IMTJ news

INDIA: How to improve Indian medical tourism

Fri, 27 Jan 2012 15:42:43 GMT

The latest official figures on travel and medical tourism to India have put paid to the claim that India has millions of medical tourists, many from Europe or America seeking cut-price treatment. A government review has suggested what has to be done to make India a leading medical tourism destination. According to the 2010 figures on inbound travel from the Ministry of Tourism, there were 156,000 medical tourists, including those on medical visas and normal visas. Very few came from Europe or North America or other developed countries. The vast majority came from poor Asian or African countries that can only afford Indian prices and have poor healthcare at home. The two biggest providers of medical tourists were way ahead of all other countries and were the Maldives and Bangladesh. India had more medical tourists from Nigeria than from the combined totals of the UK, Western Europe and North America. The government tasked the Indian Institute of Tourism and Travel Management to study the problems and challenges faced by medical tourists going to India, and in particular to throw light on the gaps between what inbound medical tourists expected and what they actually got. The research objectives were• To map the Indian medical tourism value chain of hospitals and medical tourism agents.• To identify the concerns of medical tourists.• To identify the gaps in service.• To identify weak points.• To make recommendations. The headline finding is that what medical tourists expect to pay as the price quoted for medical treatment is often much less than they actually pay for the treatment and all associated costs. The solution suggested is that hospitals and agents should offer package prices that reflect the full costs, rather than just tempting patients in with a low quote just for the medical procedure. The next major area of concern is that as most patients are actually from nearby countries, there are a large number who cannot speak Hindi; while most from Africa and the Middle East do not speak English. So there are language difficulties in communicating between doctors and patients, and that using interpreters is neither comfortable nor efficient. The third problem found that while the quality of treatment may be high, the related quality of care, buildings and accommodation is often not. While well-off patients can afford hotels, the many poor ones are often disappointed with the lower quality accommodation that they can afford. The review places much of the blame for prices being under-quoted, not on the hospitals, but on the medical tourism agents operating in a highly competitive market seeking to get business. It also blames them for giving patients a higher expectation of the overall experience than many actually get and of having no interest in after care. Another key problem area identified was on care after the patient left hospital. As the review found that for the poorer medical tourists in particular, major surgery (with cardiac treatment being the main one) is the reason for travel, after care is very important. The review found that follow up care was often poor or non-existent, with not enough communication with doctors in the medical tourists' home countries. The researchers made several recommendations including-• Increase marketing to developing countries in Africa.• Hospitals must target niche markets by country and treatment.• Hospitals should bundle costs of treatment and care.• The medical visa system leads to people going to Thailand instead.• The government should decide what type of medical tourism it wants to promote and what type of visitor from where.• The government should actively promote Indian medical tourism

UK: Private hospitals target overseas medical tourists, but NHS Global initiative falters

Fri, 27 Jan 2012 14:48:59 GMT

The London Clinic is the latest to target Middle East medical tourists but while fellow independent hospitals successfully attract top-end medical tourists, the state owned NHS Global has been a disaster. The UK's largest independently owned hospital has a long tradition of medical expertise and clinical excellence for patients from the UK and abroad. It caters for visiting nationals from over 30 countries, and is committed to further strengthening ties in the Middle East region with medical professionals, governments and patients. London has to compete with the USA, Germany and Switzerland for the top-end of medical tourism. London hospitals are active in the Middle East, many having local agents Bupa Cromwell Hospital has 128 beds and boasts a large and loyal UK and international following. Each year thousands of patients go to Bupa Cromwell Hospital from around the world for specialised medical care not readily available close to home. An international patient centre provides a high quality service and care to all international patients and their families. The team of international care co-ordinators can help with services before, during and after a visit to the hospital. It has locally based representatives to assist with various aspects of travel and treatment at the hospital in China, Libya, Pakistan, and Cyprus. Bupa Cromwell Hospital VIP suites attract stars and royalty from around the world and are available for those looking for luxury accommodation. They offer lift access from a dedicated car park so that discretion and privacy can be guaranteed, and they are also the only bulletproof VIP suites in the UK. Michele Lahey of Bupa Cromwell Hospital advises, “We want to deliver an outstanding patient experience. That is why we are embarking on an ambitious transformation programme to become a world leading facility.” In March 2010 a government scheme was launched to generate significant funds by exploiting the NHS brand abroad through consultancy services. But it has failed to secure a single contract in the 18 months since its launch. Set up by the previous Labour administration with a lack of clarity on what it sought to do, it is out of favour with the current coalition government. At launch it was claimed that NHS Global would earn at least £50billion for the NHS, by exporting models including UK general practice, but since then the models themselves have been drastically altered as part of the reforms of the NHS. It cost £75,000 to set up, plus thousands of hours of NHS management time, and a hefty fee to consultancy firm Deloitte for carrying out an initial scoping and analysis of the international healthcare market. An international visit has yet to take place with the purpose of promoting NHS Global. NHS Global claimed the NHS could make billions by advising on, designing and building new hospitals in China based on the public/private template, and by opening hospital chains across the Middle East to compete in the medical tourism market.

USA: New national strategy on travel and tourism could boost medical tourism

Fri, 27 Jan 2012 14:41:34 GMT

President Obama has announced the first ever national strategy on travel and tourism to boost travel to the United States and make it the number one destination. This could benefit the high-end medical tourism trade. The number of travelers from emerging economies with growing middle classes, such as China and Brazil, is projected to grow by 135%, and 274% respectively by 2016 when compared to 2010. The USA share of global international tourism earnings has declined from 17% in 2000 to 11% in 2010, with travel restrictions following September 11 often pointed to as one of the reasons for the decline. The latest global figures for 2011 show receipts were up significantly in the USA (+12%), while the top spenders were led by emerging source markets: China (+38%), Russia (+21%), Brazil (+32%) and India (+32%). President Obama will charge several government agencies to effect new initiatives to significantly increase travel. Some of the initiatives include: a new pilot programme and rule change for visa processing in China, Brazil, Argentina and Chile; and other improvements to the entry process for international guests. The USA is perceived by many in the medical tourism sector as a rich source of outbound patients, rather than a deliverer of care to inbound patients. But the latest figures show that the US is the biggest medical tourism destination in the world. Some of this business is from nearby countries that have poor medical facilities, such as people from the Caymans and the Bahamas going to Miami for treatment and patients travelling from Caribbean, South and Central American countries. Canadians and Mexicans also go to the US for treatment that is either not available or has a long waiting list at home. There are also the well-off medical tourists from millionaires to state leaders, who go to top of the range hospitals that are globally renowned for their specialities. When the ruler of Saudi Arabia went for treatment at the New York Presbyterian Hospital, his entourage occupied an entire floor. Many American hospitals now offer VIP facilities for rich patients from home and overseas. The Mount Sinai Medical Center only has 19 rooms in the VIP area, but 30% of patients come from overseas. Johns Hopkins Medicine International offers international patients a medical concierge to arrange all aspects of the medical visit, paying special attention to your personal, cultural and travel-related needs. It also provides language interpretation, assistance with travel arrangements and other help. For Canadian patients, it works with Medcan Clinic to offer a convenient way for Canadians to connect with specialist care and expertise and benefit from pre-treatment checks and aftercare. With this new push to make the US travel and tourism industry the focus of economic recovery, top hospitals in the USA will look to new patients from China and Brazil, plus reviving the numbers from the Middle East who have been affected by the complex and length process of gaining visas.

CAYMAN ISLANDS: Medical tourism hospital in Caymans is test bed for a chain across Africa

Fri, 27 Jan 2012 14:32:51 GMT

As Dr. Devi Shetty's plan for a medical tourism hospital in Grand Cayman gets closer to fruition, he told the BBC that if it works, it would become a blueprint for his plans to build a hospital chain across Africa. Although still saying that the Narayana Cayman University Medical Centre in the Cayman Islands will offer healthcare at less than half of what Americans pay in the USA, Shetty has moved away from earlier claims that Americans are the key target market to a position where the primary target is not American patients, but mostly people in the Caribbean region plus Central and Southern America. He has not named the US investors behind the project apart from hinting that the partners “are running a very prestigious, not-for-profit hospital chains.” Dr. Shetty plans to break ground on his proposed hospital in August 2012 and to begin accepting patients in August 2013. The first phase of the project involves the creation of a 140 bed hospital on a 200-acre site acquired in the seaport East End. The project will be completed in a phased manner over a decade and will eventually include a 2,000 bed hospital and assisted living quarters for 1,500 families of employees. The first phase will primarily focus on cancer, cardiac, orthopedic and major general surgical treatment with India-trained doctors and nurses among the 100 doctors and 600 nurses in the first phase of Dr Shetty's project. Doctors trained in India have to take exams to qualify to practise in the USA, but Cayman Islands is the first country to recognise Indian degrees. The government bowed to many demands in return for the new hospital including:• the Health Practice Law, which enables medical staff trained in India and other overseas countries to practise in Cayman; • the Tax Concessions (Amendment) Law, which exempts companies from potential future taxes for the next 20 years; • the Medical Negligence (Non-Economic Damages) (Amendment) Law, which caps pain and suffering damages awarded in medical malpractice cases to $500,000; • the provision of water at a price acceptable to the company, including a preferential rate for a fixed period of time; • and the still to be made law which would allow human organ and tissue donations and transplants to be done in Cayman. These demands have not met universal approval on the islands. The Cayman Islands is a British overseas territory in the Caribbean Sea. It comprises three islands — Little Cayman, Grand Cayman and Cayman Brac. The islands are south of Cuba on the east coast of the US mainland. Florida is the closest US state. The islands have an estimated population of 70,000 people, and a reputation as a tax haven. The hospital could be welcome news for the islands, which see at least 700 patients airlifted every year to Miami in the US because of its inadequate medical infrastructure.

SOUTH KOREA: Government promotion and encouragement of medical tourism is working

Fri, 27 Jan 2012 14:27:09 GMT

2011 was a disappointing year for many medical tourism destinations, but active promotion and encouragement from the government saw South Korea increase business by 30%, often at the expense of local competitors. Korea attracted 110,000 patients from abroad in 2011, an increase of 30 % from 81,800 in 2010. A substantial proportion of those visited the country for cosmetic surgery, according to government data. The government aims to increase the figure to 300,000 by 2015. The Ministry of Health and the Korea Health Industry Development Institute have launched a project to improve the medical service system for foreign patients by designating 38 tasks, including seven major issues to minimize inconveniences for foreign medical patients. Korea's seven major tasks for foreign patients include adopting a compensation system for medical injuries; easing floor area ratio regulations for the building and remodeling of lodging facilities in medical institutions; allowing drug dispensing in hospitals; expanding training programs at the Medical Korea Academy and permissions granted to foreign medical professionals to participate in clinical studies; increasing the cultivation of professional medical workforces; assessing foreign patient accommodation in each medical institution; and improving the visa system. Korea is considering establishing a credit union for hospitals that treat foreign patients and providing partial support for the funds with government subsidies. It plans to ease floor area ratio regulations when medical institutions build or remodel lodging facilities in hospitals for foreign medical tourists and provide them with financial support or loans through a tourism promotion fund. New one-stop medical services to foreign patients will allow hospitals to dispense drugs so that foreign patients do not have to suffer inconveniences resulting from the separation of drug prescription and dispensing. Korea is also planning to actively cultivate professional medical workforces, such as medical interpreters. The 2011 Medical Korea awards ceremony rewarded 10 outstanding medical tourism service providers. Yonsei Severance Hospital won the grand prize for attracting the highest number of foreign patients in 2010 and 2011 combined. Three medical tourism agencies, designated as first movers in the medical travel service industry, were given certification; in the Russian-speaking category - Goryeo Healthcare Tour Development and Hyundai Medis; in the Chinese and Japanese-speaking category - Hu Care; but no agencies were awarded in the English and Arabic and other language sections as no agency scored at least 70 out of 100 points in the evaluation. Incheon International Airport Corp (IIAC) seeks to attract more Chinese tourists with plans for medical centres and a hotel, as the number of Chinese visitors to South Korea increased by 17% in 2011 to over 2 million-representing a 23% share of arrivals, according to year-end figures from Korea Tourism Organization; compared to only 15% five years ago.

MIDDLE EAST: Impact of the Arab Spring on medical tourism trade in 2011

Fri, 27 Jan 2012 14:11:51 GMT

The Middle East lost five million tourists last year due to the impact of the Arab Spring, according to the latest UNWTO World Tourism Barometer. New figures from Jordan confirm that medical tourism suffered. 55 million tourists visited the Middle East last year, 6% of the total international tourist arrivals of 980 million. Although tourism arrivals to the region slumped 8% in 2011 the UAE, Saudi Arabia and Oman still recorded steady growth. UNWTO forecasts a slow recovery in visitor numbers in the Middle East, up to 5% more in 2012 than in 2011. Jordan's medical tourism sector contracted in 2011 due to instability in the region, but is expected to bounce back this year, according to Awni Bashir of the Private Hospitals Association (PHA), “180,000 international patients came for treatment in the Kingdom's hospitals in 2011 compared to around 220,000 patients the previous year, indicating a drop of nearly 20 % due to the turmoil in some countries in the region that prevented patients from leaving their countries for treatment.” Historically, most patients come from Iraq, Palestine, Sudan and Yemen. The sector was particularly hard hit by the conflicts in Libya and Yemen in 2011, but the PHA hopes for a return to growth for medical tourism if the situation in these and other countries becomes more stable. With the ongoing turbulent conditions in the region, especially in neighbouring Egypt and Syria, the year ahead could be a challenging one for Jordan. During 2011, Jordanian hospitals reported a drop in the number of Libyan, Yemeni, Sudanese, Bahraini and Syrian patients. Although the figures are often reported as being medical tourists this is not accurate. The figures are for all international patients, including expatriates, embassy staff, holidaymakers and business travellers. The PHA is vague on how many of the 180,000 are medical tourists and how many are from other categories. Of the total patients who had treatment in Jordan last year, 40% were from Libya, and there are currently some 4,000 Libyans in the country's hospitals, although this includes war casualties receiving free treatment. Accepting the need to widen the target market so the country is less vulnerable to political changes, the PHA is targeting new areas such as Azerbaijan and Russia. In cooperation with the Jordan Tourism Board (JTB), it recently organized a promotional tour for delegates from the Republic of Russia representing six medical tour operators and insurance companies. PHA argues that prices offered in Jordanian private hospitals are 25% to 49% less than in Germany or Israel, and there are Russian language speaking doctors. As more Middle East countries seek to stimulate travel and medical travel, UNWTO is urging governments to make the most of information and communication technologies in improving visa application and processing formalities, as well as the timings of visa issuance.

IRAN: New law on health tourism planned

Mon, 23 Jan 2012 15:20:46 GMT

Iran attracts patients from neighbouring states mostly for transplants, ophthalmology, orthopedics and dentistry. Mohammadreza Shams-Ardekani of the Ministry of Health says, “The reasonable cost of medical treatment in Iran compared to Europe and the high quality of medical facilities are important factors for attracting foreign patients to Iran. In addition, Iran has highly experienced and professional doctors.” A draft of the bylaw on centres qualified to receive health tourists has been prepared. 60 hospitals and clinics have declared their readiness for rendering medical services to health tourists. Mohammad Morteza Sharabyani of ICHHTO's Office for Tourism Projects, says the country does not have any problem in issuing visas to health tourists, “Iran is not a country to close its door to the world. We don't have any worry about the arrival or exit of tourists. The country issues visas for tourists from 85 nations at the port of arrival.” Based on studies conducted by Iran tourism organization ICHHTO- Iraq, Afghanistan, Persian Gulf states, Central Asian nations and Iranians residing abroad are the main targets. ICHHTO provides travel agencies active in health tourism with special facilities such as a pavilion for them in overseas fairs. ICHHTO has also specified certain provinces for health tourism with the cooperation of the Ministry of Health:• Tehran province for treating tuberculosis and lung disorders.• Khorasan Razavi for ophthalmology, skin care, heart surgery and orthopedics.• Fars for liver, kidney and marrow transplants.• Yazd for treating infertility.• Qom for its sun and desert potential.• Hamedan, Ilam and Zanjan as centres of herbal medicine. Iranian President Mahmoud Ahmadinejad recently addressed a conference on medical research in Tehran and said that 30,000 people go to Iran each year to receive medical treatment, “Medical treatment in Iran is safer, more knowledge-based and cheaper. Until 8 years ago, many Iranians travelled abroad to receive medical treatment, while now we are medical tourists. Iran has taken great strides in science and technology, particularly in medical and medicinal fields, in recent years."

UK: Are dental implants cheaper in the UK or abroad?

Mon, 23 Jan 2012 15:18:52 GMT

A UK dental provider argues that dental implants are cheaper at home than overseas. But with prices so variable around the country, it can be worth checking prices at home and overseas. UK based cosmetic dentistry provider Dentalcare Plus argues that it is now cheaper to have cost-effective dental implants at home, so there is no need to go to Thailand, Poland, Bulgaria or Hungary to receive low cost dental implants. The strong pound and the rise of discount airlines are factors that make the treatment appear cost-effective. Dentalcare Plus has significantly lowered the prices of its dental implants, and competitors are following suit. It has three clinics in Cornwall, Bristol and London, with a new clinic opening in Harley Street soon. The company suggests that while many overseas dental companies claim that dental treatment abroad is less expensive, it is important for the prospective patient to make their own evaluation to understand whether it would be less expensive than competitively priced implant treatment in the UK. When planning to go abroad, it is not just the cost of the implant that needs to be considered, but also the travel charges, meals, accommodation, miscellaneous expenses and income lost from staying off work for several days. Dental implant treatment seldom requires only a single visit, resulting in further overseas travel costs. Generally, dental implant procedures require three days of visiting the dental practice at various times of the year. So the costs of the outbound and return flight, accommodation, meals and related expenses are multiplied three times. It makes an interesting point – that when the implant is being placed it is essential to spend a minimum of three days in the country following the surgery, as airlines do not allow post-operative patients to travel due to a risk of increased blood flow resulting from the low air pressure in the cabin of a jet flying at approximately 35,000 feet. The company suggests that there is a problem of being unable to verify the capability of foreign dental surgeons. Each country has its own standards of assessing dental surgeon competencies. While these standards are stringent in countries such as UK, USA, Australia and western European nations, it can often be difficult to determine if dental tourism destinations such as Poland, Bulgaria, Hungary and Thailand have such stringent regulations in place, and even if there are, whether the clinic is following them. Dentalcare Plus suggests, "Some dental practices outside of the UK get away with issues which would usually attract the interest of Trading Standards, with some dental tourists reportedly being drawn in by photographs of apparently world class facilities but then finding the actual clinic to be considerably less well equipped. With Dentalcare Plus, as with any UK dental practice, safety is assured due to organizations such as the General Dental Council (GDC) strictly regulating the British dental industry. It is also important to consider the level of after-care treatment that is available. Many complications which arise later are often not resolved by the foreign dental clinic which provided the initial treatment, as it is not always feasible or cost-effective to book hotel rooms and flights to correct the problems.” Dentalcare Plus argues that dental implant treatment at home is now more cost-effective than receiving the treatment abroad, considering the expense involved in making overseas trips for treatment, “With a lower overall cost, the additional assurance of the competency of dental surgeon and high standard of aftercare in the UK, the making the choice between receiving implants here or abroad has never been easier.”

CROATIA: EU membership will strengthen Croatia in the health tourism sector

Mon, 23 Jan 2012 15:14:40 GMT

Croatia has signed a EU accession treaty, paving the way for the former Yugoslav republic to join the 27-country bloc in mid-2013, after almost a decade of long and often fraught negotiations. Before it formally joins the EU on July 1, 2013, citizens have voted on the question in a referendum. Two-thirds of Croatians voted in favour of joining the European Union. Croatia is the second of the six republics that formed the old Yugoslavia to join. Of the six - Bosnia, Croatia, Macedonia, Montenegro, Serbia and Slovenia - only the latter is an EU member, since 2004. With a population of only 4.2 million, its economy is based mostly on Adriatic coast tourism. It has been largely in recession since early 2009 so sees health tourism as a way of extending its tourism trade and expanding the economy. Croatian food giant Agrokor has pledged a 100 million Euro investment into a new wellness centre that will form part of medical rehabilitation facilities in Daruvar spa (eastern Croatia). The spa is well known for its rehabilitation facilities, but the new investment would strengthen its role in continental tourism with the expansion of sport and recreational offers. The new tourist complex will cover a vast area. Another new investment of 16 million euros is spread over 12,000 square metres. The Analiza Hospital in Dugopolje on the outskirts of the Adriatic port of Split will boost health tourism in southern Croatia. Once completed it will be Europe's third biggest private hospital. Marin Bosotina of Analiza Hospital explains, "We are developing a modern project that will have an impact not only in Croatia, but also in surrounding countries. At the moment, we have 14 departments, two operating theatres, a biochemistry lab, microbiology, cistology, genetics, complete radiology, CT, mammography, densitometry, and ultrasound. We expect to complete the next phase in 2012. That will include 4 operating theatres, a large rehabilitation department, intensive care, and accommodation with 120 rooms for 220 patients together with restaurants, a shopping centre, congress centre and a pharmacy. This project goes beyond Croatia. It is a European project. We are unique in Croatia not only for the size of the hospital, but also for our organisation, equipment and staff. We have hired people who worked abroad, in the USA, Germany, France, and Italy." The hospital admits that it does still need a good investor from outside the country but says that it expects to attract foreign patients as it can offer cheaper prices and EU standards of quality.

GERMANY: Berlin targets health tourism

Mon, 23 Jan 2012 15:08:39 GMT

More and more patients going to Germany for medical treatment are choosing to go to Berlin. With 18,000 specialist doctors, 121,500 hotel beds, 70 hospitals, and state-of-the-art spa facilities, the German capital offers an excellent location for medical and health-related travel. All the large Berlin hospitals have international patient centres to look after foreign patients and many hotels make special provisions for medical tourists. Wellbeing and health-related tourists are a profitable target group for the German capital. While a typical visitor to Berlin will stay for 2.3 days on average, hotels are finding that health visitors stay for 10 to14 days. Charité – Universite Medicine Berlin hospital recorded a 20 % growth in international patients in 2011. The Charité has an international reputation and extends over four campuses with more than 100 clinics and institutes bundled under 17 CharitéCenters.It has an international patient centre, while the Charité-owned Virchow Guesthouse is located on the campus, offering patients and accompanying family members 22 guestrooms in a bed and breakfast hotel. Burkhard Kieker of visitBerlin explains, "Combining Berlin's two big players, the health care sector and tourism, is the obvious thing to do. A good year ago we begun to gather together all those involved so as to promote the wellbeing and health tourism sector. So as to be well prepared for the future the city is tapping into this trend and we see great growth potential for Berlin". A section of the visitBerlin website is devoted to health and offers detailed information on hospitals, specific treatments, wellness, and health checks. Petra Hedorfer of the German National Tourist Board (GNTB) adds, "We have firmly anchored the health trend in our marketing and sales activities. Our central marketing platform, the GNTB website, provides information on health and medical-related travel in 26 different languages including Russian and Arabic. With the website we provide potential travellers from important source markets with extensive information on Germany and promote it as one of the leading health countries in the world". For the last year, visitBerlin has been actively marketing health tourism abroad. A close network of partners has grown up and in spring 2011 a website was launched in English, Russian and Arabic as these are the countries where demand is highest. At international trade fairs such as Arab Health in Dubai, visitBerlin advertises the German capital as a destination for health-related travel often in collaboration with Berlin Partner, Health Capital Berlin-Brandenburg and the GNTB.

GLOBAL: Patients Beyond Borders and Medeguide form alliance

Mon, 23 Jan 2012 15:04:22 GMT

Patients Beyond Borders, a source of consumer and industry information about international health travel, and Medeguide, an online international doctor directory, have formed an alliance to provide patients with search tools for global healthcare options, and to provide hospitals and health travel third parties with a unique offering of branding and marketing tools for the international patient. Patients Beyond Borders and Medeguide will exchange their information and services, allowing patients everywhere to search hundreds of leading international hospitals and thousands of the world's best doctors throughout Asia, Latin America, Europe, and the US by specialty, procedure, region, and cost. Healthcare providers and networks can take advantage of a wide offering of marketing and branding tools tailored to maximize international visibility through online, mobile and light device apps, video, social communications, and traditional publishing channels. Ruben Toral of Medeguide says, “Merging our product lines will create a comprehensive programme for those ready to take their international marketing campaign to the next level, and will create a win-win for healthcare consumers seeking reliable healthcare information. Josef Woodman of Patients Beyond Borders adds, “ Access to trusted, vetted information is key to millions of patients worldwide who are seeking quality and cost options, whether across town or across oceans. Our alliance is a big step toward connecting leading international hospitals and doctors to healthcare consumers in this currently underserved global marketplace.” Medeguide, based in Bangkok, Thailand, is an online doctor directory that lists doctors from leading hospitals in medical travel destinations. Popular with expatriates and medical tourists, Medeguide allows users to find doctors by country, hospital, specialty, procedure, or condition. Users can view and compare doctors' information without the hassle of going through multiple hospital websites. Medeguide's easy-to-use online platform enables users to get recommendations about doctors from other patients, request appointments, and read articles about doctors, treatment options, and destinations. Patients Beyond Borders provides independent information to healthcare consumers and industry leaders, through books, e-books, consumer websites, mobile devices, and social media. Patients Beyond Borders, soon to be released in its third edition, is a leading consumer reference guide for medical tourism.

GLOBAL: Medical tourism training programme for international patient centres

Mon, 23 Jan 2012 14:27:45 GMT

An increasing number of hospitals are setting up international patient centres to help medical tourists with treatment, accommodation and travel; but they often need help. Medical Tourism Training has launched a new training programme "Welcoming the World" for international patient centres. "Welcoming the World: building an outstanding international patient department" is an online and on-site offering. Medical Tourism Training is a US based global training and consulting company offering on-site training and consulting services for dental and medical clinics as well as hospitals. Created by its team of healthcare and training experts, it is a fully scalable and flexible package for both new and established international patient centres. Providers small and large will benefit from the training, systems, forms and structure of this offering. With a focus on the customer experience, the programme offers practical and detailed information about staffing, department infrastructure, forms and systems, billing and financial issues, and concierge services. One of the creators is Pam Frank, former director of international health services at Children's Hospital, Boston, Massachusetts, “We focused on the basic information dental and medical care providers need to build or improve services for patients coming from different countries or regions. These valuable clients and their family members notice every detail from arrival to departure plus they serve as word-of-mouth advertising, both good and bad. To succeed, healthcare providers must deliver a patient experience that is better than their competitors.” The affordable on-line course gives users the option to study to their own pace, in the comfort of home or office. With a running time of more than five hours plus knowledge checks and reviewing sample documents, it is a complete do-it-yourself kit. Clients can take advantage of adding additional support with essays questions including expert feedback or purchasing online consulting services to answer specific questions. Medical Tourism Training offers stand-alone consulting services in English, Spanish, Portuguese, and Arabic for clients who want the company's team of experts to provide services on site to build or improve patient services. Elizabeth Ziemba of Medical Tourism Training says, “Set goals, schedule time, and share the information with co-workers. This will contribute to improved learning, sharing content, and implementing what is learned. Turning individualized learning into team work generates the most value for employees and employers”.

USA: Medaway and Gorgeous Getaways expand their offices to the US

Mon, 16 Jan 2012 16:52:16 GMT

Medaway Health and Gorgeous Getaways, the avant-garde partnership companies of medical tourism and cosmetic surgery have announced their corporate expansion to the United States with two offices opening in New York City and Miami, Florida. Since 2004, the companies have served as a research platform for internationally recognized surgeons and hospitals; a holistic and safe support system for patients traveling abroad for these procedures while offering a range of services from diagnosis and treatment to travel arrangements. The surgeons sought have a minimum of 10 to 15 years experience and treat every patient personally, possessing the ultimate goal of complete and successful recovery. The company considers their longevity in the industry as medical tourism experts by offering surgery holidays all over the world. Over the past 8years, patients have traveled to countries such as Malaysia, Thailand, , Costa Rica, and Mexico to have their procedures done by world renowned surgeons. Not only does the company pride itself with superb customer care, it works with tourism bodies, affiliates of the industry, as well as the local government. CEO Rachel Rowling is ecstatic about the expansion. “The company has grown so much since 2004, and I am honored to announce our expansion into the United States markets. We look forward to continue to make our clients happy with medical tourism and their surgery choices. We believe that it is an outstanding alternative to the rise of medical costs in the United States, and we believe our Clients are for Life” which translates to our clients having a rich and rewarding healthy future! Medaway Health and Gorgeous Getaways is looking to further offer the best in medical tourism to the growing United States market. According to Deloitte Center for Health Solutions, it is estimated that Americans will spend $21.4 billion dollars in 2012 for medical tourism. This amount is only going to increase as health care costs maximize each year by 9 percent. The safety and quality of care available overseas is no longer an issue as many of these facilities are accredited by the Joint Commission International. In order to streamline their message in the US, Medaway Health and Gorgeous Getaways have retained New York based media relations firm Cordelia Donovan Inc. Medaway Health and Gorgeous Getaways look forward to a successful 2012 with their two new offices at 245 Park Ave ,24th fl, NY, NY 10167 and 1111 Lincoln road 4th fl Miami Beach, Fl 33139.

UK: Dental treatment abroad by auction

Mon, 16 Jan 2012 16:48:19 GMT

A new auction site claims that it will shake up the dental tourism industry. ClickFlySmile has launched a new dental auction tool that enables patients to compare dental treatment costs in the EU. The company argues that people spend too much time finding the right clinic and treatment options and could still be concerned about the quality of the treatment abroad, while dental tourism agencies charge extra money for their services. The dental auction tool allows customers to make choices on their dental treatment, with a wide selection of dental clinics and treatment options. Only fully screened dentists are listed who have experience in treating international patients. How qualified Intice Ltd is to screen dentists, as it is not an approved health accreditor, is an interesting point. The organization provides no information on how it assesses or selects the participating clinics. Intice Ltd is a tech development company that appears to have no background or expertise in healthcare, nor involvement from dentists or healthcare professionals. Its previous development project is a calendar sync tool for the iPhone. Erwan Allene of Intice, owner of ClickFlySmile.com, says, “There are a huge number of people who would love to have dental treatment abroad. If only they had a tool that makes it simpler for them to find the finest clinics and the largest choice of treatment plan options. We believe this new auction tool allows patients and dentists to meet regardless of time and space.” Auctioning of services is always tricky as it encourages customers and providers to concentrate on the bottom line price rather than differences in quality of treatment or service. No two dentists are alike, and there is no universal standard of accreditation for dentists across Europe, it varies widely both between country, and within countries depending on what type of dental treatment is involved; a dentist may be brilliant at dental implants but have little experience of cosmetic dentistry. We wait to see how the UK dental profession and the British Dental Association reacts to this auction approach to the marketing of dentistry.

TAIWAN: Taiwan receives first Chinese application for medical tourism

Mon, 16 Jan 2012 16:46:23 GMT

The first application for Chinese visitors seeking to go to Taiwan for medical treatment was submitted to the National Immigration Agency (NIA) one day after the new initiative took effect. Mainland Chinese can now visit the island specifically for the purpose of having physical examinations, elective or non-urgent surgery and cosmetic procedures. The application was filed by Taipei-based Shin Kong Wu Ho-su Memorial Hospital, which is expecting to receive a 26-member group from the Chinese province of Liaoning, headed by the president of a Liaoning-based hospital. Scheduled to arrive in mid February, the members of the group will undergo advanced health screening programs such as positron emission tomography, and learn more about Taiwan's techniques in health checkups and cosmetic surgery. During the six-day trip, the group is also scheduled to visit top tourist attractions around the country such as Taroko Gorge in Hualien County and Alishan National Scenic Area in Chiayi County. Under a new measure for 2012, Chinese people can now go to Taiwan for health checkups or cosmetic surgery. Medical facilities qualified to provide such services can apply to the NIA on behalf of the potential visitors. It will take five days to review and approve applications. These will be given top priority for processing by the NIA with life-threatening cases put on a four-hour fast track, even during weekends and public holidays. Under the programme, visitors from China can stay in Taiwan for up to 15 days, including three days for shopping and tourism in addition to medical treatment. Before the new initiative came into force, Chinese visitors seeking health checkups or cosmetic surgery in Taiwan only had access to medical treatment as part of group or individual travel itineraries. Compared with China, Taiwan provides quality services at more modest prices. 30 Taiwan hospitals and clinics are qualified to submit applications to the National Immigration Agency (NIA) on behalf of their potential Chinese clients for entry to receive medical treatment in Taiwan. The 30 hospitals include National Taiwan University Hospital, Taipei Veteran's General Hospital, Cathay General Hospital and Adventist Hospital in the north, China Medical College Hospital and Changhua Christian Hospital in central Taiwan, and E-Da Hospital and Kaohsiung Medical University Chung-Ho Memorial Hospital in the south. More small-scale hospitals and cosmetic surgery clinics are expected to be added to the qualified list soon. Although Taiwan's health care providers had only 85,000 medical tourists in 2011, this is considered something of a success given the government did not begin making significant headway in growing the industry until President Ma Ying-jeou took office in May 2008. Internationalized health care became one of 10 emerging service industries selected for intensive development. The government is also establishing special international medical zones, seeking to raise substantial sums in private investment for the planned aerotropolis project near Taiwan Taoyuan International Airport. An estimated 40,000 tourists are expected to visit the zone each year. With four of these zones in the pipeline, Taiwan has committed to going head to head with regional competitors. The government is banking on these facilities, along with the state-of-the-art health service technologies and low treatment costs, to take business from competitors. For Taiwan's hospitals and clinics, mainland Chinese represent a surefire way to bolster the number of tourists seeking treatment on the island. Many of the island's hospitals were instrumental in laying the foundations for the development of this market. The tour packages they put together, which combined sightseeing and treatment, left participants more than impressed by Taiwan and the standard of its medical facilities and workers. The anticipated influx of patients from Europe and the USA has not happened. The county blames the financial crisis, but other factors such as distance, culture, air miles and poor language skills may be as important. So the government and the local medical tourism industry are now concentrating on a target market where language, culture, short distance and low cost all make it attractive for more mainland Chinese to go to Taiwan as medical tourists. The government's pragmatic approach to cross-strait relations, ignoring the historic severe problems between the two, has been the catalyst for this development and plays a valuable role in helping Taiwan to become a major player in medical tourism. The proactive, co-ordinated, targeted nature of government support is in contrast to better known local rivals who may suffer for their assumption that being an early entrant to medical tourism is enough to prosper in the future.

USA: More employers to follow PepsiCo and Lowe's on domestic medical tourism

Fri, 13 Jan 2012 15:48:30 GMT

US hospitals that made deals with major US employers are negotiating with other national companies on domestic medical tourism. Cleveland Clinic and Johns Hopkins are negotiating with several national employers for deals involving a bundled payment that covers most of the necessary care related to a particular procedure. Payments are then distributed to physicians and others involved in care. An outside company generally arranges travel provided to patients and their companions. Employees get the option of local care or travelling, with incentives to travel, but no there is no compulsion to do so. Lowe's has 234,000 employees plus dependents covered by its self-funded health insurance plan. In February 2009 it made heart surgery at Cleveland Clinic an employee benefit. During the past year, Lowe's has paid for 38 employees or their dependents, including three children, to travel to Cleveland Clinic for heart surgery that was fully covered by health insurance with no co-pays or deductibles. Lowe's considered hospitals in Mexico, but went for Cleveland Clinic when it became clear that domestic travel would get more buy-in from workers as an extra option, and that with many employees living in rural areas, going to Cleveland is a big decision but more attractive than Mexico. PepsiCo, the world's second-largest food and beverage business, has a new deal giving employees the option to travel to Johns Hopkins Medicine in Baltimore for cardiac and complex joint replacement surgery. The travel surgery benefit is for PepsiCo's domestic employees and their dependents, almost 250,000 people. PepsiCo, which sponsors its own self-funded medical plans, will waive deductibles and coinsurance for those who elect to have their surgery at Johns Hopkins. The company will also cover the travel and lodging expenses to Baltimore for the patient and a companion. The payment methodology for these procedures is a bundled rate, an all-inclusive rate for hospital and physician charges and certain preoperative testing. This innovative reimbursement model provides payment for all the patient care over the course of a clinical episode instead of paying for each service on a fee-for-service basis. Patricia Brown of Johns Hopkins HealthCare says, “We are offering their employees some of the best health care available, which should mean fewer complications and should result in employees being able to return to work sooner. At the same time, we are offering PepsiCo predictability regarding cost.” Bruce Monte of PepsiCo explains, “This is designed to help our employees and their families live healthier lives and ensure a high level of workforce support.” To be eligible, the patient must be approved for surgery in advance and be healthy enough to travel. Other types of surgery may be made part of the programme in the future. The company looked at overseas providers but preferred to stay in the USA, is looking at other US deals, and will look at overseas providers for employees outside the USA. For national US companies, and their insurers, international medical tourism is yet to take off. Employers are looking closer to home as a means of controlling health care costs and improving outcomes. Some US medical tourism agencies are shifting their focus to domestic trips. Several cities, including Miami and Las Vegas, are starting to market themselves as destinations for healthcare. These deals between large companies and hospitals mean employees and their families will pay less for out of pocket for care. Companies pay a flat rate for some procedures.

