Research Project Report On
Promotional Strategies of Medical Tourism in India Submitted in partial fulfillment of the requirement for the award of Post Graduate Diploma in Management
Submitted by
Praveen Hans JKPS/PGDM/09/27
Under the guidance of
Faculty Guide
Dr. Makrand Upadhyay 1
CERTIFICATE I, Dr. Makrand Upadhyay , hereby certify that Mr. Praveen Hans of J K Padampat Singhania Institute of Management (Semester VI) has completed his project titled Promotional strategies of Medical Tourism in India in the academic year 2009-2011. The information submitted herein is true and original to the best of my knowledge.
Dr. Makrand Upadhyay
(Project Guide) 2
DECLARATION I, Praveen Hans , Student of J K Padampat Singhania Institute of Management & Technology- Gurgaon, hereby declare that the Project work entitled “ Promotional Strategies of Medical Tourism in India ” Submitted by
me for the fulfillment of the requirement for the award of Post Graduate Diploma in Management, is my original piece of work and has not been published or issued to any other institution before. The present document is only submitted to JKPS J KPS IMTIMT- Gurgaon.
Signature of the candidate
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ACKNOWLEDGEMENT I would like to acknowledge the following as being instrumental in the completion of this project: First and foremost I would like to thank my guide, Dr. Makrand
Upadhyay , and Prof. Dr. Saurabh Gupta whose invaluable support helped me to compile this project. I also availed of the Internet which is a source of vast, spontaneous and accurate information on the subject being researched. Lastly I would like to acknowledge the support of my family and friends without whom t he project wouldn‟t have been a success. I sincerely hope that the project lives up to your expectations.
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INDEX S. No. 1.
Topic
Page No.
Introduction
World Tourism Industry
Medical Tourism
Why Medical Tourism
2.
Medical Tourism as an Industry
3.
Growth of the medical tourism Industry
4.
Major Medical Treatments & Tourism To urism Destinations of the world
5.
Medical Tourism in India
6.
Why India ? (Advantages)
7.
The current Indian healthcare situation
8.
Indian Healthcare Specialties
9.
Ancient Indian Therapies
10.
Promotion of Medical Tourism
11.
Medical Tourism: Price Comparisons
12.
13.
Medical tourism in metros & suburban cities Potential of India in area of medical tourism to urism and steps taken How to apply a Medical Visa to India
14.
Conclusion of the Study
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World Tourism Industry- An Introduction
World Tourism Industry is an industry which is flourishing all over the world. The scenario of the World tourism industry is always in a state of flux, ever changing. It is reckoned that end of 2007 will see the World tourism industry generating as many as 234 million job opportunities for the people. It is also assumed that the contribution towards the GDP by the World tourism industry will be approximately 10.3%. People can afford overseas travel. However, in order to meet the requirements, constant changes in the travel and tourism policies need to be reframed and restructured.
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Tourism has been a major social phenomenon of societies all over the world. It is driven by the natural urge of every human being for new experiences, and the desire to be both educated and entertained. The motivations for tourism also include religious and business interests; the spread of education has fostered a desire to know more about different parts of the globe. The basic human thirst for new experience and knowledge has become stronger, as communication barriers are getting overcome by technological advances. Progress in air transport and development of tourist facilities has encouraged people to venture beyond the boundaries. The importance of Tourism, as an instrument of economic development and employment generation, particularly in remote and backward areas, has been well recognized the world over. It is a large service industry globally in terms of gross revenue as well as foreign exchange earnings. Tourism can play an important and effective role in achieving the growth with equity – an objective which we have set for ourselves. Tourism has the potential to grow at a high rate and ensure consequential development of the infrastructure of the destinations. It has the capacity to capitalize on the country‟s success in the services sector and provide sustainable models
of growth. Tourism sector stimulates other economic sectors like agriculture, horticulture, poultry, handicrafts, transport, construction, etc. through its backward and forward linkages and cross-sectoral synergies. Expenditure on tourism induces a c hain of transactions requiring supply of goods and services from the related sectors. The consumption demand, emanating from tourist expenditure also induces more employment and generates a multiplier effect on the economy. eco nomy.
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World tourism industry and the environment The impact of the World tourism industry on our environment cannot be overlooked. While global tourism industry is expanding manifold, every effort is being made to protect the heritage of historically significant places. With every passing year, world tourism industry is experiencing new changes to adapt to the needs of time. Increase in the world tourism activities mean more consumption of energy and the natural resources. Alternative sources of energy are being worked out. Global warming causing rise in sea levels pose to be a great threat to all the nations worldwide. Concepts of Eco tourism is fast catching up with the common people. peo ple.
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World tourism industry and the economy In order to find out the contribution of the travel and tourism industry to a particular country, the Travel and Tourism Satellite Account or the TTSA is an important tools to determine the economics in detail. The TTSA throws light on matters related to travel, tourism job opportunities, comparing related tourism industries including hotels, transport etc. TTSA furnishes information about global travel, tourism pertaining to growth, demand, export, GDP, employment employment opportunities, o pportunities, capital investment etc.,.
Tourism Industry- A Special Focus on India India‟s tourism industry is experiencing a strong period of growth, driven by the
burgeoning Indian middle class, growth in high spending foreign tourists, and coordinated government campaigns to promote „Incredible „Incredible India‟.
The tourism industry in India is substantial and vibrant, and the country is fast becoming a major global destination. India‟s travel and tourism industry is one of them most
profitable industries in the country, and also credited with contributing a substantial amount of foreign exchange. This is illustrated by the fact that during 2006, four million tourists visited visited India and spent US $8.9 billion. billion. Several reasons are cited for the growth and prosperity of India‟s travel and tourism industry. Economic growth has added millions annually to the ranks of India‟s middle
class, a group that is driving domestic tourism growth. Disposable income in India has grown by 10.11% annually from 2001-2006, 2001 -2006, and much of o f that is being spent on travel. Thanks in part to its booming IT and outsourcing industry a growing number of business trips are made by foreigners to India, who will often add a weekend break or longer holiday to their trip. Foreign tourists spend more in India than almost any other country 9
worldwide. Tourist arrivals are projected to increase by over 22% per year through till 2010, with a 33% increase in foreign exchange earnings recorded in 2004. The Tourism Ministry has also played an important role in the development of the industry, initiating advertising campaigns such as the 'Incredible India' campaign, which promoted India‟s culture and tourist attractions in a fresh and memorable way. The
campaign helped create a colorful image of India in the minds of consumers all over the world, and has directly led to an increase in the interest among tourists. The tourism industry has helped growth in other sectors as diverse as horticulture, handicrafts, agriculture, construction and even poultry. Both directly and indirectly, increased tourism in India has created jobs in a variety of related sectors. The numbers tell the story: almost 20 million people are now working in the India‟s tourism to urism industry.
India‟s governmental bodies have also made a significant impact in tourism by requiring that each and every state of India have a corporation to administer support issues related to tourism. A new growth sector is medical tourism. It is currently growing at around 30% per annum. Medical tourist arrivals are expected to reach one million million soon. soo n. The tourism industry of India is based on certain core nationalistic ideals and standards which are: Swaagat or welcome, Sahyog or cooperation, Soochanaa or information, Sanrachanaa or infrastructure, Suvidha or facilitation, Safaai or cleanliness and Surakshaa or security. As per the Travel and Tourism Competitiveness Report 2009 by the World Economic Forum, India is ranked 11th in the Asia Pacific region and 62nd overall, moving up three 10
places on the list of the world's attractive destinations. It is ranked the 14th best tourist destination for its natural resources and 24th for its cultural resources, with many World Heritage sites, both natural and cultural, rich fauna, and strong creative industries in the country. India also bagged 37th rank for its air transport network. The India travel and tourism industry ranked 5th in the long-term (10-year) growth and is expected to be the second largest employer in the world by 2019. 201 9.
Foreign Tourist Arrivals (FTA) Ministry of Tourism compiles monthly estimates of Foreign Tourist Arrivals (FTAs) in India and Foreign Exchange Earnings (FEE) from tourism on the basis of data received from major airports. Following are the important highlights, as regards these two important indicators of tourism sector for 2010 and December 2010.
FTAs in India during 2010 were 5.58 million with a growth rate of 9.3 per cent as compared to the FTAs of o f 5.11 million during 2009.
FTAs during the December 2010 was 6,55,000 as compared to FTAs of 6,46,000 in December 2009 and 5,34,000 in December 2008.
FEE from tourism during 2010 were US$ 14,193 million as compared to US$ 11.39 billion during 2009 and US$ 11.74 billion during 2008. The growth rate in FEE in US$ terms during 2010 was 24.6 per cent.
