TOURIST destinations in India today are no longer confined to the Taj Mahal, the temples of South India or the beaches of Goa. Our state-of-the-art hospitals are attracting a fair share of ‘medical’ tourists from across the globe these days.
India is fast growing into one of the leading and most preferred global health destinations in the world. From 850,000 medical tourists in 2011, the number is expected to go up to 32,00,000 this year.
Chennai, the hub of medical tourism
Chennai, which is considered the healthcare capital of the country, attracts 40% of the visitors from abroad, and also caters to about 30-35% from the rest of the country. With super and multi-specialty hospitals mushrooming all over the city, boasting internationally trained doctors, cutting-edge procedures, and the most advanced facilities, the prospects have gotten even brighter.
“A good balance of highly professional well-trained doctors and world-class services make India one of the most sought after destinations for patients across the globe”, says Dr. P.K. Thomas, Consultant Pulmonologist at Apollo and ortis Malar Hospitals, Chennai.
“In the last 5-7 years, the country has seen a significant increase in the number of patients visiting the country. Most of the big hospitals have an International Patient Service Division with an entire team to look after their every need. Patients are usually offered an all-inclusive package that includes treatment, transport from their country, airport transfers, assistance with visa formalities, accommodation for the attendants, food and every other little detail. The hospitals do everything in their power to ensure that their stay here is as comfortable as possible. A language interpreter, usually a native from their own country, who speaks flawless English, is employed to help with their interaction with the doctors, nurses and other staff. They are totally pampered and this facilitates a steady stream of overseas patients into the country”, he explains.
At present, there are 23 JCI-Accredited Organisations (the Gold Standard for hospitals across the globe) in the country. India today attracts patients from West Asia, Middle East and several African nations for treatments as diverse as cardiothoracic care, hip and knee replacements, bone marrow transplants, cosmetic surgeries, infertility and alternative medicine.
Dr. Thomas says that cost-effective treatments without compromise on quality is our biggest strength. “It first started with patients from the low-end Middle East countries like Yemen and Oman. But now you find patients from several Asian and African countries like Somalia, Ethiopia, Kenya and the Ivory Coast. Patients usually travel abroad, if their country does not provide a particular treatment or if it is too expensive for them. So it makes more sense for them to come to India, where they can get treatment, which is on par with those available in European nations. There is absolutely no doubt that we offer international standards and the best quality care for less than one-fifth of the rates charged in developed nations”.
He adds that the biggest advantage of coming to a country like India is that here the people run the system, whereas if you go to United States (US) or United Kingdom (UK), it is the system that runs you. “You have insurance and a waiting period, and it usually takes a long time to get things done. Just the day before yesterday, I had this patient from Cuddalore with a subdural hematoma. He came to see me at 8 in the morning, had a CT done at 10, operated at 3 and night 8 o’clock, I see him with his eyes wide open. You rarely see this kind of speed anywhere in the world”.
With the government easing visa restrictions, which earlier required a two-month gap between consecutive visits for people from certain countries, medical tourism has received yet another boost.
In the last one decade, India has seen some radical changes in the healthcare industry. With the emergence of the corporate sector and the liberalisation and privatisation policies of the government, healthcare service in the country is flourishing.
The other side of the story
Medical tourism has grown into a multibillion dollar industry, but there is another side to this success story. “People today need to understand that despite the best hospitals, latest technology and the most qualified doctors, the harsh truth is that 99% of our population still cannot afford these services”, says noted pulmonary expert Dr Raj B. Singh at the Apollo Hospitals, Chennai.
Talking about the misconceptions surrounding this industry, he says, “Medical tourism can be looked at from different angles. From the perspective of the patient, they go elsewhere, when their own country does not have a particular facility or cannot provide the treatment at a cost that they can afford. They do not make this decision out of choice. So how can this be described as a good thing for the patient? It is the responsibility of the government in such countries to really look at the healthcare services in their country and improve upon it, so such a situation becomes unnecessary”.
He further adds, “There is no doubt that medical tourism is a very good business; it benefits the recipient and the provider, as well as the respective countries. There is money in it for everybody. As a business venture, it is no surprise that their primary objective would be to make money. When a hospital gets patients from outside, they earn more and acquire a better image, which in turn gets them more business. But the question to be asked here is whether medical care should be bought and sold like a regular commodity. Let us not confuse medical tourism with health care. Healthcare is the basic right of every individual and should be the responsibility of the government; it is certainly not a business”. He continues, “One prime example is that of the British. Their healthcare programme is one of the best. The state is responsible for providing quality healthcare to all the residents of the country, which prevents them from going outside for treatments. Earlier, they had a long waiting period for certain surgeries like hip replacement and prosthetic surgery, which prompted some to seek treatment in Greece, Italy or India. But the government immediately recruited more doctors for these surgeries, efficiently taking care of the problem”.
Suggesting that India should be spending a lot more than what it is doing now on healthcare, he points out that, “Indian government spends among the least in terms of percentage of GDP for healthcare, when compared to other countries like Sri Lanka and China, which spend 3-4% of their GDP on healthcare”.
For centuries, people have been travelling across national borders to access better treatment facilities. In olden days, people visited healing waters or temples to seek relief from their various ailments. Crossing borders to find a cure is not a new concept, but the sheer volume of medical tourists these days is staggering.
The adverse impact of medical tourism
Regardless of its exponential growth, it is vital to determine the impact of medical tourism on the public healthcare system in both the countries; the country from where they depart and the country to which they travel. While in countries like US and UK, the system of healthcare is highly regulated, this is sadly lacking in other nations, where there are no effective guidelines.
There are various dimensions to medical tourism that are still not very clear. The risks, controversies and the ethical implications of globalisation of health services need to be researched and analysed. Cross-border travel increases the risk of spreading infectious diseases. The long transplant waiting list has given rise to organ trafficking and commercial transplantation targeting vulnerable individuals.
Even a developed nation like the United States, which continues to attract medical travellers looking for world-class facilities, has a good number of patients travelling outside in search of treatment at more affordable rates.
Whatever the reason for an individual travelling across international borders to seek medical expertise, be it accessibility, affordability, or quality, medical tourism only serves to emphasise the shortcomings of the healthcare system in their own country. And definitely benefits the host country, in this case, India.