SAUDI ARABIA: New hospitals and health tourism project in Saudi Arabia

Fri, 13 Jan 2012 15:24:51 GMT

Brazilian construction company Braengel has been chosen to design a $500m complex including a hospital and a five star hotel in Riyadh. The project will cover an area of 76,000 sq m in the Saudi capital city, and will also include a luxury spa, gym, shopping centre and several restaurants. The focus of the project is to offer aesthetic medicine services to women in the Middle East. The hospital will also target obesity and diabetes, two rapidly increasing problems in the area. The contract is part of a partnership established by Prince Abdulaziz Bin Mishaal Al Saud, who runs Al Shoula Holding Group, a Saudi-based conglomerate, and Marinho Uhlmann of Alicerce Business Solution Holding, the parent company of Braengel. The hospital aims to attract custom from all of the Middle East, particularly attracting women from other countries in the region to Saudi Arabia. Construction of the complex will begin in October, with the project completed in two years. The investment of $500 million is 60% from Saudi and Qatari businessmen, and 40 % from various Brazilian companies. A Brazilian company will manage the site, which is yet to be chosen by the Saudis. Three luxury spa operators in Brazil are being considered to run the enterprise. A new joint venture has been launched to develop a chain of specialised hospitals in Saudi Arabia. RED House Group, a Beirut-based real estate investment company, has forged a partnership with healthcare operator Rizk Healthcare to form RRHH (Rizk RED House Healthcare). Under the deal, RED House has handed RRHH a $1.35bn project for 10 hospitals totalling over 3000 beds in Saudi Arabia in a venture with Ebram, a Saudi investment and healthcare firm. RRRH also plans a 500-bed hospital in Abu Dhabi, UAE. The Ministry of Health plans to build a 500-bed hospital in memory of the late Prince Sultan - the Prince Sultan Bin Abdulaziz Hospital is to be built in the Riyadh. This is part of the Health Ministry plans to construct 12 new hospitals to provide comprehensive integrated health services for citizens in all parts of the Kingdom. In addition to the 12 new hospitals, which will have a total capacity of 3100 beds, the ministry will build 15 integrated clinics in Riyadh, a centre for tumours in Madinah, a centre for cancer treatment, and specialized centres for dental care. Health minister Dr. Abdullah Al-Rabeeah, says the private sector is a strategic partner in providing healthcare services to both citizens and expatriates. 10 of the ministry's hospitals are in the process of gaining accreditation by Joint Commission International.

CHINA: China stops all stem cell tourism

Fri, 13 Jan 2012 15:11:21 GMT

China's instant ban on unapproved stem cell treatment will affect some US patients, and a handful of specialist medical tourism agencies who have been accessing China for treatment that is not available in the US or most European countries. In recent years, China has attracted foreign citizens to experimental hospitals and doctors willing to treat seriously ill patients with unproven stem-cell therapies. The Ministry of Health announced that the country has stopped all unproven and experimental stem-cell treatment programmes and refuses to accept any new applications for approval of stem-cell treatments. The ban will initially last until the end of June 2012, but the chances of the ban being lifted quickly after then seem very slim. China's experimental stem-cell treatments have been used on patients with severe neurological diseases, other chronic illnesses and injuries. While some patients have said that these unproven stem cell therapy programs in China have done them good, critics argue that the benefit is purely in the mind. The government seeks to bring under control its growing but loosely regulated industry. It realizes that an official ban will not work unless it can be enforced. A ban on organ transplants is still blatantly ignored by some hospitals. The ministry is implementing a year long campaign to halt unauthorized stem cell therapy trials. Regulations on stem cell treatments were relatively relaxed in China compared to other nations and the country is often seen as a last hope for people suffering from serious medical problems ranging from cancer to spinal cord injuries. But there are many horror stories where unapproved untested stem cell treatment has led to death, disease and infection. Stem cell therapies introduce new cells into damaged tissue in order to treat disease or injury. Patients, both local and from overseas, can pay tens of thousands of dollars in a last ditch attempt to restore back functions or sight. The lucrative nature of the treatment for hospitals and agencies, as many patients will pay anything asked, means that an official ban will reduce it, but may just drive it underground. China has no specific policy for clinical trials or applications of stem cell technology. Such trials are subject to the same general regulations governing all medical practices, such as the importance of volunteers' rights and health. Stem cell treatment and trials already approved by the State Food and Drug Administration will continue. Those that are not approved must be stopped immediately-even in mid trial. The Ministry of Health and State Food and Drug Administration are working together to seek to control the expanding stem cell industry. Stem cells have the ability to become any type of cell in the human body, and researchers around the world are studying them to see whether they can cure disease. The potential of Chinese stem-cell research is high and the long-term aim of the government is to get stringent regulation working and seen to be working, so that it can sell research results, treatment and drugs to overseas countries. A growing number of hospitals and clinics in large cities in China have been offering stem cell therapies for treatment of diseases ranging from cancer and Alzheimer's to spinal cord injuries, treatments that are backed by little or no scientific evidence and which are considered at best experimental. Some of these involve large general hospitals where patients pay thousands -- or even tens of thousands -- of dollars for treatments that are advertised online, which attract both Chinese patients and those from overseas. According to patients, doctors and relatives of patients, patients have come away with little or no improvement and a number have died. The ministry has made it clear that health providers can no longer charge money for experimental stem cell applications under the new order. Whether the government can enforce the ban is questionable, as many hospitals making money from stem cell treatment are affiliated with government organisations such as the army, the PLA, and the domestic police forces, each more politically powerful than either of the enforcing government departments. They were unable to enforce a 2009 order that hospitals and clinics offering advanced and experimental medical technology had to obtain approval or face closure. Days before the Chinese ban, the United States' Food and Drug Administration (FDA) issued a warning about unproven stem cell claims, where patients are vulnerable to unscrupulous providers of stem cell treatments that are illegal and potentially harmful. The FDA warned consumers that any stem cell treatment they are considering must be approved by FDA or studied under a clinical investigation that has been submitted to and allowed to proceed by FDA. The FDA has recently participated in activity to fight illegal activity involving stem cells. In December 2011, three men were arrested and charged with 15 counts of criminal activity related to manufacturing, selling and using stem cells without FDA sanction or approval. One of these was a consultant at a university in South Carolina who used university facilities to manufacture stem cell products, then sold them to a man posing as a doctor who travelled to Mexico to perform unapproved stem cell procedures on people suffering from cancer, multiple sclerosis and other autoimmune diseases. The three defendants received more than $1.5 million from patients seeking treatment for incurable diseases. Medical tourists may turn to clinics and hospitals in Mexico, India, Turkey, Russia and elsewhere for stem cell therapies that have not undergone clinical trials, are not recognised as standard treatment, and where governments have a more relaxed view of a practice that brings in income from overseas patients.

GLOBAL: Which countries do people select as a medical tourism destination?

Fri, 13 Jan 2012 14:54:15 GMT

Working out which nationalities go where for medical treatment is an intriguing question. Speaking at a recent medical tourism seminar at the University of Texas, USA, a Texas based medical tourism agent Deepak Datta of Medical Tourism Corporation, shared his insights with a class of MBA business students. He discussed the current trends in medical tourism and the various factors that have fueled globalization of healthcare in the past decade. Deepak Datta discounted the myth that medical tourism is about flying thousands of miles across continents, “Medical tourism is a regional phenomenon, with most medical tourists preferring to visit nearby countries for their healthcare needs. While Americans and Canadians mostly head to Mexico and Costa Rica, people from Africa and the Middle East prefer to go to India. Korea is the medical destination of choice for many people from Japan, while Thailand is the top choice for most Australians.” Datta went on to explain why medical tourism is regional, “Price, safety, travel distance, visa rules, local laws and quality of healthcare are obviously the chief considerations for medical tourists while deciding their healthcare destination, but cultural influence is important. While US Hispanics head to Mexico, the British prefer other European countries.” He explained why there is some global medical tourism for certain specialties, “A destination's reputation for a particular medical service also matters and some countries are more popular for certain procedures than others. Surrogacy in India attracts foreigners struggling with infertility issues.'' An issue often wrongly dismissed by analysts is cross-border healthcare. Datta commented, “Low cost dental treatment and weight loss surgery in Mexico are preferred by Americans and Canadians, who do not want to travel too far for healthcare. Many Americans prefer to drive down to the border, get their root canals or dental implants in US-Mexico border clinics (which have mushroomed at a remarkable rate over the past few years) and return home the same day.” Central and South America, not Asia, are the destinations for many Americans, he explained, “Many people opt to get their dental implants in Costa Rica. They fly to get bariatric and cosmetic surgery in these Latin American countries, because not only the prices are low, but also the treatments are high quality. Realizing the potential of medical tourism, the doctors are prepared to deal with medical tourists and accordingly arrange for English-speaking staff. While the official and most commonly used language in Costa Rica is Spanish, it is not difficult to find a dentist or cosmetic surgeon in Costa Rica, who is fluent in English.” The attractions of Thailand were next up, “Low priced cosmetic surgery in Thailand is also a big draw for medical tourists as they not only get the cost advantage but also get to maintain privacy for their beauty enhancing treatments. Thailand, however, is preferred more by Australians as the distance is less and flights are relatively convenient. Who wants to wait in long lines to see the dentists, when you can get immediate dental implants in Thailand at less than half the price?” Medical tourism is often regarded as travelling for surgery, but this is not the bulk of medical tourism, said Datta, “Elective procedures like weight loss surgery, cosmetic surgery, fertility treatment and dental care are the most common medical services people travel for. This is probably because these are generally excluded from insurance coverage and a medical tourist is usually self-paying.” He went to explain why there is some surgical tourism, “Hospitals also get many foreign patients who are looking for major surgery because either hospitals in their home country are too busy to quickly give them an appointment and relieve their pain or they are too expensive in those countries without free medical care.” Datta dispelled the impression that medical tourism is a fast growing phenomenon, as many medical tourism agencies in North America have closed due to lack of business. He pointed out that there is no reliable data gathering methodology to validate the number of medical tourists, as countries and hospitals often include expatriates, home returning non-residents, tourists and business travellers having emergency medical services, as 'medical tourists' to boost the real figures, while spa and wellness travellers, are sometimes counted as medical tourists and sometimes not. The MBA students learnt about the challenges faced by patients and hospitals in the globalization of healthcare industry, which include the absence of any global standard patient outcome data, no clear cut follow-up regimen, language and cultural differences, safety issues at medical destinations, long travel, and complex visa laws in some countries; lack of follow up care, and how insurance companies have dismissed the concept. On the US market, Datta states, "The US probably benefits the most from the medical tourism industry, as thousands of patients from different parts of the world visit leading American hospitals like MD Anderson Cancer Center, Jackson Memorial Hospital, Cleveland Clinic, Mayo Clinic, John Hopkins, Harvard Medical, and others. Most of these patients are either wealthy individuals or sponsored by their home governments.”

SOUTH KOREA: Government strategy for medical tourism helps South Korean hospitals

Fri, 06 Jan 2012 16:23:55 GMT

While the governments of rival countries talk up medical tourism, few are so active and successful in assisting local hospitals and clinics as South Korea. The Korea Health Industry Development Institute (KHIDI) estimates that number of foreign patients in South Korea will reach 130,000 for 2011. The government is supporting the globalization of Korean medical institutions under the banner of Medical Korea, a brand campaign to promote South Korea's advanced medical services abroad. To guarantee the quality of the medical service and strengthen foreign patients' trust, the government has adopted a registry system for Korean medical institutions and agencies- over 2000 are now registered. The government has also accelerated its support for foreign patients' convenience and safety by issuing medical treatment visas, operating an around-the-clock medical call centre and one-stop medical tourism service centres, establishing an arbitration body for medical disputes and helping train medical coordinators and interpreters. Medical institutions also step up globalization to attract foreign patients. A growing number of medical institutions have been gaining accreditation from the Joint Commission International (JCI), the worldwide leader in improving the quality of health care. A total of 22 hospitals, including Severance Hospital, Seoul St. Mary's Hospital, Korea University Anam Hospital and Ewha Womans University Medical Center, were accredited as of September 2011. 58 medical institutions have established overseas branches in 11 countries to promote the advanced technology and services offered by South Korea. The health authority of Abu Dhabi, one of the seven United Arab Emirates, has signed an agreement with Seoul National University Hospital, Seoul St. Mary's Hospital, Seoul Asan Medical Center and Seoul Samsung Medical Center to have patients treated in Korea. The oil-rich country sends 130,000 people overseas for medical treatment each year at its own expense. In 2010 3000 patients from Abu Dhabi travelled to the United Kingdom, Germany, Thailand and Singapore for medical treatment, but only 54 went to Korea. According to the Ministry of Health and Welfare, 81,789 foreign patients visited Korea for medical treatment in 2010; up 36 % on 2009.The government's active promotion of medical tourism has led to the sharp increase. The total revenue from treating foreign patients nearly doubled to $88 million in 2010. The number of foreign patients in 2010 was 64,777 outpatients and 11,653 for medical screening. The number of in-patients was 5359.By nationality; the majority of patients were from the USA, China, Japan, Russia and Mongolia.14% had skincare-related treatment and cosmetic surgery while 13.5 % received internal medical treatment. Another 13.1 % visited medical checkup centers.43 went to local medical centres while 20.5 % opted for general hospitals, and 23.5 % chose clinics. With the popularity of Korean TV soaps, women in many Asian countries are saving up to get cosmetic surgery and skin care treatment in Korea.

GERMANY: German clinic attracts international patients for orthopedic treatment

Fri, 06 Jan 2012 15:43:31 GMT

A specialist German clinic is proof that high quality treatment and luxury accommodation is an attraction to international patients; and that high-end medical tourism is a thriving alternative market for countries not prepared to enter the medical tourism price war of offering lowest prices to attract custom. Gelenk Klinik orthopedic hospital is a successful provider of orthopedic surgery and treatment:• More than 24,000 orthopedic patients are treated a year.• More than 2,400 surgical procedures are performed a year.• More than 250 international patients a year• More than 50 healthcare professionals: orthopedic specialists, specialists for rehabilitation, physiotherapists and nurses.• 9 hospital beds for in house treatment..Patients benefit from the luxurious environment of a private clinic, with facilities and services adapted to the needs of international patients. Comfortable private rooms include an en-suite bathroom, minibar, safe, flat screen TV, DVD player and WLAN internet access. The hospital has international ISO 9001 quality accreditation. Germany takes a leading role in terms of medical education, medical standards and hospital quality management. German medical research and innovative technology are of the highest standard. Compromises in quality and safety are not compatible with the German culture and work ethic. Due to a long and broad education, German orthopedic surgeons are extremely well trained in the fields of conservative and osteopathic treatment. They have a deep understanding of the bio-mechanics of joints, prosthesis and mobility, with a thorough understanding of nonsurgical ostheopathic and physiotherapeutic therapy. This training gives German orthopedic surgeons the ability to preserve as much of patients natural bones and tissues as possible. The underlying cause of pain and immobility is treated with the smallest possible intervention. Minimally invasive surgical techniques, partial prosthesis and inlays are commonly used instead of total knee and hip replacements and are performed with precision. This preserves mobility and a quick recovery after surgery. The Gelenk Klinik is in Freiburg, where Germany, France and Switzerland meet. Freiburg is home to Freiburg University, one of the most important centres of medical training in Germany, and is easily accessible from Zurich, Basel and Frankfurt airports. The Hospital's support for international patients includes: • All doctors and staff members speak English.• Language support for Russian, French, Arabic, Romanian.• Support for visa application process for non-EU citizens.• Airport shuttle service with a private limousine.• Support with travel arrangements.• Support with organizing postsurgical rehabilitation in the clinic, a specialised provider in Germany or back home.• A dedicated case manager.

USA: Rabbi is first to be convicted of organ transplant tourism

Fri, 06 Jan 2012 15:38:05 GMT

In the USA, Rabbi Levy Izhak Rosenbaum has become the first person in the country to be convicted of selling and trafficking in human organs. A New York resident, Rosenbaum pleaded guilty to illegally buying kidneys from live Israeli donors for $10,000 each, which were transplanted into three New Jersey residents, who had paid at least $120,000 for the transaction. The case of Rosenbaum, whose sentencing is set for February 2, 2012, has brought the problem to the forefront that organ trafficking poses in the United States and around the globe. Transplant tourism started in the mid-1990s when medical researchers proved that, for organ transplants, a direct blood type match between the donor and the recipient was not needed. Confronted with a long waiting list of patients requiring organ transplants, more Americans are ready to travel abroad to purchase a liver, a kidney or even a heart. In 1984, the United States administration imposed a ban on the purchase and sale of human organs, but not on transplant tourism, where a person travels abroad to receive a vital organ in exchange for a sum of money that covers the price of such an organ. Over the last 10 years, the UCLA Medical Center's emergency room has seen 33 patients with serious complications after undergoing organ transplants abroad. Gabriel Danovitch, at UCLA says, “Transplant tourism is a risky and macabre business, but this form of tourism is not a large-scale problem here. Clients come from countries with higher purchasing power where laws regulating organ transplants are stricter, such as the United States and Japan. Colombia is a leader in organ trafficking, where donors are often fatal casualties from the guerrilla war, or people who died and whose bodies were never claimed. For some Japanese and U.S. citizens it is easier to pay up to $200,000 for a liver in Colombia than to wait up to 10 years to receive an organ transplant at home.“ According to the Declaration of Istanbul Custodian Group, an organization founded to regulate and fight this practice, a very large number of patients who have purchased kidneys have developed serious infections or have died. The World Health Organization (WHO) says that thousands of people globally are not willing to wait and so engage in this practice every year without weighing the potentially fatal consequences. In recent years the United States has witnessed an increasing demand for transplant organs, but while demand for vital organs is on the increase due to the deterioration of Americans' health, the number of donors is not increasing proportionately. Organ transplant tourism has become popular in countries such as Colombia, Egypt and the Philippines, according to the Istanbul Declaration - an organization that is supported by doctors and researchers of countries in which transplants are performed. While several countries have outlawed the process, the vast profits for a small expense are a temptation for dishonest doctors and the criminal gangs that control the trade.

SINGAPORE: Farrer Park healthcare and hospitality complex will open in 2013

Fri, 06 Jan 2012 15:33:19 GMT

Connexion at Farrer Park will be one of the world's first integrated healthcare and hospitality complexes with Farrer Park Medical Centre, Farrer Park Hospital, and One Farrer, a luxury hotel with wellness and conference facilities. Connexion is expected to be fully operational in 2013 for locals and medical tourists. The developers have changed their name from Singapore HealthPartners to The Farrer Park Company to tie all Farrer Park facilities under one clear identity. Connexion at Farrer Park is built directly above the Farrer Park MRT Station. It has a six-storey centre with two 20-storey high-rise wings. The west wing houses Farrer Park Medical Centre while the east wing combines Farrer Park Hospital and the hotel. Hotel guests can enjoy the privacy and facilities of a distinctly separate hotel with easy and rapid access to medical facilities within the same complex. Farrer Park Medical Centre will be home to more than 200 medical specialists occupying 189 medical consultation suites. The physicians and surgeons will be specialists in diverse medical fields. Outpatients have the choice of recuperating and resting in the comfort and privacy of their hotel rooms at One Farrer after a day surgery or a routine check-up. Farrer Park Hospital is one of the first private hospitals to be built ground-up in Singapore in the last 30 years. As a wholly new development, it is able to incorporate and effectively integrate the tremendous advances in hospital design and medical technology that have transformed healthcare in the past three decades. It will have 11 operating theatres, three day surgery units with a total of 60 attached beds, a 23-bed intensive care unit with state-of-the-art diagnostic imaging services, three endoscopy suites, a radiotherapy department, clinical laboratories, a full-service pharmacy and the most advanced implementation of hospital information technology. A unique feature of Connexion is the twinning of Farrer Park Hospital with luxury hotel One Farrer that offers guests accommodations ranging from serviced apartments to villas to standard hotel rooms. One Farrer will have a large ballroom and banquet hall, seminar rooms, conference facilities, two large spas, two gymnasiums, swimming pools, a ground-floor retail arcade and a range of food and beverage outlets. Travellers to Singapore, who have special health requirements such as kidney dialysis, frequent respiratory care, or the need for regular injections and infusions, can opt to stay in One Farrer with essential medical support amenities at their doorstep. Family and friends, who provide significant emotional and physical support, can stay in the same hotel. On the ground level of Connexion, there will be a mix of lifestyle retail, amenities and services for the leisure, business and medical tourism traveller.

MAURITIUS: Mauritius needs strategic focus to develop medical tourism sector

Fri, 06 Jan 2012 15:28:44 GMT

Among the critical factors for a country to be a successful medical tourism destination it has to have geographical proximity, good airlinks, comfortable environment, friendly people, unrestricted travel, and a broad spectrum of accommodation choices for both high-end clients and less well-off ones. All that before even looking at the medical care, quality of hospitals and price. Mauritius satisfies many of these conditions and the number of privately owned clinics and hospitals is increasing. The government is working on a regulatory framework to address the socio-economic and ethical issues surrounding high tech cures. It is in the process of setting up the appropriate frameworks for stem cells treatments. Mauritius has its own medical schools, and many doctors are trained overseas. Foreign doctors fly in to practice locally. The Mauritian healthcare facilities treated some 11,000 foreigners in 2010 year and about 100,000 medical tourists are expected to visit the island by 2020. Most medical tourists come from the South West Indian Ocean region, with a few from South Africa, France and the UK. If Mauritius wants to achieve the target of tenfold increase in medical tourist arrival by 2020, it has to diversify its markets. The long distance from Europe means patients are reluctant to travel to Mauritius for surgery. To succeed, Mauritius must focus on the regional market. But almost all patients from Southern Africa tend to go to South Africa, while those of Eastern Africa find easy access to Nairobi, which is positioning itself as a regional medical centre. Perhaps the best opportunity for Mauritius is to drastically improve the marketing strategy in the oil-rich countries of the Middle East, where it would compete with many others including Turkey and India. With its 350 million population, the Arab world still has a great need for treatment overseas; but with local hospitals mushrooming, how many years that will last is debatable. Mauritius only needs a fraction of this market to achieve the figures. Mauritius must actively raise an awareness campaign on this market, overcome its image deficit in the Middle East and multiply the air connections towards this region. Another potential and perhaps longer term market is China. Chinese enterprises are spending $1 billion on a special enterprise zone in Mauritius, on the island a thousand miles off the coast of the African continent. Mauritius is a gateway between Asia and Africa and could act as a regional business hub due to its market-access, stability and business climate. Mauritius is a member of the Southern African Development Community and the Common Market for Eastern and Southern Africa. Only 10 to 15% of the 40,000 jobs to be created will go to Mauritians, the majority will be Chinese expatriate workers who will need medical care. The zone will be a Chinese administration centre for all the African countries that the Chinese are investing in, so the zone will be mostly offices, hotels, apartments, recreational services, schools and medical facilities.

GLOBAL: AAAHC international accreditation gathers pace

Fri, 06 Jan 2012 15:26:43 GMT

Following a successful start to accrediting Costa Rica clinics that desire international accreditation to help in their efforts to attract more American medical tourists, AAAHC International is now keen to expand into other countries in South and Central America. AAAHC International, a subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC) has accredited the Luis Kaver Clínica Dental, a cosmetic dental clinic, the Hospital Clinica Metropolitana, a multi-specialty ambulatory health care clinic, and Instituto Centroamericano de Medicina ICEM-all in San Jose, Costa Rica, under the AAAHC international accreditation programme. John Burke of AAAHC comments, “With the growth of medical tourism and the significant number of Americans living abroad, we believe it is important to offer a programme that helps ensure that ambulatory medical services in foreign countries meet high standards. By voluntarily participating in the AAAHC accreditation process, these ambulatory organizations demonstrated their commitment to the safety and quality of the care they offer patients. The AAAHC peer-based survey process makes our accreditation unique, and enable us to work closely with ambulatory centres to assess their services and assure they provide high-quality care.” The accreditation surveys were conducted by a team of U.S.-based AAAHC surveyors who are themselves active practitioners of ambulatory health care. The first organization to be accredited by AAAHC International was the Nova Dental Center in San Jose, Costa Rica. 95% of customers of the Nova Dental Center, a full-service dental clinic that specializes in cosmetic dentistry, are from the USA. Luis Obando of Nova Dental Clinic says, "The accreditation process was a lot of work to get everything together to meet the standards, but in the end it helped to improve our clinical and administrative processes." Nova Dental received a three-year accreditation. The association launched its international accreditation program in Costa Rica, and other clinics in that country have begun the process toward AAAHC International accreditation. The AAAHC will soon add accreditation for ambulatory organizations in other Central and South American countries. AAAHC International is a subsidiary of the Accreditation Association for Ambulatory Health Care (AAAHC). Founded in 1979, AAAHC is the leader in ambulatory health care accreditation with nearly 5,000 organizations accredited nationwide. AAAHC accredits a variety of ambulatory health care organizations, including ambulatory surgery centres, office-based surgery centres, college student health centres, managed care organizations, military health care clinics, large medical and dental practices and medical homes. Third-party payers, medical organizations, liability insurance companies, state and federal agencies and the public recognize AAAHC accreditation as a symbol of quality. In 2012, all AAAHC accreditations will be for a standard three-year term and the less common six-month and one-year terms will be discontinued. Following an accreditation survey, there now will be only two possible outcomes: a three-year term or a denial of accreditation. The policy is effective for organizations that apply for accreditation on or after March 1, 2012, or have their surveys conducted on or after July 1, 2012.Organizations that receive accreditation but have some deficiencies will be required to submit a plan for improvement within 10 days of receiving the accreditation decision. After reviewing the plans for improvement and the survey report, the AAAHC accreditation committee will determine if an organization will require an interim survey. Organizations that demonstrate compliance with all AAAHC standards at the interim survey will maintain accreditation for the remainder of the three-year term. Organizations not in compliance may have their accreditation term revoked. In accordance with existing AAAHC policies, random and discretionary surveys of any organization also may be conducted.

GLOBAL: OECD comparisons of international health systems

Fri, 30 Dec 2011 16:35:44 GMT

The availability and quality of care at home are key drivers of medical tourism. The latest study by the Organization for Economic Cooperation and Development (OECD) evaluates the state of healthcare in all 34 member nations, including how much each government spends on healthcare, and how much its citizens have to pay out of pocket. This sixth edition of 'Health at a Glance' provides the latest comparable data on different aspects of the performance of health systems in OECD countries. It provides striking evidence of large variations across countries in the costs, activities and results of health systems. This edition presents data for all OECD member countries. Where possible, it also reports data for Brazil, China, India, Indonesia, the Russian Federation and South Africa, as major non-OECD economies. It uses OECD Health Data 2011, the most comprehensive set of statistics and indicators for comparing health systems across the 34 OECD member countries. The quality of medical care is improving in OECD countries, with higher survival rates for life-threatening diseases. But there is a need for better prevention and management for chronic diseases, such as asthma and diabetes, with too many people unnecessarily admitted to hospitals. Obesity is a key risk factor for many chronic conditions, with severely obese people dying up to 10 years earlier than those of normal weight. 'Health at a Glance 2011' shows that obesity rates have doubled or even tripled in many countries since 1980. In more than half of OECD countries, 50% or more of the population is now overweight, if not obese. The obesity rate in the adult population is highest in the United States, rising from 15% in 1980 to 34% in 2008, and lowest in Japan and Korea, at 4%. In 2009, the country spending the most on health was, by far, the United States, devoting $7,960 per capita, two and a half times the OECD average. The next highest spending countries, Norway and Switzerland, spend only around two-thirds of the per capita level of the United States, but still spend more than 50% above the OECD average. Despite public concerns about privatisation of health financing, the public sector continues to pay 72% of all health expenditure on average across OECD countries, a share that has not changed over the past 20 years. Long waiting times are often seen as a reason for people becoming medical travellers. Since there are no universally accepted definitions of waiting times, data derived from different sources and different countries are not be fully comparable. Waiting times for specialist consultations were higher in Canada, Norway and Sweden, with 50% or more of survey respondents waiting at least 4 weeks for an appointment. In Germany, Switzerland and the United States, more timely access was provided. Waiting times for elective surgeries such as cataract removal or hip replacement also show substantial differences. In 2010, a considerable proportion of patients in Canada, Sweden, Norway, the United Kingdom and Australia reported waiting four months or more for elective surgery. Waiting times can vary within countries. Though very moderate waiting times for a doctor consultation are reported for Germany, patients in the eastern part of the country report waiting longer. There is evidence from several countries, including England, Germany and Austria, that persons in higher socio-economic groups or with private health insurance have shorter waiting times. The report warns that it can be cost-effective to maintain short queues of elective patients because the adverse health consequences of short delays are minimal, and there are savings in hospital capacity from allowing queues to form. They may also deter patients who stand to gain only small health benefits from demanding free treatment.

MALAYSIA: Malaysia to relax advertising guidelines for medical tourism?

Fri, 30 Dec 2011 11:25:03 GMT

Advertising guidelines for the healthcare sector in Malaysia may be further liberalized in 2012 to promote medical tourism and ensure targets under the National Key Economic Area are achieved. Health minister Seri Liow Tiong Lai says health practitioners appealed to the government for a review of the guidelines because they were losing out on medical tourists, "Although doctors and hospitals are now allowed to advertise their services, there are certain limitations. We will review this and see how it can further boost the health industry. Since healthcare travel has been identified as one of the entry point projects to generate greater income and create new jobs, this will be considered.” Health practitioners cannot claim to be the best providers of a particular treatment and are not allowed to use too many personal photographs to promote themselves. The government hopes that by 2020, the country will attract 2 million medical tourists a year. In the first nine months of 2011, 350,000 foreigners, most of whom were Indonesians, sought treatment in Malaysia. 2010 saw 400,000 medical tourists. Malaysia still struggles to compete with Singapore and Thailand. The health minister has told private healthcare providers to improve their services and facilities in order to be on par with their foreign counterparts, if not better, “Clearly, our private hospitals have to improve their quality of service in order to remain competitive, but I am confident it can be done. Competitors such as Singapore and Thailand have shown stronger growth in this area and have established themselves as leaders in high value healthcare experiences.“ As part of recent budget measures, the private healthcare service industry will be liberalized to allow up to 100% foreign equity. The government has initiated various strategies to transform its healthcare tourism industry by marketing itself beyond Indonesia, which makes up about 80% of Malaysia's revenue in healthcare tourism. The Ministry of Health is setting up call centres in China and Indonesia in 2012 to attract more medical tourists, and is targeting China, Australia, the Middle East and the UK. The government has been supporting the industry with significant investment in many areas, including the refurbishment of existing hospitals, building and equipping new hospitals. More hotel/resort spas are opening across the country, increasing from 108 outlets in 2009 to 130 in 2010, as the demand for these resorts has soared. Malaysia badly wants this niche market, as medical visitors spend more than leisure travellers, stay longer and also tend to become repeat visitors. People are starting to go to Malaysia from the UK, Australia, New Zealand, the Middle East and USA for cosmetic surgery. The latter group tends to come for cosmetic surgery and dental treatment, while Indonesians come for medical treatment. If Indonesia builds the hospitals it promises, then many Indonesians will stay at home, which is why the country is urgently trying to seek new markets.

TAIWAN: Medical travel gets new apps and an insurance deal

Fri, 30 Dec 2011 11:23:09 GMT

Taiwan is gearing up for more Chinese and American medical tourists. It has launched a new app service for medical travel that provides handy information on tourist attractions and healthcare facilities around the country. The app, designed by the Taiwan External Trade Development Council (TAITRA) under commission from the Department of Health (DOH), has versions for English, as well as for traditional and simplified Chinese. The service, which is free, covers information ranging from health checkups to cosmetic medicine, with a map service for each listed facility. Users can access information on the 31 medical and healthcare facilities under the DOH's international medical programme. Now available for iPhone and iPad users, the App will expand to Android users in the first quarter of 2012. Four major hospitals in Taiwan have signed a cooperation agreement with New Era Life Insurance Co. of the USA to provide unique medical services to American policyholders of the insurer when they choose to get medical treatment in Taiwan. New Era Life Insurance of Houston, Texas, will pay for American customers to get medical services at the Taipei Medical University Hospital, Chang Gung Memorial Hospital System (made up of hospitals in different areas in Taiwan), Changhua Christian Hospital in central Taiwan, and E-Da Hospital in southern part of the island. New Era Life Insurance has designed a US medical insurance policy for customers who can speak Chinese. The new service will help American customers, including Taiwanese who hold U.S. passports, to get medical treatment in Taiwan - including health examinations and cosmetics surgery, which are uncommon in insurance policy contracts. The customers can also get treatment in the USA. The details are still vague but founder Bill Shun-zer Chen, a Taiwanese immigrant, suggests customers have to pay a bigger share of medical costs if treated in the USA and funding for air flights to the island for themselves and families. The insurance group is controlled by shareholders who are primarily Asian and has 150,000 policyholders. The company makes the bold claim that they plan to sell it to 1% of the total 20 million Asian Americans. We will get 1% of the total market - is a marketing claim that turns off experienced investors as it never happens. Keeping this deal in perspective, by the standards of US health insurers the company is tiny, the equivalent of a family retailer when compared to insurance supermarket Cigna. In any one year, if more than 5% of the 150,000 policyholders have a medical claim in any one year then the insurer would lose money. The big question is how many of these US based Asians will rather be treated in Taiwan than in the USA. Similar deals for other countries have yet to find more than a handful, if any, US policyholders prepared to go overseas even when they have overseas links. What may determine the answer is how good the incentive is for the policyholders to go to Taiwan. This is an interesting pilot, but neither the insurer nor the hospitals should expect a rush of medical tourists.

GLOBAL: Global Comparators seeks 30 more hospitals to make international comparisons on healthcare quality

Fri, 30 Dec 2011 11:17:34 GMT

The Global Comparators project is a unique opportunity for leading hospitals to work together in sharing best practice to:• Deliver meaningful cost savings.• Improve clinical outcomes.• Increase efficiencies in care delivery. Leading hospitals from around the world are sharing data to define comparable, worldwide indicators of quality and efficiency across international boundaries. Hospitals from the USA, UK, Italy, Belgium and the Netherlands have joined the project as founding members. The project brings together state-of-the art technical solutions, academics and recognised global leaders in the provision of quality healthcare. It formalises a collaborative approach to quality improvement based on evidence created from a shared international dataset. In phase one, 32 hospitals will collaborate to compare clinical outcomes and share best practice across international borders to inform strategies for improving quality of care. Phase two will welcome a further 30 participants. The project is managed and led by Dr Foster Intelligence. For participants, the project delivers:• Access to a web based analytics tool allowing real-time data analysis of mortality, length of stay and readmission sub divided by individual diagnosis and procedures down to a patient level. These can be directly compared to all participant institutions on a named baasis.• Membership of the Global Comparators global outcomes accelerated learning work streams focused on specific clinical areas and delivering measurable impacts on quality, safety and efficiency for participants.• 2 international conferences and other networking forums each year. Tom Jackiewicz of San Diego Medical Center says, “Global Comparators has the potential to revolutionise the way leading hospitals share outcome data and collaborate on clinical outcome improvement.” Professor Misa Dzoljic of Academic Medical Center Amsterdam comments, “The project gives us a unique forum for engaging and collaborating with our peers from around the world, to drive improvements in our clinical quality.” Carol Peden of the Royal United Hospital Bath, concludes, "As a doctor focused on quality, the opportunity to compare outcomes, engage and network with international peers is a potentially very valuable opportunity to drive further improvement in patient care.'