FEE from tourism during the month of December during 2010 were US$ 1.55 billion.
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Types of tourism
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Introduction to Medical Tourism Medical tourism is an opportunity for patients to travel for medical care and take advantage of reduced costs co sts and wait times. The industry may be categorized into three t hree groups:
• Outbound: Indian patients traveling to other countries for medical care
• Inbound: Foreign patients traveling to India for medical care
• Intrabound: Indian patients traveling domestically for medical care.
The most recent trend in privatization of health services is medical tourism, which is gaining prominence in developing countries. Globalization has promoted a consumerist culture, thereby promoting goods and services that can feed the aspirations arising from this culture. This has had its effect in the health sector too, with the emergence of a private sector that thrives by servicing a small percentage of the population that has the ability to “buy” medical care at the rates at which the “high end” of the private medical sector provides such care. This has changed the character of the medical care sector, with the entry of the corporate sector. Corporate run institutions are seized with the necessity to maximize profits profits and expand e xpand their coverage. These objectives o bjectives face a constraint in the form of the relatively small size of the population in developing countries that can afford services offered by such institutions. In this background, corporate interests in the Medical Care sector are looking for opportunities that go beyond the limited domestic “market” for high cost medical care. This is the genesis of the “medical tourism tou rism”” industry.
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Health tourism is tipped to be next big-bucks business for India. Health care is a $3 trillion industry worldwide and India is in a position to tap the top-end segment by highlighting its state-of-art facilities and services, and exploiting the brand equity of leading Indian healthcare professionals across the g lobe. – in many cases for The world-class medical institutes in India carry out surgeries for for half –
a third or fifth – of the cost in the west. More importantly appointments are available much quicker than in the US or the UK, where patients often face long waiting lists. There are also a clutch of good health and wellness clinics along with spa resorts, and great locations of tourist interest in the state, which can help position India as a leading health tourism destination. The US, Canada, the UK, the Mid-East, and even Asian states like Sri Lanka are viewed as great markets for selling health tourism packages in India. Assistant director for Sri Lankan tourism, Madhubani periera, told ET that Lankan tour operates are already exploring the opportunity with medical centres in Bangalore. The success of the recently set up Apollo Hospital in the island is said to have egged travel companies to scout for fresh possibilities in Karnataka, since there are four direct weekly flights to Bangalore from Colombo. Narayana Hruduyalaya‟s Devi Shetty says tourism related to healthcare generates higher
revenues than pure vacationers. Patients who visit Bangalore for treatment along with their families tend to stay longer than most tourists. Post-op eration, family members often relax by visiting places of tourist interest. For instance, a person staying in the city for a heart surgery spends around Rs.2 lakh during a week-long halt, which is miles ahead of the expenditure incurred by a typical t ypical tourist. Hospitality industry experts say there is another aspect of health tourism, pampering and wellness which is gathering momentum in the west and has been successfully packaged by Kerala. Leela palace Bangalore‟s Eric Swanson explains that pampering involves
offering people an experience – massages, herbal wraps and exfoliating scrubs – that makes them feel relaxed. Wellness involves helping healthy people stays well, both 14
physically and mentally. Sometimes, this means offering diagnostic testing to identify potential problems. The West‟s fascination with fitness and alternative therapies for health maintenance and healing is another factor. Spas for healthy people currently represent the lion‟s share of
the health tourism market in the west. New trendsetters have started arising on the horizon of the widespread global trade. One of these trendsetters, who is fast emerging and has an added value of making huge economical profits, is „Medical Tourism‟. According to a research professor Rupa
Chanda, IIM; Medical Tourism will single handedly fetch a very impressive amount of $4 trillion on a world-wide scale. The World Trade Organization studied the scope of this new found field. The study was conducted in Thailand, Malaysia, Jordan, Singapore & India, which resulted in the findings, that in these 5 countries the number of medical travelers in the year 2003 was almost 1.3 million and thus collectively earned almost $1 billion (in treatment cost alone). In case of these nations the medical travel spends are growing at the rate of 20% plus on a year-to-year basis. Now, let us know who could be the potential clients for Medical Tourism purposes. These medical travelers could be broadly classified into 4 distinct geographical groups. The first group of medical travelers is made up of Americans. The U.S. boasts of the best medical facilities in the world & that to instantly. But the value of these services offered is very high. Also the American healthcare system is pre-dominantly insurance driven which includes only critical care and not cosmetic care for and not cosmetic care for which a vast no. of American people are opting now including facelifts, liposuction, dental treatments, etc. Going by an estimate a full facelift in the U.S. costs $8000-20000, which costs only $1252 in South Africa. Thus Americans go in for the cosmetic surgeries that are available outside America in other countries like South Africa, Thailand, etc. that mean a vacation well. Given these increasing costs of medical treatments in the U.S. it makes sound economical sense to seek treatments abroad.
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The second major group is the people in UK. Unlike in the US the British healthcare system ensures free treatments to all its citizens. Yet the people are being forced to seek medical treatments in other countries by the sheer waiting lists caused by the National Health Service. This is probably because of the shortage of doctors and hospital beds. Also private medical facilities here are prohibitively expensive and relatively fewer in number. The third chunk of medical travelers comes from the Middle-East, where the people of these oil-rich nations fly abroad to seek medical facilities that are either unavailable or in short supply in their own countries. According to an estimate more than 5lakh people from the Middle-East travel abroad every year for Medical Treatments. They travel mainly to Jordan, Saudi Arabia, Bahrain, US, India, Thailand & Malaysia. By some estimate India itself attracted around 70,000 plus travelers from the Middle-East last year. The final lot includes people from the least developed nations traveling to their well developed neighbors. Last year it was estimated that nearly 50,000 people from Nepal and Bangladesh came for medical treatments treat ments to India. India is considered the leading country promoting medical tourism-and now it is moving into a new area of "medical outsourcing," where subcontractors provide services to the overburdened medical care systems in western countries. India's National Health Policy declares that treatment of foreign patients is legally an "export" and deemed "eligible for all fiscal incentives extended to export earnings." Government and private sector studies in India estimate that medical tourism could bring between $1 billion and $2 billion US into the country by 2012. The reports estimate that medical tourism to India is growing by 30 per cent a year. India's top-rated education system is not only churning out computer programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses each year. The largest of the estimated half-dozen medical corporations in India serving medical tourists is Apollo Hospital Enterprises, which treated an estimated 60,000 patients between 2001 and spring 2004. It is Apollo that is aggressively moving into medical 16
outsourcing. Apollo already provides overnight computer services for U.S. insurance companies and hospitals as well as working with big pharmaceutical corporations with drug trials. Dr. Prathap C. Reddy, the chairman of the company, began negotiations in the spring of 2004 with Britain's National Health Service to work as a subcontractor, to do operations and medical tests for patients at a fraction of the cost in Britain for either government or private care. Apollo's business began to grow in the 1990s, with the deregulation of the Indian economy, which drastically cut the bureaucratic barriers to expansion and made it easier to import the most modern medical equipment. The first patients were Indian expatriate who returned home for treatment; major investment houses followed with money and then patients from Europe, the Middle East and Canada began to arrive. Apollo now has 37 hospitals, with about 7,000 beds. The company is in partnership in hospitals in Kuwait, SriLanka and Nigeria. N igeria. Western patients usually get a package deal that includes flights, transfers, hotels, treatment and often a post-operative vacation. vacat ion. Apollo has also reacted to criticism by Indian politicians by expanding its services to India's millions of poor. It has set aside free beds for those who can't afford care, has set up a trust fund and is pioneering p ioneering remote, satellitesatellite-linked linked telemedicine across India.
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Why Medical Tourism? Medical tourism - patients going to a different country for either urgent or elective medical procedures - is fast becoming a worldwide phenomenon. The reasons patients travel for treatment vary. Many medical tourists from the United States are looking for treatment at a fraction of the cost at home. Canadian and UK medical tourists are frustrated by long waiting times. Becoming a medical tourist also provides a chance to combine a tropical vacation with elective or plastic plastic surgery, for others. India's top-rated education system is not only churning out computer programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses each year. India is considered the leading country promoting medical tourism-and now it is moving into a new area of "medical outsourcing," where subcontractors provide services to the overburdened medical care systems in western countries. India's healthcare industry is growing at 30 per cent annually and could earn more than $1-2 billion annually, creating 40 million new jobs in the process, pro cess, by 2012. Today while we look up at the tourism sector the foremost thing that come to our mind are leisure tourism activities, adventure activities etc. but the sector of medical tourism remains unexplored and untapped. The sector has great potentialities in lending the tourism activities. The estimated Indian market alone at present amounts to almost $40 million approximately which suggest that there is even more value than the mentioned one and is yet to be tapped.
