Agents needed to drive medical tourism
The Indian medical tourism sector is set to cross ` 10,800 crore by 2015 according to an ASSOCHAM study. But Anil K. Maini, Chairman, CII Sub Committee on Medical Tourism and Medanta’s senior advisor, insists that the sector will not grow unless travel ag
Tell us about the growth of medical tourism in India through the years.
It really took off in 2003 with Pakistan’s baby Noor’s successful heart operation in Bangalore. Till 2007, only a handful of international patients were arriving from Nepal and Afghan for treatments at Escorts Heart institute, Apollo Chennai and Devi Shetty’s Narayana Hrudayalaya. Apollo Delhi was simply getting 50-60 international patients when we entered into an agreement with Iraq after the liberation. We had to make sure that the patients got bed on time and had the kind of food they needed. But when 100 war-ravaged kids arrived at the hospital for cochlear implants, we had a tough job in hand. Looking after the attendants was more challenging than the actual patient care. Language was a barrier, so we had 24-hour interpreters on the floor. We had to serve their cuisine at the hospital.
After the procedures, most patients had to stay back for recovery. So we needed to develop guesthouses as hospital stay was expensive. These had to be certified by us for being secure, safe, patient-friendly, offering proper sanitation, good food and clean water. Then came challenges like converting foreign exchange at the hospital as these patients usually travelled with wads of cash. And finally, the hospital had to deal with Foreigner Regional Registration Offices (FRRO).
Now the hospitality part of healthcare is pretty finetuned by now. There are a lot of bed-and-breakfast places charging between $40 to $100 per night. Hospitals are arranging visa-assistance letters, airport picks and drops. Initially embassies would delay, but now a lot of embassies have gone online.
What are the challenges that still persist?
Medical tourists are issued a special visa called N9. But it is twice as expensive as an ordinary visa. But why should we charge more for medical visa? Also, patients or their attendants need to go for police verification the moment they arrive in India. But how can you expect a patient to be taken to the police station? So usually, the attendant has to go to the police station in person after arrival and at the end of their stay. The hospital has to ensure that this information is given to the cops. Also, if a person needs a visa extension, then the patient or his attendant has to go to the embassy and the ministry to get an extension and then approach the FRRO. Another issue is that these medical tourists can’t return for a review within six months. A review is particularly crucial for cancer patients, for a child who has undergone a heart surgery, and liver and renal transplant patients.
CII’s subcommittee on medical tourism has been working on this since the last seven years. Initially, it was involved in marketing, organising roadshows and travels in Dubai, UK, US and Thailand. But now, it is more focused on policy matters like visa issues and other matters concerning medical travel. All the major hospitals are part of this committee, including Fortis, Apollo, Medanta.
What is the market size and growth potential of medical tourism in India?
According to an ASSOCHEM study, the market size of the Indian medical tourism sector is likely to be worth Rs 10,800 crore by 2015. The inflow of medical tourists in India is also likely to cross 32 lakh by that time. While health tourism involves wellness, Siddha yoga and cosmetic, dental, eye procedures; medical tourism involves top-notch health care procedures like cancer, cardiology, neurosciences, orthopedics and transplants. It is 70 percent of the total business.
Unfortunately, it is not growing at a pace that was anticipated as the level of health-care is fast improving in countries like Mexico, Costa Rica, Ireland, etc. Thailand and Singapore were always ahead of us, but now Mexico is catering to the Americas, as it is closer home. And nobody will come to India unless they are saving US $5,000 or more. Also, NHS has improved its efficiency by inducting more doctors and reducing waiting periods for procedures. So the Western world is not coming to India. Our source market lies between India and Africa and also SAARC nations, Middle East, Central Asian countries and erstwhile Soviet Union, including Uzbekistan, Ukraine, Azerbaijan, Kazakhstan, etc.
But we can’t be complacent. Even in the depth of Africa, Chinese and Korean doctors are opening up hospitals with local partners. So our opportunities are fast depleting and at this pace, the market will slow down in another 15 years.
Can travel agents revive this market?
Travel agents have a big role to play in marketing medical tourism overseas. They can provide hospitality support to patients and their attendants by providing services on the ground, like travel, local transportation, hotels, guest houses and site-seeing. But more importantly, they should try to bring patients to India as most of them have offices abroad. They need to penetrate and liaise with local doctors, hospitals, associations who can refer patients here. India, after all, offers world- class healthcare at one- fifth the cost. I fail to understand why Incredible India, which pushes health and wellness, cannot push medical tourism as well.
Travel agents are scared of the indemnity side of this business. They feel that if a patient dies, agents may get sued. But they should understand that this is not a possibility, as the patient is coming to India on his own will, after signing a consent form. Otherwise, hospitals would be out of business in no time. We need to address this concern, and then travel agents will be the right arm of medical tourism. We can work together, pick out a market or two and test it out.
Chairman CII Sub Committee on Medical Tourism