Friday, August 16, 2013, 09:45
Asia Weekly: India gives value for money
By Sudeshna Sarkar in Kolkata

Asia Weekly: India gives value for money

Staff at work in a post-operative pediatrics observation and care unit at Narayana Hrudayalaya Hospitals in Bangalore. Due to the low-cost factor and state-of-the-art facilities, India’s medical travel industry is growing by 30 percent annually and has become one of the most preeminent markets in the world. (AFP)

What is common to British model Naomi Campbell, award-winning film director Bernardo Bertolucci, and German actress Ingeborg Schoner — besides showbiz?

They have all been to India, not to visit the fabled Taj Mahal, but as health tourists to undergo the rejuvenating experience of Ayurveda, the traditional Indian healing and wellness system that dates back thousands of years.

Campbell visited the southern Indian state of Kerala in 2012. That year, the number of medical travelers to India was estimated to have reached 1.1 million from 150,000 in 2002 and the medical tourism market touched $2 billion, according to a report by the Confederation of Indian Industry (CII) and the consulting firm McKinsey & Company.

Healthcare has emerged as one of the largest service sectors in India. By 2012, CII assessed it contributed 6 to 7 percent of GDP and added at least 2.5 million new jobs. A key driver for this growth was medical value travel, which has the prime attraction of delivering quality treatment and benefits at a fraction of the cost in the US and UK, and without patients having to undergo a long wait.

"Over the last five years, there has been a change,” says Dr Rana Mehta, executive director, healthcare, at PricewaterhouseCoopers (PwC) India. “India is one of the most pre-eminent markets for medical value tourism. Earlier, Thailand and Singapore were leading. But India is probably the biggest destination now.”

According to Dr Mehta, the subcontinent further derives its advantages from good connectivity. Its major metros — New Delhi, Chennai, Hyderabad, Bengaluru and Mumbai, which are the hubs of medical tourism — are serviced by a large number of international airlines.

Many Indian hospitals have Joint Commission International accreditation, a US assurance of international quality, and the large English-speaking population provides an edge over countries which do not, like South Korea.

The other clinching factor is cost.

"Treatment in India is much cheaper than in the other Asian hubs like Jordan, Malaysia, Singapore and Thailand,” Dr Mehta points out.

Patients Beyond Borders, the definitive US publication providing details on medical resources for international health travelers, calculates that patients willing to undergo India’s “cultural challenges” will profit from “savings of up to 85 percent on high-acuity procedures such as heart and joint work”.

Due to the low-cost factor, despite the global economic crisis, or perhaps because of it, India’s medical travel industry, it adds, is growing by 30 percent annually.

Visitors seeking treatment come from all corners of the world — from the US and Europe, where medical costs are high despite insurance; the Middle East and Africa where facilities are inadequate, especially for complex procedures; and neighboring countries. The large Indian diaspora living in these regions also acts as a brand ambassador for Indian medical tourism.

"We have a word-of-mouth reputation in Bangladesh, which is much more effective than any advertisement,” says Tarun Chakraborty, deputy general manager, marketing, at Peerless Hospital and BK Roy Research Centre in Kolkata.

The 19-year-old multi-specialty hospital was founded by a non-banking financial institution with its origins in Bangladesh. The cultural linkage has been strengthened by the group’s other businesses, which include a travel agency and a hotel in a prime location to facilitate visits by outpatients.

The hospital’s unique selling point is its state-of-the-art trauma center, open for emergencies 24 hours. Chakraborty draws visitors’ attention to the case of a teenage girl who was shot in the eye with an arrow by her brother.

"It was an accident,” he explains. “The arrow pierced the eye and the brain. The local hospitals washed their hands of the case and she was flown to us in a critical condition.”

Miraculously, she was saved, though she lost the eye. Explosions and accidents bring patients to this eastern Indian hospital from Bangladesh, Nepal, Bhutan and Myanmar.

"Due to security reasons, obtaining a visa is sometimes a time-consuming process but the Indian embassies and consulates abroad are reasonably flexible in cases of medical emergencies,” Chakraborty says.

Peerless, like many Indian hospitals catering to foreign patients, has turned to technology to boost services. Video-conferencing and telemedicine complement physical consultations.

Due to the low cost, foreign hospital chains are now outsourcing diagnostic examinations from India, using Indian laboratories for pathological and other tests.

While foreign patients seeking mainstream medical treatment come mostly for cardiac surgery, oncology services, orthopedic and neurological treatment and joint replacements, India also has a holistic healthcare unique to the country.

"Medical tourism should be promoted in tandem with health tourism,” says the saffron-robed Swami Pranavashudhan Jnana Tapaswi, who is head of marketing at Santhigiri Ashram, a spiritual center founded in Thiruvananthapuram city in Kerala in 1964.

The center propagates ancient systems of Indian medicine like Ayurveda, running more than 100 alternative medicine hospitals at home and abroad.

"India’s traditional health sciences have a crucial role in Kerala’s medical tourism,” the swami adds, standing against a breathtaking backdrop — a 90-foot marble shrine shaped like a lotus in full bloom that glows surreally in the evening light, adding to the Ayurveda mystique.

Kerala, home to about 900 different medicinal plants, is called “God’s own country” and sometimes “Ayurveda’s own country”. It boasts over 100 Ayurveda hospitals run by the state and more than 3,000 in the private sector. Then there are nearly 5,000 dispensaries, more than 800 medicine-manufacturing units and 16 Ayurveda colleges. The panoply is rounded off by resorts, spas and yoga centers.

The swami adds that Kerala derives 40 percent of its tourism income from the Ayurveda segment. About 350,000 foreigners visit this lush green state every year. Most of them are from Europe, with Germany at the top (22 percent), followed by France (13 percent) and Switzerland (12.8 percent).

The success has inspired Kerela’s neighboring state Andhra Pradesh too to develop health tourism.

But while the going is good for now, there are speed breakers ahead.

PwC India’s Dr Mehta warns that to retain its dominant position, India needs to see more action from the government.

"Medical value travel in India is predominantly developed by the private sector,” he says. “Unlike in countries like Singapore, where the government has set up agencies like SingHealth to promote the sector.”

The medical travel business, a PwC India update says, is highly unorganized and fragmented. Most of the large hospital providers are working on their own medical travel models, reducing the scope for stand-alone medical travel companies

Accreditation and quality control are a must, adds Dr JA Jayalal, a member of Tamil Nadu Medical Council.

"If not checked, the mushrooming of (medical) centers with unrealistic advertisement wars will produce a negative result,” he says. “A healthcare policy to match and retain Western standards in accredited hospitals is mandatory. And there should be a strong infection control policy.”

Dr Jayalal draws attention to the dark side of medical tourism in India: “Growing concentration on medical tourism makes our corporate hospitals unaffordable for rural Indians. There should be universal health insurance and ensuring minimum standard of treatment for all.”

The other challenges are building new capacity, by way of infrastructure and trained personnel, and ensuring security and stability, Dr Mehta says. Medical tourists prefer to go to destinations that offer better infrastructure and safety.

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