and India is perceived as a safe destination, adds Anjali.

The cardiac success rate here is more than 98.6 per cent. “We are planning to work with insurance providers and healthcare providers abroad in the UK and the US”, she adds. Patient break-up at Apollo from various countries is as follows: US and other countries-10.5 per cent, Maldives-46 per cent, Nepal-16.6 per cent, Oman-10.1 per cent, Sri Lanka-22 per cent, Bangladesh-27 per cent.

Disagreeing Dr Marwah on the importantance of accreditation in medical tourism, Moncure says, “Unlike the popular belief, accreditation is not at all important to attract the foreign patients. The patients are concerned about facilities and outcomes at hospitals. They would want to know the number of cases done, success of outcome and incidence of infections at the hospital. It is about setting the expectations and nurturing the outcomes.”