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Medical Tourism as an Industry Medical tourism is actually thousands of years old. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing god, Asklepios, at Epidaurus. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans travelled to spas from Germany to the Nile. In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate. The reasons patients travel for treatment vary. Many medical tourists from the United States are seeking treatment at a quarter or sometimes even a 10th of the cost at home. From Canada, it is often people who are frustrated by long waiting times. From Great Britain, the patient can't wait for treatment by the National Health Service but also can't afford to see a physician in private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with elective or plastic surgery. And more patients are coming from poorer countries such as Bangladesh where treatment may not be available.
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Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now entering the field. South Africa specializes in medical safaris-visit the country for a safari, with a stopover for plastic surgery, a nose job and a chance to see lions and elephants.
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Growth of the medical tourism industry The countries where medical tourism is being actively promoted include Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical tourism. According to a study by McKinsey and the Confederation of Indian Industry, medical tourism in India could become a $1 billion business by 2012. The report predicts that: “By 2012, if medical tourism were to reach 25 per cent of revenues of private up-market players, up to Rs 10,000 crore will be added to the revenues of these players”. The Indian government predicts that India‟s $17-billion-a-year health-care
industry could grow 13 per cent in each of the next six years, boosted boo sted by medical tourism, which industry watchers say is growing at 30 per cent annually. In India, the Apollo group alone has so far treated 95,000 international patients, many of whom are of Indian origin. Apollo has been a forerunner in medical tourism in India and attracts patients from Southeast Asia, Africa, and the Middle East. The group has tied up with hospitals in Mauritius, Tanzania, Bangladesh and Yemen besides running a hospital in Sri Lanka, and managing a hospital in Dubai. Another corporate group running a chain of hospitals, Escorts, claims it has doubled its number of overseas patients - from 675 in 2000 to nearly 1,200 this year. Recently, the Ruby Hospital in Kolkata signed a contract with the British insurance company, BUPA. The management hopes to get British patients from the queue in the National Health Services soon. Some estimates say that foreigners account for 10 to 12 per cent of all patients in top Mumbai hospitals despite roadblocks like poor aviation connectivity, poor road infrastructure and absence of uniform quality standards. Analysts say that as many as 150,000 medical tourists came to India last in the year 2004. However, the current market for medical tourism in India is mainly limited to patients from the Middle East and South Asian economies. Some claim that the industry would flourish even without Western medical tourists. Afro-Asian people spend as much as $20 billion a year on health care outside their countries – Nigerians alone spend an estimated $1 billion a year.
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Major Medical Treatments & Tourism Destinations of the world 1. South Asia South East Asia offers some great advantages for medical tourism with Thailand and India being the major destinations . Thailand‟s Medical profession is one of the most advanced in this region and government
has extended and invested heavily in supporting suppo rting high standards. Medical staffs undertake specialist trainings in foreign countries, including United States and Europe. Singapore and Malaysia are also well emerging as medical t ourism destinations. destinations.
2. South America Brazil is the main Medical tourism destination in South America. It is a well established centre for plastic surgeries & treatments. treat ments. Brazil has built a good reputation in many areas of medical & healthcare treatments with volume of medical tourists, mainly from North America Although Brazil is expensive, still it is one of the most beautiful countries and offers good quality medical & healthcare treatments. treat ments. Argentina also has a flourishing medical tourism industry, but its geographical position is problem for many.
3. The Rest Of The World Medical Tourism industry is growing in many other countries with Eastern Europe, Africa and Dubai joining the list. Africa and Eastern Europe can also be considered as emerging medical tourism destinations, but still have a long way to go to match medical & healthcare treatments available in other countries. 22
Medical Tourism in India As per a market research report „Booming Medical Tourism in India‟ by RNCOS, India‟s
share in the global medical tourism industry will reach around 3 per cent by the end of 2013. Moreover, medical tourism is expected to generate revenue worth US$ 3 Billion by 2013, growing at a CAGR of around 26% per cent during 2011 – 2013. 2013. The number of medical tourists is anticipated to grow at a CAGR of over 19 per cent during the forecast period to reach 1.3 Milli M illion on by 2013. Factors such as, low cost, scale and range of treatments provided by India differentiate it from other medical tourism destinations. The growth in India‟s medical tourism market
will be a boon for several associated industries, including hospital industry, medical equipments industry and pharmaceutical pharmaceut ical industry. Domestic medical tourism in the country has also seen growth in the recent years. As per the report „Domestic Tourism in India, 2008-09‟ released by the National Sample Survey Office (NSSO), trips for „health and medical‟ purposes formed 7 per cent of overnight
trips in the rural popu lation and about 3.5 per cent in the urban population. „Health and medical‟ purposes accounted for 17 per cent of same-day trips in rural India and 8 per
cent in urban India. Expenditure on medical trips accounted for 30 per cent of all overnight trip expenditure for rural India and 15 per cent for urban. Recently, the Union Ministry of Tourism has included Medical Tourism under the Marketing Development Assistance (MDA) Scheme. The Ministry of Tourism has sanctioned US$ 27,400 as MDA to 10 Medical Tourism Service Providers Pro viders during 2010
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“Research has shown that recovery in a new and stimulating environment is much faster than if you were to stay in hospital or at home”.
The procedures in countries like India are usually far less expensive – in certain cases, as less as 15% of the cost co st for the same treatment abroad.
The medical professionals in these facilities are some of the most well-trained and experienced surgeons in their fields.
The standards of hospitality at hospitals in countries like India and certain other far and middle-Eastern countries are far higher than in America or Europe.
Research has shown that recovery in a new and stimulating environment is much faster than if you were to stay in hospital or at home.
All doctors and medical staff speak fluent English, as does most of the population.
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Advantages of going to India for Medical Treatment
Internationally accredited medical facilities using the latest technologies
Highly qualified Physicians/Surgeons and hospital support staff
Significant cost savings compared to domestic private healthcare
Medical treatment costs in India are lower by at least 60-80% when compared to similar procedures in North America and the UK
No Wait Lists
Fluent English speaking staff
Options for private room, translator, private chef, dedicated staff during your stay and many other tailor-made services
Can easily be combined with w ith a holiday / business trip
India rated among the top 5 favorite tourism destinations destinations worldwide. 25
India the World Class “Medical Treatment Destination” World-class Medical Professionals & Doctors As a matter of fact, India produces more doctors and surgeons per person every year than most European countries cou ntries..
World-class Medical Facilities The health care industry in India is amongst some of the best in the world, equipped with the latest in Medical Technology. Techno logy. Equipments. Facilities & Infrastructure in India at par with International Standards.
Medical Research & Technology Many new surgical procedures are pioneered in India, and many experts and leaders in various surgical fields work in Indian hospitals. Biotechnology research has significant investment and India is a leader in stem cell research at a level approached only by Britain.
The biggest advantages are that World Class Medical Treatments, with practically no waiting time and at a fraction of comparative cost in western countries are available in India
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India the “Tourism Destination”
Lonely Planet in a survey of 134 countries co untries -India has been rated among the top 5 favorite destinations.
i-explore - India has been rated among top 5 destinations of the world. National Geographic Traveler describes- India as “Land of Mystery & Majesty” Forbes says - “India is one of the world‟s fastest growing travel markets". The most important unique selling points of India include the variety and beauty of India‟s mountain ranges, colorful deserts, green rain forests, virgin beaches and holiest rivers besides its history, culture, religion and people. Besides India has architectural wonders like the Taj Mahal, The Golden Temple, Khajuraho Temples, The Sun Temple, Trimurti and many more.
The equation holds so true.
