Medical tourism: India’s prescription for growth

Low-cost medical treatment is drawing patients to India. Offering better rates than even Thailand, the sector has vast potential, but the government must first cure a few ills that are holding it back.

A hospital in Chennai caters to patients, including a group of men from Oman who have journeyed there for a consultation with orthopaedic specialists. Manjunath Kiran / AFP

Rebecca Bundhun

Jane Herbert, 47, and her husband, David, 48, flew to Goa from Nigeria and checked into a hotel a couple of months ago — but not as tourists o enjoy the Indian state’s Portuguese heritage made famous by its beaches. They were seeking treatment after Jane was diagnosed with cervical cancer.

“What we have seen in India is a little bit above what we have in Nigeria scientifically,” says Mr Herbert, an accountant, who explains that they opted for India based on a colleague’s recommendation and because doctors were on strike in Nigeria at the time. “I am impressed by what’s on offer.” The low cost of treatment in India also made it attractive, he adds.

The private hospital where his wife was treated, the Manipal Hospital Goa, opened up an international patient care division in January to attract patients from abroad.

“We’re now receiving 100 patients plus a month from abroad in the peak months,” says Raghavendra Prasad H, a senior marketing executive who focuses on international business at the hospital. He says the hospital receives patients from the Middle East, Africa and Europe.

He explains that the hospital has tied up with local agents to offer a range of services to international visitors known as medical tourists who arrive for treatment. The agents help them in arranging isas and accommodation for patients and also sightseeing tours.

Medical tourism is a lucrative business for hospitals and has enormous potential with the industry at a nascent stage.

Themedical tourism industry is expected to expand at an annual growth rate of 27 per cent to reach US$3.9 billion this year, compared to $1.9bn in 2011, becoming the fastest-growing sector within India’s tourism, according to a recent report by the consultancy KPMG and business group Ficci.

The number of international visitors travelling to India for medical treatment has increased in recent years with the rise of private hospitals hat offer world-class medical infrastructure and the capabilities for complex operations, analysts wrote in the report. Globally, medical value travel is projected to increase to $32.5 billion over the next five years from $10.5bn, as a large ageing and uninsured population struggles with rising incidences of chronic diseases and healthcare costs, the report added. Cost is a major advantage for India over its biggest competitors, which include Thailand. There are also newer players such as Dubai trying to boost medical tourism inflows.

A heart bypass operation in India, for example, costs $7,000 compared to $130,000 in the United States; $40,900 in the UAE; and $11,000 in Thailand, according figures published in a study by JP Morgan. A hip replacement is also about $7,000 in India, while the same procedure costs $43,000 in the US; $46,000 in the UAE; and $12,000 in Thailand.

“With the emergence of newer needs and with India establishing a firmer footprint as a healthcare delivery destination, medical tourism is likely to gain impetus,” says Amit Mookim, a partner and the head of health care for KPMG India. “One can argue on whether the country should prioritise medical tourism as a priority given the fact that India continues to score low on metrics of penetration, doctor and nurse density, number of hospital beds and disease burden. However, any proposition that adds value, funds and builds India’s credibility and visibility globally can only lead to economic traction, a scenario that will eventually benefit the domestic industry and help propel its growth.”

Medical tourism also brings in revenues for the aviation and hospitality sectors.

Despite the growing numbers of medical tourists to the country, experts say India is far from fulfilling its potential and there are a number of other destinations that are competing for a bigger share of the multibillion dollar industry.

Apollo Hospitals is one group in India which is making efforts to attract medical tourists. It announced a tie-up with Emirates Airline in July to boost the inflow of patients from the Middle East and Africa, offering air fare discounts of between 4 and 10 per cent for patients and their travelling companions. Apollo received 30,000 international patients last year, with the majority coming from other South Asian countries, including Bangladesh, Sri Lanka and the Middle East and Africa, says Raj KR Raina, the general manager of marketing and strategic business at Indraprastha Apollo Hospitals, New Delhi. Within the Middle East, its main target markets are Iraq and Oman. “High waiting time and high costs in other countries lead the patients to our hospitals,” Mr Raina says. “India’s strength is cost-effective health care which is combined with world-class healthcare infrastructure and highly skilled doctors.”

The main specialities that international patients come to the group for are cardiology, orthopaedics, neurosciences, oncology and transplants, he says, adding that the New Delhi hospital “is one of the busiest centres for organ transplants in the world”.

In the Middle East and Africa, there is often a lack of availability of quality health care.

Liver transplant treatment is an area in which hospitals in the UAE do not have as much expertise, Mr Raina says.

Manish Banker, the executive director of Nova IVI Fertility, which has clinics in Bangalore and Mumbai, says he has observed a trend of more patients from abroad coming to India for treatment.

He explains that surrogacy is a rapidly growing area of medical tourism, with large numbers of international patients coming in from the US and Australia.

Commercial surrogacy is illegal in Australia and is legal only in some US states. Costs are much lower in India than the states in the US where it is available and there is no waiting list. India is known for its expertise and technology in fertility treatment, including IVF, compared to many countries in the Middle East and Africa.

Thailand was a major competitor for commercial surrogacy until its government proposed a ban. Dubai is “trying to emerge” as a destination for medical treatment but it would not offer surrogacy, he said.

“I feel that medical tourism will still grow for the next five to 10 years,” says Dr Banker.

But there are factors that could hold back the industry in India.

“The industry lacks strong government support, initiative to promote medical tourism,” says Harshavardhan Hegde, the medical director for orthopaedics at Nova Orthopaedic and Spine Hospital in New Delhi, which receives a number of medical patients from the Gulf countries, the US and Europe. “There are no proper accreditations and regulation system for hospitals. Hospitals lack uniform pricing policy and also suffer from low investments in infrastructure. The negative perception about India with regard to public sanitation and hygiene standards or prevalence of contagious diseases is also among the major challenge that the country still suffers.”

Getting medical visas an also be a challenging bureaucratic process.

For the Herberts, dealing with red tape was the biggest hurdle they faced; but with early diagnosis, they feel they made the right choice by seeking treatment in India.

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