In the News

Times of India Nov 5, 2000
'Skilled manpower, low cost of treatment attract foreigners'
By Shabnam Minwalla

With the trickle of international patients coming to the country for treatment, 'medical tourism' is becoming a trend.

So, while our hospitals are accustomed to Bangladeshis, Sri Lankans and residents of West Asian countries, they are suddenly noticing a new breed of patients - the American secretary who has found that a chin implant in Khar makes financial sense; or the Britisher who, frustrated by interminable National Health Service (NHS) queues, realizes that a cataract operation in Madras is a viable option.

As far as the Indian healthcare industry is concerned, the future certainly holds dollar-filled promises. Already, British politicians have suggested that NHS patients be sent to India for cataract and hip-replacement surgeries, while it is entirely possible that insurance giants will soon funnel patients to India for, says, bypass operations or organ transplants.

"India can certainly become the healthcare destination of the world," says George Eapen, CEO, Apollo Hospitals, adding that his group is actively targeting the Africa, SAARC and West Asia market. "We have two great advantages-highly skilled manpower and substantially lower cost of treatment."

Dr Sharma estimates that about ten percent of his clients come from as far afield as the U.S., Argentina and South Africa - a statistic which might well double by the end of the year. The Apollo Hospitals, too, have found themselves catering to a fair number of Americans on the lookout for re-modelled noses and Britishers who need new hips.

Most doctors first noticed this phenomenon about three years ago when numerous NRIs decided to use their holidays to get in touch with both their roots and root-canals."Until about ten years ago, we were lagging far behind our Western counterparts," explains Dr Bhatia, adding that today, this gap has largely been bridged.

"The NRIs who visited us began to tell their friends and word spread. More than anything else, however, the Internet has made a difference. Our technology is only six months behind that of the West," explains Dr. Hrishikesh Pai, an infertility specialist. "The Internet has given us a chance to convey this to the world." Concurs Dr Bhatia, "one of my dentist friends recently put up a website, and within months three patients had come from the UK for teeth implants." Clearly, the money saved is worth the hassle of the trip and treatment in an alien land. An in-vitro fertilization (IVF) cycle in the U.S. costs $6,000 as opposed to $1,200 in India. Similarly, getting a nose reshaped in Argentina costs $4,000 - five times the going rate in Mumbai, while Lasik surgery in India saves the average Westerner at least $1,500 per eye. Given these figures, why aren't more patients stampeding into our hospitals and nursing homes? Part of the problem is India's image - which fills potential patients with trepidation and doubts about hospital hygiene and disposable syringes.

Times of India Nov 6, 2000
`Foreign insurance firms may shift patients to India if facilities are up to the mark'
By Shabnam Minwalla

MUMBAI: If globalisation works for Korean cloth and New Zealand apples, why not for Indian cataract operations and cardiac procedures?

This is the question that the Indian medical community has suddenly begun to address. Over the last couple of years, a handful of international patients has started coming to India for laser eye surgery, infertility treatments and cosmetic surgery - a phenomenon which has lead to the sudden realization that this country just might have what it takes to become a `healthcare destination'.

"The potential certainly exists,'' says Vishal Bali, general manager of the Wockhardt Hospital in Bangalore. "Our services are very competitively priced. In terms of clinical talent, we are not just on par with doctors in developing countries, but sometimes even superior. With the advent of foreign insurance companies, our hospitals will soon reach international standards. It is time we made an effort as an industry.''

The first step is, clearly, to convince the world that there is more to India than snake charmers and elephants. At the moment, the UK, with its crumbling National Health Service, seems the prime target for a spot of hardsell. Already, a handful of disgruntled patients have made their way to India for various treatments. Many, however, believe that the relationship should be formalized.

About a year ago, a Labour MP undertook complicated calculations and arrived at the conclusion that long-suffering British patients should be sent to India for snappy treatment. Pointing out that 162,000 people were waiting for eye operations and 243,000 were in queue for hip replacements, he stressed that this move could save the NHS billions of pounds. Not surprisingly, the British Medical Association dismissed the suggestion as "utterly astonishing and bizarre."

"Sending patients to India would mean acknowledging the failure of the NHS, something which would greatly hurt the British ego," says Dr S. Bannerjee, who practices in the UK.

"Also, there has been nothing in the British media to foster confidence about medical care in India. The system would first have to build its reputation, doctors would need to be accountable, and corruption weeded out. Also, suitable infrastructure would have to be created, not only for patients, but also for their careers during their stay in the country."

These comments clearly hit home. "Thanks to a slump in oil prices in the late '70s and early '80s, many West Asian countries began to send their patients to India rather than the West," says Dr G.M. Bhatia, an orthopaedic surgeon, who agrees that much groundwork needs to be done. "But our nursing homes and hospitals resorted to blatant exploitation - often performing unnecessary surgeries, like the removal of an appendix. The medical boards in the West Asian countries grew suspicious and, as a result, we lost a sizable market. Nevertheless, if we guard against past mistakes, we can offer the British government a workable solution."

Besides a tie-up with the NHS, other schemes are also being proposed. One somewhat disturbing suggestion floating around is that India should set up "old-people's homes" for Europeans and Americans in an attempt to become a "global nursing centre". More realistic is the oft-reiterated hypothesis that foreign insurance companies might soon start diverting patients to India for routine surgeries. "If they find the facilities up to the mark, it is entirely possible that they will shift a percentage of their patients to India," says Mr Bali, who feels that the hospitals still have to achieve international standards.

But won't a huge influx of outside patients further increase the inequalities and stresses of the Indian healthcare system? If all eyes are on the lucrative dollarwallas, won't Indians become second-class citizens in their own hospitals? Isn't there a danger of the medical system becoming the impersonal conveyor-belt that it is in the U.S.?

There are no easy answers to these questions, but many believe that India can cash in on medical services in less disruptive ways. "Many doctors offer free online consultation, but in time we will start charging," says Dr Hrishikesh Pai, an infertility specialist, pointing out that in the Western world, doctors are very inaccessible.

People often get desperate and are turning to online experts.

Already, a number of canny entrepreneurs are planning tele-medicine centres - where patients from around the world can phone in and talk to doctors and specialists.

While technology is bound to offer solutions, the Indian medical community is uncertain about the extent of its market. "It is unrealistic to target countries like the U.S.," says Mr Bali, who feels that India should emulate the Singapore example. "If we even manage to attract Asian countries, it will be a major achievement."

Others disagree, however. "We already get patients from neighbouring countries and from West Asia," says Dr Pai. "There is no reason to think small. Today, we are living in a global village. If we offer the best deal, we will certainly get the patients."