Medical Tourism in India = World Class Treatment + Holiday +Big Savings
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The current Indian healthcare situation Besides being the land of Taj, a land of diverse cultures, a land of tradition, a land of highly developed spiritualism, India can also be called the land of healing for the ailing. Contemporary India is a forerunner in providing healthcare facilities for all kinds and type of patients. This has been possible largely because of the professionalism that has creped in to the healthcare sector. The credit for this goes wholly to the private sector. Also as a result of this the medical help in India is now comparable to the best in the world. India provides a long list of various facilities like world class hospitals, state-of art technology, technology, competent doctors, professional pr ofessional management, management, top quality nurse and paramedical staff and all this with an icing of comparatively lower prices making it economical as well. More and more people are realizing that India is the right place for top quality and economically affordable treatments. It is also reliable and can be regarded as one of the best in the world. As far as India is concerned price factor is the major advantage. It has been taken into account that the cost of getting treated in India is almost 10% and in some cases 80- 90% cheaper than what it costs in the developed countries. This becomes very evident when you notice the average the Indian cost of a cardiac surgery and Compare it with the average US cost. This coupled with the fact that cardiac surgery in India has a success rate of 98.5% which is comparable to the best institutions in the world. This is certainly a major benefit. Hospitals in the major metros of India have already recorded a 12% international patient flow. These patients are mainly from the neighboring South East Asian countries. And these figures will be growing in the near future. India can catch up by the medical travelers for specific medical treatments as well as for regular medical checkups. Most of the hospitals are centrally located in the major Indian cities, are easily accessible and are capable of looking after the patients with best care. This was in regards with urban medi-care but rural India also runs back to back. It may not have world class infrastructure but the medical attention is prompt with competent doctors even in the remotest parts of the country. For those who plan to get a regular medical check up done, India is the ideal the place to be. With its numerous attractions one can come here with the family and combine the health check up with a pleasure trip for the family. 28
All this is because of the enormous growth witnessed by the private sector. It was very modest in the early stages and has now become a flourishing industry with the most modern state-of-art technology at its disposal. It is estimated that 75-80% of the healthcare services and investments in India are now provided by the private sector. An added advantage that India has is that it has one of the largest congregations of pharmaceutical companies in the whole world. It is self-sufficient in drug production and exports drugs to more than 180 countries. The privatization of this sector has brought with it facilities of the star categories & world class treatments. The country now boasts a number of corporate hospitals. India is a market for professionals in the medical field for most of the renowned hospitals in the whole world. Hi-tech medical facilities have become a necessity following the consumer demand among the world‟s fastest growing middle -class masses. India offers at its own doorsteps a range of
world quality hospitals and treatments at a fraction of world costs with comparable success rate and service levels directly in proportion to the high value system and natural caring that comes along with its traditional heritage. Indian hospitals are now being acclaimed the world over for the standards of healthcare delivery. The country boasts of superior technology with skilled super specialists along with sound infrastructure & professional outlook. Major hospitals in Chennai, Mumbai, Hyderabad & New Delhi have recorded a 125 patient flow from the neighboring & South-East Asian countries. This is because people have realized that they can now have access to international quality medi-care at 10% of international costs in India. Technologies of the new millennium including ECG through conferencing will soon be introduced in India, making it feasible for doctors to benefit from the advice of other experts. Indian doctors performed the country‟s first robotic heart surgery
which reduces the risk and trauma associated with critical conditions.
Apart from that, India has also become an important destination for medical conferences. Major international medical conferences on ophthalmology, oral cancer, etc. were held in India with many more on the anvil.
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International Conference
An international health and medical tourism conference is slated to be held towards the end of this year at Bangalore, which will see delegates from various South- East Asian countries, the Middle-East and even Africa participating. This will serve as an ideal platform for Incredible India to market its health and medical tourism products and services.
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Indian Healthcare Specialties Specialties Cardiac Care Cardiac care has become a speciality in India with names such as the Escorts Heart Institute, AMIIS and Apollo hospitals becoming names to reckon with. They combine the latest innovations in medical electronics with unmatched expertise in leading Cardio logistics and cardio-thoracic surgeons. These centers have the distinction of providing comprehensive cardiac care spanning from basic facilities in preventive cardiology to the more sophisticated curative technology. The technology is contemporary and world class and the volumes handled match global benchmarks. They also specialize in offering surgery to high risk patients with the introduction of innovative techniques of minimally invasive and robotic surgeries. The success rates here at these hospitals in India are at an average of 98.5% which are at par with the leading cardiac centers around aro und the world. They are in possession of cardiac care units with sophisticated equipments and investigate facilities like echocardiography with colored Doppler, Nuclear scanning and Coronary Angiography.
Dialysis and kidney transplant Common diseases like Diabetes, Hypertension and Chronic G lomerulo-Nep lomerulo-Nephritis hritis can lead to permanent loss of renal function with Dialysis and renal transplantation being the frequent outcome. The emergence of new therapeutic interventions has created opportunities in India to manage the progression of renal diseases. For those who need replacement therapy, services like Hemodialysis, Chronic Ambulatory peritoneal dialysis (CAPD), and transplantation are also available. Patients can also avail of the Bicarbonate Dialysis facilities. The cost of getting a dialysis is around Rs.1700-1800 per dialysis. Similarly a Kidney transplant package in India is available for around Rs.3 lakh.
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Neurosurgery & Trauma surgery Other routine procedures performed with excellent results are replacement Arthroplasties, Diagnostics and Operative Arthroscopy, spinal surgery including Harrington rod instrumentation, corrective and reconstructive procedure for poliomyelitis and cerebral palsy. In addition the advanced Luque technique is employed for the correction of complex scoliosis and decompression and stabilization of fractures of dorsal and lumbar spine by neurosurgeon with excellent training and background. Some super speciality hospitals in India like AIIMS, Ram Manohar Lohia hospital, Bombay hospital, Jaslok hospital and Apollo hospitals have advanced facilities dedicated to the treatment of entire range of brain and spinal disorders with highly experienced neurosurgeons, neurologists and neuro-anaesthetists. neuro -anaesthetists.
Joint replacement surgery Shoulder/ hip replacement and bilateral knee replacement surgery using the most advanced keyhole or endoscopic surgery and anthroscopy is done at several hospitals in India including the Apollo hospital, Delhi; Bombay hospital, Mumbai and Madras Institute of Orthopedics and Trauma Sciences. Some hospitals like Apollo in Delhi have operation theatres with laminar air flow system. A knee joint replacement costs about Rs.2 and a half lakhs in India.
Refractive surgery This type of surgery is gaining popularity in India both among the public as well as the opthalmogistis. Till a few years ago only a few centers performed high volume radial keratotomy. Today, the highest international quality of eye care for cornea, cataract, squin and glaucoma is available in over 40 centers all over India. When it comes to reliability India has the best ophthalmic surgeons with clinic-academic expertise honed to perfection in the best possible institutions. institutions. 32
The no stitch cataract surgery with the most modern way of removing cataracts through the use of phacoemulsification procedure can be performed in India for as little as Rs.20000 for both the eyes. Facilities for PRK, Myopia and astigmatism are now available in almost all parts of the country. Hyperopic and LASIK are available and even supra-hard cataracts are treated using just 1mm instead of 3mm incision size.
Nuclear medicine This is now common place, as it involves use of radioactive isotopes in very small doses in diagnosing and treatment of diseases, radioactive medicine is injected or administered orally and the distribution in the organ is scanned using a gamma camera. ca mera. Various non cardiac planar/SPECT studies for bone, thyroid, liver and lung scanning functions are performed at specialized centers in India.
Cosmetic surgery A new dimension of the medical field taking off in India is the cosmetic surgery which utilizes some of the latest techniques in corrective procedures. Some disfigurations corrected include hair restoration, rhinoplasties, stalling of aging process, dermabrasions, otoplasty for protruding ears, chin and cheek enlargement, lip reductions, various types of breast surgeries and reconstructions and liposuction. Non invasive surgical procedures like streotactic radio surgery and radiotherapy for brain tumors are practiced successfully.
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Ancient Indian Therapy Ayurveda Of the many forms of alternative medicine currently in vogue in India, yoga and ayurveda almost certainly lead the pack- and both forms have much in common. Both, for instance, date back to over 5,000 years ago, and have a long history of carefullyresearched and highly scientific reasoning to back them up. Both seek to integrate mind, body and soul for holistic healing, and both are increasingly gaining popularity as therapeutic sciences that aim to heal without causing harmful side effects. Ayurveda' is derived from the two words `ayu' (`age' or `life') and `veda' (a knowledge of'). As is apparent from the word itself, ayurveda centers round a close understanding of life; and in the case of ayurveda, this means an intricate relationship between the many aspects of human life, physical as well as mental and sp iritual. iritual. According to the tenets of ayurveda, the human body comprises of five basic elementsearth, fire, water, air and ether (space). Each of these elements is also present in the atmosphere surrounding humans, and their combination affects the human body and mind. These combinations include vatadosha (ether + air, which affects the nervous system, circulation, elimination and respiration); pittadosha (fire + water, which governs digestion and metabolism) and kaphadosha (water + earth, responsible for growth as well as for immunity). Ayurveda bases itself on these three doshas, using the premise that each individual is a unique combination of the doshas, and any imbalance in this combination is the ultimate cause of all diseases. The cure for these diseases, then, lies in a customized cleansing process, tailor-made specifically for the affected individual. The cure is known as `panchkarma' and it aims to treat the disease by eliminating accumulated toxins from the body. Panchkarma can take many different forms, ranging from special diets and oil massages to therapeutic vomiting and purgation.