RUSSIA: Attracting health and wellness investors and tourists to Russia

Fri, 30 Dec 2011 11:13:52 GMT

The tourism industry in Russia is expanding with health resorts a popular choice for vacations, says the Federal Agency of Tourism. Tourism is growing at a rate of 7 % a year and one in three Russians favour health resorts as their vacation destination. Grigory Sarishvili of the Federal Agency comments, "Health resorts are gaining popularity and in certain regions are fully booked all year-round.” Russia is to spend up to $60 million on a six-year advertising campaign to bolster its image as a tourist destination, as part of the government's programme for the development of tourism through 2018. The $60 million earmarked for advertising will be spent on subjects and programmes about Russia on federal channels, promotion on social networks, exhibitions, the organization of presentations about Russia in foreign countries, promotional campaigns and the organization of press tours. While the campaign is directed at both domestic and foreign tourists, the total number of foreign tourists visiting in 2011 is disappointing as European economic problems are affecting the chief suppliers of visitors to Russia: Germany, France, Britain and Italy. Of the 22 million foreign visitors in 2010, only 2.1 million were tourists. Northern Caucasus Resorts Company (NCRC) is developing a massive system of ski, beach and natural heath spa resorts covering 50,000 sq km in the North Caucasus Mountains, stretching 1,200 km from the Caspian Sea to the Black Sea and bordering Asia. It is attracting Asia-Pacific investors seeking to diversify outside their domestic markets in a new national strategy to use public-private initiatives in tourism to spur much-needed economic growth in depressed regions of the Russian Federation. Moscow-based NCRC was established last December to drive the massive tourism project, which will create up to 300,000 new jobs. A collaboration with the federal government, the development is part of a long-term strategy to address the economic lag that underlies social tensions in the North Caucasus region. The ten-year project is anticipated to require up to $30 billion to complete all phases, including a cluster of five world-class skiing and five modern seaside resorts, as well as an array of health spas that will take advantage of the area's legendary healing mineral and hot springs. The eventual aim is 150,000 visitors a day. The Russian government has designated the entire 50,000-sq-km development area a special economic zone. State guarantees will cover up to 70 % of investments for three to ten years. The state will impose no corporate or transportation taxes for the first ten years, no land taxes for five years and no VAT tax will be applied on equipment imported into the SEZ. The project offers opportunities for foreign companies interested in hospitality, health and wellness, food and beverage, retail, real estate, logistics and warehousing industries. The French state-owned banking group and long-term investor Caisse des Depots et Consignations (CDC) has signed a strategic joint venture with NCRC to provide advanced technical, legal, planning and environmental expertise to support the project. 20 French companies have already expressed interest in investing in ski lifts, hotels, airports, mountain tunnel and other construction projects.

BAHAMAS, BERMUDA: Can the Bahamas and Bermuda attract medical tourists?

Fri, 30 Dec 2011 11:10:56 GMT

The organization running hospitals in the Bahamas sees great potential in medical tourism, but the money for expanding a local hospital is coming from overseas bank loans, and is based on hopes of attracting large numbers of American medical tourists. With the first phase of the Princess Margaret Hospital extension underway, Herbert Brown of the Public Hospitals Authority (PHA) plans to aggressively pursue medical tourism, "I have no doubt medical tourism will play a key role in the economic expansion of this country. We need to think of ways of attracting investment and expanding the economy. The Bahamas have some of the finest doctors, nurses and administrators in this part of the world. We have the skills. It is more the facilities, so with the upgrade we are beginning to say to the world - we are ready for medical tourism.” The $75 million construction of the critical care block, will bolster's PMH's efficiency, capacity and technology. The expansion is needed, as at present it is regular for patients to lie on trolleys because there are not enough beds. In a four-phase plan, the PHA intends to add some high quality individual rooms, separated from the standard hospital rooms to specifically cater to foreigners seeking long-term treatment in a comfortable facility. It is also likely, that it will add accommodation for family and friends. The PHA, or more specifically Herbert Brown, argues that having planned procedures done in The Bahamas could be a viable and attractive option to Americans, and perhaps other markets such as Canada, Latin America, the Caribbean and beyond. The four-phase expansion and construction of PMH could eventually create a steady source of revenue for the country. But there are concerns as to where this investment money is coming from, and whether enough medical travellers would come to make the investment offer real returns. Currently, the Bahamas is a depressed economy. When local papers asked where the money is coming from, Brown gave replied, “Financial institutions have confidence in The Bahamas to pay the bills and I have confidence in the government to see this through.” For the first phase, the Royal Bank of Canada has extended a $55 million loan. To make the investment work, even the PMH admits that the Bahamas must invest considerably in training and development of medical and service staff. The Cayman Islands and Bermuda are potential local competitors also relying almost exclusively on a hoped for American market. While all three could be a potential destination for Americans to receive the care they need, many other countries in Central and Southern America already offer an existing product from a much lower treatment and staff cost base than these three. It is unlikely Bermuda or the others two will be able to compete as travel costs (including hotel stay and flight) alone could exceed the total costs in a low cost jurisdiction. According to a recent World Health Organisation report, 71 % of hospital costs are for labour, and this might be difficult for these three to overcome. All three also have very small populations that limit the number of procedures that can be economically performed on the islands and it would be difficult to increase volume of procedures or medical tourists significantly without bringing in medical staff from overseas. The problem is that the numbers required to make any investment pay off, would mean that as a proportion of the tourism industry or total economy, medical tourism would have to be so huge as to make the whole local economy dangerously reliant on it and at risk from boom and bust cycles. In Bermuda and The Bahamas, the enthusiasm for medical tourism is led by a handful of individuals based on optimistic figures on the future numbers of American medical tourists. Local doubters see two key risks; the first is that the promised number may not happen. The second is that even if it does, whether these islands can get their cost base low enough to attract business in the face of stiff competition from a score or more of other local countries. Some locals see the prospect of using borrowed money for medical tourism as a worse gamble for the investment of capital or time than alternate product offerings such as casinos, short-term retreat packages, and even retirement homes.

GLOBAL: Who will win the Health Tourism Battle?

Fri, 30 Dec 2011 10:58:10 GMT

Health Tourism Battle at ITB Berlin Convention, 9 March 2012 The International Tourism Exchange ITB Berlin is known throughout the world as a leading trade fair for the global tourism industry. The ITB Berlin Convention in March 2012 will feature a “Health Tourism Battle”. In cooperation with visitBerlin, nine destinations or companies that focus on health tourism will be given the chance to present their concepts and products at the ITB Destination Day on 9 March 2012. The audience will vote for the winner. The winner will be awarded a city trip to the German capital Berlin. More information on the ITB Berlin Convention can be found at www.itb-convention.com. Details of the participants in the “Health Tourism Battle” can be downloaded here. The deadline for entries is 13 January 2012. The full convention program 2012 is available online. If wellness guests, medical tourists or health travelers are your target group, then ITB Berlin is worth a visit.

SPAIN: Travellers at pioneering Spanish health retreat are beating diabetes

Fri, 16 Dec 2011 10:24:06 GMT

British and Irish health travellers at a pioneering Spanish health retreat in Alicante, claim that they are living a medication-free life as a Type 2 diabetic on a vegan nutritarian diet, because it is low fat and nutrition rich – combined with light exercise. Many have halted or reversed their diabetes and are now living medication-free for the first time in years. Cancer and heart disease sufferers, and those struggling with obesity, say the British-run centre in Spain has also made a significant and lasting impact on their recovery. 99% of guests at the Obsidian Retreat say their lives have been transformed after embarking on its healthy living programme. Most diabetic guests are beating the odds with a staggering 90% of Type 2 Diabetics either greatly reducing or stopping their drugs, including insulin and Metformin. During their stay, guests stick to a specially prepared vegan diet high in micronutrient content. Foods with the highest micronutrient scores are green vegetables, colourful vegetables, and fresh fruits. The diet, which is tailored to suit each person, as the micronutrient richness must be adjusted to meet individual needs, is proven to have powerful disease-protecting and therapeutic effects. There are an increasing number of people suffering from Type 2 diabetes - 2.9 million in the UK, estimated to rise to 4 million by 2025.The International Diabetes Federation estimates that by 2030 438 million – or nearly 8% of the global population – will suffer from the condition, which is largely attributed to poor diet, sedentary and stressful lifestyles. Obsidian Retreat's owner Andy West explains: “The link between poor health and poor diet could not be clearer and with a quarter of the UK population classed as obese this problem is only set to get worse, Our unhealthy eating is costing us all dearly in terms of life quality and expectancy, but we have an approach that addresses this. Applying this approach to diabetes management could save many lives. We give guests the tools to take control of their own health in a direct, immediate way – and the results speak for themselves. We really want people to sit up and take notice of what's being done. Not only can a nutrition-rich, low fat diet help prevent problems, it can actually reverse even major illnesses and we have already had doctors recommending us to patients.” Obsidian Retreat is just 45 minutes' drive from Alicante Airport. Known as an immersion centre because guests are immersed in their treatment, it is the brain-child of healthy living pioneers, Andy and Carol West, who launched it earlier this year following in depth studies into diets around the globe that have dramatic effects on serious health conditions and a desire to make them available to visitors year-round. The healthy living programme combines best practice from across the US and Europe. The approach is based on the simple idea that a nutrition-rich vegan diet in a stress free holiday setting is the quickest, easiest and often most cost-effective way to restore health, improve well-being and boost energy levels. Guests undergo a full medical assessment and continuous monitoring during their stay, with all visits supervised by a qualified GP. They are encouraged to participate in light exercise such as swimming, walking, yoga and rebounding (mini trampolining) and can also enjoy a wide range of complementary therapies from colonic hydrotherapy, hypnotherapy, Swedish massage, colon massage, crystal massage, bio-resonance, Reiki, metamorphic or Indian head massage; food intolerance testing, beauty treatments and life coaching are all available.

THAILAND: Service quality has a direct impact on medical tourists' loyalty

Fri, 16 Dec 2011 10:19:18 GMT

According to new academic research on medical tourists in Bangkok, service quality has a positive relationship with value, satisfaction and brand trust. And it has a direct impact on medical tourists' behavioral loyalty. 'International Tourists' Service Quality Perception And Behavioral Loyalty Toward Medical Tourism In Bangkok Metropolitan Area' has been published in The Journal of Applied Business Research. The independent research was by Assistant Professor Aurathai Lertwannawit of Suan Dusit Rajabhat University, and Associate Professor Nak Gulid of Srinakharinwirot University. The Office of the National Research Council of Thailand and Suan Dusit Rajabhat University sponsored it. This research assesses the relationship between service quality, value, satisfaction, and brand trust on the behavioral loyalty of international tourists acting as medical tourists toward private hospital medical services in the Bangkok Metropolitan area. A quantitative study was performed using 400 international tourists who used medical service from private hospitals in Thailand. Most of the respondents used services from BNH Hospital. Medical tourists ranked several factors for deciding to use medical services at the hospital according to order of importance: medical quality, value of services, patient safety and security, location, international patient marketing, international patient management, attention to unique needs of the medical traveller, and transparency. Service quality has a positive relationship with value, satisfaction, and brand trust -which also has direct impact on medical tourists' behavioral loyalty. In addition, value, satisfaction, and brand trust have an effect on the relationship between service quality and behavioral loyalty. Nationality does not have any effect on the relationship between service quality and value, satisfaction, and brand trust. The research model is an extended service quality-loyalty model by insertion of brand trust from relationship market research. The results of this study provide empirical evidence better suited to the research model in a medical tourism context, in which distance between the service provider and the customer is relatively high. The researchers suggest that brand trust plays an important role in creating loyalty and also in leveraging the relationship from service quality and value to loyalty. Brand trust is an important mechanism in generating both attitudinal and behavioral aspects of loyalty. The main rationale that explains this phenomenon is that tourists have to travel to a distant country in order to receive medical services, which provides a direct challenge to the individual. Consequently, a high level of brand trust can reduce uncertainty. Brand trust is important when tourists travel from a developed country to use a service in a developing country where they think the overall level of technology and knowledge is relatively low. So everybody in medical tourism should devote more effort and resources to building a strong brand trust. Medical providers are able to generate loyalty among customers; this loyalty is directly beneficial, in terms of both creating repeat purchases and positive word-of-mouth. Word-of-mouth is important in medical tourism because key informants for medical tourism have a close relationship with the consumer. Word-of mouth and Internet reviews hugely impact which country and which hotel tourists go to, and medical tourism has not yet grasped the increased importance of peer review compared to traditional advertising.

OMAN: Why do Omanis go abroad for medical treatment?

Fri, 16 Dec 2011 10:17:58 GMT

Oman wants to become a medical tourism destination, but before that can happen it has to find out why so many people, often at the expense of the state, go to another country for medical treatment. Suggesting that for their own country there are some negative aspects of medical tourism worldwide, experts in Oman have stressed the need for comprehensive studies on the growing tendency among their people to go abroad for medical treatment. Professor Lamk Al Lamki of Sultan Qaboos University Medical Journal (SQUMJ), says that the quality and safety of medical treatment abroad has to be analysed and it should be under the scrutiny of the medical professions and the Ministry of Health in Oman, “Many Omani patients go abroad as outsourced patients. They are sent abroad by the government, when the necessary treatment or the specialist is not available locally. Sometimes locally available treatment is not trusted by the patients. Unless we have a good idea of the quality of the care that our patients are receiving abroad, their safety may be at risk. We need more statistics, better studies and better reporting systems. The question of who will look after these patients when they return, has not been answered, but it must be tackled.” In SQUMJ, Professor Lamk points out that there is a major lack of systematic data about health services provided abroad, not only for Omanis, but also for citizens of many other countries, “More organised studies are needed and specifically outcome studies. Research into the delivery of healthcare has not yet adequately evaluated the case of medical tourism. The issue of lack of data must be taken very seriously. Medical tourism has some benefits, but there are problems with it and, as doctors, we have to keep in mind our basic principles. One problem is poor or no follow-up care. After being in hospital for a short while, the patient comes home with, perhaps, complications of the surgery or side effects of the drugs. It is a surgical principle that every surgeon looks after his own complications and obviously that does not apply for most, if not all, patients who have been treated abroad. Many countries have very weak malpractice laws and thus patients have limited ability to complain about poor medical care.” He also raises concerns that patients may not be able to endure travel, or may not have inherent resistance to some of the diseases in the host countries. He underscores the need to have better scientific studies on the impact of medical tourism on the healthcare services of the source and destination countries as well as on the patients themselves, “We need more statistics on the rate of complications. Many medical tourists are satisfied, but satisfaction does not always parallel good outcome. Often, satisfaction can simply be a result of good service. The outsourced patients, or those who are sent by the government, are often dissatisfied with the total experience compared to the true self-financed medical tourists. That is why an institution has to be accredited for good medical care with a good quality assurance programme rather than just good service.” Professor Lamk says that patients going abroad need to get good advice. The World Tourism Organization's Global Code of Ethics for Medical Tourism says medical tourists should have the same rights as citizens of destination countries. He suggests that this is not always the case. A real concern from Professor Lamk, is that outbound medical tourism can effect the source country's health care system. Oman may become complacent by being able to send its citizens abroad for certain procedures and thus fail to develop the appropriate national services. He cites the development of positron emission tomography scans in Oman as an example of this. Prof. Lamk has ethical concerns. He argues that doctors should examine the risks and discuss these with the patient, but patients must have the final say in decision-making. Another ethical consideration is that each country may have a different standard of medical ethics. For example, what is considered experimental therapy in one country, like stem cell therapy, is routinely used in the private institutions providing care for medical tourists in other countries.

CYPRUS: Cyprus targets Middle East and UK for medical and wellness tourism

Fri, 16 Dec 2011 10:13:46 GMT

Cyprus is making inroads in the Middle East to promote medical tourism, and also promoting itself to the key target market of UK visitors. The Embassy of Cyprus, in collaboration with American Institute of Minimally Invasive Spine Surgery (AIMIS Spine), recently held a symposium on spine surgery in Muscat, Oman, AIMIS Spine is a spine centre that brings together the best minimally invasive international and American spine surgeons in a collective environment in Cyprus for medical tourism. The surgeons travel to Cyprus for ten days once or twice a year to perform surgeries. Nikos Anastassiades of AIMIS Spine says, “Our mission is to bring the best of American healthcare to the world at a fraction of the cost. AIMIS Spine provides the best American quality healthcare and necessary follow-up to the patients back home. It is offering collaborations with the medical community in Oman so that surgeons there share their know-how and expertise.” The ultimate aim of AIMIS Spine is to train the doctors in Oman whereby they will be sensitised on different ways of dealing with spine problems. It is a three-hour flight from Oman to Cyprus and there are plans to have a direct flight from Muscat to Cyprus in 2012. In the UK, Cyprus Tourism teamed up with travel and wellness expert Paul Joseph on a November radio campaign to promote the benefits and opportunities of wellness holidays for health-conscious holidaymakers visiting Cyprus for wellbeing breaks. Paul Joseph talked to local radio stations on topics such as how to get the most out of a wellbeing holiday, who should be thinking about wellness holidays, when the best time to go is and what activities and treatments are on offer. Orestis Rossides of Cyprus Tourism says: “Wellness holidays are one of our fastest growing areas, with health tourism visitor numbers up year-on-year and a wealth of exciting new spas and specialist centres opening up across the island in recent years. Regular flights from the UK and year-round good weather makes the island a popular destination with visitors from the UK.” Paul Joseph adds, “The trend for healthy holidays is one which is affecting all areas of the industry. It is no longer just about the girls – men are as equally likely to step over the threshold as their female counterpart - and the scope of the getaways appeal to a broad range of holiday-makers, from solo travelers looking for a healthy retreat to the over 60s concerned about health and ageing.” Cyprus - the third largest island in the Mediterranean - attracts over 2million tourists annually, although how many of these are medical or health/wellness travellers is not known.

CUBA: Cuba relaunches Servimed medical tourism service

Fri, 16 Dec 2011 10:09:53 GMT

Cuba is one of the unsung heroes of medical tourism, as it has been quietly attracting people from overseas for decades. The government controls access to all local hospitals for overseas patients, and has just relaunched Servimed. Empresa Comercializadora de Servicios Médicos de Cuba S.A., known as Servimed, is a state owned and run company that offers foreigners access to the 16 Cuban hospitals and clinics that provide more than 100 types of health services on the island, ranging from cancer treatment and drug addiction programmes, to dentistry and cosmetic surgery. As an organization, their work has been ongoing for more than 20 years, initially as Servimed; later as Cubanacan Tourism and Health, then as Tourism and Health, and now back to Servimed. It has been hidden away, but as part of a more public international role, the for-profit medical services company relaunched itself before an international business audience at the recent International Havana Fair. The expectation that President Obama will fulfil his promise to do away with the rules that prevent most US citizens going to Cuba for tourism or healthcare is part of the reason for the new openness. Servimed deals with private individuals but its main role is to coordinate the bigger-volume business of government-to-government services. Servimed provides for-pay medical services by Cuban personnel to governments of 15 countries; which includes medical tourism. For-pay medical services to other governments are not new. Panama announced in 2011 that it will pay for the hands-on specialty training of Panamanian doctors in Cuban hospitals. Also in 2010 Qatar agreed with Cuba to pay for an undisclosed number of Cuban doctors to work in a new 54-bed hospital in the oil-rich country. Cuba also agreed in 2010 to manage and staff eye surgery centres in hospitals in China and Algeria. Servimed is providing services to 15 countries this year, including Algeria, China, Portugal, Jamaica, Qatar, Surinam and Ukraine. Cuban medicine has become a worldwide leader in healthcare services for people in poor and rural areas as well as in disaster zones; at least 38,000 medical workers from Cuba are currently deployed in 77 countries. Cuba is in charge of a $690 million plan to rebuild Haiti's healthcare infrastructure. Since 1998, the Escuela Latinoamericana de Medicina (ELAM) in Havana has been training 7200 students from all over the world, and graduates 1500 doctors per year. Many of these programmes are funded by Venezuela, and others by countries such as South Africa, Brazil and Norway, but many are subsidised by Cuba. Cuba has proposed to the European Union and Canada that its doctors and medical services could be part of triangulated aid service provided in developing countries; so far, no agreement has materialized. Venezuela is paying at least $5 billion in oil and cash per year for the services of Cuban doctors and for training of Venezuelan and third-country medical students in Cuba. Venezuela has also funded Operación Milagro, a billion-dollar programme led by Cuba that has given free eye surgery to hundreds of thousands of low-income Latin Americans. Now, the government wants to use Servimed to make Cuba's public health services sustainable and more efficient by generating revenues from paid for medical services and medical tourism and investing the profits in maintenance, repair and purchase of equipment for Cuba's public health institutions. Servimed is spearheading a Cuban effort to increase for-profit medical exports. A Public Health Ministry document published in December 2010 said that, as part of an overhaul of Cuba's healthcare system, medical institutions should begin to sell services to foreigners wherever possible, “The medical services will remain free for poor countries. But they will be sold to those whose economy allows it, with the goal of reducing our expenses and contributing to the development of the national health system.” The Cuban medical system now offers medical services for Canadians. Servimed's individual subsidiary Health Services International began in January 2007. HSI is the agency officially recognised by Turismo y Salud and the Cuban medical system. It assists and guides medical tourists. In the agreement between HSI (Servimed) and Turismo y Salud, anyone who does speak Spanish will always have a medically trained person nearby who will act as an interpreter to help the medical tourist understand test results and to help when decisions are necessary. Many doctors and nurses do speak English and some speak French, also.

USA: US cities explore potential for inbound and domestic medical travel

Fri, 16 Dec 2011 09:47:34 GMT

Several US cities and states are keen on promoting medical tourism, to boost the economy and as an alternative to declining numbers in tourism from other areas and overseas. A recent study commissioned by Nevada recommended that the state leverage its medical/health sector to take advantage of opportunities in medical tourism. The study, by Brookings/SRS, urged Nevada to incorporate niche tourism markets, such as health and wellness travel, as part of its new economic development plan. The Greater Miami Convention & Visitors Bureau (GMCVB) is a private, not-for-profit sales and marketing organization. It is a private-public partnership with more than 1000 private business members and four local governments. The GMCVB medical tourism initiative is aimed at marketing Miami as an international medical destination. GMCVB wants more local medical tourism members and offers a dedicated web page on MiamiHealthCare.org website, printed insert for inclusion in its medical tourism brochure, inclusion in ads of in-flight publications and the opportunity to participate in international media familiarisation tours The Las Vegas Convention and Visitors Authority has produced a 176-page Las Vegas health and wellness destination guide. The guide contains information on medical and dental treatment, cosmetic procedures, corporate wellness programs and retirement living in Las Vegas and southern Nevada. Also included are a directory of medical facilities and travel information. Las Vegas mayor Carolyn Goodman says that the recent opening of the Cleveland Clinic's Lou Ruvo Center for Brain Health “has put Las Vegas on the map as a premier medical travel destination.” Promoting domestic medical tourism with lots of marketing and brochures looks good, but not all cities or hospitals can deliver what individuals and employers want. Shai Gold of medical tourism agency International Triage, recently commented; “The challenge for most domestic destinations is that destinations typically do not offer a meaningful discount to the retail consumer. The wholesale client (self insured group, or insurance companies) does not need these guides as they already purchase healthcare services at substantial discounts via re-pricing networks. To attract retail consumers, healthcare providers will have to offer Medicaid level fee structures. Will the prices of medical procedures in Las Vegas and these other cities be competitive with what we can offer in Latin America, and the quality of care standardized in delivery and quality?“

GLOBAL: New medical tourism certificate of quality for hospitals

Wed, 14 Dec 2011 10:35:17 GMT

Hospitals involved with medical tourism are offered an array of third party accreditation and certification services, ranging from detailed inspections to a certificate for little more than filling in a form and paying a fee. Reputable German international accreditor TEMOS has launched a new certificate for quality in medical tourism for hospitals and clinics - 'Excellence in Medical Tourism'. Health tourism is a rapidly growing market but treatment of international patients is a challenge. Quality, costs, culture, distances and legal aspects have to be kept in mind – demands which are not completely covered by any certification system. Temos identified the demands of international patients and treating hospitals and transferred them into an international quality assessment system. Certified care providers get a neutral, professional assessment. Patients trust in the Temos Seal of Quality as a worldwide brand for certified quality in medical care. Patients have unique requirements and needs when undergoing treatment outside of their own country. Pre-, on-site and post-treatment take place in different countries and have to be managed to assure high quality and cost-effective medical care on all levels and at all stages of the care cycle. Information, communication, interconnection between various services, administrative processes, and data security have to be organized cross-border. The Temos “Excellence in Medical Tourism” programme focuses on the optimization of non-medical services. Certification for hospitals with an international patient centre covers the complete processing of non-medical services before, during and after treatment in the hospital and in cooperation with partners and referrers in compliance with international ethical, medical and qualitative requirements. Application for the specific Temos medical tourism certificate is only available as an additional service in the Temos certification process. An on-site visit is obligatory. One option is a mock survey and gap analysis with feedback and consultancy. The other option is help in implementation of recommendations, assistance and monitoring. For hospitals wanting to set up an international patient centre, Temos offers a consultancy package that includes a mock survey, gap analysis, feedback, help in implementation of recommendations, assistance and monitoring; with the option of an on-site visit as a start of the certification process. Temos offers a range of accreditation services to international hospitals and dental clinics. After a self-evaluation questionnaire, Temos experts (always a team of an internationally experienced medical doctor and a quality management expert) carry out an on-site inspection. Based on professional judgment and with the management, the team discusses ways and options for optimized care and services. Hospitals and clinics meeting the Temos demands and passing the process obtain the Temos Certificate, the Seal of Quality for high quality medical services for international patients. Temos also offers consultancy for hospitals, medical service providers and health ministries that intend to enter the health and medical tourism market. The organization recently partnered with Florida based medical tourism agency Orbicare to offer consultancy and certification in Latin America. Another new launch is Temos Aegean, offering certification and consultancy in Greece and Cyprus. This follows the certifications of its first two hospitals in Greece, Hygeia and Mitera, both part of the Hygeia Group.

IRELAND: Irish patients save money by shopping around for treatment

Thu, 08 Dec 2011 15:51:33 GMT

Although healthcare and dental costs have fallen across Ireland this year, people can save considerable sums by travelling within Ireland or going overseas, a new survey shows. According to the second annual Avantis Health Global Health and Dental Price index, Irish health and dental charges dropped by an average of between 3% and 10% since the Spring. The survey also shows that there is a variation of up to 70% in the cost of some treatments around Ireland, and patients could also save up to 50% on some procedures if they travelled to countries such as Spain, Belgium and Germany. The index looks at treatment costs within Ireland and globally and covers a range of elective procedures including dental treatment, eye surgery, cosmetic surgery and elective surgery. Prices for common dental procedures have fallen by as much as 21% in some cases, while cosmetic surgery procedures have seen costs decline by between 10% and 20%. Elective medical procedures have fallen in price by up to 16%. Laser eye surgery has increased in price by 21%, and the cost of nose reconstruction surgery has increased by 24%. The survey reveals vast differences in prices throughout Ireland. Although Dublin is more expensive for some procedures, such as a tooth extraction, it is significantly cheaper for others. A simple dental implant costs 75% less in Dublin compared with some cities in Connacht or Leinster, while some cosmetic surgery procedures are 67% cheaper in the capital compared with other Irish cities. Orla Fahy of Avantis says, “These figures show a modest reduction in health and dental prices. It also shows a startling variation in prices between Irish regions for the same procedures. Irish patients can make significant savings on their health and dental care, by merely shopping around within Ireland, with substantial savings possible if they are willing to travel abroad for treatment.” Despite the cuts, Ireland remains one of the most expensive countries in Europe for health and dental treatments International average cost comparisons: Tooth extraction:• Ireland: €84• Dublin: €100• Rest of Leinster: €80• Connacht: €80• Munster: €75• Belfast €53• London €64 Laser Eye Surgery:• Ireland: €1868• Dublin: €2025• Connacht: €1700• Munster: €1750• Rest of Leinster: €1996• London: €2260• Belfast: €1785• Tunisia: €892• Hungary: €545 Breast augmentation• Ireland €2774• Munster: €5000• Leinster: €4700• Connacht: €3050• Dublin: €3000• Belfast: €4875• London: €4500• Belgium: €2256

ISRAEL: Is medical tourism good or bad for local Israeli patients?

Thu, 08 Dec 2011 15:50:51 GMT

Most attacks on medical tourism are on the alleged dangers to medical tourists of going overseas for treatment. But national television in Israel has suggested that Israel is very safe for medical tourists, but medical tourism is impairing care of Israelis. The debate between the pro and anti medical tourism supporters began a while back, but is getting increasingly heated. An investigation by Raviv Drucker on Channel 10's television show "The Source" used leaked internal correspondence from Schneider Children's Medical Center of Israel that the programme claimed shows that medical tourists do divert resources from Israeli patients. Sheba Medical Center, Hadassah University Hospital in Jerusalem, and Assuta hospitals are reported to be the top three earners from medical tourism, followed by Tel Aviv's Ichilov complex, Rambam Medical Center in Haifa and Beilinson Hospital in Petah Tikva. Medical tourism is highly lucrative for Israeli hospitals, most of which run at a loss due to the way Israeli healthcare is funded. They get 20% to 30% more per procedure from foreign patients than for Israeli ones Earlier in 2011 a government commission investigating the potential regulation of medical tourism in Israel, headed by Professor Arnon Afek, of the top medical tourism hospital Sheba Medical Center, delivered its conclusions to the Health Ministry. The commission rather sat on the fence as to whether or not Israeli patients could be suffering because medical tourism is not regulated in Israel. It recommended the establishment of an organisation to supervise medical tourism. It suggested that service to medical tourists should be handled separately from service to Israelis if the hospital has the infrastructure to provide separate care, which some do and some do not. After six months with the recommendations, the Health Ministry has not commented or decided on any action. This lack of progress prompted television journalists to investigate. The Source investigation made several allegations, including quoting on air, leaked internal documents at Schneider in which nurses, other carers and doctors appear to warn that mixing medical tourists with Israeli patients on the ward could be hazardous, and one department wanted the hospital to cease accepting new medical travellers from Palestine, as this was affecting resources for Israelis. The investigative show also noted the general increase in the number of medical tourists from the Palestinian Authority. Care has to be taken in assessing the quality of the information as in Israel it is impossible to separate the local Israel/Palestine politics from either medical tourism, or what appears to be internal disputes between different departments in hospitals. Schneider's business plan for 2011 includes a figure of less than 5% of patients being medical tourists, but other hospitals have percentages, which are much higher. The Health Ministry responded that the Schneider Children's Medical Center handles cases that other hospitals cannot, and the acceptance of non-Israeli children is based on the number of beds that are available without impairing treatment of resident children. Schneider Children's Medical Center said it complies with all the rules on accepting non-Israeli patients, who constitute fewer than 5% of its patients. In any case, as it is a nonprofit organization, any revenues from medical tourism are put to good use in buying advanced technology. What we are seeing is public and private debate within hospitals on whether or not a hospital should accept and/or seek more medical tourists. Intertwined with this is the use of the debate to get the government and health funds that pay hospitals for treatment, to pay local hospitals a higher and fairer price for treatment. Mix in local and international politics, and a government not sure where it stands on either regulating or promoting medical tourism, and the argument is far from the apparent simple question as to whether or not medical tourism is good for Israeli patients; and the debate also makes good television.

UK: New international healthcare tourism project for Northern Ireland

Thu, 08 Dec 2011 15:49:27 GMT

An international healthcare tourism project has been officially opened in South Belfast, Northern Ireland. The opening also saw the launch of a new prostate cancer treatment at 3fivetwo healthcare's Kingsbridge Private Hospital. Mark Regan of 3fivetwo healthcare predicts that the private healthcare sector is set to be one of the major new industries in Northern Ireland. At the launch the company revealed plans to treat prostate cancer patients from the United States, Asia and the Middle East from December 2011 with a revolutionary new HIFU procedure to be undertaken by local urology consultants. Mark Regan adds, "Patients will be travelling with friends and family who will be staying in hotels locally for up to five nights resulting in a minimum of 1,500 bed nights in the first year, eating at local restaurants and visiting tourism attractions particularly in time for the Titanic celebrations. As the largest direct private healthcare provider in Northern Ireland we believe we are in a unique position to demonstrate the enormous local, national and international opportunities we see for the healthcare sector here. Our business has grown significantly in the last eight years, with three facilities in south Belfast, a training academy in Titanic Quarter, cosmetic surgery, dental and fertility businesses employing a total of 180 people throughout Northern Ireland. This new hospital will significantly improve the choice available to the 10% of the local population who invest in private health insurance or those who simply make the choice to pay for the healthcare they want. We have two state of the art operating theatres and one of the most highly specified endoscopy suites in Ireland. Our minor injuries unit is the first of its kind in Northern Ireland.” Kingsbridge Private Hospital had a soft opening in the summer of 2011, and offers a comprehensive range of elective surgery and endoscopic procedures under general and local anesthesia. It is a doctor led hospital as doctors own the company, and control the running of the hospital. A key market is patients from the nearby Republic of Ireland. In-patients have a private room, with en suite facilities and a plasma screen T.V. A nurse call system in every room, with locally sourced meals, visitors welcome at most times, and a free private car park. Officially opening the hospital, tourism minister Arlene Foster said, "Representatives from the company have recently returned from an Invest Northern Ireland Trade Mission to Boston, where they were able to showcase their expertise to a multibillion-dollar market. The healthcare manufacturing and services sector continues to be an area of growth. Northern Ireland has a highly skilled and motivated workforce and the establishment of this new facility proves that we can compete with other international destinations when it comes to excellence in this field."

EUROPE: First European cross-border healthcare simulation

Thu, 08 Dec 2011 15:47:56 GMT

The first ever European simulation on the impact of the EU Directive on the application of patients' rights in cross-border health care was held in Brussels in November. The right of EU citizens to access planned healthcare across borders has been one of the most hotly debated health policy issues at EU level in recent years. With the European Parliament vote in favour of the Directive on Patients' Rights in Cross Border Healthcare in January 2011, attention has now switched to the Directive's implementation. The cross border health care simulation was co-organised by the European Social Observatory (OSE), European Health Management Association (EHMA) and Association Internationale de la Mutualité (AIM) to find out what effect the new Patients' Rights Directive might have in practice. Many health managers deal with cross border care on a daily basis, through existing EU frameworks or through bilateral agreements between countries or providers. EHMA is particularly interested in the impact of the new Directive on the volumes and patterns of cross border care, and on how payers and providers will deal with difficult questions around prior authorisation, reimbursement and information for patients. The simulation sought to find out what effect the Directive could have in practice. The EU 27 member states still have to transpose the directive into their own legal systems and the simulation aimed to find any bottlenecks in the system. What is particularly tricky is that each state has a different mix of health payment systems and variation between what the state, individuals, employers and health insurers pay for, with most states having multiple options. So the simulation sought to see how insurers, health systems and other providers are planning to deal with problems. The simulation used three case studies with 32 participants in 6 countries to identify key issues on how information is provided to patients, interaction with existing regulations, rare diseases and prior authorization. The simulation highlighted that the Directive may mean more patients applying for prior authorisation for cross border healthcare in order to avoid the risk of out of pocket expenses; particularly when it comes to uncertainty of how much, or even if, they will get reimbursed, and from who. The bureaucracy and complexity of passing invoices from one state to another, and from and to different organizations both within and across country borders, has been underestimated with a real risk that hospitals treating foreign patients on an invoice basis may not get paid by anyone. Jeni Bremer of EHMA notes, "We need to know how much impact the Directive will have in practice. Health managers need to know how public authorities and health insurance funds are going to apply the rules, if they are to plan and deliver high quality patient care.” The simulation focused on information available to patients with a call for usable and independent information on the process itself and the quality of health providers. Bart Vanhercke of OSE says, “As this simulation has demonstrated, many issues remain open for discussion and states and others will make use of the new legal framework in a creative way. This might well lead to new litigation before the European Court of Justice.”

