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of India Nov 5, 2000
'Skilled manpower, low cost of
treatment attract foreigners'
By Shabnam Minwalla
With the trickle of international patients coming to the country
for treatment, 'medical tourism' is becoming a trend.
So, while our hospitals are accustomed to Bangladeshis, Sri
Lankans and residents of West Asian countries, they are suddenly
noticing a new breed of patients - the American secretary
who has found that a chin implant in Khar makes financial
sense; or the Britisher who, frustrated by interminable National
Health Service (NHS) queues, realizes that a cataract operation
in Madras is a viable option.
As far as the Indian healthcare industry is concerned, the
future certainly holds dollar-filled promises. Already, British
politicians have suggested that NHS patients be sent to India
for cataract and hip-replacement surgeries, while it is entirely
possible that insurance giants will soon funnel patients to
India for, says, bypass operations or organ transplants.
"India can certainly become the healthcare destination of
the world," says George Eapen, CEO, Apollo Hospitals, adding
that his group is actively targeting the Africa, SAARC and
West Asia market. "We have two great advantages-highly skilled
manpower and substantially lower cost of treatment."
Dr Sharma estimates that
about ten percent of his clients come from as far afield as
the U.S., Argentina and South Africa - a statistic which might
well double by the end of the year. The Apollo Hospitals,
too, have found themselves catering to a fair number of Americans
on the lookout for re-modelled noses and Britishers who need
Most doctors first noticed this phenomenon about three years
ago when numerous NRIs decided to use their holidays to get
in touch with both their roots and root-canals."Until about
ten years ago, we were lagging far behind our Western counterparts,"
explains Dr Bhatia, adding that today, this gap has largely
"The NRIs who visited us began to tell their friends and word
spread. More than anything else, however, the Internet has
made a difference. Our technology is only six months behind
that of the West," explains Dr. Hrishikesh Pai, an infertility
specialist. "The Internet has given us a chance to convey
this to the world." Concurs Dr Bhatia, "one of my dentist
friends recently put up a website, and within months three
patients had come from the UK for teeth implants." Clearly,
the money saved is worth the hassle of the trip and treatment
in an alien land. An in-vitro fertilization (IVF) cycle in
the U.S. costs $6,000 as opposed to $1,200 in India. Similarly,
getting a nose reshaped in Argentina costs $4,000 - five times
the going rate in Mumbai, while Lasik surgery in India saves
the average Westerner at least $1,500 per eye. Given these
figures, why aren't more patients stampeding into our hospitals
and nursing homes? Part of the problem is India's image -
which fills potential patients with trepidation and doubts
about hospital hygiene and disposable syringes.
Times of India Nov 6, 2000
`Foreign insurance firms may shift
patients to India if facilities are up to the mark'
By Shabnam Minwalla
MUMBAI: If globalisation works for Korean cloth and
New Zealand apples, why not for Indian cataract operations
and cardiac procedures?
This is the question that the Indian medical community has
suddenly begun to address. Over the last couple of years,
a handful of international patients has started coming to
India for laser eye surgery, infertility treatments and cosmetic
surgery - a phenomenon which has lead to the sudden realization
that this country just might have what it takes to become
a `healthcare destination'.
"The potential certainly exists,'' says Vishal Bali,
general manager of the Wockhardt Hospital in Bangalore. "Our
services are very competitively priced. In terms of clinical
talent, we are not just on par with doctors in developing
countries, but sometimes even superior. With the advent of
foreign insurance companies, our hospitals will soon reach
international standards. It is time we made an effort as an
The first step is, clearly, to convince the world that there
is more to India than snake charmers and elephants. At the
moment, the UK, with its crumbling National Health Service,
seems the prime target for a spot of hardsell. Already, a
handful of disgruntled patients have made their way to India
for various treatments. Many, however, believe that the relationship
should be formalized.
About a year ago, a Labour MP undertook complicated calculations
and arrived at the conclusion that long-suffering British
patients should be sent to India for snappy treatment. Pointing
out that 162,000 people were waiting for eye operations and
243,000 were in queue for hip replacements, he stressed that
this move could save the NHS billions of pounds. Not surprisingly,
the British Medical Association dismissed the suggestion as
"utterly astonishing and bizarre."
"Sending patients to India would mean acknowledging the
failure of the NHS, something which would greatly hurt the
British ego," says Dr S. Bannerjee, who practices in
"Also, there has been nothing in the British media to
foster confidence about medical care in India. The system
would first have to build its reputation, doctors would need
to be accountable, and corruption weeded out. Also, suitable
infrastructure would have to be created, not only for patients,
but also for their careers during their stay in the country."
These comments clearly hit home. "Thanks to a slump in
oil prices in the late '70s and early '80s, many West Asian
countries began to send their patients to India rather than
the West," says Dr G.M. Bhatia, an orthopaedic surgeon,
who agrees that much groundwork needs to be done. "But
our nursing homes and hospitals resorted to blatant exploitation
- often performing unnecessary surgeries, like the removal
of an appendix. The medical boards in the West Asian countries
grew suspicious and, as a result, we lost a sizable market.
Nevertheless, if we guard against past mistakes, we can offer
the British government a workable solution."
Besides a tie-up with the NHS, other schemes are also being
proposed. One somewhat disturbing suggestion floating around
is that India should set up "old-people's homes"
for Europeans and Americans in an attempt to become a "global
nursing centre". More realistic is the oft-reiterated
hypothesis that foreign insurance companies might soon start
diverting patients to India for routine surgeries. "If
they find the facilities up to the mark, it is entirely possible
that they will shift a percentage of their patients to India,"
says Mr Bali, who feels that the hospitals still have to achieve
But won't a huge influx of outside patients further increase
the inequalities and stresses of the Indian healthcare system?
If all eyes are on the lucrative dollarwallas, won't Indians
become second-class citizens in their own hospitals? Isn't
there a danger of the medical system becoming the impersonal
conveyor-belt that it is in the U.S.?
There are no easy answers to these questions, but many believe
that India can cash in on medical services in less disruptive
ways. "Many doctors offer free online consultation, but
in time we will start charging," says Dr Hrishikesh Pai,
an infertility specialist, pointing out that in the Western
world, doctors are very inaccessible.
People often get desperate and are turning to online experts.
Already, a number of canny entrepreneurs are planning tele-medicine
centres - where patients from around the world can phone in
and talk to doctors and specialists.
While technology is bound to offer solutions, the Indian medical
community is uncertain about the extent of its market. "It
is unrealistic to target countries like the U.S.," says
Mr Bali, who feels that India should emulate the Singapore
example. "If we even manage to attract Asian countries,
it will be a major achievement."
Others disagree, however. "We already get patients from
neighbouring countries and from West Asia," says Dr Pai.
"There is no reason to think small. Today, we are living in a global village.
If we offer the best deal, we will certainly get the patients."