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Ayurvedic treatments, if rendered properly, can be very helpful in curing a range of illnesses and physical disorders, including asthma, diabetes, obesity, skin diseases, digestive disorders, joint disorders, allergies and more. Treating diseases of a complex type will obviously take much more than a mere weekend of ayurvedic massages, but a quiet 3 days (or even a week, if you can afford to spare the time) is good enough to get a very rejuvenating taste of what ayurveda is all about. A huge number of ayurvedic resorts and spas are mushrooming all across India, and all of them offer a tempting range of packages to choose from. Some are specifically geared towards curing certain minor ailments, although most offer a short-term but highly intensive `ayurveda package' which runs the gamut from oil massages and herbal steam baths to special diets and the pouring po uring of medicinal oils on the forehead o f the individual.
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Among the many places that offer excellent Ayurvedic packages are:
Ananda in the Himalayas -Tehri Garhwal (Uttaranchal)
Sereno Spa -South Goa
Aayurgram Ayurvedic Health Resort -Bangalore
Ayurveda & Yoga Retreat -Coonoor (Tamilnadu (T amilnadu))
Kadavu Ayurvedic Health Centre -Malappuram (Kerala)
Travancore Heritage Ayurvedic Centre -Chowara (Kerala)
Kairali Ayurvedic Health Resort -Palakkad (Kerala)
Angsana Oasis Spa and Resort -Bangalore
Keraleeyam Ayurvedic Health Resort- Alappuzha (Kerala)
Manaltheeram Ayurveda Beach Village- Chowara (Kerala)
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Hydrotherapy Hydrotherapy, or water therapy as it is also known centres around (as you've probably guessed) the use of water as a healing agent. The buoyancy, viscosity and mineral components of water are used through hydrotherapy to heal or relieve ills as varied as fatigue, sore throats, and colds, inflammation of the joints, jaundice, rheumatism, arthritis, arthritis, spondylitis, insomnia, soft tissue injuries and even e ven diabetes. As an alternative system of healing, hydrotherapy is one of the oldest, safest and cheapest- which is definitely part of the reason why it's swiftly gaining in popularity. Hydrotherapy is no upstart; it's been around for more than 5,000 years, when the first mineral and thermal baths appeared in Greece. The Greeks, however, were not the only people to realize the healing powers of water. They were followed in their appreciation of the therapeutic liquid by the Romans (who are credited with having set up well-planned baths all across their empire); the Egyptians, the Japanese and the native Indian Americans. Most modern techniques borrow from both Eastern and Western forms of water therapy, and span a vast range of treatments. Basically, hydrotherapy is instrumental in stimulating blood circulation, increasing the production of stress hormones, improving the immune system and a nd lessening pain sensitivity. sensitivity.
The most common curative methods used in hydrotherapy include:
Cold Baths: Cold baths are used mainly as a means of stimulating blood circulation, and are also used for reducing swelling.
Steam Baths: Hot steam helps encourage sweating, which in turn opens the skin's pores, leaving the individual feeling refreshed and rejuvenated. It's not specifically healing, but it works wonders if you're feeling tired and drained, and can be an effective means of detoxification.
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Neutral Baths: A neutral bath-as the name suggests- uses water that is neither hotter nor colder than the temperature of the human body (cold or hot water draws or transmits heat to or from the body, as the case may be). For a neutral bath, the individual is immersed in water that is maintained at a steady temperature of between 33.5°C and 35.6, for about half an hour. This has a sedative, and even soporific, effect on the patient and is used to calm the nervous system. s ystem.
Floatation: As relaxing and refreshing as a neutral bath, floatation involves lying face up in a dark, enclosed tank of o f warm, heavily salted water.
Hot and Cold Sprays: High-pressure spray jets of hot or cold water are used to heal or relieve a number of minor ailments, and mainly to stimulate organ function, the nervous system and the immune immune system.
Hot and Cold Compresses: Both hot as well as cold compresses actually start off as cold compresses- a cloth dipped in ice-cold water and left on the effected part of the body for a certain period of time. In the case of a cold compress, the pack is replaced by an equally cold pack once it begins to lose its chill. In the case of a hot compress, the pack is left on and allowed to heat up by the warmth of the body. Both types of compresses are used in various ways, especially to treat acute injuries. injuries.
Ice Packs: Ice packs- which contain crushed ice or a special gel- are applied to the body to reduce swelling, pain and inflammation.
Wet Sheet Packs: A wet sheet pack (also known as bodies wrap) is, as the name suggests, a procedure in which the entire body is wrapped in a cold, wet sheet that is in turn covered with a woolen blanket. The sheet is left in place until it dries by the warmth of the body (usually about half an hour to relieve a fever; longer to relax and soothe the body; or up to 3 hours to induce sweating, which can be a good detoxification method for those with drinking or smoking problems). 38
Among the spas in India that offer hydrotherapy treatments are:
Ananda in the Himalayas -Tehri Garhwal (Uttaranchal) Spa Aguada -Goa Angsana Oasis Spa and Resort -Bangalore
The Leela Palace -Bangalore
Golden Palms Spa and Resort -Bangalore
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Yoga Yoga, now recognized globally as a highly effective form of alternative medicine, originated in India about 5,000 years ago as a discipline that sought to unite the moral, mental and physical aspects of human life to contribute to the overall wellness of the individual. Yoga is believed to have been propounded by the sage Patanjali (2nd century BC). Patanjali, in his treatise (known as the sutras) of yoga, explained the basics of yoga, its benefits and its steps ( padas), without going into the details of what postures to adopt, how to breathe and so on .
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Health Check-Up Many common and life threatening conditions can be treated successfully if detected early. Many leading hospitals in India have health check-up programs that screen every part of the body meticulously and professionally. A proper health check-up scans your bio- history, interprets signal and provides the opportunity for the proverbial „stitch in time‟. A heart check-up constituting of echocardiography, consultation by a senior
cardiologists, blood tests, general test & haemogram can go long way in ensuring a healthy heart. The test can be done at any of the leading cardiac hospitals or private clinics.
A comprehensive health check-up contains the following tests :
• Doctor’s consultation and full medical examination • Blood tests • Blood group • Blood sugar • Blood urea • Serum uric acid • Serum creatinine • Serum cholesterol • Lipid profile • Urine and faeces examination • X -ray -ray chest PA • ECG • Exercise stress test (tmt) • Stress screening by psychologist • Gynecologist consultation and PAP smear test • Post check -up -up consultation • Optional tests • ENT examination 41
• Screening for li ver disease • Screening for thyroid disease • Hepatitis B screening • Test for AIDS • Screening for Kidney disease
These tests can be done in leading private and public hospitals. The full health check-up package costs between Rs.2000-2500.
World Class Medical Treatments • Cosmetic Treatments
• Dental Treatments • ENT Treatments • Eye Treatments • Gastroenterology • Cardiology • Neurology • Nephrology • Gynaecology & IVF • Kidney Transplant • Minimally Invasive Surgery • Orthopaedics & Joint Replacement • Surgical Gastroenterology • Urology
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Promotion of medical tourism The key “selling points” of the medical tourism industry are its “cost effectiveness” and its
combination with the attractions of tourism. The latter also uses the ploy of selling the “exotica” of the countries involved as well as the packaging of health care with traditional
therapies therapies and treatment methods. Price advantage is, of course, a major selling point. The slogan, thus is, “First World treatment‟ at Third World prices”. The cost differential across the board is huge: only a tenth
and sometimes even a sixteenth of the cost in the West. Open-heart surgery could cost up to $70,000 in Britain and up to $150,000 in the US; in India‟s best hospitals it could cost
between $3,000 and $10,000. Knee surgery (on both knees) costs 350,000 rupees ($7,700) in India; in Britain this costs £10,000 ($16,950), more than twice as much. Dental, eye and cosmetic surgeries in Western countries cost three to four times as much as in India. The price advantage is however offset today for patients from the developed countries by concerns regarding standards, insurance coverage and other infrastructure. This is where the tourism and medical industries are trying to pool resources, and also putting pressure on the government. We shall turn to their implications later. In India the strong tradition of traditional systems of health care in Kerala, for example, is utilized. Kerala Ayurveda centres have been established at multiple locations in various metro cities, thus highlighting the advantages of Ayurveda in health management. The health tourism focus has seen Kerala participate in various trade shows and expos wherein the advantages of this traditional form of medicine are showcased. A generic problem with medical tourism is that it reinforces the medicalised view of health care. By promoting the notion that medical services can be bought off the shelf from the lowest priced provider anywhere in the globe, it also takes away the pressure from the government to provide comprehensive health care to all its citizens. It is a deepening of the whole notion of health care that is being pushed today which emphasizes on technology and private enterprise. The important question here is for whom is „cost effective‟ services to be provided. Clearly the services are “cost effective” for those who can pay and in addition come from countries
where medical care costs are exorbitant - because of the failure of the government to provide 43
affordable medical care. It thus attracts only a small fraction that can pay for medical care and leaves out large sections that are denied medical care but cannot afford to pay. The demand for cost effective specialized care is coming from the developed countries where there has been a decline in public spending and rise in life expectancy and noncommunicable communicable diseases that requires specialist services.