INDIA: Medical tourism investment opportunity

Thu, 08 Dec 2011 15:39:45 GMT

India's Merar Investment Network is offering an investment in a new medical tourism agency sending people to India. It is a seed investment and the principals are anonymous, but the full listing makes some interesting points about the problems that India has in turning potential into real numbers. Indian medical tourism suffers from many hospitals and many small medical tourism agents all fighting for business with each other, so losing out to rival countries that offer good national marketing. The investor is also dismissive of the unfounded claims that India has over a million medical tourists a year, putting it at the more modest 200,000 in 2008. Merar was launched in October 2010 with the idea of creating a best platform for entrepreneurs and investors from the emerging markets. It supports entrepreneurs from India, China, Brazil, Africa, Central, and Eastern Europe, and all other developing regions with the necessary platform to connect with investors worldwide. It only hosts investment projects with 'outstanding qualities from legitimate sources'. The mix of investors on Merar is also considered very carefully. The investment opportunity as on the virtual network- Health Care Consulting & Medical Tourism in India. Seed investment project in India • Country: India• Industry: Internet, eBusiness• Stage: Seed• Required Investment: $50,000• Minimum Investment: $30,000• Date submitted: 21 November 2011 We are starting a health care consultation and medical tourism company in India. In 2008 over 200,000 patients have visited India for medical tourism and this number is growing day by day. However, there are no big players in this industry and we aim at becoming the #1 medical tourism provider. www.way4healthcare.com (under construction) Every day hundreds of people visit India to avail medical care. There are 3 important reasons for them to do so:1. No waiting period2. Low cost (60 %+ lesser)3. For example, a heart bypass surgery that costs US $144,000 in USA costs only US $8,500 in India.4. Experience of the doctors, success rate and facilities available. Nevertheless, the patients face a major inconvenience when they come to India. The difficulties come in the form of language problems, cultural change, insecurity, cheating etc. This is where we come into place. We provide A-Z services to the patients who come to India through us. Right from initial consultation, appointment setting, visa assistance, airport pickup, lodging, food, surgery, post-surgery care, travel arrangements and post-surgery tourism, we will take care of all the needs of our patients. We also have a secure account on our website for our patients where they can upload and store all their medical documents and records, which can be accessed from any part of the world. Cash Payback Period:The estimated payback period is 12 months from the start of the business. Stage of development:1. Our website is under construction and will go live on 30-11-2011.2. We have got an agreement with Apollo Hospitals to pay us a commission for the patients we refer to them.3. We are in talks with other hospitals and service providers to include them in our business. Competitive advantages:1. We have a state of the art website with wide range of information for the patients, which will be constantly updated.2. We have a discussion forum, which will play a very important role in the development of this business.3. We have 24/7 live support and phone support.4. Our city of operation is Chennai, which is the hub of the top hospitals in the country. This is a major advantage for us as there are no major competitors in our city.5. We will appoint a service manager to each patient who will personally be with them and take care of each and every need of the patients, while our competitors just refer patients to hospitals and other services.6. One of our partners has been working in a major hospital for over 20 years, dealing with the international patients who come to their hospital. So, we have the huge advantage of having an experienced person in this field.7. Our other partner is an online marketing specialist who will play a major role in bringing customers. The competitors can repeat our success but we grow and keep improving ourselves, leaving no room for the competitors. Rationale for the deal: Income will flow in the following ways:1. The hospitals have agreed to pay us a % of the total bill of the patients we refer to them.2. Hotels, service apartments, guest houses, medical shops, scanning centers, travel & tourism operators and Forex traders will pay us a % from the patient's bill.3. Depending on the patient's country we will charge a small fee as service charge on a monthly basis. For a heart bypass surgery, a patient will bring in a profit of $2000.We are also in negotiations with other service providers who can provide the necessary service to our patients. With proper marketing we can easily capture a major market share within 1 year. There are other players in the market who provide a similar service and earn good money. But most of them stop with just referring patients to the hospitals and service providers. There is a big difference between the number of patients who come to India and the number of service providers who are available for them. Use of financing: The initial investment is for a period of 6 months after which the business will run and grow with its own money. Here is how the finance will be used:1. $6000 - Office Rental2. $3500 - Server Expenses3. $20,000 - Salary for employees4. $15,000 - Online and Office Marketing5. $5500 - Misc Expenses and Backup Money Investment can be made on a monthly basis of $8300 for 6 months.

AUSTRALIA: Australian study on stem cell tourism to begin in 2012

Fri, 02 Dec 2011 16:21:03 GMT

Why are increasing numbers of Australians travelling overseas to have expensive and potentially harmful treatments where what is promised by the clinics offering stem cell tourism far outweighs scientific evidence? Is science too timid? Are clinics exploiting people desperate to have what may be life saving treatment? In 2012 Professor Alan Petersen of Monash University's School of Political and Social Inquiry, with Dr Megan Munsie of Stem Cells Australia and Professor Steven Wainwright of Brunei University, will undertake the first sociological study of what shapes peoples' understandings and expectations of stem cell therapy options abroad. Professor Petersen explains, "Stem cell tourism is a phenomenon where people travel to other, often developing, countries to undergo radical, experimental treatments that are not offered in Australia. People with a range of illnesses and injuries, including cerebral palsy, multiple sclerosis and spinal cord injury are heading overseas for treatment in increasing numbers. These procedures are not scientifically proven and may actually be harmful to the patients. The health risks include infection, immune system rejection, and cancer. We need to understand patients' decision-making processes so we can help protect them from harm and financial exploitation." Professor Petersen believes that the regulatory and educational strategies currently employed will fail to stem the flow of SCT tourists because they underestimate the power of hope and desperation, "These patients obviously want an improvement in their quality of life or respite from suffering and are frustrated by the lack of progress in stem cell therapies in Australia. Hope is very powerful and tends to be nurtured by communities and support networks. It helps people form their own conceptions of risk, despite the recommendations of medical professionals. Their high expectations of stem cell treatment are understandable considering the enthusiasm around the potential of stem cells from various levels of the scientific community here and abroad. This enthusiasm is reinforced by the persuasive online advertising from the overseas clinics." The researchers will canvass the views of Australians who have undergone stem cell overseas, as well as the views of medical professionals, policy-makers and regulators. The advertising, practices, and claims of clinics and agencies offering stem cell tourism will be analysed. The Australian Research Council supports the project. New therapeutic approaches to multiple sclerosis, diabetes, stroke and heart disease may be discovered at the new $21 million Stem Cells Australia research initiative. Led by stem cell researcher Professor Martin Pera from the University of Melbourne, the research initiative is receiving $21 million in funding from the government through the Australian Research Council (ARC) Special Research Initiative in Stem Cell Science. Professor Pera recently led a major stem cell research centre at the University of Southern California in the USA. The government hopes that the initiative will give stem cell researchers the opportunity to carry out highly innovative, internationally-competitive research that could produce discoveries that fundamentally change the direction of health care, and stimulate a greater public awareness of the benefits of stem cell research. Stem Cells Australia could make an important contribution to life-changing research by delivering stem cell research breakthroughs that will help ease suffering and save lives. It will also take a leading role in encouraging public debate into the ethical, legal and public policy issues associated with stem cell science and technology. Stem Cells Australia will have national and international partnerships, including with Monash University, the University of Queensland, the University of New South Wales, Victor Chang Cardiac Research Institute, Walter and Eliza Hall Institute of Medical Research, Florey Neuroscience Institutes and the CSIRO.

MEXICO: Crossborder healthcare for Californian employers

Fri, 02 Dec 2011 16:16:51 GMT

Californian medical tourism agent Jim Arriola of Sekure Healthcare explains the possible the advantages of using cross-border healthcare for self-funding employers in California and gives an insight into the alternative of cross-border insurance schemes. “The case for cross-border healthcare is not a new phenomenon. Take California's experience with cross-border healthcare. Because of the consumer demand, laws were enacted and regulations were developed to allow for cross-border healthcare coverage. The Department of Managed Health Care, the regulatory agency for HMOs in California, approved several plans that allow for cross-border healthcare, including Blue Shield of California, Health Net, CIGNA, Aetna, Delta Dental as well as a Mexican Health Plan. Some of these health plans have been operating for over 10 years. Needless to say, the concern for quality has been adequately addressed to the point that cross-border health care is now an established option with consumer appeal for its affordability. The cost of healthcare is largely a function of the unit cost for hospital services, doctor services and medication. Since the unit cost of healthcare in Mexico is significantly less than in the USA, the cost of healthcare cover for similar benefit plans would also be significantly less. The cost differential can be seen in the Aetna health plan offerings. Aetna is one of the approved carriers in California that offers cross-border health coverage plans. Take the Aetna small group HMO Plan offering for San Diego employers with a standard 1.0 Rate Adjustment Factor based on October 2010 Rates. For this illustration, an employee is 38 years old with a spouse and two children. The Aetna HMO offering for care delivery in San Diego County is $1,311 per month. The Aetna HMO Plan offering for care delivery in Baja California, Mexico is $465 per month, or just over one-third of the cost of a similar Aetna offering in the US. Under this comparative illustration, the co-payments are slightly more favorable for care delivery in Baja California than in San Diego. There are several well-known examples in California where some agriculture employers and some union trusts have formed ERISA self-funded plans that included cross-border healthcare benefits. The Western Growers Association, United Agriculture Benefit Trust and the United Farm Workers RFK Trust are but a few ERISA programs with cross-border health care benefits. For those who live close to the border with Mexico, it is no news that the price differential for the same procedures is very significant and continues to widen between the two countries.” Michael Tarabay of Mercury Healthcare International adds, “Once an employer has decided to add a domestic or international health travel benefit option to their ERISA self-funded, group health benefit plan, they need to design their benefit option and add the details of their unique program to their summary plan description. ERISA requires plans to inform participants of their rights under the plan and of the plan's financial status. To be qualified for tax preferences, plans must meet requirements with respect to benefits, and there are special rules for plans that primarily benefit highly compensated employees or business owners.” He also mentions that employees not only have to be told of any changes such as adding cross-border benefits, it has to be in language that is easily understandable by the average employee.”

BULGARIA: Bulgaria seeks to become a world-class spa destination

Fri, 02 Dec 2011 16:12:16 GMT

Bulgaria has launched a major new tourism strategy highlighting the wide range of attractions the country has to offer as it attempts to raise its profile as a mainstream holiday destination One key market for Bulgaria is the UK, with the launch of a new UK advertising campaign that promotes Bulgaria under the banner of "Magic Lives Here" and focuses on some of the country's lesser-known tourism products including spas and well-being, culture and folklore; and eco-tourism. The campaign forms part of a wider effort by Bulgaria to position itself as a desirable tourist destination in three of its major markets: the UK, Germany, and Russia. Traycho Traykov, Bulgaria's minister of tourism, says: "300,000 UK tourists visited Bulgaria in 2010. With the help of the new advertising campaign our target is to increase this number to around 500,000 by 2020.A lot of people still assume that Bulgaria is a country for mainly cheap beach holidays and skiing but there are many other offerings which deserve to become much better-known. Our new strategy positions Bulgaria as a destination that can offer the discerning traveller a wide range of experiences all year-round. Stronger promotion of health spas and wellness are key priorities for us. Bulgaria has been blessed with the gift of nature. Our country is rich in mineral springs. We have more than 600 sites that provide endless opportunities for health and beauty treatments." The advertising campaign is being supported with a wider communications campaign of PR activities. Bulgaria Tourism has also launched an official new web portal available in nine languages. It covers more than 450 cities, resorts and villages and provides information on everything from conference facilities to UNESCO World Heritage Sites. There are more than 100 spa and wellness centres in mountain areas such as Rodopi, Pirin and Rila and also on the Black Sea coast. According to the forecasts of the Bulgarian Union of Balneology and SPA tourism, the expected growth in the revenue in this sector could reach 20% in 2011. In a boost to Bulgaria's ambitious plans to establish itself as a world-class spa destination, Sofia has been selected to host the 18th Annual Congress of the European Spas Association in 2013. Minister Traykov adds that Bulgaria is now totally committed to long-term investment in its tourism industry, "We have already embarked on a plan which will see massive developments in infrastructure over the next few years including a new motorway network. We are also investing heavily in restoring historical attractions, improving the quality of our beaches and ski resorts and laying new hiking paths and mountain trails". Bulgaria has 48 mountain resorts, 15 marine resorts, and 38 balneological resorts. The country is known for offering a wide range of services including massage, baths with mineral water, pearl baths, reflex therapy, traditional needle therapy, medicinal exercises, acupuncture, laser therapy, acupressure, paraffin treatment, apitherapy, phytotherapy, mud treatment, aroma therapy, anti-stress programs, dieting programs and programmes for losing weight, balneo-cosmetics, sauna, solarium, fitness, and medical cosmetics.

ABU DHABI: Hospital development will remove need for locals to go elsewhere, and attract medical tourists

Fri, 02 Dec 2011 16:07:05 GMT

Mubadala Healthcare, a unit of Mubadala Development Company, has announced the structural completion of Cleveland Clinic Abu Dhabi, adding that it is set for handover in the second quarter of 2013. Cleveland Clinic Abu Dhabi will offer a 364-bed hospital with the option to expand to a 490-bed facility. It will be organised into the five institutes of digestive disease, eye, heart, neurological, plus respiratory and critical care, to offer an advanced range of medical services. Like its counterpart in the United States, it will be a doctor-led hospital served by North American board certified medical professionals. Cleveland Clinic Abu Dhabi is a key project in Mubadala's strategy to stimulate Abu Dhabi's healthcare sector by establishing world-class healthcare facilities. Mubadala appointed Aldar as development manager in 2007 to oversee the design, construction and commissioning of the hospital, which is scheduled for a full-service opening to patients in late 2013. Suhail Mahmood Al Ansari of Mubadala Healthcare says,” Cleveland Clinic Abu Dhabi will be an outstanding facility that brings the highest international standards of care to patients in this region." Cleveland Clinic Abu Dhabi will serve local and international patients in an environment that combines excellent amenities with world-class medical care. The site is Sowwah Island, the heart of Abu Dhabi's new central business district. It shares the island with a hotel, stock exchange, and office buildings. Access to the island is by multiple bridges to the mainland. Cleveland Clinic Abu Dhabi will be an extension of the Cleveland Clinic model of care, providing a spectrum of specialty services that are designed to cater to the healthcare needs of Abu Dhabi and the region. One of the objectives of Cleveland Clinic Abu Dhabi is to address the needs of patients currently travelling abroad for treatment. Local and international patients will be cared for in an environment combining excellent amenities and service standards with the highest quality patient care and superior clinical outcomes. The hospital is being designed to offer state-of-the-art diagnostic and treatment capabilities and utilize advanced technologies in surgery, imaging, telemedicine and electronic medical records. Abu Dhabi Health Services Company (SEHA) owned Madinat Zayed Hospital in the Al Gharbia region of Abu Dhabi has achieved international JCIA accreditation. Carl Stanifer of SEHA comments, “JCIA accreditation is an important element in ensuring excellence in healthcare that meet or exceed globally accepted standards. We are working on developing a healthcare system that is on par with the best in the world, and Madinat Zayed's accreditation is further confirmation of our commitment to this goal. We are working towards ensuring that all our healthcare facilities, clinics and operations are eventually JCIA accredited and deemed to be operating to the highest healthcare standards." Other JCIA accredited SEHA facilities include Al Rahba Hospital, Corniche Hospital, Tawam Hospital, Al Ain Hospital, SEHA's Ambulatory Healthcare Centre in Khalifa City A, SKMC Hospital, SKMC's Outpatient Clinics, Abu Dhabi Blood Bank and Tawam Dental Clinic. SEHA owns and operates 12 hospitals with 2644 beds.

PHILIPPINES: International marketing programmes needed to fulfil medical tourism potential

Fri, 02 Dec 2011 16:03:03 GMT

The Philippines earned a total of US$1.3 billion from healthcare and wellness services from overseas foreign tourists and balikbayans (expatriate Filipinos) who visited the country in the five-year period 2006 to 2010, says healthcare business intelligence firm Healthcore. The Healthcore report, 'The Philippine Medical Tourism Compendium' contains analysis of the key competitive strengths of the country in terms of its hospital and healthcare infrastructure, cost structure advantages, market segmentation, value propositioning and quality systems in relation to the global market. Joyce Alumno of Healthcore explains, “The Philippines has the potential to grab a bigger share of as much as US$1 billion to US$3 billion in annual revenues in the global medical tourism market by 2018 if it puts in place an attractive investment environment that will enable the country to expand its healthcare infrastructure, more open and liberal travel arrangements for medical tourists and better and more extensive international marketing promotions and programmes.” Joyce Alumno adds, “The Philippines is losing out in Asia to Singapore, Malaysia and Thailand. But the country has a world-class medical infrastructure and facilities and well-trained and proficient doctors, nurses and medical personnel. The top three hospitals in Metro Manila have put up hotel-quality facilities that will cater to not just the high-end Filipino patients, but also foreign medical patients who go to the Philippines for their healthcare needs. The country possesses the added competitive advantage of having English-speaking and compassionate and caring medical personnel. Most Americans are familiar with the friendliness and caring attitude of Filipino nurses in the USA.” Alumno wants the medical and tourism sectors and other industry stakeholders to get their act together and to develop broad-ranging strategies as well as improving healthcare infrastructure, quality management, international accreditation, liberalisation of visa restrictions for the medical traveller and international marketing and promotions. Health Secretary Enrique Ona underscores the need for the Philippines to become globally competitive because of the challenges posed by medical tourism,“While the competence, compassion and communication skills of Filipinos give us an advantage, other countries are also recognizing the opportunities in this global village. Losing out may prove too costly for our country grappling with limited resources for health care. Philippine medical tourism is moving but the country has not truly maximized its potential. It was back in 2004 that the Philippine Medical Tourism Program, a public-private partnership project, was conceived and launched after the government realized the potential return of medical tourism. The number of patients who come to our country for health-related services has continued to grow since then, and if it keeps pace, we may be able to generate a cumulative income amounting to as much as $3 billion from this industry by 2015. Years before former President Gloria Macapagal-Arroyo decided that she needed medical attention overseas, the government started promoting the Philippines as a destination for medical tourism. As in several other aspects, the promotion was either belated or lacked the steam manifested in other Asian countries. Today the Philippines are lagging behind Thailand, India and Singapore in medical tourism.” The Philippine Medical Association says that what is lacking is more aggressive marketing of the expert and affordable medical services available in the Philippines. A similar problem afflicts the tourism industry in general. The Philippine Medical Tourism Program is no longer active and the Healthcore report says that there was a failure to sustain and capitalize on the momentum of the project. Former president Gloria Macapagal Arroyo has caused much embarrassment to the country in recent weeks by her attempts to go abroad for medical treatment, on hold after authorities stopped her because she is under investigation for corruption. In a high-profile drama, the government ignored a Supreme Court order to allow the former president to travel and blocked her at the airport. Arroyo stepped down last year and immediately faced at least half a dozen complaints accusing her and her husband of tampering with election results, diverting state funds for her campaign effort and benefiting from foreign contracts. She has denied any wrongdoing. Arroyo has had three surgeries on her cervical spine but says they failed to make her better and she needs treatment abroad that is not available in the Philippines. Offers to have foreign doctors of her choice treat her in Manila have been refused. In the dramatic airport showdown Arroyo, in a wheelchair and a surgical mask covering her face and the contraption over her head, tried to board a plane only to be turned back by immigration officials. The current government claims that local medical treatment is available and if she goes abroad she will never return. Arroya claims that local doctors cannot cure her and medical facilities are not adequate. Whoever is right or wrong, it is an embarrassment for those seeking to promote medical tourism.

GLOBAL: Medical tourism survey exceeds 600 participants

Fri, 02 Dec 2011 16:00:35 GMT

The 2011 Treatment Abroad Medical Tourism Survey has attracted over 600 participants in the two weeks since it was launched. The initial 600 participants have been attracted by targeting enquirers to the Treatment Abroad family of medical tourism web sites. The research aims to find out about the experiences of patients who have gone abroad for some form of surgery or medical or dental treatment. The research is being undertaken by European Research Specialists on behalf of Intuition Communication who run Treatment Abroad, and the International Medical Travel Journal. The research data will be provided at no charge to a Medical Tourism Research Team led by Dr Neil Lunt at the University of York and Professor Richard Smith at the London School of Hygiene and Tropical Medicine. The team recently completed a review of Medical Tourism for the OECD. Intuition is encouraging all healthcare providers who offer services to international patients to encourage their past patients to complete the survey. Intuition is offering £100 (or €100 or $150) of Amazon vouchers to five participants drawn at random, who complete the survey in full. In addition, for every completed questionnaire, Intuition will donate £1 to Smile Train, an international charity that provides cleft palate surgery to children around the world. Healthcare providers will get a free copy of the full report of the research, provided that more than twenty of their patients complete the survey. Providers can download an email template to send to medical tourists who have used their services.

BORNEO: New international hospital will attract medical tourists

Fri, 02 Dec 2011 15:54:56 GMT

A large integrated commercial development on the coastal highway at Riverson in Borneo is to include a hospital and is expected to be ready by 2014. Developed on 5.5 acres of prime commercial land, the project includes The Gleneagles Kota Kinabalu Medical Centre, three-storey retail shops, a tower of six-storey office suites with mezzanine floor and a seven-storey tower of residential flats. Ben Kong Chung Vui of Riverson Corporation says that it will part of many other attractions in the city, “Riverson, being the upcoming new addition to the city, together with its immediate neighbours, will bring about substantial integration of activities and continuous crowd movements, served and generated by about 900 residences, 600,000 square feet of commercial retail outlets, 800,000 square feet of office space, 6000 car parking spaces and 12 hotels. This new integration of Southern Hub will cover leisure and wellness in one destination.” The Gleneagles Kota Kinabalu Medical Centre will be the main anchor for Riverson. It will be developed as a hospital, bringing Sabah a healthcare facility of international standards. Gleneagles KK will have five-star hotel amenities and comfort, service levels to match, cutting edge technology and have a highly trained team of consultants and staff. With up to 250 beds, 180-seat auditorium, and six operating theatres, it will be built to comply with Joint Commission International (JCI) standards. Initially it will cater to the growing healthcare needs of the residents in Kota Kinabalu and the surrounding areas and serve as one of the main private referral centres for Sabah. Ben Kong Chung Vui adds, “Saharans will not have to go overseas anymore for medical treatment. Gleneagles Kota Kinabalu will contribute to the development of Sabah's medical tourism targeting patients from Indonesian cities such as Balikpapan, Pontianak in Kalimantan and from Brunei Darussalam, as well as neighbouring countries such as Philippines, Singapore, Hong Kong and even Korea. There will be a focus on setting up centres of excellence on cardiology/cardiac surgery, neurosurgery, surgery, orthopaedics, gastroenterology and women /children. Gleneagles KK will also act as a catalyst for young local talents with 95 specialists covering all major specialties.” Gleneagles Kota Kinabalu Medical Centre - the anchor component in Riverson development will be run by Asia's largest private hospital chain, Parkway Group, and is a joint-venture between Riverson, Sabah government's investment arm, Warisan Harta and Saham Murni.Groundwork has already started at the private hospital which is just 10 minutes from the Kota Kinabalu International Airport, within the central business district, and enjoys the seaside views of Sabah.

EUROPE: How will cross-border healthcare affect hospitals?

Fri, 25 Nov 2011 11:15:33 GMT

While the subject of cross-border healthcare has been debated endlessly at political level, few seem to have thought through how it will affect those places that will have to actually deal with what the politicians have agreed. Hospitals in Europe, and healthcare budgets throughout Europe are under pressure, with Spain already closing hospitals. 150 medical professionals at the first European Hospital Conference debated the current European health policy and the impact of the EU patients' rights directive. Passed by the European Council of Ministers in February, these guidelines envisage patients having cross-border access to healthcare services, inclusive of a free choice of doctors and hospitals across the entire EU. Prior to the conference three senior figures offered some insights in European Hospital. Although the European healthcare systems are very much geared to their own national control mechanisms, there are common grounds on an EU level regarding the patient's rights directive, Heinz Kölking of the European Association of Hospital Managers (EAHM) says, “The implications for hospitals will differ widely depending on their locations and the range of clinical service being offered. Every healthcare institution will have to deal with issues such as the quality of structures, processes and, not to forget, outcomes. There are also many legal, cultural and linguistic requirements that must be met by the organisation and staff.” Georg Baum of the German Hospital Association (DKG) agrees that one of the effects on hospitals of the EU patients' right directive will be that they must prepare to receive streams of foreign patients and this includes providing the necessary communication skills, within the hospital as well as for follow-up communications with patients' physicians abroad: Many hospitals are actually already responding to enquiries from abroad and also actively promoting their services abroad. We are already working with the Federal Ministry of Economics to promote medicine made in Germany as an international brand. I think it is a legitimate approach for each country to offer its medical treatment capacities and qualities on the international healthcare market. The cross-border freedom of choice can actually promote quality competition amongst hospitals and doctors.The directive requires that all EU Member States provide transparency about their range of services, prices and quality of treatment. We are already well on our way with this in Germany; we introduced a hospital catalogue a few years ago that systematically informs about the range of treatment on offer, and the quality of results in all German hospitals. There will probably be a need for clarification on how services are being reimbursed. The directive envisages that patients will pay for their treatment immediately. However, there is also discussion as to whether it would be possible to process payment via the respective social security systems. In countries that lack capacity for patient care, things will depend on how they handle the right of provision of their own medical insurance systems, that is, how they will handle their national guidelines on the authorization of treatment abroad.” The directive requires that all EU Member States provide transparency about their range of services, prices and quality of treatment. Dr João de Deus of the European Association of Senior Hospital Physicians (AEMH) sees three key strategies to achieve standards that could guarantee treatment quality and patient safety of healthcare in a cross-border environment, where health professionals and patients can move freely within the EU: “ 'First, the introduction of risk management routines; for example, by developing guidelines and indicators as a part of a quality assessment system in the healthcare sector. Second, the involvement of senior doctors in hospital management is crucial. Doctors take responsibilities for many hospital decisions that influence performance and quality of care and therefore interrelate with other areas in the hospital and human resources, financial success, healthcare policy and economics. The third aspect is the evaluation of pre- and post-graduate education as Europe faces a huge problem of harmonising medical training and a consistent recognition of professional qualifications in working life. When it comes to specialisation, the countries have very different rules for training periods, certification and validation processes.” In his role as elected president of the European Hospital and Healthcare Federation (HOPE), Georg Baum adds, “Our European healthcare systems are very much geared towards their own, national control mechanisms. There are different opinions across HOPE member states as to how much freedom patients should be given regarding their choice of treatment abroad. In Germany, we do not have concerns because we can provide all forms of maximum care ourselves. However, there are countries with different national healthcare systems that fear they might lose patients. This includes countries with long waiting list problems, such as the Nordic countries and Great Britain, and Eastern European countries that are only just in the process of developing independent healthcare infrastructures.

GLOBAL: Ethics and medical tourism under scrutiny

Fri, 25 Nov 2011 11:13:05 GMT

The ethics of medical tourism are coming under scrutiny from academics in the USA. Leigh Turner is an associate professor at the University of Minnesota Center for Bioethics. Turner's blog, Health in the Global Village, provides regular updates on medical travel and globalization of health care. This Canadian citizen's research addresses ethical and social issues related to transnational medical travel and the emergence of a global marketplace in health services, “My work suggests the importance of moving beyond hyperbolic promotional rhetoric and notions of the self-regulating marketplace and better addressing risks to individual medical travellers, public health systems, and global health as increasing numbers of patients participate in cross-border health care. Several forthcoming publications draw upon five years of research. Finding credible information is a major problem. Many medical tourism companies provide little information about risk, and instead emphasize any benefits associated with going abroad for treatment. A global marketplace for health care doesn't equate to uniform global health care standards.” Medical tourism agency Mercury Healthcare International comments, “It makes no mention of the detailed vetting and credentialing done by organizations such as us, that follow strict protocols established by several accrediting bodies, perform primary source verification and negotiate recourse into their provider agreements.” Glenn Cohen has also done research in this area and produced three major law review articles on the subject .The first law review article focused on quality of care and medical malpractice recovery. The third, which is coming out soon, focuses on circumvention tourism - patients who travel abroad for the purpose of circumventing a home country restriction on access, such as in the case of abortion, assisted suicide, female genital surgery, and reproductive technology. 'Medical Tourism, Access to Health Care, and Global Justice' is his second law review article and the author says, "Does medical tourism have negative effects on health care access for the poor in the destination country? If so, do home countries or international bodies face obligations to prevent or correct those negative effects, and under what circumstances? While my focus is on medical tourism, I also show how some of the ideas I develop are applicable to other instances of the globalization of health care such as medical migration. The goal is to have a dialogue between these theories and medical tourism cases, to see ways in which the theories speak to the cases but also the ways in which the cases identify gaps, ambiguities, and possible divergent ways of filling the blanks.” Cohen is currently editing a book for Oxford on legal and ethical issues in health care globalization and starting a new book project on medical tourism. Glenn Cohen adds, “When medical tourists consume health care abroad, they are essentially investing in that country's health care infrastructure. This gives foreign hospitals an incentive to invest in the relevant medicines and technologies. At some point of saturation, these medical goods spillover into the general population and will become accessible to all.”

OMAN: New medical tourism project in Oman

Fri, 25 Nov 2011 11:05:38 GMT

The Apex Medical Group (AMG) has signed its first land acquisition deal as part of plans to set up a $1bn medical city in the seaside resort of Salalah, Oman. AMG will develop a medical city to include a 530-bed hospital, a regional organ transplant and rehabilitation centre, a diagnostic and medical prevention centre, healthcare resort and a healthcare education complex. The medical city will also have a luxury hotel, wellness centre, and will also offer free medical and educational community support services to poor families. The project will be developed initially on 500,000 sq m of land but AMG has government approval to expand on a further 300,000 sq m. The site is already connected to major utilities including electricity, gas, water and telecommunications. It is just 15 minutes drive from the Salalah International airport which is undergoing expansion so it can deal with up to 6 million passengers a year; due for completion in 2014. It is in line with the Oman government's five-year tourism development plan and is the first healthcare infrastructure development project in Oman being set up by a private investor. The medical city project also aims to tap the inbound medical tourism market. AMG is a subsidiary of Aljoaib Holding, a Saudi group with diversified portfolio of business in Saudi Arabia and elsewhere. Company founder Dr Abdullah Al-Joaib says an agreement had been signed with the Oman authorities for the integrated medical tourism complex in Salalah, which aims to put Oman on the global medical tourism map, "The strategic vision of the project is to create a high quality sustainable healthcare led mixed use development that functions as a vibrant, sustainable and self sufficient community and place Oman as a preferred destination for medical tourism." Oman's Vision 2020, revolves around establishing Oman as a regional travel and tourism hub, increasing the contribution of travel and tourism to at least 3% of GDP, increasing the participation of the private sector in the development of tourism activities and increasing the Omanization to 80% in the tourism sector. Sandeep Sinha of Frost & Sullivan comments, “The initiative of an integrated medical tourism complex in Salalah by the Oman authorities is justified to meet the healthcare needs of Oman and the GCC region. Oman has the lowest per capita expenditure in healthcare across the GCC region though the increase in population is second highest. Expenditure on healthcare in Oman is also second last across GCC. Additionally, Oman lags behind in both public hospitals as well as private beds across the GCC region. This new setup is primarily expected to address the need for healthcare facilities in Oman and provide huge opportunities for medical tourism across the GCC and neighboring countries.”

MEXICO: Crossborder care for selffunding Texas employers

Fri, 25 Nov 2011 10:43:50 GMT

Californian medical tourism agent Jim Arriola of Sekure Healthcare explains the possible advantages of using cross-border healthcare for self-funding employers in Texas. “Why would any employer choose to include medical providers from Mexico? The three major reasons are: • Employers may have Latino workers who may prefer their healthcare from Mexican medical providers.• Cost of care in Mexico is significantly less expensive than in the USA.• In some rural US communities along the border, there is a long wait for access to some medical specialties. The cost of healthcare is largely a function of the unit cost for hospital services, doctor services and medication. Since the unit cost of healthcare in Mexico is significantly less than in the USA, the cost of healthcare cover for similar benefit plans would also be significantly less. Unlike California, where there are several cross border insurance plans, Texas law does not allow its insurance carriers to contract with Mexican providers. Several studies in the early 2000's were conducted by the University of Texas to look into the merits of cross-border healthcare for Texas after California had allowed cross-border healthcare plans. The Texas medical community convinced Texas legislators in public hearings that patients could be seriously harmed if insurance carriers were allowed to contract with Mexican providers. For those Texas employers who might be considering the merits of going self-insured, access to cross-border health care might be a positive tipping point factor. Under ERISA and federal law, a self-insured Texas employer is not prohibited from establishing benefit plan services that would allow participants to access healthcare services in Mexico. Such a plan could be developed to offer much more healthcare benefit bang for the employer's allocation buck. The Texas market has been largely void of any self-funded employer benefit programme with integrated cross-border healthcare benefit services. This is not entirely surprising given the Texas market and the relative complexity of an employer going self-insured versus the easier fully insured health plan model. One pioneering effort is underway in Laredo, Texas with a large self-insured employer association. Our firm was contacted a year ago by a third party administrator working for an employer association offering self-insured health cover that had several employer members with a large Hispanic workforce along the Texas-Mexico border. The association had a number of employees who were already accessing care in Mexico, since some of them actually lived there and worked in the USA, while others were attracted by the much more affordable price tags for their care than those they could find locally in the USA. Everybody agreed that the standards of care that they found across the southern border were excellent, and that they could find high quality doctors and medical providers, if they knew where to look. After many meetings with staff, actuaries, benefit consultants, steering committees, claims processing centers, medical directors, legal counsel, reinsurance carriers and countless other entities, the green light was finally given to proceed. It seems that cross-border health care is going to be a new win-win initiative that provides relevancy to the employer association in demonstrating innovations in the form of out of the box thinking to achieve healthcare cost savings to its employer members, while expanding consumer choice for employees. Since self-funding has more moving parts than fully insured coverage, introducing cross-border healthcare benefits into the self-funding coverage offering increases the level of complexity. The biggest challenge by far is the lack of credible information and basic knowledge related to cross-border healthcare expenses, utilization frequencies, medical management processes, quality of care standards, provider networks credentialing and operations, the legal framework and the operating environment. My company has been focusing on this kind of question for over six years. Cross border healthcare is an idea whose time has come, as the cost of care continues to increase in the USA For those who live close to the border with Mexico, it is no news that the price differential for the same procedures is very significant and continues to widen between the two countries.”

CAYMAN ISLANDS: Future of medical tourism project may be in the hands of UK government

Fri, 25 Nov 2011 10:25:33 GMT

The ultimate vision for Dr. Devi Shetty's proposed medical tourism development involves the creation of a massive healthcare city on 600 acres in East End, with a 2,000-bed hospital, a teaching hospital and assisted living homes for seniors. This is a huge project that will require significant improvements to Grand Cayman's infrastructure, in transport, housing and public services. Dr Shetty says, “Once we have a facility of 2,000 beds everything has to change in this country. The current infrastructure will not sustain that.” Major infrastructure upgrades should not be necessary for the first phase of the 15-year project, consisting of a 140-bed hospital. Infrastructure requirements will be taken into account by government agencies as developers seek planning approval for each phase of the project. Apart from the Narayana Cayman University Medical Centre itself, the greatest stress on Cayman's infrastructure will be the predicted volume of people going to and from and residing at the hospital. It expects to cater to 120 patients a day in its first year of operation and eventually expand to 1,400 per day when fully operational. Patients would stay on the island for an average of nine and a half days. Dr Shetty plans for the assisted living centre to expand beyond the 1,500 units approved by government, “We need to have at least 10,000 people living in this city in this assisted living facility.” Grand Cayman currently has only the 124 bed Cayman Islands Hospital and 18 bed Chrissie Tomlinson Memorial Hospital. Just the initial 140 bed Shetty hospital would double the number of hospital beds. If the 2,000 bed hospital is completed, Grand Cayman would have more than 14 times the number of hospital beds it currently has. Premier McKeeva Bush predicted last year that by 2013 87,600 patients and accompanying family members would arrive in Grand Cayman to visit the hospital centre, and by 2025 the number of medical tourists would increase to over a million a year. These are very ambitious and optimistic figures both for medical tourists and others coming with them. To put those figures of a million in perspective, in 2010, only 288,000 tourists arrived in Cayman by air. In 2009, the number of tourist air arrivals was 272,000. According to the government projections, the hospital would lead to a 30 % increase in tourist air arrivals in 2013 (compared to 2010) and a 365 % increase in 2025 (compared to 2010). The government has bent over backwards to make this project happen, and has effectively staked their economic future on success, which is why the estimates are so optimistic. If those figures and the 2,000 beds are both reached, there is still a huge problem for the local economy. It will need 10,000 new hotel rooms-on top of the existing 2,000 hotel rooms and 2,600 rooms in apartments, cottages and guesthouses. This would be a 500% increase in the number of hotel rooms. The hospital's phased approach will allow the development to progress without infrastructure upgrades being immediately required. David R. Legge, spokesman for the project, says, “The existing infrastructure- the road system, the airport, and of utilities are sufficient and will be so for the first three to five years of the project. The reason for that is the project starts out rather modestly.” The government plans to build an east-west road corridor from George Town to East End once Cayman has the funding, but not yet and with no set date. One reason for the delay is simply that the government has no money. The government expects the hospital developers to pay for and build their own feeder roads to the site, just like any other developer- and may well ask them to fund the new road too. The government has agreed to upgrade Owen Roberts Airport to handle the proposed number of medical tourist arrivals. The airport expansion is an existing government initiative to begin in the next four to five years- although where the money is coming from is unclear. The hospital will have to build its own medical waste recycler, as the country's bio-waste service is one man and a truck. The Cayman Islands is not fully independent. The government has opted not to sign a fiscal policy document put forward by the UK government that seeks to control spending in the overseas territory, and is attempting to negotiate. The British government is seeking to pin down the local government to restrict the UK's exposure to fiscal irresponsibility in Cayman. The deal will affect how the local government spends and borrows money in future as well as the consequences for not sticking to the deal. The UK asks the Cayman Islands government to undertake effective medium-term planning to ensure that the full impact of fiscal decisions is understood, that it puts value for money considerations at the heart of the decision-making process, that it demonstrates effective management of risk and drives the delivery of improved accountability in all public sector operations. The government took over from a previous government that had borrowed and its overspending had placed the country in a dangerous financial position. The UK government will not be prepared to bail out the islands again, and if the local government fails to agree to terms or makes a deal and breaks those terms, the UK government will take control. The current offer from the UK will require the local government to gain approval not just for borrowing but for the whole budget as well as any projects that are planned over CI$5 million or to use any public asset as collateral for any arrangement with a party outside of government. The agreement will tie this and any future government into responsible and transparent financial practices with greater reporting requirements to the UK. It will also require government to make a proper business case to spend any public money and provide far greater accountability to the people for its spending. So the UK have to agree any public spending on improving the local infrastructure, and is likely to take a much tougher line on cost sharing than the local government. Effectively, whether or not the full 2,000-bed hospital ever happens could depend more on Britain's Foreign Office, than local investors or politicians.

