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Forward thinking

In the search for new patients, hospital groups are becoming more adventurous. TOM OTLEY  joined HCA International Hospitals as it set up the first of its overseas offices in Pakistan

Whether hospital groups use medical travel agents, representatives or invest in setting up overseas offices, there is recognition that a presence in a market, along with the cultivation of contacts among referring physicians, can help the flow of patients travelling abroad for treatment.

HCA International Hospitals,  the largest private hospital group in London, has been doing this for some time, and welcomes a significant proportion of inpatients from the Middle East to its London hospitals which include the Wellington, Princess Grace, Portland, London Bridge, Harley Street Clinic and Lister Hospitals. In September, it continued this expansion by appointing the Akbar Group as its national representative in Pakistan, and opening the first of three offices in Karachi.

It’s a significant move, particularly since in all the publicity covering new markets, it is India which seems to grab the attention as a new source of world business, rather than its neighbour Pakistan. Yet Pakistan is the sixth most populous country in the world, and one with strong contacts with the UK. Indeed this bi-lateral trade is extremely valuable to both countries. The new British Foreign Secretary, David Miliband’s decision to come to Afghanistan and Pakistan on his first foreign trip outside Europe within a month of taking office was a partial recognition of this. In 2006, the bilateral trade broke through the US$2billion, up fromUS$1.9billion the previous year, and it is a very balanced trade (tilting just in Pakistan’s favour). The imports from the UK include telecommunications and industrial machinery, which UK foreign direct investment in the country in the last Pakistan financial year that ended in June was some US$860 million, only marginally behind that of the US, and accounting for 16.7 percent of the total.

Although HCA has a head office in the US, its presence in London is a significant one, and it was at the British High Commission in Karachi that the official announcement of the opening was made. It was an interesting mix of traditional hospitality – the High Commission building has generous grounds, and an old colonial feel about it – and the new – medical tourism and a burgeoning Pakistani middle class are all recent developments. Mr Jim Petkas, the vice-president of HCA International Hospitals, announced the opening along with a six-month brand awareness campaign within the country and a broader range of activities including the development of closer ties with the Pakistani medical community through visiting doctor programmes, conferences and seminars. The company plans to open a second office in Lahore in October this year, and a third in Islamabad before the end of the year.

The opening of the office is the culmination of two years’ work by the HCA International Hospitals team, headed up by Elizabeth Boultbee, head of International Business.

“We identified Pakistan as a place with a growing middle class, and of course it is a population with close links to the UK,” says Boultbee. “What we were very keen to show is that we are here as a long term commitment, and so as well as finding the right partner in Pakistan, it was also important to demonstrate our commitment both financially, in establishing these offices, and also by establishing relationships with the local medical community.”

To that end, HCA Hospitals has developed closer links with several facilities, including the Aga Khan University Hospital in Karachi (www.aku.edu/AKUH), the Pakistan Institute of Medical Sciences (www.pims.gov.pk); the Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore set up by former Pakistan cricketer turned politician Imran Kahn (www.shaukatkhanum.org.pk) and the Shifa International Hospital in Islamabad (www.shifa.com.pk): see page 47 for further details. The relationship has been built on everything from arranging seminars and conferences to allow an exchange of knowledge and to introduce the specialists from London to their Pakistani colleagues, to the development of an electronic multi-disciplinary team software package for telemedicine purposes.

Although there are a small number of accomplished hospitals in Pakistan, there is also a shortage of healthcare generally, and those hospitals which do offer world-class care such as the Aga Khan University Hospital, are also presently constrained with their capacity, though it has plans to address this with new facilities. As such, travelling to the UK for treatment is both affordable and familiar to a percentage of the Pakistani population, particularly since in the UK there are some 800,000 British citizens of Pakistani origin (and the new Government of Prime Minister Gordon Brown has two government ministers of Pakistani origin).

“It’s difficult to put a figure on the number of patients we are welcoming from Pakistan because they are self-pay,” says Boultbee. “But if you consider this is a country of some 160 million citizens, we think that around 10 per cent have the sort of incomes where they could consider self-pay in London. It is also demonstrated by the number of British Universities who have set up offices in Pakistan to try and attract students to come and study in the UK.”

The frequency of flights between the countries, both direct with PIA and British Airways, and indirect, particularly with the Middle Eastern carriers such as Emirates (four times daily from Dubai), Etihad (twice daily from Abu Dhabi) and Qatar, (daily from Doha), also means that connection options are not a problem.

HCA Hospitals’ Pakistani partner is also able to help on this side, since the Akbar Group is the representative of several international airlines, as well as being the representative of Amadeus in Pakistan and running its own private jet company – Princely Jets. The Akbar Group plans to provide a one-stop-shop service for patients in Pakistan who wish to enjoy the benefits of exceptional medical treatment in London without having to worry about organising all the relevant medical appointments, treatment, travel, visas and accommodation. The HCA International Offices in Pakistan will be headed by Dr. Hasan Ramzi, who will have a team of doctors working with him so that potential patients from Pakistan get the best possible service and advice from the time they seek medical help until they return from the UK.

The Akbar Group vice-chairman, Ghouse Akbar said that “We welcome the opportunity to add HCA International Hospitals to our rapidly expanding portfolio of international brands that we represent in Pakistan. We can now claim to represent one of the worlds leading providers of healthcare, boasting over 3,000 consultant specialists and seven state-of-the art hospitals offering the most technologically advanced medical treatment in the world. We already have considerable experience in providing high levels of service and look forward to extending this into the healthcare sector within Pakistan.”

This allows for a patient to pick and choose what elements the company organises for it, from a complete package to merely help in streamlining the visa process, itself a challenge since of the 200,000 plus visa applications made in Karachi and Islamabad each year, only 42percent are initially successful.

Dr Hasan Ramzi, Country Head for HCA International Hospitals says, “A major reason give for this is simply applicants filling out the visa form incorrectly, so help with that will streamline the process.”



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