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

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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.

Anil K. Maini

Chair­man CII Sub Com­mit­tee on Med­i­cal Tourism

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