CHINA: Beijing medical city would be a medical tourism attraction

Fri, 25 Nov 2011 10:17:11 GMT

A planned medical city for east Beijing's Tongzhou district is eyeing the growing demand for high-quality medical services and has set a goal of becoming a medical tourism destination. The initial aim is to attract some of the 60,000 and growing number of Chinese people going to other countries for medical treatment. Chen Lihua of the Fu Wah International Group, developer of the medical city, says, "Since Chinese people are becoming richer and richer, their awareness of health is growing rapidly. That is why we are going to build a first-grade medical city. The medical city will include disease prevention centres, excellent general hospitals, a nursing home and a health examination centre." Zeng Yixin of Peking Union Medical College comments, “As an international metropolis, Beijing should have health centers that provide high-quality medical services and set a model for nearby cities. Being able to provide high-quality medical services, especially curing complicated and chronic diseases, is essential. Since we do not have much experience with high-quality health service in China, we can surely learn a lot through cooperation with foreign researchers." Though the cost and time needed for construction have not yet been set, the developer is determined to invest in the project and build the largest hospital in China. As the first-stage of the medical city, a cancer research centre will be built for Chinese scientists to cooperate with University of Oxford experts on introducing target therapy to China. The therapy is a type of anti-cancer therapy that blocks the growth of cancer cells by interfering with specific targeted substances essential for tumor growth. Professor David Kerr of the University of Oxford explains, "Some of the treatments have been used in the West for many, many years before they come to China. Now we want to do trials both in the West and China, so this will hugely speed up getting the therapy and new drugs to Chinese citizens on time. Target therapy has been in clinical application in Western countries since 2003, and was proved more effective than current treatments and less harmful to normal cells than traditional methods.” Besides introducing the therapy, Kerr and his team will train Chinese doctors and nurses with their knowledge of tumours. Professor Sun Yan of the Cancer Institute and Hospital at the Chinese Academy of Medical Sciences says, "Only 10 % of the cancer patients who need drug therapy in China can get access to target therapy, which is lower than in the West. Target therapy is effective for cancers like lung cancer, breast cancer and liver cancer, but it is more costly than chemotherapy, and some Chinese doctors do not know how to use it. We wish that every single patient who needs target therapy will have access to it."

GLOBAL: International spa and wellness tourism aims for excellence

Fri, 18 Nov 2011 17:54:46 GMT

While medical tourism concentrates heavily on price, wellness and spa tourism is promoting quality, excellence, and professionalism. Elisabeth and Heinz Simonitsch run Austria's GrandHotel Lienz, which was recently named Europe's leading wellness hotel. The five-star hotel opened in 2009, and offers wellness tourism by pairing conventional medicine with the latest medical advances. GrandHotel Lienz overcame stiff competition from Adler Thermae Spa & Wellness Resort, Bagni di Pisa Natural Spa Resort, La Reserve de Beaulieu & Spa, and Richmond Nua Wellness Spa to win the prestigious World Travel Award. Under the management of Professor Peter Lechleitner the hotel offers a range of wellness, medical and spa facilities for the improvement of wellbeing through effective exercise, nutrition and relaxation programmes. It offers preventative medicine, medical check-ups, individual health advice and targeted therapies. Also offered are numerous professional treatments including traditional Chinese medicine, beauty, health, nutrition, fitness and well-aging. Four Seasons Hotels and Resorts has held its first ever global spa week to shine the spotlight on the company's international collection of high quality spas. It offered access to global and regional experts through exclusive offers and robust social media experiences, including a partnership with American Express. There are six more spas at Four Seasons properties due to open within a year. Access to its global network of spa professionals is through an expert panel called "Curators of Calm." They share their unique insights on the latest industry developments, spa trends and more on Twitter, Facebook and Foursquare. Guests who check into Four Seasons spas on Foursquare will receive spa tips from those properties and the Curators of Calm. A series of Twitter chats led by the Curators of Calm were hosted and centred around industry trends in categories such as aging gracefully and the growing male spa segment. Christopher Norton of Four Seasons says, "Evolution is essential in spas, and our extensive specialised network provides a truly global perspective on the latest trends and innovations that shape the industry." As one of the largest operators of luxury spas in the world for more than 25 years, Four Seasons has continually created treatments and environments that are ahead of the curve. Spas at Four Seasons are beautifully and comfortably designed with an authenticity of style that inspires guests and reflects the local flavour of each destination. Indigenous ingredients and locally inspired treatments are offered alongside international and domestic brands and a broad variety of traditional, classic and new spa treatments. Many Four Seasons spas are emphasising organic local products, recycling, ozone or negative ions. By the end of 2011, all Four Seasons spas across the globe will offer an organic or chemical free option. Four Seasons has partnered with American Express to offer guests extra time when paying for a spa experience with an American Express card at participating hotels or resorts. Until March 15 2012, guests can receive 30 extra minutes of service when booking a 60-minute massage with an American Express card. Spas are a top priority for Four Seasons Hotels and Resorts, with five new property and spa locations opening in the coming year in Toronto, Guangzhou, Shanghai Pudong, St. Petersburg and Baku, Azerbaijan. Baltimore opened in November. More than 60 new properties, each with luxury spas, are slated to open in the next decade.

TAIWAN: Taiwan targets Japanese and Chinese medical tourists

Fri, 18 Nov 2011 17:53:06 GMT

Groups of Japanese medical tourists can now take a direct charter flight from Komatsu, Japan to Taiwan. Groups tend to visit some of the ancient city's well-known historical sites such as Anping Fort and the Tainan Grand Matsu Temple, and go to the city's leading hospitals for medical treatment. Taiwan is set to let mainland Chinese visit the island purely for physical examinations or medical treatment without the necessity of fitting their journeys into tourism itineraries, announced the National Immigration Agency (NIA). Under the new regulation, Chinese nationals can cite health checkups and medical cosmetology services as the purpose of travel when applying for an entry permit for Taiwan. Visitors for medical reasons can file entry applications via medical institutions in Taiwan. Existing regulations only allow ordinary Chinese visitors to receive such services after they enter the country with tour groups or as individual travelers for tourism. After receiving the medical services, mainland visitors have to leave the country with the same groups they entered with or leave within the allotted time under the individual travel programme, which is currently only open to residents of Beijing, Shanghai and Xiamen after a relaxation in rules in June 2011. Hsieh Li-kung of the NIA said the new policy will bring more mainland people to Taiwan for medical services and will boost the business of the local medical sector and the traditional tourism industry. NIA has reached a consensus on the proposal with other government agencies, including the Mainland Affairs Council, the Department of Health and the Ministry of Justice. The program will take effect soon pending approval from the Executive Yuan. People in China generally have highly positive impressions about the capability of medical workers and medical facilities in Taiwan. The relaxed rules on visits are expected to bring more Chinese customers to Taiwan in part due to the fact that Mandarin Chinese is used on both sides of the Taiwan Strait. Medical spending by travellers from mainland China, Hong Kong, and Macau amounted to NT$60 million in 2010. The new open policy will help significantly boost the revenues for medical centres and larger hospitals in Taiwan. The NIA has shortened the processing time for medical treatment applications from mainland Chinese people. In cases concerning people facing life-threatening situations, entry permits for people on the other side of the Taiwan Strait can be completed within four hours, including on holidays.

CHINA: Medical tourism demand from China

Fri, 18 Nov 2011 17:52:08 GMT

Although China is promoted as a medical tourism destination, with the difficulty of getting visas and lack of destinations, the numbers going there are small so far. But the real interest is the quiet but hidden growth that now makes China one of the main suppliers of outbound medical tourists. The number of Chinese going abroad for medical treatment has increased significantly in recent years due to rising affluence and mobility of the country's emerging middle class population. Chinese health consumers are not motivated by price but by the poor availability of services. Outbound Chinese have high-middle to upper class income levels and are going abroad to receive a quality of service, care and discretion not widely available in their home country. China's rapid development into the world's second largest economy over the past few decades has generated millions of people wealthy enough to demand the highest quality of care available worldwide and pursue elective medical procedures China's healthcare system has and will be improved but it starts from a low base of public care rather than a mix of private and public care as in other countries. Treatment costs are very low, the range in services is narrow and service quality varies by and within region from excellent to very basic. Medical tourism countries are finding that Chinese consumers are willing to pay high prices for quality services and privacy, but only if the service is meeting Chinese consumer needs. One key to this huge market potential, is as some hospitals and clinics in South Korea and the USA have quickly realized is Chinese-speaking staff. While many Chinese speak several languages, they are comfortable using these for tourism, but not for medical treatment or business. According to the Chinese Medical Doctor Association, the most popular destinations for Chinese medical tourists include Taiwan, Japan, South Korea, Singapore, Hong Kong and the USA. The number of outbound Chinese medical tourists has increased from just a few thousand at the start of the decade to nearly 60,000 annual travelers in 2010. The Shanghai Medical Tourism Products and Promotion Platform says anti-aging therapy, cancer screening, high-end diagnostics, and treatment and care for chronic diseases have become the most common type of procedure sought out by China's medical tourists. For those who want to venture abroad for treatment but have not yet: language barriers and lack of private health insurance are seen as the principal obstacles to partaking in overseas medical treatment. Health insurance in China is very new still. Some Chinese health travellers are expectant mothers leaving the mainland to give birth in a foreign country-maternity tourism. While some argue that it is to avoid local laws on the number of children, this argument falls down as they all return to China. The more believable reason is that many come from other parts of China such as Hong Kong or Taiwan so want to' go home' for birth. In 2010, 40,648 mainland mothers gave birth to children in Hong Kong hospitals, out of the 88,000 total in the city for 2010. New legislation by Hong Kong limits the number of non-residents allowed to give birth in the city to 34,000 in 2012 and beyond.

USA: Global Health Voyager buys medical tourism agency, Planet Hospital

Fri, 18 Nov 2011 14:18:05 GMT

Global Health Voyager has bought US medical tourism agency PlanetHospital from Healthcare International Networks. Rudy Rupak, founder of PlanetHospital, will work with GLHV. PlanetHospital has been a pioneer in medical tourism since 2002 and has served thousands of patients to become one of the largest medical travel agencies in the USA. PlanetHospital will release a new state-of-the-art website by the end of the year, featuring a clean, minimalist appearance that is simple to navigate, and includes an updated customer relationship manager, virtual detailed anatomical procedure body and video of patient testimonials. The business targets individuals, self-insured employers and third party intermediaries by providing a range of services to assist access to medical procedures, including cosmetic surgery, hip replacement and stem cell therapy. Global Health Voyager is an international medical tourism company that offers technology solutions, medical tourism consulting services, and access to a worldwide network. PlanetHospital is showing a new documentary on US television networks,” Under the Knife.” The 60-minute documentary takes a comprehensive look into the process of medical travel, including a PlanetHospital patient's trip from California to Mexico to get surgery she could not afford in the USA. Global Health Voyager has added to its global network the Indian hospitals of Apollo Hospitals Group, Assaf Harofeh Medical Center in Israel, and AMERIMED Hospitals in Mexico. Ali Moussavi of Global Health Voyager says, “Mexico is a short plane ride from most cities in the United States, offering convenience and ease of travel – key considerations for those traveling outside the country for medical care. The Mexican government is expecting the number of medical tourism patients to reach 650,000 annually by 2020.” Global Health Voyager has a strategy to operate as a full-service medical tourism agency in the United States. The company offers access to a network of accredited facilities and providers to patients seeking healthcare, surgical, dental, and wellness procedures. Global Health Voyager Inc. incorporated on March 14, 2000, changed its focus to develop medical tourism websites and in April 2011, launched its initial medical tourism website www.globalhealthvoyager.com. The company was formerly known as NT Media Corp. of California, Inc. and changed its name to Global Health Voyager, Inc. in August 2011. The group was founded in 1999 and is based in Los Angeles, California. The company was originally focused on development, production and distribution of programming in the entertainment industry, including creating music platforms and skilled gaming in the United States and abroad and vertical social and professional networks. The company has phased out several websites, which it had developed, including www.neurotrash.tv, www.singlefathernetwork.com, and www.stemcellstalk.com. NT Media had developed and implemented an aggressive marketing plan for www.singlefathernetwork.com to expand audience and revenue. It also sought to develop of neurotrash.tv, the first in a planned series of websites to establish the organization as an online entertainment and media provider.Neurotrash.tv was a video-sharing site targeting young adults between the ages of 18 and 35. Users were able to post and share videos on the site as well as take advantage of video player to place videos on their own sites, social networking profile pages and blogs. It promoted the development of content by amateur and professional videographers, and information channels. Extensive social networking opportunities exist on the website. NT Media developed and implemented an aggressive marketing plan for neurotrash.tv to expand audience and revenue. The company's plans to take advantage of these new trends failed and so it has now turned to medical tourism. So far, the company has announced many deals that are just adding hospitals to a global network or promoting its services. It has yet to send more than a handful of people overseas for treatment, and the PlanetHospital acquisition seeks to turn promises into reality. The latest SEC return shows market capitalization of $ 1.1 million, enterprise valued at $3.2 million, one listed employee, nil revenue and net income of $559,000. Enterprise value is market cap plus debt, minority interest and preferred shares, minus cash and cash equivalents.

GLOBAL: Top wellness travel trends for 2012

Fri, 18 Nov 2011 12:34:33 GMT

Wellness holiday specialist Health and Fitness Travel has forecast the top wellness travel trends for 2012: Spa and cultureMore spas around the world enable you to dip your toes in another country's culture and experience your destination on a holistic level. Combining a healthy getaway with culture is a way to experience spa therapies that are indigenous to the country you are visiting. More innovative spas have created treatments based on their local culture and customs. Bootcamp for the soulThe new wave of active and wellness retreats help you wind down and tone up at the same time with a little bit of luxury in comparison to the tough military bootcamp approach. More holidays offer a gentler approach in how to exercise with dedicated tailor-made wellness programmes and some much needed time for relaxation. Age adapted spasMore generation spas to appear in 2012, adapted to the needs of specific age groups. Age adapted spas targeting younger groups will be focusing on the preventative aspect of healthy ageing, while 55+ spas will be incorporating rehabilitation treatments and looking at how to prevent age related diseases such as osteoporosis. Holidaying with health gurusTop health and fitness experts work at some of the leading resorts around the world. More people want to receive dedicated support and guidance from the best in the industry; wellness retreats are bringing in the top yoga teachers, nutritionists, doctors, personal trainers and more health gurus to raise their game. Nutrition as a foundationSpas will start to focus more on nutrition with follow-up consultations for clients to make healthy changes to their lifestyle. It is imperative that more spas stress the importance of nutrition, as we cannot expect to see proper results from spa treatments without the spa-goer making the necessary adjustments to their diet. Health and fitness consultationsWellness retreats are introducing comprehensive health and fitness consultations to analyse clients' needs in order to create a lifetime goal-driven tailor-made programme. This could range from losing weight to comprehensive post-recovery from an injury to building strength or flexibility. Social spa-ing2012 will continue to see a rise in community spas where socialising is a major aspect. The spas will be designed in ways that allow spa-goers to socialise and receive treatments at the same time. Healthy breaks for menThe stereotype that pampering is for women and fitness for men is cracking. More men every year are opting for healthy breaks rather than adrenaline-filled action-packed holidays. The dawning realisation that healing spa therapies and detox are not a feminine concept is increasing demand for such retreats for both genders. There are many spas that cater to men and have specialised treatments for their neglected muscles and abs. Healthy agingFor 50+ travellers - walking, cycling, tennis, spa and yoga holidays become more popular as retirees seek to prolong their vitality. It is not about reducing wrinkles, but rather health enhancement and disease prevention. Mind and body awarenessAs well as keeping in good physical shape, the equal importance of mental fitness and body awareness is being more widely acknowledged. Meditation is no longer viewed as a spiritual past time, but as an essential daily tool for coping with stress, and more holistic classes are appearing on activity schedules such as Tai Chi, Qi Gong and yoga. Wellness retreats around the world are incorporating programmes to aid stress reduction through meditation and healing therapies. Health and fitness in natureMany wellness resorts are moving their programmes outdoors and encouraging guests to engage with the natural resources exclusive to their locations. Outdoor activities include hiking in the mountains, yoga in the garden, outdoor rock climbing, open air spas, water sports and meditation on the beach. Family wellnessMore families are searching for these types of getaways. Parents want their children to be healthy on holiday and also keep busy with plenty of activities so they do not get bored. More resorts are also introducing healthy children's menus so they can learn good habits early. Parents also want to be able to enjoy holistic activities and spa treatments, whilst their children are staying active. Health concernsAlongside personal financial worries the consumer mind-set is also dominated by health and weight concerns. More adults are trying to engage in healthier activities to fight the flab and beat stress. Active holidays help encourage a healthier lifestyle away from home. Sleep wellWith the majority of workers getting less than the recommended eight hours of sleep per night, more of us are suffering from sleep problems due to stress and hectic lifestyles. Wellness retreats round the world are introducing sleep programmes to assist clients with problems such as chronic insomnia or even just mild sleep problems.

US: Medical tourism network agrees four new deals

Tue, 15 Nov 2011 09:33:31 GMT

Mercury Healthcare International (MHI) has selected Practice Fusion, the fastest growing electronic medical record community in the USA, for its electronic medical records system within its globally integrated health delivery system. Electronic medical records used properly with other information technology can improve communication and patient safety if fully implemented in hospitals as they can help reduce medication errors, avoid the need to repeat diagnostic testing, and improve continuity of care. Practice Fusion currently has iPhone and Android applications in private beta testing. When the stable release comes out, the mobile solutions will provide MHI people a lightweight and secure way to stay connected to a global network of providers and other medical advisers on the go. MHI's network includes over 6,000 pre-screened and inspected hospitals, more than 4,300 of which are in the USA, along with over 750,000 vetted doctors, clinics, dialysis centres, physical therapy and rehab centres, labs, imaging and hearing centres, plus substance abuse and mental health clinics. MHI operates several offices worldwide where staff work to operate a health travel and medical tourism logistics hub, conduct patient safety reviews and use medical records to conduct extended outcomes measurements for health travel and medical tourism patients seeking care in a location other than their home town. MHI's core business is to provide employees of self-funded / self-insured companies and individual consumer members the opportunity to access clinically coordinated health and wellness services. MHI uses innovative and well-developed outcomes measurement tools originally developed by Rand Corporation to monitor, measure, and report functional, clinical and patient satisfaction outcomes over a 36-month period and to document continuity of care. Maria Todd of MHI says, "Practice Fusion will make our operations flow more efficiently and lower the cost.” MHI clients and members can access affordable hearing aids as well as free hearing exams, walk in free battery replacements, and savings on hearing aids throughout the USA. TruHearing has developed a discount hearing services programme. MHI clients who enroll in this plan can receive hearing benefits for their plan participants, but also for members of their immediate and extended family. Hearing loss is a condition that affects 12 % of the American population. There are 1500 TruHearing centres throughout the USA and Canada. MHI clients and members can access prescription discounts at most local chain and independent pharmacies throughout the USA. For members of self-funded health benefit plans pharmacy copays are more than $25 and some medications may not be covered at all. The new deal can save money on any prescription where the copay is more than $10. Some members have already saved up to 90% at Walgreens, CVS, Costco and Sam's Club.MHI members get the prescription savings at more than 54,000 pharmacies as a free added bonus of membership. MHI clients and members can access affordable diagnostic imaging tests at more than 3900 locations throughout the USA. Maria Todd explains, "Almost every medical tourism case that we have coordinated in the last five years has required some pre-procedure testing in the form of MRIs and CTs especially for shoulder, knee and hip surgeries, or in the case of cancer patients, PET. These tests have been available to medical tourism patients at a cost of generally $1000 or more. If they go to a hospital to have it done, they are charged a radiologist fee for the interpretation and a facility fee. Now they can go to a small private free-standing location, be treated with respect for their time, the pain they may be in, and the hard-earned money in their pockets." Diatri is a diagnostic imaging network and scheduling/referral service. MHI can now offer client employers and insurers a way to control their health spending for diagnostic services such as MRI, CT, Arthrograms, and PET. It is estimated that 10-15% of employees will need an MRI, CT or PET scan in the next 12 months.

MEXICO: MedToGo travels with American patients to Mexico

Tue, 15 Nov 2011 09:31:43 GMT

While many medical tourism agencies have come and gone, US agency MedToGo International has increased the number of American patients it takes to Mexico, and has launched a new discount package. US surgical patients in search of premium quality, affordable, safe medical care will travel with MedToGo International to Mexico, every two months from November. For new customers MedToGo offers a $500 discount on cosmetic and orthopaedic surgery packages, and a 25% discount for obesity surgery. The medical tourism agency is unusual as it owned and operated by a family of practicing doctors educated and trained in the USA. MedToGo International, based in Tempe, Arizona, coordinates every detail of a patient's trip south of the border. It uses leading doctors and hospitals in Mexico and Costa Rica. Dr. Robert H. Page of MedToGo has accompanied patients on the trip in November to Puerto Vallarta, along with a patient coordinator. Currently the owner of a bilingual medical practice in Tempe, Arizona, Dr. Page works alongside his two American educated and trained sons at MedToGo, Dr. Curtis Page and Robert R. Page. MedToGo's mission to provide quality, safe alternatives to medical care for the underserved in America and Canada began more than a decade ago. The organization's founder, Arizona native Dr. Robert H. Page, got his medical degree from the Universidad Autónoma de Guadalajara in 1971. MedToGo helps to connect Americans and Canadians, often those who either do not have insurance or those whose insurance company will not pay for surgery, with medical services in Mexico and Puerto Rico. The company has focused on providing orthopedic, cosmetic, obesity, gynecological and cardiovascular surgery. What originally started as research on Mexican emergency services for American tourists turned into something different. Many US medical tourism agents either have no medical or tourism background or are travel agents who have branched out. While doctors may run others, the company claims it is the only one run and owned by doctors who also run their own practice in the USA. The company claims it can do many non-emergency surgeries for 50 to 85 % less what the same surgery would cost in the United States. Despite the reduced costs, the company strives to ensure quality care. All doctors are extensively screened. Dr. Page completes a vetting process on both surgeons and hospitals before using them. All of the doctors speak fluent English and most have completed their post-graduate training in the United States, Canada or Europe. In a typical month the company helps anywhere from 10 to 15 clients. Many patients are from Arizona, California, Washington and Texas, but some are from Canada as well. During the client's time in Mexico or Costa Rica, they are met at the airport by a patient coordinator, who acts as a translator, guide and advocate for the patient.

UK: New cosmetic surgery site for consumers

Mon, 14 Nov 2011 15:56:21 GMT

The loudest and most frequent criticism of cosmetic surgery tourism in the UK, Australia and elsewhere is that 'it is not safe'. But what tends to be forgotten is that in many countries, including the UK, domestic cosmetic surgery is unregulated. This makes it impossible to compare the number of problems or number of unhappy customers among those who go overseas and those who stay at home - whether or not it really is safer at home or abroad. Cosmetic treatment ranges from simple beauty treatment to complex surgery. Like all surgery, it carries a risk even when the surgeon, clinic and staff all perform their tasks perfectly. A new consumer website has been set up by Katherine Griffiths, ”After years of working as a journalist in the beauty industry I know how often a treatment, product or procedure is pushed, whether it works or not, by over-enthusiastic PRs and compliant journalists looking for material to fill their pages. I became concerned that people were not getting an honest opinion about the options available. So I launched a website where people can discuss the treatments and procedures in a free and open way amongst their own peers; where people can receive an honest opinion and get genuine advice from people with first hand experience before embarking on a costly and potentially life-changing treatment.” Katherine Griffiths founded TreatmentAdviser.com to prevent the rising number of botched and bungled procedures. The site is a Facebook-style forum where people can discuss pros and cons of procedures, discuss surgeons and clinics, and post comments about their experiences. According to official figures, 100,000 cosmetic procedures are carried out in Britain each year. New research by TreatmentAdviser.com suggests a fifth of cosmetic operations regularly go wrong. Katherine Griffiths adds, “The number of people in the UK choosing to have cosmetic surgery is increasing, yet many patients are trusting their lives to surgeons without a clear picture of their experience and success rates. Operations can, and do, go wrong yet there is no easy way to find out who is routinely making mistakes or putting profits before patient welfare.” Despite reforms, the British cosmetic surgery industry is still poorly regulated. Unscrupulous clinics use digitally enhanced models in advertising and financial incentives. In addition to the forum, TreatmentAdviser.com has a comprehensive gallery of 'before' and 'after' pictures. The site provides some useful advice whether you are staying at home or going abroad for cosmetic surgery:• ResearchBefore embarking on any procedure it pays to be informed – know the limitations and risks before handing over your money. Often the best way to find out information is to ask others who have had the same treatment. • ExpectationsIf your expectations are not realistic then the treatment will not be a success in your eyes. An experienced practitioner should be able to spot this, but by doing research yourself then you will know if that particular treatment will achieve the results you desire.• Avoid the Hard SellThere are so many treatments out there promising to turn back the clock or make you more beautiful, but how do you know which to choose, particularly as practitioners are often geared to sell you their services. The best thing is to do your research beforehand and chat to others.• PremisesAll UK clinics and independent hospitals offering cosmetic surgery or laser treatments should be registered with the Care Quality Commission. Any aesthetic treatments that do not involve surgery such as Botox, dermal fillers and skin peels are not regulated by the CQC. Laser treatments that are not carried out by medical practitioners have also been deregulated. So for these treatments, it is important that you ensure the staff are properly trained.• ExpertMake sure that the person carrying out your treatment is suitably qualified and experienced. Most surgeons and beauty therapists have a governing body or non-profit organisation that works hard to promote safety and good practice. They are always a good place to start checking out credentials.• CareAftercare is often as important a factor in the eventual success as the procedure itself. Make sure you know how you will be looked after, particularly if there is a complication. Also many procedures are not one-offs and your practitioner should fully explain this and the cost implications.• TimingSurgery is best avoided when going through one of life's major events. Know that you are embarking on the procedure for all the right reasons

EUROPE: European hospital gains international accreditation on cancer treatment

Mon, 14 Nov 2011 15:49:02 GMT

Aintree University Hospital and the Royal Liverpool and Broadgreen University Hospitals NHS Trust have been recognised internationally as leaders in the treatment of a rare form of cancer. The hospitals have received joint accreditation from the European Neuroendocrine Tumor Society (ENETS). They are one of just four centres of excellence in the UK, and 12 others across Europe in just 7 countries. Domestic and cross-border medical tourism in Europe for rare diseases such as this type of cancer will increase under proposed cross-border rules. Neuroendocrine tumours affect one in every 50,000 people and are unusual because they are typically slow growing, going undetected for many years. They are mostly found in the intestine, but can occur anywhere elsewhere in the body, including the lungs. The symptoms, which include indigestion, altered bowel habit; wheezing and facial flushing can often be difficult to deal with. Because of their rarity, many doctors are reluctant to treat these patients due to a lack of experience. Graeme Poston at Aintree University Hospital says, “This is one of only four centres in the UK where people can come for treatment endorsed by ENETS.” Aintree University Hospital and the Royal Liverpool University Hospital have been treating patients with neuroendocrine tumour disease for a number of years. The accreditation acts as a quality assurance and will likely lead to more referrals from GPs in the UK and internationally. ENETS was founded in 2004 and is the largest endocrine tumor society internationally, with more than 700 members and 16 centres of excellence across Europe. It aims to unify research among European medical professionals and establish guidelines for the diagnosis and treatment of the disease. Professor Martyn Caplin of ENETS says, “The accreditation follows a robust independent audit of the neuroendocrine tumour service at the hospitals and recognises the excellent multidisciplinary care. Liverpool joins three other centres in the UK, which has the most centres in Europe and has become a leading light for care of neuroendocrine tumour patients.” The other UK centres of excellence are the Royal Free Hospital in London, Oxford Radcliffe Hospitals NHS Foundation Trust and Christie NHS Foundation Trust in Manchester. Other non-UK accredited centres:• Zentrum für Neuroendocrine Tumore, Bad Berka, Germany• Oslo University Hospital, Rikshospitalet, Oslo, Norway; • Marburger NET Zentrum at Philipps University, Marburg, Germany• University Hospital Gasthuisberg, Leuven, Belgium • Hopital Edouard Herriot, Lyon, France• Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy• Umbria, Regional Cancer Network, Perugia, Italy.• Charite University Hospital in Berlin• Rigshospitalet, Copenhagen• Hopital Beaujon, Clichy ,Paris• Erasmus Medical Center, Rotterdam• University Hospital, Uppsala Sweden

INDIA: Fortis Healthcare buys Fortis Healthcare International

Mon, 14 Nov 2011 15:47:11 GMT

Fortis Healthcare (India) is paying $665 million to acquire Singapore-based Fortis Healthcare International, a business run by the Indian company's founders Shivinder Singh and Malvinder Singh. The plan is to consolidate local and overseas operations. Fortis Healthcare India has agreed to acquire 100% of Fortis Healthcare International from RHC Financial Services Mauritius, for a purchase consideration of $665 million. RHC Financial Services Mauritius is owned by the Singh brothers-Malvinder and Shivinder. A valuation of $695.7 million was recommended by a committee of independent directors but the brothers agreed to offer their investment in Fortis Healthcare International at a price of $665 million, as they decided that they did not want to look at making a profit from this transaction. The acquisition is expected to be completed by mid- December 2011 subject to relevant regulatory approvals in certain jurisdictions. This acquisition is a part of consolidation of domestic and global operations of the healthcare group, which gave up the bid to control Singapore-based hospital chain Parkway Holdings to Malaysia's Khazanah in July last year. The combined revenue is estimated to be more than $1 billion. The Singh family set up the Singapore-based firm in October 2010 to drive the group's international expansion following last year's aborted bid by Fortis Healthcare (India) for Singapore hospital chain Parkway Holdings Ltd. The local and overseas entities have been growing through acquisitions and by setting up new hospitals as demand for health-care services rises. Fortis Healthcare India and its joint venture partner International Centre for Robotic Surgery will set up ten robotic surgery centres across India in the next 24 months. Both partners have an equal stake in Fortis ICRS, which has just opened the robotic surgery centre at Fortis Escort Heart Institute in Delhi. The centres will be set up within Fortis Hospitals in Bangalore, Gurgaon, Mumbai, Chennai, Kolkata and in smaller cities including Mohali and Jaipur. Fortis ICRS centres will offer robotic surgeries in cardiac, thoracic, urology, gynaecology, general, head and neck and orthopaedics. After the consolidation, the combined network will have 74 hospitals in ten countries, with 12,000 beds, 580 primary care centres, 188 day care speciality centres, 190 diagnostic centres and 23,000 employees. Fortis Healthcare India has 66 hospitals and 190 diagnostic labs across India. 1018 Omani nationals obtained medical visas from the Indian Embassy last year, and 778 people took medical attendant visas to accompany them during their treatment period in India, says the Indian Embassy.

PHILIPPINES: Overseas Filipinos become key target for Philippine medical tourism

Mon, 14 Nov 2011 14:24:12 GMT

Filipinos living abroad are a huge market for medical tourism, says Joyce Socao-Alumno of HealthCore Philippines. She says that in the USA there are 5 million Filipinos holding American passports who could kick start the local medical tourism industry if it can convince them to 'go home' for medical treatment, cosmetic surgery and other wellness needs, “We have a big market from among Filipinos based abroad. It is better for Filipinos abroad to get healthcare procedures in the Philippines because they have relatives here and they are familiar with the language.” Alumno argues that the industry has virtually ignored this key market, while becoming left behind by neighboring countries like Malaysia, Thailand, Singapore and India. In 2010 the country had an estimated 100,000 of the 3.5 million medical travelers in Southeast Asia. Despite much promotion, the 100,000 figure has stayed static since 2008, and some local tourism organizations argue that the real figure is at best 70,000. Alumno adds that to effectively promote Philippine medical tourism, several key issues need to be addressed, including the image of the country as having poor security, poverty and lacking in quality facilities and/or doctors. Her solution is to benchmark standards for doctors and healthcare facilities with international level accreditation to help attract foreign medical travelers. HealthCore is in the accreditation business. Health investors feel that sooner or later, medical tourism in the Philippines will produce income and profit. And if medical tourism is only small, then profit can be made from local business. Manuel V. Pangilinan's Metro Pacific Investment continues to buy or acquire shares in hospitals in the Philippines. In 2007 Metro Pacific bought a minority stake in Makati Medical Center as the troubled hospital had long term potential. In 2008 Metro took over the management of Cardinal Santos Medical Center (CSMC) in San Juan, to use subsidiary Medical Doctors Inc, originally formed to manage Makati Medical Center. The group then bought a minority stake in Davao Doctors Hospital, acquired Riverside Medical Center in Bacolod City and took over the management contract of Our Lady of Lourdes Hospital in Manila, which includes a commitment to spend heavily on facilities and equipment for the hospital over the next five years. All acquisitions are or have been upgraded and refurbished to improve hospital operating standards, as medical tourists will not come to substandard hospitals St. Luke's Medical Centre recently opened in Global City, Taguig. The new hospital offers a wide range of medical services covering cardiovascular medicine, ophthalmology, cancer, neurology and neurosurgery, and treatments for liver and digestive diseases. It gets international patients from the United States, Europe, Asia and the Middle East. It has an international patient care centre providing extra services for the medical tourist such as travel planning and airport pickup. Hospital groups in other provinces, notably Cebu, have been busy upgrading their facilities and expanding their services. The Philippines is starting to show potential due to investments in new and existing healthcare facilities. Returning Filipino doctors and nurses who have trained and worked abroad bring with them valuable insights that help medical tourism. But although the country has low costs compared to the USA and Europe, it is not always cheaper than other competitors such as Malaysia and Korea, who have a better national approach to marketing medical tourism.