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Medical Tourism: Price Comparisons When it comes to medical treatment. India is not only cheaper but the waiting time is almost nil. This is due to the outburst of the private sector which comprises of hospitals and clinics with the latest technology an d best practitioners.
Cost Comparisons on some major procedure between India and US Procedure
US ($) approx.
India ($) approx.
Bone Marrow Transplant Liver Transplant Heart Surgery Orthopedic Surgery Cataract Surgery Smile Designing Metal Free Bridge Dental Implants Porcelain Metal Bridge Porcelain Metal Crown Tooth Impactions Root Canal Treatment Tooth Whitening Whitening Tooth Colored Composite Fillings / Tooth Cleaning Breast:
$2,50,000 $3,00,000 $30,000 $20,000 $2,000 $8,000 $5,500 $3,500 $3,000 $1,000 $2,000 $1,000 $800 $500 $300
$69,200 $69,350 $8,700 $6,300 $1,350 $1,100 $600 $900 $600 $100 $125 $110 $125 $30 $90
Mastopexy Reduction Mammoplasty Mammoplasty Augmentation Replacement Of Implants Face:
$7,500 $8,000 $8,000 $6,500
$2,800 $3,300 $2,750 $3,000
Blepheroplasty (Upper & Lower) Facelift Dermabrasion Dermabrasion Total T otal face) Canthopexy w/Orbicularis suspension Hair Transplant Endoscopic Brow lift lift
$6,000 $6,500 $5,500 $6,000 $50 Per graft $5,800
$2,000 $2,800 $2,150 $2,200 $3 Per graft $2,300 45
Neck lift Otoplasty(For prominent Ears) Nose:
$6,100 $4,700
$2,400 $1,500
Primary Rhinoplasty Tip Rhynoplasty Body Contouring:
$7,300 $6,300
$2,900 $1,300
Abdominoplasty $7,700 Thigh Lift (Bilateral) $7,200 Total Lower Body Lift(Belt Lipectomy) Lipecto my) $9,500 Liposuction (One Region) $6,100 Non – Surgical Procedures:
$3,200 $3,150 $6,000 $1,750
Laser Hair Removal Laser Resurfacing/ Wrinkle Reduction Laser Acne Treatment Laser Scar Treatment Botox
$225 $225 $230 $210 $8 Per Unit
$550 $550 $575 $500 $70 Per Unit
* These costs are an average and may not be the actual cost to be incurred.
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Cost Comparison - India vs. United Kingdom Significant cost differences exist between U.K. and India when it co mes to medical treatment. Accompanied with the cost are waiting times which exist in U.K. for patients which range from 3 months to over months.
India is not only cheaper but the t he waiting time is almost nil. This is due to the t he outburst of the private sector which comprises of hospitals and clinics with the latest technology and best practiti pract itioners. oners.
Procedure
UK ($) Approx
Open Heart Surgery Facial Surgery and Skull base Neurosurgery with Hypothermia Complex spine surgery with implants Hip Replacement Simple Spine Surgery Simple Brain Tumor:
$18,000 $13,000 $21,000 $13,000 $13,000 $6500
India ($) Approx $4800 $4500 $6800 $4600 $4500 $2300
Biopsy Surgery
$4,300 $10,000
$1200 $4600
$6500 $26,000
$2300 $17,800
Parkinson’s:
Lesion DBS
* These costs are an average and may not be the actual cost to be incurred.
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Medical tourism in metros & suburban cities Delhi: Although Delhi has witnessed an unprecedented growth in health care industry, how far has the capital become successful in attracting the medical tourist to its swanky and big hospitals? Sapna Dogra finds out When baby Noor Fatima, a two-and-a-half- year old Pakistani girl, successfully underwent an open heart surgery in India, she opened news vistas reminding the potential of medical toursim.The Ministry of External Affairs took this opportunity to encourage medical diplomacy, by facilitating the visit of cabinet ministers and provincial leaders to India for treatment. Medical tourism is the buzzword now. The government as well as private players are keenly assessing the potential and means to tap the same. The boom in state-of-the-art hospitals and well-qualified doctors, have attracted the patient population from neighbouring countries, the Middle East and the t he West. The equation is „First World treatment‟ at “Third World prices”. A CII -McKinsey report
last year, postulating the opportunities in health tourism, states that the medical tourism market in the country pegged a 30 per cent growth in 2000 and it has been growing at the rate of 15 per cent for the past five years. “By 2012, if medical tourism were to reach 25 per cent of revenues of private up market
players, up to Rs 10,000 crore will be added to the revenues of these players,” adds the report. One of the Indian states, Kerala, setting an example by attracting health tourists, has emerged successful in generating revenues from medical tourism. Hospital groups in Delhi have realized the potential of health/ medical tourism but most of them are playing it by the ear. Among private players, Apollo has been a forerunner in health tourism. It has been a choicest destination for patients from Southeast Asia, Africa, and the Middle East. The group has tied up with hospitals in Mauritius, Tanzania, Bangladesh and Yemen besides running a hospital in Sri Lanka, and managing a hospital in Dubai. In 2002, the number 48
of patients who visited the hospital was 3001 and about 700 were hospitalized. Along with providing treatment, the stay of the foreign patients is taken care of by the hospital itself. itself. The group g roup has tied up with hotels hot els in Delhi for this purpose. According to Dr Chabra, additional medical director, ISIC (Indian Spinal Injury Centre), ISIC is another destination for patients from neighbouring countries, Gulf and a few NRIs from the US. Now, to attract more people, the emphasis is on vacation plus treatment and special packages have been planned for this. On the anvil is another plan to make the patients and their relatives stay in the hospital complex with all the luxuries a hotel provides. Dr Shakti Gupta, AIIMS, stresses on the need to export health services. According to him, Indian doctors, medical services, and hospitals are at par with good hospitals in Europe and the US, so it is the right time to make the most of it. AIIMS is a destination for patients from Nepal, Bangladesh, Bhutan, Myanmar, Mauritius, Malaya and Pakistan. Besides regular patients from the Middle-East, an occasional patient from the US drops in. Patients from Pakistan, especially children with heart afflictions, have been regularly coming to AIIMS‟ heart centre.
According to Dr Gupta, AIIMS was made for the entire south-east Asia populace and since it is a government institute there are no plans to attract more foreigners. The attractions at AIIMS include cardiac surgery, neurosurgery, cancer treatment and ophthalmic procedures. “The services are charged on actuals and ours being a
government institute we are not angling to make money but are here to serve the people,” stressed Dr Gupta. The Metro hospitals and Heart Institute, Noida, also manages to attract patients from Nepal, Bhutan, Sri Lanka, Bangladesh and a few from Maldives and the Gulf region. Their motto is to extend excellent health services to people who travel here for health care and also for tourists who need health care while their stay in India. Indian hospitals getting recognition from international insurance companies will bring in more patients from abroad, says Anil K Maini, head, marketing, health care business, Escorts Heart Institute and Research Centre.
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The centre is emerging fast as a favourite destination for patients from neighboring countries, Africa and CIS. With BUPA recognition, patients from the UK are coming here for treatment. About 1,000 patients from abroad are treated in Escorts on an annual basis. Although only a few hospitals are making conscious efforts to increase the existing inflow of health tourists, nobody denies the huge potential medical tourism has. And it will not be long before its full potential is realised, provided we cu ltivate the service mind set, put in place an accreditation system and project our capabilities overseas through multiple media.