CAYMAN ISLANDS/BAHAMAS/DOMINICAN REPUBLIC: Medical tourism developments in the Caribbean

Fri, 04 Nov 2011 14:24:30 GMT

Doctors Hospital in the Bahamas is aiming to grow and diversify its business mix into an ultimate 50/50 split between its current domestic business and medical tourism, following a year when local patient activity dropped off by 25 %. The hospital's prostate cancer treatment programme is in place as its first medical tourism initiative, and Doctors Hospital hopes to establish a spinal surgery centre in Nassau within the next five to six months, followed by a centre for hips, knee and joint replacement in 2012. It is looking to attract 250 patients a year to the Bahamas through the spinal treatment and surgery centre. The hospital's Dr. Barry Rassin is honest as to the attractions of medical tourism, "Increased revenue streams, pure and simple. The Bahamas is a very small population, and to provide service to a small population we can see the effects of the recession, Impact has been especially heavy on the business generated from providing treatments to visiting stopover and cruise ship tourists. While tourists normally accounted for 18 % of the hospital's patient activity, this has dropped to 11 % due to the recession and reduction in travel demand and an almost 25 % drop in activity across the board. Medical tourism will reduce the reliance on residents and transient visitors. I'd like to see us get to a 50/50 ratio, 50 % local, 50 % medical tourism. It is a very competitive business, so we want to focus on niche markets, and no one else is looking to bring the surgeons over. With the prostate cancer treatment centre attracting 15-20 patients per month, and the potential to attract 250 patients annually to each of the spinal and knee/joint replacement centres, the hospitals believes an initial target of 1,000 medical tourists a year is achievable. It has worked over many years to put in place the foundations to break into medical tourism, including getting Joint Commission International accreditation last June. Doctors Hospital will set up the spinal surgery and care centre as part of a consortium, together with specialists from Florida and Washington, to give US patients options as to whether they have their treatment at home or in Nassau. If the latter, the programme brings both patient and surgeon to the Bahamas, an element designed to give Doctors Hospital a market niche and stand out from the competition with medical costs in the Bahamas are 20-25 % less than in the USA. Cayman Islands Medical and Dental Society is raising concerns about who will be allowed to practice and who will assess foreign doctors' credentials, if Dr. Devi Shetty's proposed medical centre opens. The society is calling on government to clarify the proposed changes to the medical practice law. The Narayana Cayman University Medical Centre aims to be a centre for medical tourism, spearheaded by Indian heart surgeon Shetty. Plans to change the medical practice laws however to allow overseas doctors to offer medical tourism in Cayman is causing concern within the society; Dr. Sydney Ebanks is concerned that the changes to the law, particularly 42A of the amendment, allows legislators the final say as to who can practice in Cayman, not physicians. However, Health Minister Mark Scotland says that this was not the case. Dr. Shetty's local partner, Gene Thompson, says that all doctors would be certified by the Medical Council of India. The medical society is not convinced by either answer. Hair loss patients in the US and Europe are choosing to travel to the Dominican Republic to get hair loss treatment and hair transplant from Dr. Alba Reyes, because of its proximity to the USA. Dr. Alba Reyes Sagiv has run the Skin and Hair Transplant Institute for more than 10 years, using the latest surgical techniques to help hair loss patients get full hair restoration with a personalized treatment. In the case of hair transplant surgery, cost plays an important role because lower surgery cost enables many more hair loss patients to go for hair restoration. Patients have saved 50-70% compared to surgery costs in the USA (average round trip cost from any part in the USA is only $350-$500). The clinic offers four packages with hair transplant surgery along with the opportunity to enjoy the Dominican Republic as a mini-vacation during the surgery trip.

BULGARIA: Bulgaria promotes health and wellness tourism

Fri, 04 Nov 2011 10:56:51 GMT

Bulgaria has a new tourism strategy for the next decade, which includes the launch of an enhanced advertising campaign called 'Bulgaria: Magic Lives Here'. Known primarily as a beach and skiing destination, Bulgaria is keen to showcase its other attractions including a rich history and culture, a diverse landscape and delicious food and wine. Bulgaria also wants to turn the spotlight on some of its fast-expanding tourism products including city breaks, spas and eco-tourism. Launching in November 2011, the campaign will reveal little-known aspects of Bulgaria such as its natural mineral springs. The campaign's underlying message is that Bulgaria is both unexpected and value for money. Ivo Marinov explains, "The awareness of Bulgaria is both low and outdated, and not enough is being done to shape positive perception about us. We have an ancient culture, rich in history and architecture, with mineral spas and preserved nature destinations. Bulgarian bio-climatic, hydrothermal, mud treatments and natural mineral spas are considered some of the best in Europe." The campaign is targeted toward people who want their vacation to be an enriching experience, and consists of advertising in print and electronic media, the internet and outdoor advertising. Advertisements, advertorials and articles about Bulgaria will be published in specialised travel media as well as in more general media. The television campaign includes four new promotional videos of Bulgaria - "Image", "Nature", "Culture" and "Spa & Wellness". The other components of the campaign are outdoor advertising as well as internet campaigns with seven websites. A new web portal, www.bulgariatravel.org is available in 8 different languages. Developed earlier this year, the portal contains an interactive catalogue of more than 450 tourist destinations, 50 short movies, 50 multimedia components in addition to 5000 pictures. The website also has a special search feature whereby visitors can look for destinations according to specific interests such as balneology, spa and wellbeing. Visitors can publish their comments, itineraries and reviews in a special section of the portal. Bulgaria's tourist boom has made the residents of the resort village of Ognyanovo, Southwestern Bulgaria, give up their traditional living of growing tobacco and take up spa tourism. Farmers like the change – they work less and earn more. Local residents use their savings to build and furnish small hotels. Last summer Ognyanovo's ten hotels were full of tourists not only from Bulgaria, but also from neighbouring Greece. The local spa resort is famous for its healing mineral and thermal spas, whose permanent temperature is 43°C. In 2002 95% of the local population grew tobacco and only 4% catered for holidaymakers. Today 40% of the village residents work in tourism. There are more than 550 known sources with 1600 springs. Predominant are waters with low mineral content. Cool mineral springs are found throughout the country. Bulgaria also possesses valuable deposits of curative firth mud and curative peat. Mineral springs in the southern part of the country are influenced by the Mediterranean climate; other springs are found in mountain regions with coniferous vegetation and crystal springs; and others are along the Black Sea coast. The Republic of Bulgaria has 48 mountain resorts, 15 marine resorts, and 38 balneological resorts.

THAILAND: New medical tourism association to promote Thailand

Fri, 04 Nov 2011 10:52:17 GMT

Medical service providers, hotels and travel agents are establishing their own association to develop and promote Thailand as a medical tourism destination, and particularly to attract medical tourists from high-spending markets including the Middle East, Russia, Western Europe, China and Japan. Prapa Wongphet, president of the Thailand Medical Tourism Cluster, who will become president of The Thailand Federation of Medical Tourism Association, explains that the association which is in the process of being registered with the Commerce Ministry, will be officially launched by the end of this year, "We are now ready to move forward after working closely with our partners to design the master plan to develop and promote Thailand as a world-class medical tourism destination." It will take over from the Thailand Medical Tourism Cluster that was set up a year ago by the Institute of Small and Medium Enterprises Development, and now has 15 travel and medical services associations as members. Among the cluster's membership are the Thai Hotels Association, the Society of Aesthetic Plastic Surgeons of Thailand, the Thai Clinical Physicians Association, the Association of Thai Travel Agents, the Thailand Incentive and Convention Association and the Thai Spa Federation. The major stakeholders in medical tourism, the hospitals, have joined forces with supporting organizations, including hotel/rehabilitation facilities, travel agents, nurses, ambulance operators, medical specialists, Thai traditional medicine specialists, spa operators, and the Translators and Interpreters Association. Government agencies and educational institutes support the collaboration. It aims to enhance the quality of medical tourism in Thailand and assist foreigners seeking medical services in Thailand. Under the promotion plan, the cluster had organised business matching between local medical service and tourism operators and overseas travel agents and insurance companies, especially from Russia, Iran and China. Producing booklets and conducting road shows in key markets also formed part of the initiative. The new association plans to build on this good start. Prakit Chinamornpong of the Thai Hotels Association says that better-promoted medical tourism will enable hotels and other accommodation businesses to enjoy longer stays by foreign visitors who want to travel and experience Thai hospitality as well as receiving medical treatment or being a health tourist. The Tourism Authority of Thailand says medical tourism is an area where visitors tend to spend more and stay longer than normal tourists. Although recent flooding has caused problems in and North of Bangkok, it is likely to cause local difficulties only for a few weeks.

UK: VAT on cosmetic surgery: New tax may encourage outbound medical tourism

Fri, 04 Nov 2011 10:51:14 GMT

The cost of facelifts, tummy tucks, liposuction and breast enlargements in the UK is set to rise by 20% after new government guidelines on Value Added Tax. Doctors performing purely cosmetic operations must register for VAT and pass the charge on to patients in a move that will boost public finances. According to the British Association of Aesthetic Plastic Surgeons (BAAPS), cosmetic surgeons in the UK in 2010 carried out 9,430 breast enlargements, 3,417 tummy tucks, 5,000 facelifts, more than 4,000 nose jobs and over 1,000 operations to correct ears that stick out. At the moment, a breast enlargement operation can cost up to £5,000, which will rise to £6,000 once VAT is added. The average cost of a facelift could rise from about £6,000 to £7,200. HM Revenue and Customs (HMRC) argues it is only clarifying existing laws in guidance sent to trade professionals and that there is no change in government policy on VAT for cosmetic surgery; VAT is not charged on surgery for medical reasons. HMRC guidance to health professions states that services are only exempt of VAT if the purpose is to 'protect, maintain or restore the health of the person concerned'. BAAPS says that over 90% of procedures deemed cosmetic are non-surgical treatments such as injectables and lasers, and it agrees they should be taxed with VAT. However, they warn that including surgery such as breast reductions and tummy tucks will present an ethical minefield. Fazel Fatah of BAAPS warns, “Using blanket terminology such as 'free choice rather than medical necessity' and 'purely for aesthetic purposes' places a value judgment on treatment and compromises the doctor-patient relationship. Treatments carried out by cosmetic surgeons do improve the psychological as well as the physical wellbeing of patients. The subjective proposals by HMRC will potentially harm large numbers of patients. They imply that any procedure that corrects appearance rather than function is not a medical need. With surgery, we are quite literally, dealing with human lives." Dr Samantha Gammell of the British Association of Cosmetic Doctors adds, 'When patients seek out care from doctors they expect to be treated without judgment or prejudice, putting the maintenance of their health as our primary concern. We are appalled that HMRC inspectors are demanding to review confidential patient records for proof of their medical needs. It is an obscene invasion of privacy based on a ridiculous premise that a doctor, having taken on a duty of care, could do otherwise than protect the health of their patient. There is simply no legal basis for the HMRC's approach and we will continue to fight for patients' rights.” In 2009, in the USA, the authorities had the idea of charging a 5% tax on all cosmetic procedures. It failed to get through the Senate. The UK situation is different as it is not a planned legislative change but a change of interpretation by HMRC who act independently of politicians. A number of people already travel abroad for cosmetic surgery, as it is cheaper in Eastern and Central Europe. Although it is even cheaper in parts of Asia, few travel that far for simple cosmetic work. UK cosmetic surgery associations have warned that patients ”unable to afford elevated prices in the UK, will be forced to travel abroad where standards and guidelines for cosmetic surgery are not necessarily as strictly controlled.” If you are prepared to travel for cosmetic surgery abroad, with clinics everywhere from Brazil and Bulgaria to Thailand and Tunisia seeking UK clients, you can certainly get a much cheaper deal. In many places, the standards of surgery are as good as the unregulated UK cosmetic surgery industry.

EUROPE: Update on European Cross-Border Healthcare

Fri, 04 Nov 2011 10:44:46 GMT

European news is currently focused on the economic crises in several EU countries. The official line on Cross-Border Healthcare legislation is that all countries are on track with their plans. But back in the real world, the chances of certain EU countries implementing the new Directive by the due date look increasingly remote. Even when they do, how country A with a good economy is going to get paid by country B with economic problems and where more patients are going from B to A, than A to B, is unclear. The policy currently seems to be that these problems are so far in the present and so minor compared to current crises, that they will be sorted in time; an unofficial 'it will be all right on the night.' Directive 2011/24/EU on the application of patients' rights in cross-border healthcare has been published in the Official Journal of the European Union. The directive applies to individual patients who decide to seek healthcare in a member state other than the member state of affiliation. Member States must adopt the necessary laws, regulations and administrative provisions by 25 October 2013. Health First Europe (HFE) has launched a task force on patient safety to demand more stringent recommendations for member states on the safety of patients. As part of the review of the Council recommendations on patient safety, including the prevention and control of healthcare associated infections; the task force will formulate further recommendations for following on the European Commission's review. John Bowis of HFE explains, 'The aim is to enshrine patient safety throughout the member states and set specific, quantitative targets for the reduction of healthcare associated infections to encourage member states to take every precaution to protect the safety of citizens when they enter a healthcare setting – whether that be in hospital or home care.” Health First Europe is a non-profit, non-commercial alliance of patients; healthcare workers; academics, healthcare experts and the medical technology industry across all 27 EU countries. The European Centre for Disease and Prevention Control (ECDC) estimates that healthcare associated infections occur in one hospitalized patient in 20, which equates to almost 4.1 million patients per year who acquire an infection while in hospital. They also account for 37,000 deaths each year in the European Union. MEP Chrisofer Fjellner declared, “There are many aspects to patient safety. Patients must be protected from adverse events while receiving care. Equally important, continued innovation in medicines and healthcare practices must be ensured. Also, to feel safe, patients must be given good and reliable information to be able to determine risks and make informed choices about their own health.”

USA: West Virginia offers new medical tourism opportunity

Fri, 04 Nov 2011 10:42:27 GMT

White Sulphur Springs in West Virginia is to be the location for a new medical initiative. Work is due to begin soon on the first phase of The Greenbrier Medical Institute being developed on a 6,750-acre site in White Sulphur Springs, West Virginia at a total estimated cost of $250 million. Phase one of The Greenbrier Medical Institute will have five buildings including a relocated and expanded executive health Greenbrier Clinic, a Jim Andrews sports medicine centre, a cosmetic surgery and lifestyle enhancement academy, a sports performance and training facility and a boutique hotel with 20 VIP suites designed to attract medical tourists from around the world. The original Greenbrier Clinic was the first executive health programme in the US when it opened in 1948. The design for the new Greenbrier Medical Institute will feature classic Georgian architecture similar to the current resort's façade. A replica of the Springhouse, the site of the property's sulphur springs, will also be incorporated. Jim Justice, owner of The Greenbrier, says: "Over 200 years ago people came to White Sulphur Springs in West Virginia to improve their health; soaking in the sulphur water, using hollowed-out trees for bathtubs, that's how The Greenbrier was born. By developing the new Greenbrier Medical Institute, the world's leading doctors and healthcare experts can come together and act as a think tank to stimulate medical research, drive innovation, force change and redefine how the world and individuals approach health, wellness and longevity." The professionals responsible for the concept and development of the new Greenbrier Medical Institute include doctors James Andrews and Michael Immel, and healthcare developer Jack T. Diamond. The aim is to create a state-of-the-art medical facility and forum for research. The first buildings of phase one will be completed late 2012/early 2013. In lush landscape in West Virginia's Allegheny Mountains, Greenbrier is an award-winning resort that has been offering a welcoming home to its guests since 1778. This National Historic Landmark, also known as America's Resort, provides a haven for travellers. In 2010, the resort opened the Casino Club and hosted the inaugural Greenbrier Classic golf event. In addition to golf on four championship courses, The Greenbrier's amenities and services include a wide variety of meeting and event venues, several restaurants and lounges, access to more than 50 recreational activities and a 40,000 square-foot Spa. The Greenbrier is a founding member of Preferred Hotels & Resorts and of Historic Hotels of America.

USA: 'VISIT USA Act may reduce barriers to entry

Fri, 04 Nov 2011 10:23:38 GMT

The U.S. Travel Association has commended legislation by Senator Charles Schumer and Senator Mike Lee that would create jobs by stimulating international travel to the United States. The Visa Improvements to Stimulate International Tourism to the United States of America (S.1746), or the VISIT USA Act, amends the Immigration and Nationality Act to make improvements to the U.S. visa process, which is currently a major barrier to international business and leisure travelers seeking to travel to the USA. Roger Dow of the U.S. Travel Association comments, "Increasing the amount of business and leisure travelers to the U.S. brings significant economic benefits to the U.S. economy, and the VISIT USA Act is comprehensive legislation that makes America competitive once again. We commend Senator Schumer and Senator Lee for this innovative bill, and we urge their Senate colleagues to quickly support this bill to create much needed U.S. jobs." The VISIT USA Act includes key directives for improving the U.S. visa system, including:• Five-Year Multiple-Entry Visas for Chinese Nationals - The bill includes a recommendation to allow Chinese nationals to receive five-year multiple-entry visitor visas. Currently, Chinese nationals must apply for new U.S. visas annually, while travelers from other countries can receive up to 10-year, multiple entry visas.• Premium Visa Process - A premium visa processing process is created to allow travellers the option of paying a much higher visa processing fee in order to receive a visa interview within three business days. This applies to both B-1 and B-2 visas (tourist and business travel visas). Currently, the State Department fails to meet its goal of processing visas within 30 days of an application submission in critical travel markets, with wait times reaching upwards of three months in countries like Brazil and China. This new process will facilitate medical tourism for applicants who need emergency travel to the USA and currently may be prevented from taking a trip. The fee assessed for premium visa processing will pay for additional staff, but can also be used to pay for innovative approaches such as videoconferencing technology and mobile interview teams to meet market demand in any country.• Visa Waiver Program Expansion - The bill allows the Secretaries of State and Homeland Security to designate new countries for the Visa Waiver Program (VWP). Citizens of VWP countries are allowed to travel to the U.S. under the Electronic System for Travel Authorization (ESTA) program, rather than go through the more lengthy and complicated U.S. tourist visa application process.• Videoconference Pilot Program - The Secretary of State is authorized to conduct a secure videoconferencing pilot program to conduct visa interviews, lowering the hassle and additional costs of obtaining a U.S. visa. Currently, an in-person interview is required of each applicant seeking a U.S. visa but millions of potential travelers do not live in a city where a U.S. Embassy or Consulate is present. This provision maintains the visa interview requirement, while allowing for greater access to conduct the interview via videoconferencing technology.• Encouraging Canadian Tourism - A new Canadian retiree visa (non-immigrant visa) is created that lasts 240 days and is renewable every three years for Canadians who are over 50 and can show that they own a residence in the U.S. or have purchased rental or hotel accommodation in the U.S. for the duration of their stay.• Low Peak Season Incentives - The bill permits the State Department to lower visa application fees during off-peak visa demand seasons to give travellers the incentive to apply for visas when demand is lower. This is expected to help spread visa demand throughout the year, helping State to better manage applications.• Increasing Home Ownership by Priority Visitors - The bill creates a non-immigrant visa, renewable every three years, for an individual who expends at least $500,000 to purchase single-family homes in the United States. The U.S. share of overseas arrivals has fallen from 17 to 12.4 percent since 2000, even as worldwide travel grew by 40 percent over the same timeframe. Last May, a U.S. Travel Association report identified difficulties international travellers experience with the U.S. visa system, which causes many to choose other countries for business or leisure travel.

KOREA: Government allows private for-profit hospitals

Thu, 27 Oct 2011 10:25:13 GMT

The South Korean government plans to ease rules in the nation's free economic zones (FEZs) to allow foreign medical institutes to more easily set up and operate for-profit hospitals in them. Allowed in FEZs since 2003, no foreign investors have shown any serious interest due to various legal hurdles. Many civic groups strongly oppose the move, arguing that relaxing regulations are preparatory steps towards the full-scale, nationwide establishment of for-profit hospitals. Despite the underlying disapproval from the groups, the Ministry of Knowledge Economy plans to amend the ordinance governing the country's six free economic zones by the end of the year to welcome foreign hospitals to establish and manage medical facilities in them. Under the revision, the ministry will permit foreign medical institutes to manage for-profit hospitals in FEZs and hire a certain number of doctors with licenses acquired overseas. Rules on recognizing foreign medical licenses will also change to accept more foreign doctors, dentists and nurses. The government is separately allowing new internationally competitive for-profit hospitals in FEZs. In Incheon FEZ construction of the Incheon Songdo International Hospital will begin later this year by American developers Cordish Development. Incheon has agreements with Johns Hopkins hospital and Seoul National University on management of the 350-bed Songdo hospital, Under the current law, hospitals are non-profit entities and banned from seeking investment. They must follow guidelines set by the health authorities on their operations including charging patients. Proponents of for-profit hospitals claim that allowing such hospitals is the key to boosting medical tourism and to attracting outside investment in order to make local facilities more competitive. Busan has launched the first hospital hotel in Korea. A 17-floor building at the city's Bujeon subway station has Smart Hospital from the first to ninth floors and Ibis Ambassador Busan City Center Hotel from the 10th floor. The hospital has begun to take patients and the hotel has opened. As both the hospital and the hotel are owned by a single owner, it can provide a comprehensive service to patients and their families. Owner Kim Yang-hoo has let Ibis take care of hotel management. The hospital has 12 departments and staff who speak five languages other than Korean welcome foreign patients. Patients can stay in either a patient room (150 beds) or a hotel room. According to the Korea Tourism Organisation, in 2010 81,879 medical tourists visited Korea, up 36 % on 2009. The revenue from foreign patients rose 89 % to USD88.4 million. The Health and Welfare Ministry of Korea estimates that eventually 1.42 million medical tourists will visit Korea annually, while the Korea Tourism Organization expects 2.6 million foreign patients. South Korean authorities are planning on attracting over 300,000 overseas patients by 2015, by developing a medical city - Jeju Healthcare Town.

THAILAND: Promotion of domestic and international health and wellness tourism

Thu, 27 Oct 2011 10:13:01 GMT

Thailand Medical Tourism Cluster (TMTC) says it will promote both domestic and international markets, claiming the wellness sector can be sold locally to domestic travellers. Prapa Wongphaet of TMTC says, “Medical tourism is much more than visiting a hospital or local doctor. We can market wellness, healthy living and spas to Thai travellers promoting the idea of turning a holiday into an opportunity to improve health. We are working with Tourism Authority of Thailand (TAT) to promote products and routes in Thailand that have a medical tourism theme for Thais.” According to TMTC, Thailand earned Bt147 billion from 1.5 million international tourists who sought medical treatment in the country in 2010, but these are both rough estimates. Medical clients spend 12,000 baht per day, three times higher than normal visitors. Each medical client stays in Thailand between 8-15 days on average. Prommate Nathonmtong of TAT adds: “We are promoting lifestyle tourism and wellness that features meditation, healthcare and wellness and even healthy cooking classes.” Currently, medical tourism concentrates on Bangkok, Hua Hin, Phuket, Krabi and Samui that have international grade hospitals. TMTC hopes to extend the reach to other destinations in North Thailand and the Northeast. In 2012 it plans to develop two provinces – Ubon Ratchathani and Udon Thani – to attract ASEAN medical tourism mainly from Laos. Hospitals in Chantaburi, Trat and Rayong province could draw business from Cambodia. A key problem is that most of the regional hospitals are already overcrowded, while the few private hospitals in the North, lack sophisticated diagnostic equipment found in hospitals in Bangkok, Phuket, Samui and Pattaya. Despite being one of the most highly regulated spa industries in the world, Thai operations must be more proactive in developing better standards or else other countries could outstrip Thailand, warns Andrew Jacka of the Thai Spa Association (TSPA), "Competition is going to change radically in 2015. Thai spa operators must speed up improving their standards prior to the advent of the Asean Economic Community in order to secure the country's position as leader in the Asia-Pacific. The global positioning of Thai spas is defined through the element of “Thai-ness”, which is an intangible quality that no one can copy. But spa treatments in Indonesia, Cambodia and Laos are very similar to those in Thailand, while in terms of numbers, Malaysia and the Philippines are the main competitors.' Of the 75,000 spa businesses worldwide, 30% are in Asia Pacific. Thailand has 2% of the global market and is the seventh-largest employer of spa therapists. Thailand's first spa opened in 1992 and the industry grew by 25% a year until 2005, when the rate slowed to 10% as more spas opened. Last year the industry was valued at US$400 million. 1500 spas are registered with the Public Health Ministry – including 800 day and resort spas and 700 massage parlours for health and beauty. The TSPA and the certification body SGS (Thailand) have established the voluntary Thai Spa Excellence Quality Standard, which focuses on five areas - facilities and infrastructure, sanitation, personnel, monitoring and improvement, and operational control. A compulsory standard is the minimum requirement applied by the Public Health Ministry. A standard that would help spas expand abroad has been undergoing trials and was recently launched by SGS.

NIGERIA, DUBAI, TURKS AND CAICOS: Government sponsored medical tourism under pressure

Thu, 27 Oct 2011 10:02:46 GMT

The government of the Turks and Caicos Islands has followed Dubai and Nigeria with a public declaration of the need to drastically cut government funded outbound medical tourism. While for Dubai and Nigeria it is a point of principle to improve local healthcare so patients do not have to be sent abroad, for the Turks and Caicos it is matter of dire economic necessity. Other countries that pay for citizens to go overseas for treatment either have economic problems or a desire to spend the money on improving local healthcare. This could well be the beginning of the end for government paid outbound medical tourism in these countries. Nigeria loses an estimated £10 million annually to medical tourism to India, says Henry Mojekwu of medical tourism agency New Horizon Healthcare Nigeria Limited. He says that the trend is due to India's ready availability of relatively cheaper healthcare, and accepts that when Nigeria has quality hospitals, the country will benefit financially. At present, patients go to India to avoid the long waiting times that patients experience in Nigeria. The Turks and Caicos Islands interim government is seeking public input on how to reduce the cost of a two-year-old health care system that the country now cannot afford. Among a raft of budget measures that include renegotiating contracts with InterHealth Canada for operating the two local hospitals, is the intention to limit services for temporary residents. The local economy hit the system hard by reducing the number of foreign workers who left when jobs dried up; reducing insurance contributions that help pay for the nation's health care, according to the government's “Health Care Funding Challenge”. The total annual cost of healthcare is $61.5 million. NHIP contributions pay for only $19 million, while the government picks up the $42 million difference. Costs include $44 million to InterHealth Canada for infrastructure, equipment and clinical services to operate the hospitals A key target for cuts is the $9 million that the health insurance pays to get locals treated overseas. Because of tight budget constraints, the Ministry of Health has had to suspend or downsize a number of its programmes, including closing a hospice and care home. Part of the problem is that much of the healthcare plan of the previous elected government was never implemented. A Health Regulatory Authority to govern and monitor many aspects of the healthcare delivery process has never been created, neither has primary health care been upgraded or a healthy lifestyles initiative developed. Also, a clinical services review board has been appointed but has not met, and a contract management board to deal with InterHealth Canada has been ineffective. Although blaming their predecessors makes political points, the government needs to reduce the high cost for medical treatment overseas. While NHIP reduced the cost from $36 million for 10,000 Turks and Caicos Islanders in 2008 to $9 million for more than 30,000 beneficiaries, the cost is threatened by what the review calls “an open door, no limit policy as required by current legislation.” Also increasing costs is unlimited funding for medical care overseas for migrant workers who do not permanently reside in the TCI and unlimited funding for their dependents, regardless of the number of dependents. Illegal immigrants do not make any contributions, but they get treatment on humanitarian grounds and under international accords and agreements. Only those who are employed contribute, so 11,000 dependants are being supported by 18,000 contributors. The government suggests dramatic increases in contributions and allowing long-term residents not currently eligible for cover, such as retired persons and winter visitors, to join the program to increase contributions. Other ways to increase income would be applying high healthcare taxes on tobacco, alcohol and high sugar content products, and encouraging health and medical tourism, although the suggestion that the government receive 50 % of revenues may not go down well.

CANADA: New analysis demonstrates transitory nature of Canadian medical tourism agencies

Thu, 27 Oct 2011 09:56:56 GMT

An analysis of defunct Canadian medical tourism agencies. Medical tourism companies play an important role in promoting medical travel for elective, out-of-pocket medical procedures. Though researchers are paying increasing attention to the global phenomenon of medical tourism, websites of medical tourism agencies have received limited scrutiny. Every week we see a new launch or new initiative from an agency, but little is known about how many agencies close down or simply vanish into the night leaving customers in the dark. Looking purely at the online websites of active and defunct medical tourism agencies in Canada, Leigh Turner has produced fascinating research into the transitory nature of these businesses. His analysis is of Canadian medical tourism companies that have exited the marketplace. Using content analysis of company websites as an investigative tool, the article provides a detailed account of medical tourism companies that were based in Canada but no longer send clients to international health care facilities. Internet searches, Google Alerts, searches on Google News Canada and ProQuest Newsstand, and searches of an Industry Canada database were used to locate medical tourism companies located in Canada. Once medical tourism companies were identified, the social science research method of content analysis was used to extract relevant information from company websites. Company websites were analyzed to determine: 1) where these businesses were based; 2) the destination countries and medical facilities that they promoted; 3) the health services they advertised; 4) core marketing messages; and 5) whether businesses marketed air travel, hotel accommodations, and holiday excursions in addition to medical procedures. In total, 25 medical tourism companies that were based in Canada are now defunct. Given that an estimated 18 medical tourism companies and 7 regional, cross-border medical travel facilitators now operate in Canada, it appears that approximately half of all identifiable medical tourism companies in Canada are no longer in business. 13 of the previously operational companies were based in Ontario, 7 were located in British Columbia, 4 were situated in Quebec, and 1 was based in Alberta. 14 companies marketed medical procedures within a single country, 9 businesses marketed health care at 2 or more destination nations, and 2 companies did not specify particular health care destinations. 22 marketed many different types of medical procedures. 3 medical tourism companies marketed specialist services restricted to dental procedures or organ transplants. In general, medical tourism companies marketed health services on the basis of access to affordable, timely, and high-quality care. 16 businesses offered to make travel arrangements, 20 companies offered to book hotel reservations, and 17 medical tourism companies advertised holiday excursions. The report's conclusionsThere is a fluid marketplace, with many medical tourism agencies exiting this industry. In addition, by disclosing identities of companies, providing their websites, archiving these websites or print copies of websites for future studies, and analyzing content of medical tourism company websites, the article can serve as a useful resource for future studies. Author: Leigh Turner Credits/Source: Globalization and Health 2011, 7:40 Published on: 2011-10-14

SWITZERLAND: Swiss healthcare the gold standard?

Thu, 27 Oct 2011 09:49:09 GMT

Switzerland is often cited by the medical tourism industry as having excellent quality healthcare to match other top performers such as Germany. Switzerland is attracting an increasing amount of medical tourism business, despite the global recession. It shows that medical tourism is not just about offering the cheapest possible healthcare. Switzerland is one of several EU countries including Germany, France and The Netherlands where there is universal health care, not provided by the state such as in the UK or Scandinavian countries, but by competing private/non-profit health insurance companies, The OECD has studied Switzerland's health system and declared it high performing but warns that it must prepare for the future. Swiss residents currently enjoy easy access to a wide range of health care services and a vast array of choice in insurers and health care providers. However, in their “Review of Switzerland's Health Care System”, the OECD and the World Health Organization warn that while the Swiss health system is currently amongst the best in the world, it will need to adapt to deal with increasing costs and rising chronic diseases such as cancer, cardiovascular disease and diabetes. Switzerland's life expectancy is amongst the highest in the world and positive patient satisfaction reflects the high performance of the Swiss health system. But it comes at a considerable cost: Switzerland spent 11.4% of GDP on health in 2009, well above the OECD average of 9.6%, according to OECD Health Data 2011. Maintaining a large number of hospitals drives up costs. Though this system has served Switzerland well in the past, it will need to support the increasing numbers of patients suffering from chronic diseases who will need less intensive care on a more regular basis. Governments and insurers should encourage healthcare providers to co-ordinate their efforts by developing innovative payment methods and medical records that can help improve the accuracy of diagnosis and reduce duplication of tests. The review recommends focusing more on primary care and preventing illness. Today, around 2.3% of total health expenditure is devoted to preventing disease and promoting good health. Signing a federal law on prevention, which clearly assigns responsibilities and provides the financial capacity to promote healthy lifestyles across the country, would help. Planning now for the future health workforce would ensure that Switzerland is equipped to respond to growing demands and changes in the types of health care that patients need. This includes training more health personnel, attracting and retaining health professionals such as nurses, encouraging more doctors to become general practitioners, and improving human resource management in hospitals. Greater effort is needed to collect data on health outcomes so Switzerland can track key health risks and map people facing those risks. At present, Switzerland reports on the quality of care in hospitals. That should be extended to the wider system in order to allow patients, insurers and governments to informed choices. Further OECD/WHO recommendations to improve value for money in Switzerland and prepare the system for future health challenges include:• Assessing the clinical and cost effectiveness of health services.• Increasing the scope for value-based competition in health insurance, for example by allowing insurers to contract selectively with providers.• Continuing with the implementation of funding hospitals based on the cases they deliver coupled with safeguards to avoid unwarranted increases in the number of services, and preventing undesirable subsidisation of inefficient hospitals. • Pursuing further pharmaceutical reforms, encouraging patients to buy generic drugs and reducing the role of physicians in dispensing drugs.• Monitoring the impact of health costs on households, such as high out-of-pocket payments and high-deductibles for insurance.

SOUTH AFRICA: New medical tourism destination at planning stage

Thu, 27 Oct 2011 09:22:11 GMT

A large new health and wellness centre to be developed in South Africa will be the first of its kind in the world, says Dr Colleen Coetzee, “We have put together a one-stop shop for medical tourism and health.” The plan is that patients seeking the most sophisticated treatments, operations and cosmetic surgery will fly in from around the world for cutting edge medical attention at a fraction of the price back home. Construction will start in February on the main health and wellness centre and hotel villas operated by the Three Cities Hotel Group. Local and international specialists will staff the centre, while patients will be able to bring along their families for support while they undergo their operations and treatment. The complex will be North of the Tugela River, have river and sea views and be called the Thukela Health and Wellness Centre (Thukela is the Zulu name of the river). It will also include an oncology unit as well as a rehabilitation centre for addiction, depression, stress and eating disorders. There will also be a cooking school where patients can learn about healthy eating. As well as a hotel, the project envisages fractional ownership villas, a residential complex, schools, restaurants, shopping complexes and a wedding chapel. Dr.Coetzee believes that South Africa has been sidelined in medical tourism in the past because people are unaware of the country's five-star hospitals and doctors, and that many hospitals are not interested. Although many patients from elsewhere in Africa already go to South Africa for medical treatment, there is a lack of after-care, “But that is about to come to an end. After patients have their procedures at the centre, they will check back into their rooms. Should a complication arise, we can link the patient up within five minutes and he can be taken care of. A nursing sister will also be allocated to a patient.” The centre will be linked to the Ethekwini Hospital and Heart Centre in Durban where heart procedures will be carried out. The project is the brainchild of Oriana and Linden Honeywill, who say, "We have all the necessary approvals and are in discussions with financial partners.” South Africa is taking the first steps towards establishing national health insurance. South Africa is one of the world's most unequal societies, where quality health care is skewed towards the private sector. More than 80% of South Africans cannot afford private medical insurance and rely on publicly funded hospitals, which charge a small fee for treatment and are often overstretched. Piloting of the National Health Insurance Scheme will begin in April 2012 in ten selected districts. Health Minister Aaron Motsoaledi plans to build six new academic hospitals and medical schools in the next decade, in a bid to address the pressing shortage of well-trained healthcare professionals. South Africa is producing 1200 doctors a year but the number needs to be trebled at least. The public sector is short of at least 12 000 doctors and 46 000 nurses.

GLOBAL: Nuts...dispute over medical tourism domain names continues

Tue, 25 Oct 2011 20:57:43 GMT

Following the publication in an IMTJ blog of the 370 domain names owned by Jonathan Edelheit, a co-founder and CEO of the US based Medical Tourism Association (MTA), affected domain owners have expressed their displeasure at Edelheit's alleged breach of the ICANN guidelines and are considering action to regain what they believe is rightfully theirs. Dr Uwe Klein, Chairman of the European Medical Travel Conference (EMTC) a long established event for the medical tourism industry was shocked to find that a rival conference organizer had registered a collection of web domain names that he believes infringe directly on his trade and service marks. Dr Klein has run previous EMTC events under the domains emtc2010.com,emtc2011.com, and emtc2012.com. Planning for his future events, Dr Klein found that a third party had registered emtc2014.com, his conference brand - europeanmedicaltravelconference.com - and a string of similar names such as europeanmedicaltravelcongress.com. It became apparent that the domain name speculator was Jonathan Edelheit. Alongside the “non-profit” MTA, Edelheit and his partner Renee Stephano are involved in several for profit businesses including a conference business. ICANN rules are very clear.”By applying to register a domain name, ..........you hereby represent and warrant to us that ...........to your knowledge, the registration of the domain name will not infringe upon or otherwise violate the rights of any third party; ......you are not registering the domain name for an unlawful purpose; ........... It is your responsibility to determine whether your domain name registration infringes or violates someone else's rights.” ICANN also defines use of a domain name in “bad faith” where “by using the domain name, you have intentionally attempted to attract, for commercial gain, Internet users to your web site or other on-line location, by creating a likelihood of confusion with the complainant's mark as to the source, sponsorship, affiliation, or endorsement of your web site or location or of a product or service on your web site or location.” Dr Klein has requested the return of the offending domain names from Edelheit, stating . “Your domain registration of emtc2014.com and of europeanmedicaltravelconference.com is a clear breach of the ICANN rules. If you do not hand back the names, I will pursue the matter through the domain dispute resolution process. Let me know how you want to proceed here.” A reply was received from Lisbeth Stein, Membership Coordinator at the MTA, on behalf of Mr Edelheit. The reply in full; >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>From: Lisbeth Stein [mailto:lisbeth@medicaltourismassociation.com]Sent: Monday, 17. October 2011 21:04TO: 'CHAIRMAN 2012'Subject: RE: Jonathan Edeleheit Nuts <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< The nature of the reply speaks for itself. It also raises questions about the relationship between Edelheit's conference business and the MTA. Stein replied as an MTA employee not as an employee of Edelheit's conference business. Two other domains trentaccreditation.com and trentaccreditation.org have also been registered by Edelheit. These are alleged to infringe on the long established brand of the UK's Trent Accreditation Scheme, a healthcare accreditation scheme based in the UK. (It's similar in nature to JCI). Professor Stephen Green commented: “The QHA Trent accreditation standards for hospitals and clinics contain a potent section on probity and ethics in advertising and finance. We should be expecting no less of other organisations involved in the healthcare and medical tourism businesses including trade associations, doctors, hospitals and businesses. Patients' welfare should always be put first.” The registration of the domain names - arabhealht.com and arabheatlh.com - by Edelheit appears to conflict with the long established Arab Health, the major health event in the Middle East run by global conference organisers, Informa. It's not the first time that domain name speculators have attempted to abuse the Arab Health brand. According to Simon Page, Managing Director at Informa: “We have found that as soon as anything is successful there are always companies and people that want to ride of the back of your success, we have had many cases of people not only using very similar named websites but also logos and fonts that are similar to our brands. We have numerous cases where people have blatantly used our good will to say they are our official travel partner or official magazine etc that is just completely unfounded. Normally we have a very good relationship with our customers and they pass us on information when people are illegally using our brand or association with that brand. When the customers find out that they are not officially linked with us it tends to do more damage to that company. We find that a letter from our lawyers is enough from them ceasing the use, we have trademarked our shows and logos around the world, but this can be very expensive.”

EUROPE: Western and Eastern Europe expand medical and health tourism

Fri, 21 Oct 2011 10:03:35 GMT

Europe continues to develop into a major medical tourism destination with individual Western European countries attracting medical tourists from the Middle East and China, while Eastern counterparts see a huge potential. Since 2000, agency MAPE has offered medical tourism services in Spain. It has now launched a subsidiary MAPE Middle East, with a promotion campaign offering medical treatment to people from the Middle East in Barcelona, Madrid, Alicante, other Spanish coastal locations, plus the Balearic and Canaries islands. The German National Tourist (GNTB) has had a successful road show in the Middle East with a focus on wellness and medical tourism. The workshops were run by medical and tourism representatives as well as German doctors. The road show, organized in partnership with Lufthansa, confirmed that wellness, health and medical tourism destinations in Germany are among the favourite destinations of people in Gulf states The Arabian Gulf is a key one for the German tourist industry. Germany's healthcare has an excellent reputation in the region. What has particularly benefited medical tourism is that GNTB has focused on producing specialised informative material in Arabic. This includes an Arabic version of a print brochure entitled 'Medical tourism - You'll be well looked after in Germany' which provides information for international patients. More affluent Chinese patients travel all the way to Switzerland for medical and cosmetic treatment for quality as well as privacy reasons. China has a rapid growth of both the middle and upper class. Well-off Chinese patients increasingly go overseas for quality medical care. They are not looking for lowest prices. While affluent Chinese patients used to travel to the USA, Taiwan or Singapore for medical care, many now prefer Switzerland; Chinese travellers are the fastest-growing traveller segment within Swiss tourism, doubling over the last 12 months. It is not possible to identify how many visited Switzerland for medical reasons, but Swiss clinics and private doctors have seen a noticeable increase in Chinese patients as the demand for Chinese medical translators has increased. Georgian president Mikheil Saakashvili wants the country to expand and improve medical services to attract more medical tourists, "Already foreigners come to Georgia for treatment. One of the important parts of tourism is medical tourism that must be developed in Georgia. We have a great potential for this, since we have highly skilled doctors most of whom speak a foreign language.“ Ukraine is capable of accommodating up to 50 million health and medical tourists a year, but at present the country's spas and hospitals only get 4 million guests including Ukrainians. Vladimir Sokolov of the national project Spas and resorts says, "Ukraine could become Europe's leading medical tourism destination. It should attract visitors from Russia, Belarus and other former Soviet republics, as well as from Europe, Asia and North America. Health costs in the country are relatively cheap, and the savings could reach up to 70% compared to the prices in the European Union.”

EUROPE: Developments in dental tourism

Fri, 21 Oct 2011 09:57:46 GMT

Eurodent has launched new dental treatment packages to Norway, there is a study into the competitiveness of the private dental sector in the UK, and low cost treatment in Eastern Europe is gaining popularity. Eurodent, a company that offers dental services in Norway, has launched new affordable dental treatment packages. These includes various dental services, such as tooth extraction, dental implants, fillings, veneers, bleaching, porcelain crowns, root canal treatment, bridges, dentures, and cosmetic dentistry. Eurodent arranges travel and accommodation. The increasing costs of UK private dentistry are making Eastern Europe an attractive destination for dental patients. This and the fall in the number of people paying for dental treatment has lead to the UK Office of Fair Trading (OFT) to investigate why British dental charges, both NHS and private, are among the highest in Europe. The OFT market study will examine whether the private and NHS dentistry markets are working well for patients. The UK market for dental services was worth £7.2 billion in 2010. Forecasts suggest this could grow to £8.2 billion by 2014 with much of the growth coming from the private market. While the OFT recognises that the UK has some of the highest standards of oral care in the world, it wants to examine concerns raised by consumer bodies such as Which? that many patients are confused over dental treatments and prices. The study will focus on how dentistry services are sold, whether patients are given appropriate information to help them choose between dental practices, the types of treatments on offer and different payment methods in the context of both NHS and private dentistry. It will also look at how easy it is to change dentists, and whether the current system for customer redress works. The study will also examine whether there are any unnecessary barriers to new practices entering either private or NHS funded markets, and consider the issue of professional restrictions on direct access to specialists or providers of auxiliary services, such as hygienists. Sonya Branch of the OFT says, “Patients appear to be confused about the prices they are being charged and concerns have been raised that they may not be getting sufficient information or adequate choice over the dental treatments they receive. We also note that the costs of private dental treatment in England are among the highest in Europe. Given the current strains on people's finances, we think it is a good time to examine whether competition is working effectively to drive up the quality of private and NHS dental services and deliver better value for money for consumers.” Consumer organization Which? has compared the average cost of a dental implant and crown in a few EU countries-• UK £2,200 • Spain £850• Hungary £750• Poland £750

EUROPE: Patient mobility will be a strong incentive for enhancing quality of care

Fri, 21 Oct 2011 09:52:51 GMT

Patients and health care providers are increasingly crossing borders within the European Union to deliver or receive treatment. New EU regulations are trying to come to grips with what has long been recognised as a right of citizens to do so. Motivations vary among member states and social groups, but specialty treatment and speed of access are important factors. Cross border care is potentially a strong incentive for enhancing the quality of therapies to let patients stay where they are, experts told the European Health Forum Gastein (EHFG) EHFG was founded in 1998 as a European health policy conference with the aim of providing a platform for discussion. It has developed into a key annual event, bringing together politicians, senior decision-makers, representatives of interest groups, and experts from government and administration, business and industry, science and academia. This year it attracted more than 600 decision-makers from 45 countries for discussions on the latest developments in health care policy. Albert van der Zeijden of EHFG said, “The central principle within the EU of freedom of movement for people, goods and services also applies to the freedom of patients to find the best health care solution, fitting to their personal need and preferences.” The European Court of Justice issued its first ruling on this principle as far back as 1998. But it was only this year that the European Parliament and Council formally adopted a directive on the application of patients' rights in cross-border healthcare aimed at providing greater clarity governing such care and the reimbursement of its costs. The conference agrees that the directive still needs to be adopted as national legislation in member states, some of which are strongly reluctant to go along. It may therefore take more time than the prescribed thirty months, in addition to further discussion, before the principles of uniform implementation are accepted throughout the EU. Generally people prefer their healthcare close to home but Albert van der Zeijden commented, “Quicker access to treatment is sometimes a factor when patients opt for a different country, as is specific expertise, or because the nearest hospital is just across a border. Cost is a factor. There is a strong advantage of cross border treatment from the patients' point of view: Cross border care is potentially a strong incentive for enhancing the quality of care, as the health care systems have to take into account the health care successes in other countries. Just as with the opening of markets in goods, competition generates greater efficiency in terms of combined price and quality. If enough patients vote with their feet, their home providers will presumably be pressured to explain why. Patients should have the freedom to make a choice for the best treatment option but should not be forced to accept treatment abroad." The directive will help rare disease patients, noted Albert van der Zeijden,“Cross border care can be a matter of life and death for people with a rare disease. Patients with a rare disease sometimes cannot find diagnosis locally, or may prefer to access a centre of expertise based in another country. Some rare diseases are not even recognised in all countries, let alone treated, and small countries are often less able to offer comparative medical services.” Some of the 6000 to 8000 known rare diseases affect as few as dozens of people, while others afflict several hundred thousand. Overall, between five and eight percent of the EU population are affected, meaning at least 25 million people suffering from widespread diseases designated as rare. The conference agreed that cross border care within Europe is an increasing reality, and it is working both ways: patients going abroad and health care professionals coming to the patients.

DUBAI: Dubai plans health reforms and a new medical tourism strategy

Fri, 21 Oct 2011 09:44:11 GMT

Dubai's national health insurance system to cover every employee has been delayed for at least two years. A national medical tourism strategy is to be developed and launched. The Dubai Health Authority (DHA) has postponed the implementation of compulsory health insurance requirements for local employers for two more years. In Dubai, few private sector employers provide insurance for their staff. The new insurance system, which would have made healthcare a required benefit for every worker in the Emirate, may now never happen. Although employers would have funded the plan, the plan has been under consideration for several years and a key problem is that the DHA does not have the resources to enforce compliance. Treatment costs in government hospitals have risen to roughly the same as those of private hospitals. The Dubai compulsory health insurance scheme was originally scheduled to come into effect in January 2009 but the global financial crisis decimated Dubai's private sector and property market. Dubai is part of the United Arab Emirates. Individuals are not taxed in the UAE. Better off families can afford private insurance and/or private healthcare, but much of the country's low paid expatriate blue collar workforce has neither. The DHA wants the number and quality of private hospitals and clinics in Dubai to expand and lift the burden off the public treasury. This will be necessary to not only maintain a sustainable national healthcare system but also to give impetus towards growing the local medical tourism industry. Over the next two years, Dubai will implement a new health strategy that will seek to reduce the burden of lifestyle diseases and make access to health facilities much easier and more efficient. The DHA has several initiatives, including measures focusing on changing the behaviour related to healthy eating and physical activities, strengthening relations on sale and consumption of tobacco products as well as expanding the functioning of treatment and cessation programmes for smokers to encourage them to quit smoking. Plans also include early detection measures to treat conditions such as diabetes and cardiovascular diseases, and improve surveillance and monitoring for priority non-communicable diseases and conduct health surveys among schoolchildren. A Dubai medical tourism strategy will be developed and launched. A new service will centralize important health care investments and maximise the impact and effectiveness of the overseas treatment programme for Emiratis. The strategic plan will encourage local investment in services that account for a disproportionate share of overseas referrals and expenditure and implement long-term strategies to reduce overseas treatment expenditure. A Dubai Health Services Navigator will help people find, choose and obtain basic information about public and private health care services, professionals and facilities and will incorporate high-level information about the performance of health care providers. The country will publish standardised performance data from public and private providers to promote competition, transparency and choice. All these measures are a recognition that before Dubai can attempt to become a serious medical tourism destination for people from other countries, it has to solve the structural and health problems that lead to many of its citizens going overseas for treatment. It is difficult to promote Dubai as a destination when the state is already paying to send its own people to other countries for treatment, and when many of those who can afford private healthcare prefer to seek treatment overseas.

UK: UK NHS to extend patient choice...but do patients get it?

Fri, 21 Oct 2011 09:25:48 GMT

A new survey of 5,000 people suggests that 80% of NHS patients want more choice over how and where they are treated in the NHS, 79% want more choice in where they are treated and 75% want a choice of hospital consultant. 50% were totally unaware that they can, at least in theory, choose which hospital to go to for non-emergency treatment. Women and people over 55 in particular want to see more patient choice in the NHS. Nine out of 10 over the age of 55 want to have a greater say in how and where they are treated. Under the government's increasingly controversial modernisation plans, everyone will be able to choose, not only where, but which NHS consultant team provides their hospital care. Many in the NHS agree with the theory, but say that with limited resources this is not practical. Health secretary Andrew Lansley comments, “There is clear evidence that patients want more choice and control over their healthcare, which is exactly what our plans to modernise the NHS are all about. Patients no longer want to settle for second best. They want what is best for them and their families and they do not want to be restricted by geographical boundaries or bureaucratic rules. Patient choice in the NHS has been very limited, but that is about to change.” All patients now have the right to choose which hospital provider they are referred to by their GP/referrer. This legal right, which was introduced in April 2009, lets patients choose from any hospital provider in England offering a suitable treatment that meets NHS standards and costs. Now patients can choose which hospital they are seen in, according to what matters most to them, whether it's location, waiting times, reputation, clinical performance, visiting policies, parking facilities or patients' comments. Patients can also choose to go to independent sector providers who have a contract with the NHS. A choice of hospital is available for most patients and in most circumstances. Exceptions include emergency and urgent services, cancer, maternity and mental health services. A patient has a legal right to be able to choose which hospital they are referred to for their first outpatient appointment, but not a legal right to specify which consultant they see. These changes are unlikely to reduce English medical tourism as most of the treatments that people go overseas for are not offered under the NHS, very limited under the NHS, or relate to dental treatment to which separate rules apply. There has never been much evidence of British patients going overseas for surgery that is readily available under the NHS, and this increased choice may simply mean that if there are long waiting periods at one hospital, patients will go to another one. The situation is complicated as there is and probably always will be a gap between what national politicians claim and the reality on the ground in local hospitals.

INDIA: Health Minister confirms the presence of antibiotic-resistant superbug

Fri, 21 Oct 2011 09:19:06 GMT

Indian officials have admitted the presence of an antibiotic-resistant superbug in Delhi hospitals, despite earlier claims from some politicians that it was a conspiracy by foreign scientists to undermine the nation's medical tourism industry. The Health Minister of Delhi state, AK Walia, confirmed the presence of the NDM-1 gene, which makes bacteria resistant to almost all antibiotics, in several of the capital's leading hospitals, although the prevalence rate is not alarming and NDM-1 has not been found in the city's water and sewage lines, "The infection rate is very low, between 0.04% and 0.08%. We are putting in place guidelines and monitoring systems to ensure this is kept under control." The British scientist who co-authored two controversial reports into NDM-1 says that the Indian government is still underestimating the threat. Professor Timothy Walsh of Cardiff University said, "NDM-1 is no longer a hospital infection control problem, but has now become a public health catastrophe." Walsh's study in the medical journal, The Lancet, in August 2010 found that cases of NDM-1 in the UK were often people who had recently been admitted to hospitals in India and Pakistan. The research team followed up with a report in April that found evidence of NDM-1 positive bacteria in Delhi's water supply. They suggest that poor sanitation, the overuse of antibiotics and a lack of infection control procedures, particularly in public hospitals, are responsible for its spread. The gene was first identified in a Swedish patient admitted to a hospital in India in 2008. In line with standard practice, it was named New Delhi metallo-beta-lactamase 1, after the city in which it was believed to have originated. The name remains a sore point with India's health authorities. Some Indian officials have been highly critical of Walsh and have denied his team access to take bacterial samples in Indian hospitals. Walsh was following up on the first paper on NDM-1 from a team at PD Hinduja National Hospital and Medical Research Centre in Mumbai, who published a study in March 2010 showing 22 cases of NDM-1 at their hospital in a three-month period.

UK: NHS spending cuts could lead to increase in UK medical tourism numbers

Fri, 14 Oct 2011 15:45:09 GMT

The UK government's austerity measures could lead to a rise in the number of UK patients travelling abroad for medical treatment, if NHS waiting lists start to lengthen as a result. Many could end up going to newer EU member states such as Poland and Bulgaria, according to the Economist Intelligence Unit. The report, 'Travelling for health: the potential for medical tourism', looks at the push and pull factors behind the growth of medical tourism. It predicts that ageing populations and restricted healthcare budgets are shifting the flow of medical tourists. Whereas rich patients from developing countries used to come to prestigious hospitals in the UK and elsewhere for treatment, now UK patients are starting to travel abroad for lower cost care. Often patients travel to access care that they cannot obtain under the NHS, either because it is unfunded or because waiting lists are too long. Top of the list is dental care, followed by elective surgery such as hip and knee surgery as well as laser eye treatment. Some 4% of medical tourists go to get fertility treatment, and this number is likely to rise as financial pressures limit the number of IVF rounds couples can get on the NHS. The report argues that this trend could be encouraged by the EU directive on cross-border healthcare, which was passed in January 2011 and comes into force in 2013. The directive establishes patients' rights to be reimbursed for treatment they receive in other EU countries, and could lead to more West Europeans travelling to Eastern Europe for care. The report says "Both inbound and outbound hit 51,000 travelers in 2009, but that represented only 13% growth for inbound travelers since 2002. The number of outbound medical tourists, meanwhile, had risen by 170% over the same period.” The figures indicate a trend, but the actual numbers need to be viewed with caution as they are based on a small sample of passengers. Some patients want treatments that are poorly covered by private insurers or the NHS. These can include hip replacement, knee replacement, laser eye surgery and cataract removal for which there are long waiting lists. Other procedures, such as cosmetic surgery, dental treatment and fertility treatment top the list. The increasing cost of dental care in Britain continues each year, so people tend to choose dental tourism as the next best option. Among some of the top preferred countries for dental treatment are Hungary and Poland; at 50% or lower, even after taking into account travel costs. It says that the UK is less well placed to benefit as a destination, partly because of comparatively high healthcare costs and partly because it has only a small private healthcare sector. But the figures suggest that the UK has at least as many, if not more, inbound medical tourists than outbound. The report may have underestimated the size, growth and potential of the private health market too.

GLOBAL: What drives medical tourism: New report from the Economist Intelligence Unit

Fri, 14 Oct 2011 15:44:57 GMT

A new report from the Economist Intelligence Unit 'Travelling for health: the potential for medical tourism', has some surprising results when it looks at what is behind the growth of the medical tourism industry, and which destination countries it thinks will benefit most. The report also looks at the US, where it predicts that the US healthcare reforms – despite meaning that more Americans will have healthcare insurance – will encourage medical tourism, as hard-pressed companies and insurers look for cheaper treatment options in an attempt to keep down premiums; but to a much more limited extent than other trade estimates have suggested. Overall, the report concludes that low costs, as well as medical expertise, are becoming the main drivers of the industry but there are other important factors:• Global technology means that the internet enables patients to research options beyond national boundaries.• Budget airlines with low fares make foreign travel more affordable. • Trade liberalization means that consumers are getting used to seeking services outside their home country.• Increasing foreign investment has built modern hospitals in many countries. • The internationalization of the medical workforce means that many doctors and nurses get overseas experience before returning home.• Internationalization of medical accreditation makes it easier to compare hospitals.• The rise of hundreds of medical tourism agencies offering services to healthcare travellers. The report assesses data from 60 countries to pinpoint which countries offer the best combination of the factors that drive medical tourism. These factors are medical expertise, low costs, and a secure environment. A surprise at the top of the ranking is France, which has a tiny medical tourism industry at present but has the specialist care and business environment to succeed.Second place goes to Mexico although concerns over the economy and drugs wars may mean it will not reach its full potential. In third place is the USA, often negelected as a major destination. Taiwan, with its huge potential for Chinese visitors is fourth, and Germany is sixth. Three of the top six have are high cost destinations: France, Germany and the USA. Poland in fifth place and Bulgaria in seventh, score highly due to low cost. Sweden and Belgium are also in the top 10. A number of developing countries also came near the top of the rankings, by offering a combination of medical expertise and low costs. India will benefit from growing wealth levels, but has fragmented and widely dispersed healthcare and medical markets with no national focus. Although the report rates China as having high potential, it warns that healthcare quality is patchy and there will be language problems. Greece has potential but economic meltdown could cause major problems. The report suggests that many countries are well placed to develop medical tourism that will create much-needed healthcare jobs and expertise, as well as generating revenues. But it warns that to make the most of this opportunity, governments and private companies will need to work together to ensure that the benefits from medical tourism trickle down to the wider population. The industry will also need to develop consistent hospital accreditation and legal frameworks, so that patients can be sure that they will receive the standard of care they were expecting. The conclusions of the report are a warning for some of the countries trying to enter the global medical tourism market…not every country can succeed in becoming a major medical tourism destination. Some will be derailed by their economy, some by local politics and internal security problems, some by a lack of healthcare skills and systems, some by lack of government support, and others by a poor tourism infrastructure.

INDIA: Fortis forecasts 10% revenue generation from medical tourism in three years

Thu, 13 Oct 2011 14:00:32 GMT

Indian hospital group, Fortis Healthcare, has been an early proponent of medical tourism. Now it expects to get 10% of its Indian revenue from medical tourism within three years. Aditya Vij of Fortis says, "It could reach 10% by 2014. Medical tourism currently accounts for 7 % of revenue. I expect it to grow in volume by 30 % annually during the next three years. With an increasing number of hospitals the actual income will grow substantially. Medical tourism typically denotes serving overseas patients looking for cheaper treatment options or better infrastructure. Factors like the falling rupee are bound to make the business more profitable. Patients come from the developed countries, mostly in Europe. Fortis will be looking at getting patients from Afghanistan, the Middle East and Africa.” But Fortis has not forgotten the huge domestic market potential. Aditya Vij adds, ”Although the revenue share from medical tourism will go up, the company's focus will be the domestic market. The company recently announced its plans to open hospitals in tier II and III cities, is targeting to commission the first of the low-cost hospitals in early next year and will be finishing with its planned rollout in 25 cities in the next three years. The idea is to take medical care to where people are. We want to bring healthcare to more and more people who today have to commute long distances to get decent medical care. We already have identified a few locations." At present, Fortis has 51 operational hospitals spread across the country while 15 more are under construction. Once the construction is complete, its capacity will go up to 10,600 beds. The company is always seeking acquisitions and will continue to look at such options for growth. Promoting dental tourism, Chennai-based dental chain Dentistree has linked with Parveen Holidays to offer dental procedures with tour packages. The companies together are offering tour packages that help an overseas patient plan dental treatment in India and combine it with traveling. Smilingtourism.com launched by Dentistree and Parveen Holidays provides online consultation with the dentists of Dentistree. Based on the reports, the dentist fixes the schedule for the treatment. As most of the procedures need more than one sitting with a gap of a few days in between, the patient can fruitfully utilise the time visiting places of interest in the country. Parveen Holidays will arrange for all the travel and accommodation needs of the patient as a package. In the past year, Dentistree's clinics in Chennai, Kanchipuram and Pondicherry have been regularly receiving international patients. Most of the dental tourists travel to make most of the price differential in high-end procedures.

CHINA: Serious ethical concerns on Chinese organ transplant tourism

Thu, 13 Oct 2011 13:58:18 GMT

Important ethical questions are raised by the growth of “transplant tourism”. The long waiting lists for body parts in many developed countries, and the amount that patients are prepared to pay for a transplant, raise the danger that poorer local people will be coerced into illegal organ donations. Five bioethicists have published their opinion in a column entitled 'Time for a boycott of Chinese science and medicine pertaining to organ transplantation' in leading UK medical journal, The Lancet. They call for a boycott of Chinese scientists over its 'barbaric human organ market'. Transplant tourists find their way to China, frustrated by the long waiting times in their own countries and attracted by the competitive price. The article argues that it is clear from the numbers provided by China that not all of the organs for Chinese citizens and transplant tourists are provided by voluntary consenting donors. The source of many of these organs is executed prisoners whose consent is either non-existent or ethically invalid and whose demise might be timed for the convenience of the waiting recipient. The authors issue a call to action: “Despite the continuation of organ donation by execution, the international medical and scientific community has done little to make its moral abhorrence of this state of affairs widely known. Presentations about transplantation in China continue to be made at international conferences, publications about the experience of transplantation in China appear in peer-reviewed journals, and pharmaceutical companies continue their marketing efforts and engage in sponsoring research involving various aspects of transplantation in China. The time has come to bring normal scientific and medical interchange with China concerning transplantation to a halt. We call for a boycott on accepting papers at meetings, publishing papers in journals, and cooperating on research related to transplantation unless it can be verified that the organ source is not an executed prisoner. These steps are admittedly challenging. But the international biomedical community must firmly and boldly challenge the status quo — the barbarous practice of obtaining organs from executed prisoners.” Despite assurances that the practice is winding down, they suggest that China persists in using organs from executed prisoners. One of the authors, Arthur Caplan, of the University of Pennsylvania, says that the controversial practice will not stop unless international pressure is applied. He says China is building an international medical city to capitalise on the medical tourism market with facilities for organ transplants. He declares: ”Using organs from prisoners who are executed on demand to get parts for rich visitors may bring currency to China but it also ought to bring shame. The Chinese people who need transplants deserve a better system, as do the hapless prisoners who are being victimized. The rest of the world should help stop it.”

CARIBBEAN: Caribbean islands see potential in medical tourism

Thu, 13 Oct 2011 12:03:06 GMT

Doctors Hospital in the Bahamas will in early 2012 begin another medical tourism initiative. The Nassau hospital is launching a project with a consortium of US specialists, a spinal parts manufacturer and Bahamian specialist, Dr Valentine Grimes. Three US surgeons plan to go to the hospital with their own patients to carry out spinal surgery. Meanwhile, its specialist prostate cancer treatment centre is increasing the number of medical tourists it treats. If the Virgin Islands is to actively pursue the medical tourism market, the establishment of a medical school must be one of government's priorities, says Virgin Islands Party (VIP) candidate Zoe Walcott-McMillan. Her logic is that the medical school would benefit islanders and improve standards. Currently, many people living in the Virgin Islands go to St. Thomas, Puerto Rico or the US mainland for healthcare. New president of the Medical Association of Jamaica (MAJ) Dr Aggrey Irons has called for the Jamaica medical industry to restructure itself so that Jamaica may be designated and recognised as a health tourism destination. Dr Irons says that the time is ideal, "We need to expand health tourism to levels exemplified by developing models like Korea and Singapore to a level where Jamaican health care will share and sustain the reputation of being the best in the world. This will allow healthcare to be a net foreign exchange earner that will underwrite the provision of proper health care for the poor and help to stem the brain drain. The MAJ is already in partnership with JAMPRO to this end. We have the manpower and need to supplement this with the tax incentives found in other forms of tourism." Jamaica minister Christopher Tufton says health tourism has potential, and is emerging as a lucrative area of Jamaica's tourism product, “Tourism has to be diversified if it is to be sustainable. For Jamaica the idea is still virgin territory, but still one where we think we have potential. Jamaica already has experience in the tourism industry and where we don't have the specialisation, we can import it, we can create a destination for selected procedures.” Tufton is seeking potential overseas investors to develop health-related tourism in Jamaica. JAMPRO - Jamaica's investment and export promotion agency, says it is already far advanced in finalising a road map for the proposal. It has had consultations with doctors and the public on the issue. There is also a steering committee in place that includes the ministry of tourism, ministry of health and others. The agency says it is already fielding interest from prospective investors and has identified target companies that it will be approaching.

CENTRAL AND SOUTH AMERICA: American run hospital in Panama achieves JCI certification

Thu, 13 Oct 2011 12:00:06 GMT

In Panama City, a hospital run by Johns Hopkins Medicine has become the first in the country to receive JCI international accreditation. Hospital Punta Pacifica (HPP) in Panama City, Panama, has been awarded the official accreditation of Joint Commission International (JCI). Johns Hopkins Medicine International - the Baltimore, Maryland, USA-based international arm of Johns Hopkins Medicine — assisted Hospital Punta Pacifica in its preparation for the JCI accreditation review by providing rigorous training for the staff in quality, patient safety, infection control, leadership, nursing and human resource management, and by conducting assessments and mock surveys. HPP is a 74-bed hospital opened in March 2006, and managed by Johns Hopkins Medicine International since 2008. Steve Thompson of Johns Hopkins Medicine International says, “Hospital Punta Pacifica has reached a very important milestone. This accreditation validates the efforts that our medical and management teams have undertaken throughout the years to position HPP as a model private health care institution, to raise the standards of the health care in the region and to deliver world-class medical care.” Guatemala is fast emerging as a medical tourism destination as it offers lower prices than in Mexico and Costa Rica, a favorable US dollar exchange rate, short flights from the USA, doctors trained in Europe and North America, hospitals with JCI accreditation in process, plus hospitals in a residential area near international hotels and only 15 minutes from the airport. The country already gets medical travellers from Southern Mexico and other countries of Central America. It offers highly affordable prices for anti-aging and wellness treatments, and a wide choice of treatments in alternative medicine (oxygen therapy, homeopathy, acupuncture, chiropraxis). Americans, Canadians and Europeans do not need a visa to visit Guatemala, a valid passport is enough. While many Mexican hospitals and clinics concentrate on low price, some see that they need to offer more to prevent losing business to even lower cost competitors. Cosmetic surgeon Dr. Alejandro Qurioz of CosMed Clinic is one of the first to offer techniques not yet available in the US. Just minutes from the San Diego border in Tijuana, Baja California, Mexico, CosMed Clinic provides a convenient medical tourism destination for patients hoping to increase the size of their buttocks or breasts with Macrolane injections.

MALAYSIA: Health Ministry investigating allegations of illegal organ transplants

Tue, 11 Oct 2011 09:14:51 GMT

The Health Ministry in Malaysia is working with the Home Ministry and police to investigate the allegation that a local hospital conspired in an illegal kidney trade. Dr Hasan Abdul Rahman said, “Malaysia, being a member of the World Health Organisation and a signatory to the declaration of Istanbul on organ trafficking and transplant tourism is committed to ensure such illegal practices are not undertaken in this country.” In Malaysia, transplants from unrelated donors need to be vetted by the independent Unrelated Transplant Approval Committee before they can be carried out. Legal kidney transplants in Malaysia are carried out in Kuala Lumpur Hospital, Selayang Hospital, University Malaya Medical Centre and a few private hospitals in the Klang Valley. Dr Hasan Abdul Rahman is seeking to distance the government from the allegation that the illegal medical tourism is happening in Malaysia, “It seems a little far-fetched that such an illegal activity, especially involving foreigners, has been carried out in any of these hospitals. However, if there is evidence that it happened, the ministry will certainly take action against those involved. The alleged transplants from unrelated foreigners from Bangladesh would have required prior approval from the ministry. Our records show that there have been no such requests or applications." His statement is slightly misleading as if they were illegally done on a cash basis the doctors and hospitals are hardly going to be dumb enough to seek official approval. Malaysia is only one of several countries alleged to contain hospitals and/or local doctors that have taken part in illegal organ transplant tourism. Bangladesh is involved in the trade; poor people are paid for their organs, which are then sold on to foreigners prepared to pay cash to criminals to jump the queues for transplants in their home countries. Usually, the transplant is done in a remote hospital in a third country, which means that several local doctors, medical staff and administrators are in on the deal; although transplants may be done by a surgeon from another country flown in and out quickly. The Bangladeshi police are on the trail of an international syndicate linked to illegal kidney trade across several Southeast Asian countries. Local media reports allege that a reputable international hospital group with hospitals in several countries including Malaysia has been involved in the illegal business. The police investigations reveal that donors from remote villages in Bangladesh were flown to hospitals in several different countries to sell their kidneys, and the kidneys are fresh for an immediate operation on an anonymous foreign patient. Basically, the donors are very poor and the recipients are well off. Bangladeshi police have detained eight people in connection with luring poor and illiterate victims overseas for the trade. One of those arrested but not yet charged is Nafiz Mahmud a manager in Bangladesh for Columbia Asia Healthcare. In a statement he said, he has nothing to do with the illegal trade. “I have not faked the identity of any kidney donor or recipient. On the kidney transplants that took place in India, all the donors were very close kin of the organ recipients. All the donors and recipients sent abroad by me were first blood relations.” Kidney transplants are illegal in Bangladesh unless the donor is a close kin, spouse, or he or she has donated it before death. However, the Joypurhat Superintendent of Police Mozammel Haque insists that Mahmud is involved in organ trade and cites statements of people arrested earlier in this connection, “Columbia Asia Healthcare established last year keeps in touch with doctors of hospitals abroad and arranges illegal organ transplants outside the country.” The police admit that as yet they are not clear if the syndicate used or had tacit approval from Columbia Asia Healthcare, or if people who worked for the company were involved in a private capacity. Nafiz Mahmud acknowledged that he did not obtain any permission either from the health or home ministry to set up the organisation. He said he only possesses a trade licence. He claims that Columbia Healthcare has 34 hospitals worldwide including in India, Malaysia and Indonesia and, “My business does not involve any medical treatment. It is like tourism.” A document seized by police shows that the institution provides healthcare by specialised international doctors through videoconference. The police so far have identified around 100 people in Joypurhat who the syndicate lured into selling organs, and claim that up to 30 people in several Asian countries-including doctors - are involved in the racket.

DUBAI: Royal to save Dubai Healthcare City?

Fri, 07 Oct 2011 15:56:07 GMT

Princess Haya Bint Al Hussein will lead another attempt to attract international healthcare providers to Dubai Healthcare City (DHCC) and to turn around its record in attracting medical tourists. That Princess Haya, the wife of Dubai's ruler, is involved, suggests that the zone's failure to achieve any of the goals initially set, and that many of his subjects prefer going overseas for medical treatment; has become an embarrassment to her husband - Sheikh Mohammed Bin Rashid Al-Maktoum. Princess Haya will report directly to her husband. There is also a financial imperative, as Dubai Holding, a troubled state-owned developer that this year held talks with lenders to restructure $10billion of debt, owns DHCC. The princess will oversee a restructuring aimed at shifting DHCC's focus away from real estate and back to healthcare, with property supporting health establishments. All existing projects in the development are under evaluation, and DHCC is in talks with a number of medical institutions to bring the project in line with its new focus. DHCC was launched in 2002, partly to stem the tide of local patients seeking medical care abroad, and partly to attract medical tourists from neighbouring countries. Although figures are vague, the general consensus is that far more people leave Dubai for planned treatment than go there. The figures are fogged as DHCC claims on numbers only refer to international patients, and there are millions of expatriate workers, visitors and others who are counted as international patients but are not medical tourists. DHCC contains 2 hospitals and 90 clinics as well as residential buildings and hotels. It has been badly hit by Dubai's real estate crash, which saw property prices tumble more than 60 % from their mid-2008 peak. More than half of developments in the city were scrapped or put on hold in the wake of the financial crisis, leaving construction firms unable to raise cash as project finance dried up. Several overseas and local clinics that did set up in DHCC have closed due to lack of business. US-based Mayo Clinic closed in 2010 and outpatient care centre, Dubai Medical Suites (DMS), closed in 2009, less than six months after its launch. The fulcrum of DHCC was to have been a new 400-bed University Hospital, but it remains as foundations and a frame, after the owners in 2010 stated that there is now no firm opening date and all construction had ceased. With customer numbers low and the key building looking forlorn, DHCC attempts to attract foreign hospitals and visiting specialists have mostly failed. The princess hopes that high-profile international brands will help her revive DHCC and finally capture part of the medical tourism market. The basic concept of DHCC is that global brand names with new hospitals and quality doctors will attract locals to have treatment at home and foreigners to come for treatment. Many doubted that this medical tourism strategy would have worked before the economic crash, and although it may work for small numbers who can afford it, there are now scores of competitors with new hospitals and the latest technology. Unless something is done about the high treatment and accommodation costs in DHCC – when compared to local countries, let alone Asia, it will be an uphill task. International hospital groups only invest if they can be certain of making money, and often demand that local governments invest heavily too. Some specialists may open on the assumption that they can make money from local customers. June saw the first newcomer in over a year, with the opening of the local clinic of the American Spine Center based in Alabama, USA.