LIST OF HOSPITALS IN DELHI
Name
Address
Bed Capacity
Jeevan Anmol hospital G.M.Modi hospital Indraprastha Apollo hospital
Mayur Vihar Phase-I 125 Mandir Marg, Saket 100 Sarita Vihar, Mathura 600 Road
Tirath Ram Shah hospital
Sawhnex Marg, Rajpur Road B-16, Mehrauli Industrial Area 1,Tuglauabad Institutional Area A-14/15, Pushpanjali Vikas Marg Extn
Sitaram Bhartia Institute Batra hospital Pushpanjali Medical Centre
183 64 310 60
Rajiv Gandhi Cancer Institute & D-18, Sector V, Rohini Research Centre
160
M.G.S hospital (Delhi)
100
Rockland hospital Sonia hospital (Delhi) Veeranwali International hospital
35/37 Rohtak Road, Punjabi Baug Tara Cresent Road Nangloi National Highway No.10 Chandragupta Marg, Chanakyapuri
130 65 70
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Mumbai: STRENGTH Expertise and skill
The city boasts of doctors and nursing staff whose expertise is comparable with international standards. And, as Dr. Nilima Kshirsagar, dean of KEM Hospital, puts its, “Real medicine is provided speedily and efficiently”. Extensive infrastructure
Mumbai has one of the largest healthcare facilities run by the Municipal Corporation, state government, charitable trusts and private owners. Official estimates say the city has 33000 beds, four tertiary care hospitals, several peripheral hospitals. Several specialty and super specialty hospitals are spread across town, from Mulund in the north to south Mumbai. State-of-the-art equipment is available at most private hospitals as well as a handful of public hospitals. Several tourist destinations nearby
Maharashtra is dotted with tourist destinations. Packages can be developed to lure patients. As state Health Minister Digvijay Khanvilkar had in an earlier interview said: “Even in these places, our rural and primary pr imary healthcare facilities facilities are in place”. Comparative cost
A knee replacement that costs $6000(Rs.2.73 lakh) in India would cost $10000(Rs.4.55 lakh) in the UK. A cardiac bypass costing $15000(Rs.6.82 lakh) in the UK would cost up to Rs.3 lakh here.
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WEAKNESS Benefits only private hospitals
The main beneficiaries would be private and charitable hospitals. Given the conditions that public hospitals work under, u nder, it‟s unlikely that foreigners would consider them. “Most
charitable hospitals have over half their beds vacant. And the charity commissioner is doing nothing about it, “says Ravi Duggal of centre for Enquiry into health and Allied
Themes (CEHAT) Lack of funds
Even though the government aims to bring public hospitals under the purview of health tourism, there is an urgent need for faciliti es, “If we want to lure people from abroad, we have to create facilities similar to that of nursing homes,” says Kshirsagar. “The only void is the marketing of public hospitals,” says Sushil Jiwarajka, chairman (western
zone), FICCI. Costlier than other cities
Where Mumbai is likely to lose out is cost of treatment. A bypass in Mumbai is nearly comparable with cities like Delhi and Chennai costing up to Rs.3 lakh in public hospitals. In Kolkata it costs between Rs.1.12 lakh and Rs.1.33 lakh at a leading hospital. A caesarean costs over Rs.50000 in a few hospitals, while in Bangalore it costs Rs.23900. Last word “In a city where people are dying of dengue and falciparum malaria, it shows how
disassociated the government is about ground realities. It is no thing but a political ploy,” says Dr. Arun Bal, of Association for consumer Action for safety and health (ACASH).
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LIST OF HOSPITALS IN MUMBAI Hospital
Address
Bed Capacity
Asian Heart Institute Bhagwati Hospital Bhaktivedanta Hospital Bhatia Hospital Bombay Hospital Breach Candy Hospital and Research Center
Bandra (East) Borivali (West) Mira Road Grant Road Marine Lines Breach Candy
N.A N.A N.A N.A N.A 175
Cooper Hospital Guru Nanak Hospital Hinduja Hospital J.J Hospital Jaslok Hospital K.E.M Hospital Lilavati Hospital Nair Hospital Nanavati Hospital Tata Memorial Hospital Wockhard Hospital Limited
Vile Parle Bandra (East) Mahim Byculla Peddar Road Parel Bandra Recl. Mumbai Central Vile Parle Parel Mulund
N.A 150 350 N.A 377 N.A 300 N.A 400 N.A 222
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Potential of India in area of medical tourism and steps taken A nice blend of top-class medical expertise at attractive prices is helping a growing number of Indian corporate hospitals lure foreign patients, including from developed nations such as the UK and the t he US. If a liver transplant costs in the range of Rs 60 lakh-70 lakh in Europe and double that in the US, a few Indian hospitals, such as Global in Hyderabad, have the wherewithal to do it in around Rs 15 lakh-20 lakh. Similarly, if a heart surgery in the US costs about Rs 20 lakh, the Chennai-headquartered Apollo Hospitals Group does it in roughly Rs 2 lakh. As more and more patients from Europe, the US and other affluent nations with high medicare costs look for effective options, India is pitted against Thailand, Singapore and some other Asian countries, which have good hospitals, salubrious climate and tourist destinations. While Thailand and Singapore with their advanced medical facilities and built-in medical tourism options have been drawing foreign patients of the order of a couple of lakhs per annum, the rapidly expanding Indian corporate hospital sector has been able to get a few thousands for treatment. But, things are going to change drastically in favour of India, especially in view of the high quality expertise of medical professionals, backed by the fast improving equipment and nursing facilities, and above all, the cost-effectiveness of the package, said some of the hospitals Business Line spoke to. The Apollo Group, Escorts Hospitals in New Delhi and Jaslok Hospitals in Mumbai are to name a few which are established names even abroad. A list of corporate hospitals such as Global Hospitals, CARE and Dr L.V. Prasad Eye Hospitals in Hyderabad, The Hindujas in Mumbai, etc also have built capabilities and are handling a steadily increasing flow of foreign patients. "India has much more expertise than say Thailand or Malaysia. The infrastructure in some of India's hospitals is also very good. What is more significant is that the costs are much less, almost one-third of those in other Asian
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countries," says Dr K. Ravindranath, who returned from abroad to start Global Hospitals, which has facilities for liver, kidney and heart transplantati t ransplantations. ons. As Indian corporate hospitals are on par, if not better than the best hospitals in Thailand, Singapore, etc there is scope for improvement, and the country may become a preferred medical destination. This can be done through an orchestrated effort by the Centre, airlines, travel houses, insurance companies, tourism sector and healthcare providers, says Ms Anjali Kapoor, Head-International Marketing of Indrasprastha Apollo Hospitals, New Delhi. 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. The Apollo Hospitals Group is in the process of getting accredited with JCI, she said. Indian corporate hospitals excelled in cardiology and cardiothoracic surgery, joint replacement, orthopaedic surgery, gastroenterology, ophthalmology, transplants and urology to name a few, said Dr Ravindranath. Ra vindranath. The CARE Hospitals, which has specialised in heartcare, has concentrated on drawing patients from the Gulf and at least 50 were treated treat ed last year, said a hospital spokesperson. In addition to the increasingly top class medical care, a big draw for foreign patients is also the very minimal or hardly any waitlist as is common in European or American hospitals. In fact, priority treatment is provided pro vided today in Indian hospitals. hosp itals.
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Medical tourism may generate rs.100 bn. by 2022: study Medical tourism could help upmarket tertiary hospitals gain additional revenues of Rs. 50-100 billion ($1.1-2.2 billion) by 2022, said a new industry study released on April 8. The study by Confederation of Indian Industry (CII) and consultancy firm McKinsey said India has immense potential to benefit from medical tourism as healthcare costs skyrocket in the developed world. "In comparison to most developed countries such as Britain or the U.S., treatments like those for dental problems or major procedures like bypass surgery or angioplasty come at a fraction of the cost in India," said Naresh Trehan, chairman of the CII National Healthcare Committee. Similarly, cardiac surgery in India costs one-tenth of that in the U.S., he said. "Given the potential, medical tourism could account for 3 to 5 percent of the total healthcare delivery market, provided the industry re-orients itself to attract foreign patients," said the study. Infrastructure for hospitals, speciality tourist packages to include medical treatment and promotion of hospital accreditation and standardisation are some of the prerequisites needed to realise the potential. "The hospitals would have to provide state-of-the-art facilities and improve the quality of in-patient care and service to make the overall experience attractive to foreign tourists," the study noted. According to the report, India, with 1.5 beds for every 1,000 people, is currently far behind China, Brazil and Thailand with an average of 4.3 beds for every 1,000 people. The study projects that changing demographic and disease profiles and rising treatment costs will result result in healthcare spending spend ing more than doubling over the next 10 years. Private healthcare will be the largest component of this spending, rising to Rs. 1.56 trillion by 2022, up from the current Rs. 690 billion. This could rise by an additional Rs. 56
390 billion if health insurance cover is available to the rich and the middle class, the study said. In addition, public spending could double from Rs. 170 billion if the government reaches its target spending of 2 percent of the GDP, up from the current 0.9 percent. Along with the expected increase in the pharmaceutical market, the total healthcare market could rise from Rs. 1.03 trillion currently (5.2 percent of GDP) to between Rs. 2.32 trillion and Rs. 3.2 trillion by 2022. While there is a tremendous stock of intellectual capital in healthcare and with state-ofthe-art treatment and world-class surgery available in the country, the system in India faces some lacunae, the CII-McKinsey study added. "There is a pressing need for qualified specialist nurses and paramedics and qualified hospital administrators. Several private hospitals have invested in nursing education, but are concerned about loyalty as trained nurses often leave India, attracted by the higher wages offered in the Gulf countries." It said specialist nurse training would become vital as the number of single-super specialty and multi-super specialty hospitals increased. Standardization and accreditation of hospitals as also better information management are other aspects, the study highlighted. By efficiently harnessing technology, medical professionals can now consult specialists anywhere across the globe, send images and have video-conferencing to arrive at a decision for complicated cases, it said. On the importance of health insurance, the study pointed out that the number is rising rapidly from less than 10 percent coverage. "Insurance would be the main driver for raising quality consciousness and increased demand for better standards, hospital accreditation and patient-management information systems." Currently, the voluntary health insurance market is estimated at Rs.4 billion but it is growing fast. Industry expects it to touch Rs.130 billion billion by 2012. 57
Government launches medical tourism council What do you get if you combine Ajanta-Ellora, Mahableshwar and the Konkan coast with 20,000-odd medical specialists and hi-tech tertiary care hospitals? Answer (according to the Maharashtra government): a medical tourism haven. Hooked on to the idea of making the state a medical tourism hub, the Maharashtra government, in collaboration with FICCI (Western Region Council), began working on idea around eight months ago. On November 19 of 2009, the Medical Tourism Council of Maharashtra (MTCM) was formally launched at a function at which health minister Digvijay Khanvilkar, chief secretary Ajit Nimbalkar, Principal Secretary, medical education & drugs department, G.S.Gill, FICCI-WRC chairman Sushil Jiwrajka and Union minister of state for commerce and industry S.B.Mookherjee were present. Speaker after speaker outlined the fact that Maharashtra had a winning combination of prime tourist destinations and world-class healthcare facilities, which made it a great choice for a medical tourist centre. Pointing out that healthcare, from a simple root canal to open-heart surgery, was available in India at one-fifth the cost of western countries, Mr. Gill declared that MTCM would work on leveraging this advantage. “A CIIMcKinsey report had stated that the medical tourism industry could be expected to grow at 30 per cent per year from 2000 onwards,” he said. “My estimate is that if all goes well,
we can earn Rs 10,000 crore annually from medical tourism by 2022.”
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Government Plans for Attracting Medical Tourism to India To promote growth in the Indian medical travel industry, the Indian government has plans to improve improve health health infrastructure. The government is is currently in in the process of increasing the number of hospitals, clinics, and clinical laboratories in urban as well as rural parts of the country. Incentives and tax holidays are being offered to hospitals and dispensaries providing health travel facilities. The Indian medical travel and health care sector offers plenty of opportunities for businessmen, medical equipment manufacturers, healthcare service providers, and tourist agencies, and the government is encouraging them to invest in therapeutic and preventive health services so as to increase medical travel to India. The government has published analytical reports on the available opportunities in the Indian health care industry so corporate houses can make informed decisions regarding the Indian medical tourism sector.
How to apply a Medical Visa to India Govt. of India has also relaxed the terms and conditions for those who apply for the medical Visas in India.
Mentioned below are the conditions and procedures to apply for an Indian Medical Visa. Conditions
A medical category visa may be issued with the following conditions: a. The Indian Missions/Posts abroad may scrutinize the medical documents very carefully and satisfy themselves about the bonafide purpo se for which medical treatment visa is being requested. b. Mission may satisfy that the applicant has sought preliminary medical advice from his country of origin/country of residence and he has been advised to go for specialized
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medical treatment. In case the foreign national desires to go for treatment under the Indian system of Medicines, his case may also be co nsidered. c. This type of visa should be granted for seeking medical attendance only in reputed / recognized specialized hospitals/ treatment centers in the country. Although non exhaustive, following illustrative list of ailments would be of primary consideration; serious ailments like neuro-surgery; ophthalmic disorders; heart related problems; reneal disorders; organ transplantations; plastic surgery; joint replacement etc.. The basic idea would be that the mission may satisfy about the need of the foreign national to come to India for medical treatment/ health enhancements.
Validity and extension of visa The initial period for such a visa may be upto a period of one year or the period of treatment whichever less, which can be extended for a further period upto one year be the State Government/ FRROs on the production of medical certificate/ advice from the reputed/ recognized/ specialized hospitals in the country. Any further extension will be granted by the Ministry of Home Affairs only on the recommendations of the State Government/ FRROs supported by appropriate Medical documents. Such visa will be valid for maximum three entries during one year. State Government/ FRROs may permit one additional entry in emergent situation situation if required.
Registration Foreigners coming on „M visa‟ will be required to get themselves registered mandatorily
well within the period of 14 days of o f arrival with the concerned FRROs/ FROs
Visa to attendant/ family members Attendant/family members of the patient coming to India for medical treatment shall be granted miscellaneous visa co-terminus with the „M Visa‟ of the patient. Such visa may be granted the spouse/ children or those who have blood relations with the patient. However, not more than two attendants may be allowed at a time for grant of 60
miscellaneous visa. Such visa will be called „MX visa‟. Such foreigners are also
required to get themselves registered with the local FRROs/ FROs well within 14 days from the date of o f arrival.
Registration for Pak and Bangladeshi National It may be clarified that „ Medical Visa‟ will be available to all the foreign nationals
including China, Pakistan, Bangladesh, Sri Lanka. However Registration formalities for Pakistani and Bangladeshi nationals will be as per the provisions contained in para 106 in respect of Bangladeshi national and para 118 of the visa manual in respect of Pakistani nationals. Similarly entry and departure of these foreign nationals will also be governed as per the existing policy in respect of these nationals.
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Conclusion of the Study COUNTER-PLAN (To tap medical tourism to urism in India)
A $40 billion plus market worldwide growing at over 20% a year throws up huge opportunities for anyone smart enough to tap it. India has the entire base and infrastructure required to build-up a strong brand value for itself amongst the international community as a top class healthcare destination. But now depends wholly on how the coordination takes place to tap-in this sector. Some following conclusions as seen after reviewing the entire healthcare situation in India by me can be considered as important steps to improve the t he Indian „Medical Tourism‟ situation.
4. There should be a central regulatory authority to plan-up the Infrastructure development and other ot her issues regarding medical tourism.
5. The sector of medical tourism should be regarded as a totally separate entity other than the regular tourism activities by the central regulatory authority.
6. A great edge has been provided to India by the private sector which has professional management. This sector should be secured respectfully and should be boosted through attractive incentives by government authorities to achieve high valued profi pro fits. ts.
7. The biggest reason why people travel to India for treatments are the comparatively low cost which should be maintained maintained throughout. throu ghout.
8. India should be marketed as a „Healthcare Destination‟ projecting its conventional as well as traditional methods of healing and treatments.
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9. India should also attract horde of tourists by providing information to the foreign medical tourists about the very low costs offered for various treatments through various mediums. 10. Along with these efforts the places of tourist interests in and around the medical destination should be developed well to increase the tourist influx to such places.
11.
Various competent hospitals should work according to the international standards & should try and acquire international certification and accreditation
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Bibliography Newspapers
1. Times of India 2. Economics Times
Magazines
1. Business world
Websites
1. www.ourworld.compuserve.com
8. www.apollohospitals.com
2. www.mohfw.nic.in
9. www.ibef.org
3. www.cehat.org
10. www.cbc.ca
4. cities.expressindia.com
11. www.Tata-AIG Hospitals.com
5.www.expresstravelandtourism.com
12.www.TataAIGHospitalsdelhi.com
6. www.pd.cpim.org
13.www.TataAIGHospitalspune.com
7. www.cbc.ca
14. www.Scribd.com
List of articles on Medical Tourism India
Medical Tourism: India is the Favorable Destination in the World - RNCOS Market Report India‟s cost-effective and efficient medical sector has made it a favored destination for healthcare - India‟s Health Minister Dr. Anbumani Ramadoss Indian government starts issuing M (medical) visa to the medical patients, and MX visas to the accompanying spouse, which are valid for a year - Union Minister for Tourism How a UK medical tourist saved about £14,000 for a surgery in India
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