USA: Medical tourism could benefit from new US visa reform

Fri, 07 Oct 2011 11:14:56 GMT

The U.S. Travel Association is supporting new legislation that would increase international travel to America and make it easier for medical tourists to enter the country. Introduced by Congressman Joe Heck, the "Welcoming Business Travelers and Tourists to America Act of 2011" will address problems with the U.S. visa system that are currently discouraging international visitors from travelling there. Roger Dow of the U.S. Travel Association says, "The travel industry has strongly advocated for visa reform legislation and we look forward to working with other members of the house to gain support for its passage." A U.S. Travel Association survey of 500 travellers from Brazil, China and India demonstrated that an overwhelming majority of travellers found the U.S. a difficult place to visit. These add to existing problems of the time taken to get through security, and the way that many security and airport staff regard visitors as a nuisance that have to do as they are told, rather than welcome guests bringing badly needed revenue and jobs to the USA. There are many complexities and delays that travellers from other countries experience when applying for a U.S. visa. Among the key highlights of the bill is a 12-day visa processing standard and the implementation of a videoconferencing pilot for visa interviews. While the State Department currently has a goal of interviewing all visa applicants within 3 days of their application submission, it has failed to meet this performance standard in key markets - a problem that continues to grow as demand rises. Heck's legislation sets a 12-day processing standard and directs the Secretary of State to use nonimmigrant visa fees to hire foreign service consular officers in China, Brazil and India to meet that standard. Travellers who do not live in a city where a U.S. consulate is located must incur hundreds of dollars in expenses to complete a mandatory face-to-face interview. The lack of accessibility to consular offices is an issue in China, Brazil and India. There are 27 cities in China and eight in India with more than two million inhabitants that do not have a U.S. visa processing centre. The bill directs the Secretary of State to implement a visa videoconferencing pilot program for conducting visa interviews. It can take over 100 days for a Brazilian to get a visa to the USA. Since 2000, long-haul arrivals to the U.S. have increased by less than 2%, from nearly 26 million to 26.4 million in 2010, despite a worldwide increase of 60 million long-haul travellers over the same decade. Between 2000 and 2010, the United States' share of global long-haul travel fell from 17 % to just 12.4 %. A Chinese citizen seeking to enter the United States must first get a visa, a very difficult, expensive and cumbersome process. First, an applicant pays a $140 application fee and buys a pre-paid phone card he or she must use to schedule a visa appointment. The next step is to complete a lengthy online application in English. After waiting anywhere from 2 to 100 days, the applicant must travel to a U.S. consulate with complete financial, family and business records only to wait in line for two to three hours for an interview with a U.S. official that lasts three to five minutes. After the interview he or she will be informed about the visa. If the visa is granted, the applicant can then travel to the United States.It is a wonder any Chinese go to the United States at all. The process is similarly restrictive for Brazilians and Indians. With agencies and associations beginning to proactively promote medical tourism to the USA, few have overcome the main barrier to potential medical tourists - getting a visa in a simple and timely manner.

COSTA RICA: Medical tourism numbers increasing to Costa Rica

Fri, 07 Oct 2011 11:02:08 GMT

According to the Council for the International Promotion of Costa Rica Medicine (Promed), medical tourism generated $295 million dollars in revenue for Costa Rica in 2010 from 36,000 medical tourists in Costa Rica. Most came with at least one companion and spent six times more than a traditional tourist. The Council claims that the medical tourism sector is growing at a rate of 15% to 20% annually. In Costa Rica the increased demand is from Americans. 36% go for dental treatment and the rest for orthopedic and cardiovascular treatment or cosmetic surgery. Promed accepts that the country needs a higher profile to increase numbers in the face of stiff competition from other countries. Promed is a private not-for-profit organization that coordinates the efforts carried out to ensure the quality of services provided by the private health industry in Costa Rica and their international promotion, with the intention of consolidating the country as a major destination for medical tourism. It has developed regulatory standards and promotes the certification of service providers, with the support of international bodies and the training of local certifiers. The organisation brings together health service providers, health professionals, tourism service providers, academia, and other marketers of goods and services related to health and tourism. The following have been certified by Promed -• Clínica Bíblica Hospital• CIMA San José Hospital• UNIBE University and Clinic• Pino's Plastic Surgery Clinic• Hospital Metropolitano• Homewatch Caregivers Latin America• La Católica Hospital Hotel• Clínica Oftalmológica 20/20• Mind and Health• Nova Dental• Especialidades Dentales Truque Argüello• New Smile Dental Group• Clinica Dental Cosmetics Costa Rica In 2007, Costa Rica had a mere 5,000 medical tourists and by 2008 this had increased to 20,000. Promed says that by 2009 this had increased to 30,000. The industry is on track to exceed the latest target of 40,000 medical tourists a year by 2019. Nearly all come from the USA. Costa Rican Medical Care (CRMC), a medical tourism agency only dealing with treatment in Costa Rica, has added Hospital Metropolitano to its network. In San José, Hospital Metropolitano is a leading local hospital that offers state of the art technology with very competitive prices and USA standards, being fully accredited by the Accreditation Association for Ambulatory Health Care (AAAHC). AAAHC International is now accrediting hospitals and clinics in Costa Rica, with other countries in South and Central America to follow. The hospital's founder, Dr. Roberto Herrera, along with a group of Costa Rican investors, plans to open a number of clinics across Costa Rica.

NEW ZEALAND: New Zealand insurer rejects medical tourism

Fri, 07 Oct 2011 11:00:08 GMT

New Zealand insurer Southern Cross has undertaken a study of medical tourism. It is not convinced that it could save money by taking patients overseas. But flying them around New Zealand to get the best medical deal is a good idea. A report from health insurer Southern Cross argues that once travel and accommodation costs are included, the cost savings of medical tourism are not tempting for policyholders for any but the most expensive procedures. But, says the report, only 15% of policyholders would consider travelling overseas for treatment. Flying policyholders around New Zealand in search of cost savings will be accepted. Many are used to travelling for medical procedures, particularly those who live in rural areas. As health insurance premiums have risen, many customers have switched to shared costs policies where they pay a substantial portion of the costs of each procedure. The report by Stephen McKernan of Health Partners Consulting Group says that overseas travel costs would mean savings of around only 1% given New Zealand's geographic isolation from low-cost Asian countries such as India and Thailand. But, travel for procedures within New Zealand could save money. Costs can vary dramatically around the country and in many cases there appears to be no good reason for those differences. After considering the report on medical tourism, Southern Cross Healthcare sees internal medical tourism as a way of steering surgical volumes away from high-cost providers to lower cost providers. But Southern Cross says that although internal medical tourism is a possible cost-control mechanism, it is currently only being explored. It wants to see if it can make it part of the existing development of a network. Southern Cross's main mechanism for gaining greater control over claims costs is the building of a network of affiliated providers who agree to certain prices and limits on future price increases, in return for business from the insurer. For an increasing number of procedures, the insurer will only authorize and pay for treatment by a network provider. New Zealanders do self-pay for overseas medical tourism. But this is mostly cosmetic surgery, dental and optical treatment – which most insurance policies do not cover. Few travel overseas for surgery.

PHILIPPINES: Developing medical tourism in The Philippines

Fri, 07 Oct 2011 10:56:23 GMT

After initially gaining a reputation for overblown claims on numbers and activity, those promoting medical tourism to the Philippines are now making solid progress on developing facilities for medical tourists and ensuring medical quality. The Hundred Islands Medical Complex project in Bolaney is nearing completion and should be ready for business during 2012. Operated by the local city government; it is also targeting medical tourists. A nearby hotel in Lucap will also open in 2012. An airport could be completed in early 2013. One hospital keen on medical tourism is Cebu Doctors' University Hospital in Cebu City. QHA Trent, the independent clinical accreditation scheme for hospitals and clinics based in the UK, has recently completed the survey of Cebu Doctors' University Hospital, a leading private sector hospital in the Philippines, and the hospital has been successful in obtaining accreditation. It is the first university hospital in the country and Southeast Asia to become independently accredited by QHA Trent, and is also accredited by the national accreditation scheme. 54 hospitals from different parts of the country have been formally recognized as centres of excellence by the Philippine Health Insurance Corporation (PhilHealth), a testament to their continuing pursuit of quality care for their clients. The award was granted to hospitals that have met stringent criteria for accreditation. Each has to comply with quality standards in the areas of patients' rights, organizational ethics, patient care, safe practice and environment, leadership and management, human resource management, information management, and improving performance. In 2010 PhilHealth launched this accreditation. The list includes 22 from the National Capital Region, seven from Batangas, five from Laguna, four from Cavite, three from Cebu City, two each from Tuguegarao City, Iloilo City and Leyte, and one each from Legazpi City, Angeles City, Capiz, Western Samar, Bukidnon, Agusan del Norte, and Mandaue City.

MAPE extends medical tourism services to Kuwait

Fri, 07 Oct 2011 10:12:18 GMT

MAPE Turismo y Salud, the Spanish facilitator for health and medical tourism, is expanding its services into the Kuwait healthcare market. It has created MAPE MIDDLE EAST, with the support of Sharif M. Nabil el-sharif, from the Kuwait Insurance Company – S.A.K. The company will be launching a promotional campaign to attract patients to Spanish healthcare facilities with which MAPE has cooperation agreements. These include Barcelona, Madrid, Alicante and others along the Mediterranean coast and the Spanish Islands (Balearics and Canaries). MAPE provides a platform of services to support medical tourism including information about treatment alternatives, information on prices and expenses for medical travel, information on quality of care, and technology for the dissemination of health information.

KOREA: New rules on private hospitals will help Jeju Island

Wed, 28 Sep 2011 17:20:16 GMT

Controversial new rules on private hospitals and foreign investment may help Jeju become a medical tourism destination, but limitations could damage other regions. Health minister designate Lim Chae-min has reiterated the government's commitment to attracting for-profit hospitals in free economic zones and Jeju Island. His remarks are amid a fresh round of debates over the pros and cons of for-profit hospitals. Lim reaffirmed that the administration will allow for-profit hospitals only in such designated areas as free economic zones and the Jeju special self-governing province. Lim is keener on developing private hospitals and medical tourism than his predecessors. Permitting foreign-owned hospitals to do business in the country's seven free economic zones will be the starting point for a broader range of changes in the healthcare sector. Lim's remarks came after the government's decision to allow foreign medical staff to work at hospitals owned by overseas entities in free economic zones. The Ministry of Health and Welfare has revised the rules on recognizing foreign medical licences to allow foreign doctors, dentists and nurses to work at facilities in the Incheon free economic zone. The ministry is cautious on allowing for-profit hospitals nationwide and says, ”We have simply specified the existing regulations and conditions as investors said relevant rules were too vague. It has nothing to do with the allowance of for-profit hospitals outside zones, and we are still very cautious on that matter. The establishment of for-profit hospitals has been allowed in these zones since 2003 after a related law went into effect, but no foreign investors have shown any serious interest." Those keen on these new hospitals argue that they are key to boosting medical tourism beyond cosmetic surgery, and to attracting outside investment to make local facilities more competitive. Under the current law, hospitals are non-profit entities and banned from seeking investment. They must follow guidelines set by the health authorities on their operations including what they charge patients. But opponents claim that if for-profit hospitals open and health care is privatized, medical bills will go up. A record number of Chinese tourists are going to Korea's resort island of Jeju. The island has proven its competitive advantages over Japan, Malaysia and Australia. The resort island has gained popularity among Chinese tourists, thanks to its geographical proximity, and a boom of Korean pop culture. Over 1.8 million Chinese visited Korea last year. And 22 % of them traveled to Jeju. The Ministry of Foreign Affairs and Trade has made available a visa-waiver program for the Chinese. One future attraction of Jeju will particularly target the Chinese market. Jeju Healthcare Town aims to become a key medical tourism destination in Northeast Asia. Jeju Free International City Development Center (JDC) set aside a huge site in Seogwipo to build Jeju Healthcare Town. The planned investment in the project, expected to be completed by 2015, is US$830 million. Jeju Healthcare Town is divided into three areas - Wellness Park, a medical relaxation complex for beauty, prevention, health and relaxation; Medical Park, a high-tech medical complex for various high-quality specialized treatment services; and R&D Park, a medical R&D complex. Wellness Park will provide health improvement services such as medical check-up, beauty treatment, oriental medicine, Thalasso Resortel (luxurious recreational resort with therapy, beauty and spa facilities), mediation garden and accommodation. To attract patients from other countries, Medical Park will provide specialist medical treatment for health problems such as cancer, heart, vascular disease, and spine problems. There will also be a retirement community with medical care and a long-term care town to meet the demand for long-term care for elderly and chronically ill patients. Jeju Island is off the south coast of Korea, between China and Japan. Eighteen cities with populations of more than 5 million are within just two hours' flight of Jeju Island. This geographic advantage could attract overseas patients. The Korea Tourism Organization aims to attract 300,000 overseas patients by 2015.

GLOBAL: Controversies in stem cell tourism

Wed, 28 Sep 2011 17:17:27 GMT

Stem cell therapy tourism is controversial as there are disputes over whether or not it works and how safe it is. American football superstar quarterback Peyton Manning has travelled to Europe for stem cell therapy for his neck injury. Some stem cell procedures and therapies are approved in some countries but not in the USA. Stem cells are the body's source of all cells for the maintenance and repair of tissues. Typically used in treatments for leukemia and several genetic diseases, the use of stem cells in treating spinal cord injuries is not proven and experimental. Stem cell therapy is regulated in the USA and is treated as a drug, rather than a therapy, requiring three trial phases before being medically accepted. There is complex controversy on medical, ethical, religious, legal and scientific grounds. Stem cells can come from the patient themselves, which is the case with Manning. The hope is that the stem cell therapy will regenerate the nerve area in his neck and provide some relief. The main problems begin when patients use stem cells from other people. Two American scientists, Zubin Master and David B. Resnik, recently write a detailed article for The Scientist, and points relevant to medial tourism include -• Young and elderly patients have died from receiving illegitimate stem cell treatments; others have developed tumors following stem cell transplantations. • Some involved doctors have lost their licence, but the number of overseas clinics is growing, offering stem cell treatments for several debilitating and incurable ailments, including Parkinson's disease, spinal cord injury, multiple sclerosis, diabetes, and cancer. Most of these treatments are expensive and unproven “miracle cures'. • Patients are encouraged to travel abroad to receive therapies that they expect will be approved in the USA in the future and do not understand the reason why approval takes so long. • International guidelines could help by encouraging countries to develop laws and regulations ensuring that clinics offering treatments receive ethics approval and have received regulatory oversight for the products and procedures they intend to use on patients. • International guidelines may not carry sufficient weight as some countries will not adopt them or will choose to ignore them to protect lucrative tourism.• Stem cell tourism cannot be stopped by legislation or restrictions imposed by respectable scientists.• Desperate people will always take risks for an untreatable lethal condition; even an outside chance is better than no hope. Stem cell experts are worried about clinics and hospitals in China, Mexico, India, Turkey, Russia and Brazil promoting stem cell therapies that have not undergone clinical trials and which are not recognized as standard treatment. Hospitals in China are offering stem cell backed by little or no scientific evidence, which are at best experimental. Patients pay very high amounts for treatment but come away with little or no improvement and a number have died. Patients facing death or unbearable pain are easy targets for hospitals, clinics and agencies promoting stem cell tourism. They have little to lose and are also reluctant to complain if they do not get better as they are embarrassed at spending lots of money against professional medical advice. Patients can be scammed. Suspicious signs include being asked for large sums of money up front; being told there are no risks, and being offered no post-therapy care. Patients should be told how they will be treated, what stem cells are used and where they come from. They should not accept any therapy based on hearsay, or without the treatment being validated.

TURKEY: Update on Turkish medical tourism

Wed, 28 Sep 2011 17:15:52 GMT

According to Turkey's Ministry of Health, some 500,000 foreigners were treated at Turkish hospitals in 2010; the figure represents a 70% increase since 2007. (There is no data on whether these are medical tourists, expatriates, or holiday or business travelers who fall ill in Turkey.) The Foreign Economic Relations Board describes Turkey as an emerging medical destination and says the attraction to relatively low medical costs, a convenient geographic location and adherence, as a European Union candidate, to EU healthcare standards. Turkey has 556 private hospitals, competing with each other for medical tourists to offset the losses from Turkish nationals. The government plans to upgrade a few of the country's 833 state-run hospitals to accommodate foreign patients as well. Anadolu Hospital group has an international patients office with a multi-lingual team responsible for attracting foreign patients to the hospital and helping them during their stay. The group expects 2011 to show foreign patients as 25% of the total, compared to 4.5% in 2002. It reports that 5,000 patients come from more than 30 countries, but most are from the Balkans and Central Asia. Those from neighboring countries seek affordable quality car, while those from further away are more price driven. While some are self-referred, others are referred by overseas hospitals, medical tourism agencies and a host of overseas sales representatives. One problem area with Turkey is that it almost impossible to succeed with a lawsuit for medical malpractice. Turkish law rarely offers high compensation awards in the few cases that plaintiffs win. The long legal process and costs can mean the plaintiff is out of pocket even if they win damages. Foreign patients have little legal recourse in Turkey. Fortis Healthcare International has pulled out of talks to buy a controlling stake in Turkish hospital group Acibadem due to valuation concerns and political unrest in the Middle East. The stake is being sold by Almond Holding, owned by Dubai based private equity firm Abraaj Capital and Turkish family Aydinlar. Abraaj has a 46 % stake in Almond Holding, which controls 92 % of Acibadem. Acibadem Hospital Group has 6 general hospitals, medical centres, outpatient clinics, an ophthalmology center and laboratories. Turkey has been attracting international investors' interest, with one of the highest economic growth rates globally. Healthcare and private hospitals are popular choices among private equity houses, but many of the banks and private equity groups are seeking to sell their stakes.

EUROPE: Will European health services in 2020 include medical tourism?

Wed, 28 Sep 2011 17:12:22 GMT

The growing burden of cancer, heart disease, diabetes and strokes is linked to the unhealthy lifestyles that many lead. European health ministers recently gathered in Baku, Azerbaijan at the annual meeting of World Health Organisation regional office for Europe. They had a raft of action plans to discuss and a new vision of public health: Health 2020. In times of economic constraint, how do we protect health? Viv Taylor Gee at WHO Europe reports, ”There are immense challenges. We need to provide adequate services and support to the ageing population. There is a growing burden of non-communicable diseases such as cancer, heart disease, diabetes and strokes. And there is an ever-expanding array of technology we can buy for diagnosis and treatment. Health systems are expensive, and will become more so. The public expects high-quality care. Resources are under enormous pressure and budgets are under threat.” WHO Europe suggests that as health contributes to wealth and enables people to be productive and independent, investing in promoting and protecting health is a sure means to invest in the future. It makes more sense to focus on trying to keep a population fit and well than pouring scarce resources into treating them when they become ill. 53 European countries were consulted on the new policy, Health 2020. The country delegates welcomed the idea. A major shift in the way public health is managed across Europe will be needed in future if all countries are to achieve the best health standards for their citizens, says the World Health Organization. Zsuzsanna Jacob of WHO says, “Horizontal inclusive approaches to health governance are needed, involving all sectors of society and people themselves. This necessitates a whole of government approach towards health and wellbeing. Health across the European region is improving, but not by enough.” The medical tourism industry may hope that by 2020 the new cross-border directive on EU healthcare will encourage more medical tourism, but in an interview with the Irish Medical Times, EU commissioner for health John Dalli said, 'No-one wants to travel further than necessary when they are sick. However, sometimes the need for certain treatment leads patients to go abroad. Another reason could simply be that the nearest hospital lies across a border. I could not condone medical tourism. Cross-border healthcare is not intended to induce tourism. It is intended to give good care to people who need it. If you are not being served properly in your country, you have the right as a citizen to go and seek assistance and healthcare somewhere else. Then your country is obliged to reimburse you. It will force countries to invest in giving their own people the best healthcare in their own country. This is because they know that by not investing in health, they are not saving money. Patients could go somewhere else and their home country would still have to pay for their care.” Through the new EU Cross-Border Health Directive, the EU has now taken on the responsibility to co-ordinate the interoperability of health systems in Europe. The EU believes that member states have much to gain from greater co-operation on eHealth and the increasing use of telemedicine and telemonitoring solutions to reduce hospitalisation of chronic heart disease patients and to cut the use of healthcare resources. On a daily basis, hugely improved and much more expensive cures are emerging. The directive on cross-border healthcare will benefit patients across Europe by clarifying their rights to get access to safe and high-quality treatment across EU borders and be reimbursed for it. In addition to providing a clear and coherent set of rules on cross-border healthcare, the new directive will help patients who need specialised treatment, who are seeking a diagnosis or treatment for a rare disease. Major challenges facing health systems in Europe include the sustainability of health systems and the EU's ageing population. A number of factors are making health policies and health systems across the European Union increasingly interconnected:• Patients getting healthcare across the EU.• Health professionals working in different EU countries.• Higher expectations for healthcare.• New developments in health technologies. Challenges-• Providing clear rules and reliable information to patients regarding access and reimbursement for healthcare received in another EU country. The new national contact points will do this.• Meeting patients' expectations of the highest quality healthcare, which are even higher when they seek treatment away from home. The information given by national contact points on healthcare quality and patient safety will help them make informed choices before going abroad for healthcare.• Ensuring EU countries work closer together in the interest of patients.• Clearing up years of legal uncertainty. The new rules also strike the right balance between maintaining the sustainability of health systems while protecting patients' right to seek treatment outside their home country. EU countries have until 25 October 2013 to implement the Directive on cross-border healthcare that clarifies access to healthcare in another EU country, including reimbursement.

MOROCCO: Opportunities for Moroccan medical tourism

Wed, 28 Sep 2011 17:05:21 GMT

According to a new analysis from London based analysts Oxford Business Group, Morocco is beginning to emerge as an important health tourism destination for European patients, with several key advantages over its competitors such as its closeness to Western Europe, an extensive tourism infrastructure, and the prevalence of the French language. The main growth areas are cosmetic surgery, laser eye surgery and dental tourism, particularly implants. Cosmetic surgery in Morocco, can cost between 30% and 50% less than in Europe. The country has 80 specialists and 12 cosmetic surgery clinics. 15% of the 14,500 instances of cosmetic surgery that take place annually in Morocco involve foreign patients. This would give Morocco just over 2000 medical tourists a year. Women account for 75% of foreign patients, with liposuction and breast enhancements the most frequently performed operations. Dental tourism is also fast emerging and is attracting older patients from Francophone European countries such as France, Belgium and Switzerland, in particular, as well as Moroccan immigrants living in Europe. Dental implants are 50% cheaper in Morocco than in Western Europe. As it expands, the health tourism segment is attracting foreign investment. Portuguese group Malo Clinic plans to open a €24.1m clinic and surgery by the end of the year in Dar Bouazza, 20 km south of Casablanca, in cooperation with local dental surgeon Saad Zemmouri. The clinic will employ 40 specialists and include a five-star hotel and a health spa, principally targeting older retired Europeans. It will specialise in laser eye, dental and cosmetic surgery. While rival countries Tunisia and Lebanon offer packages that include travel, accommodation and childcare for women, few Moroccan clinics offer such packages. But the closeness to Europe and the extremely low costs are a huge incentive, while Morocco is further removed from African and Middle East trouble spots than Tunisia or Lebanon, so can actually benefit from the Arab Spring uprisings.

GLOBAL: Healthy growth of international tourism in first half of 2011

Thu, 22 Sep 2011 16:30:43 GMT

International tourism is now growing again, which should be reflected in many forms of medical and health tourism too. UNWTO's World Tourism Barometer says that international tourism grew by almost 5% in the first half of 2011, totalling a new record of 440 million arrivals. Results confirm that, in spite of multiple challenges, international tourism continues to consolidate the return to growth initiated in 2010. International tourist arrivals grew by 4.5% in the first half of 2011, consolidating the 6.6% increase registered in 2010. Between January and June of this year, the total number of arrivals reached 440 million, 19 million more than in the same period of 2010. Growth in advanced economies (+4.3%) has maintained strength and is closing the gap with emerging economies (+4.8%), which have been driving international tourism growth in recent years. This trend reflects the decreases registered in the Middle East and North Africa, as well as a slight slowdown in the growth of some Asian destinations following a very strong 2010. All world regions showed positive trends with the exception of the Middle East and North Africa. Results were better than expected in Europe (+6%), boosted by the recovery of Northern Europe (+7%) and Central and Eastern Europe (+9%), and the temporary redistribution of travel to destinations in Southern and Mediterranean Europe (+7%) due to developments in North Africa (-13%) and the Middle East (-11%). Sub-Saharan Africa (+9%) continued to perform soundly. The Americas (+6%) was slightly above the world average, with remarkably strong results for South America (+15%). Asia and the Pacific grew at a comparatively slower pace of 5%, but this more than consolidates its 13% bumper growth of 2010. Results from recent months show that destinations such as Egypt, Tunisia and Japan are seeing a recovery to earlier declines in demand. So far, the growth of international tourism arrivals is very much in line with the initial forecast issued by UNWTO at the beginning of 2011, 4% to 5%, for the full year 2011, a rate slightly above the 4% long-term average. As international tourism receipts were more affected by the 2008-2009 crisis and recovered somewhat slower than arrivals in 2010, this year should also see their further improvement. Following an encouraging first half of 2011, growth in the remainder of the year is expected to soften as recent months have brought increased uncertainty, hampering business and consumer confidence. UNWTO warns the travel trade to remain cautious as the global economy is showing signs of increased volatility. Many advanced economies still face risks posed by weak growth, fiscal problems and persistently high unemployment. Following the decline registered in 2009, one of the most challenging years for international tourism in decades, the sector rebounded strongly in 2010. International tourist arrivals were up 6.6% to 940 million and international tourism receipts grew by 4.7% in real terms to reach US$ 919 billion (euro 693 billion).

MALAYSIA: Partnership with airline to boost medical tourism

Thu, 22 Sep 2011 10:36:44 GMT

MASholidays, the travel arm of Malaysia Airlines is expanding its health screening packages currently offered to customers through an existing collaboration with HSC Medical Center, a diagnostic centre in Ampang, Malaysia. Under the new arrangement, HSC will offer executive health screening, heart screening, heart and stroke screening, and heart, stroke and cancer screening options to MASholidays at attractive rates. MASholidays will then incorporate these screening programmes into its all-inclusive travel packages and promote them to customers who wish to experience Malaysia's affordable world-class medical facilities. HSC Medical Center (HSC) is one of the few centres in the world to have designed and offered comprehensive health screening packages for heart diseases, stroke, and cancer, to detect some of today's life threatening diseases. HSC also provides advanced medical and cardiac therapeutic services, such as coronary angiogram, balloon angioplasty, and stent implantation. Through these packages, Individuals will be given a choice of economy or business class return travel exclusively on Malaysia Airlines, 3 nights' accommodation in a 3 to 5-star hotel, daily breakfast and a roundtrip private transfer from the hotel to HSC for the free health-screening. This package includes a preventive care programme. Dr. Amin Khany of Malaysia Airlines explains, “MASholidays introduced a health screening package in 2005 with HSC Medical Center as an expansion of the Malaysia stopover programme. Healthcare is now more affordable in Asian countries and Malaysia boasts a high number of specialists with extensive international qualifications. This is the national carrier's contribution to make Malaysia the preferred medical tourism destination”. Dr. Lim Yin Chow of HSC Medical Center adds, “In spite of being one of the established healthcare industry players in the country, we realise that in order to grow, we have to take advantage of the booming international medical tourism market. This partnership between a Malaysian private medical centre and an airline marks a significant development in HSC's effort to reach out to medical tourists from around the globe, in line with the government's effort to develop Malaysia into a global medical tourism hub. Since moving to our own building in early this year, we have put in place various mechanisms to cater to international patients. HSC is just 1 hour away from Kuala Lumpur International Airport (KLIA) via a direct highway. This makes us a fitting and convenient medical destination for foreign patients travelling with Malaysia Airlines.” The deal is in line with the Ministry of Health's aim in becoming the leader of healthcare services destination in the region. The Malaysia medical tourism industry's revenue is anticipated to grow by 16% a year between 2011 and 2014. TMC Life Sciences is targeting medical tourism to be a major contributor its revenue in the next three years as it seeks to become profitable. The group is targeting medical tourists and wants them to account for 30% of its patients within the next three years. TMC Life Sciences is offering a range of services from diagnosis to cardiac and orthopedic surgery. The group expects the 30% to contribute 40% of TMC's revenue. At the moment, less than 5% of TMC's patients are foreigners, and it has been making losses over the last 2 years. The target markets are Indonesia, Bangladesh, and Indo-China, mainly using TMC's flagship hospital, Tropicana Medical Centre in Kota Damansara. The hospital is 15 minutes away from the Sultan Abdul Aziz Shah Airport in Subang. Tropicana Medical Centre has 120 beds and is adding another 30. It has an international patient centre (IPC) with staff fluent in English, Chinese, Tamil and Malat, while interpreters for other languages can be pre-arranged.

SLOVAKIA: Growing awareness of Slovakia as a medical and dental tourism destination

Thu, 22 Sep 2011 10:28:58 GMT

Slovakia offers good quality and low price medical and dental treatment, but few people know that apart from a handful of small medical tourism agencies promoting the country in a low-key way. An increasing number of local doctors, dentists and hospitals see the potential for medical tourism. But most Slovak hospitals and clinics do little to promote themselves to foreigners. Some doctors suggest that most so-called medical tourism is only foreigners who live in the country, business or holiday travellers, or Slovaks living in more expensive European countries who to use the services of private medical and aesthetic centres. Renáta Mihályová of Medissimo, a hospital in Bratislava says, “The motivation of a person towards medical tourism is often financial. Favourable prices in Slovakia make it an affordable destination for a wide range of people. Our doctors have a good reputation in the world. Many of them have trained or worked abroad.” Medissimo provides medical care to visiting tourists as well as expats from the diplomatic and business communities living in Slovakia. It gets patients – many of Slovak origin - from the USA, India, Spain, Germany and Sweden. A recent trend is patients for cosmetic surgery from neighbouring countries.” Ústav Lekárskej Kozmetiky (ÚLK) is a specialist centre for health, beauty and anti-aging procedures and is seeing an increase in the number of patients from Austria, plus Slovaks who live on a long-term basis abroad, especially in England, France and Italy. Hungarians are not frequent patients as there are many similar centres in the northern part of Hungary as well as in Budapest. People from the United Kingdom, France and Italy come for cosmetic surgery. As well as personal recommendation, most find it after searching online and comparing what is offered and the price with other countries and their home country. Slovakia is not the cheapest location, but argues that in lower price countries the quality is also lower. Dental treatment in Slovakia costs around a third or a quarter of the prices in Western Europe. Most dentists use high quality materials and equipment so their cost in Slovakia is the same as those abroad but dentists and nurses are paid a lot less in Slovakia than in Western Europe. But Slovakia is generally not thought of as a destination for dental tourism. What may be holding the country back is that while it can compete on price and quality, unlike other competing European countries it does not have the quality or availability of hotels restaurants, travel, languages and marketing. They may be able to cope with tourism, but are not geared up for medical tourism. Also there is little government support or concerted marketing, while few locations have websites with information in the major European languages.

KENYA: Realistic hopes of becoming a medical tourism destination?

Thu, 22 Sep 2011 10:15:21 GMT

The Aga Khan University Hospital in Nairobi is hopeful of becoming a medical tourism destination, despite price increases in Kenya's top hospitals of up to 40% in 4 months, recent publicity surrounding the kidnapping of a tourist by Somali “pirates” and general concerns about the safety and security of visitors. Aga Khan University Hospital recently completed its first surgery enabled via video links. The hospital argues that video conference surgery offers limitless opportunities for procedures that Kenyans have been shopping for abroad, largely because of the high costs of the treatment locally and, in some cases, because of the long waiting times at public hospitals with the capacity to perform the operations. Besides the direct benefits to patients, it offers local doctors an opportunity to link with more experienced and skilled surgeons in other countries dictating instructions to their local counterparts. These could help form the next knowledge pool for training future doctors, hopefully helping reduce the personnel deficit that has left only 7000 doctors serving in Kenya compared to a demand of 24,000. The procedure also promises better linkages between doctors in hospitals in remote areas and specialists in leading private and referral hospitals that would help perform delicate procedures without patients having to be transferred. Infrastructure challenges limit the potential to which telemedicine can be practised in Kenya outside the main urban centres. The technology requires a dependable bandwidth in a sector where precision is, literally a matter of life and death; so this needs new fibre optic cables to major centres in Kenya. Electricity is not installed in remote outposts. The hospital hopes that once these problems are dealt with, Kenya will be on the way to becoming a medical tourism destination for other African countries. Exactly how many Kenyans travel overseas is unknown, but some doctors say that s many as 50,000 people will go to India this year because of the poor state of local healthcare, compared to 25,000 last year. Kenyans go to Asia and Europe for treatment relating to neurological disorders, brain surgery, open-heart surgery and orthopedic ailments. Kenya requires 24,000 doctors but only has 7,000, with 3,000 of them working in public hospitals and 4,000 in private ones. 1,000 go abroad each year. The capacity gap to meet the demand for services has seen many seek treatment abroad, their choice dictated by waiting lists, some of which stretch several months before surgery can be performed. Peter Nduati of local insurer Resolution Health East Africa, says, “We have for years referred our patients to other countries for critical operations because the doctors there have been practising the procedures for much longer than our own.” It is now common for families to organise fundraisers for relatives to collect money to send their patients abroad. Kenya's top hospitals have increased their charges by up to 40 % in the past four months, both caused by and helping increase inflation. Kenyatta National Hospital (KNH), Gertrude's Children Hospital, Mater Hospital and Karen Hospital have all increased their charges due to the rising cost of food, fuel, foreign exchange costs, and labour plus runaway inflation. Some locals argue that the increased costs are self-inflicted and linked to the aggressive expansion plans major hospitals are pursuing as they expand to major towns and within city suburbs. Although Southern Kenya is relatively safe, Northern Kenya is notorious for problems. Britain's Foreign Office advises, “There is a high threat from terrorism in Kenya. We advise against all but essential travel to within 30 km of the Somali border or low-income areas of Nairobi. Any travel to remote areas or border regions could put you at risk of being the target of attacks or kidnappings - six foreigners have been kidnapped in recent years.”

INDIA: Developments in medical tourism to India

Fri, 16 Sep 2011 17:26:25 GMT

Medical tourists from Pakistan India is attracting medical tourists looking for low cost treatment and has seen an increase in business from Pakistan, but 27 patients from Pakistan on medical visas have yet to return to their country and are missing. Mullappally Ramachandran, minister of state for home affairs, said in reply to a question, “27 Pakistani nationals who visited India on medical visas have not returned to Pakistan. Steps have been taken to verify whether they are still undergoing treatment or have departed." He refused to reply to suggestions that they have stayed on deliberately. The number of Pakistani patients who visited India is easy to track, as they all need visas. It was 702 in 2008, 908 in 2009, and 1,204 in 2010. By the first six months of 2011, the number has already reached 869. High profile medical touristsIndia is receiving high profile medical tourists. Bangladesh MP Khurram Khan Choudhury needed a cardiac bypass surgery as well as a procedure to remove a bulge on the aorta, and was treated in Mumbai at the Asian Heart Institute. In association with the Vattikuti Foundation it recently launched the Asian Vattikuti Institute of Robotic Surgery, which has the only da Vinci robotic surgical system in India. Ministers from other countries have gone to Mumbai hospitals for complicated treatment or surgery. Jaslok Hospital has a German patient who travels to India every two years seeking relief for his back pain. Mohammad Ali, a 13-year-old boy from Mauritius, with a malignant bone tumour, recently underwent a total femur replacement surgery at Apollo Specialty Hospital, Chennai, which has enabled him to walk again. The uniqueness of this replacement surgery is that the patient is given a practically new limb, which is tumour free and can achieve full independence with rehabilitation. Fortis and Apollo report growthLeading Indian hospital groups, including Fortis Healthcare and Apollo Hospitals, report an up to 80 % increase in the number of foreign patient arrivals this financial year. The top three healthcare chains, Fortis Healthcare, Apollo Hospitals and Max Healthcare together treated 90,000 foreign patients last year, although not all these international patients are medical travellers. Cosmetic surgery tourism to IndiaCosmetic surgery is an area that the leading hospital groups report as being increasingly popular, particularly by non-resident Indians who feel that apart from price, that when dental and cosmetic surgery is done by an Indian surgeon that they have a much better understanding on what features are suitable and which are not suitable for different Indian types. The most sought-after cosmetic services are Botox, fillers, face-lift, hair transplant, neck lift and rhinoplasty procedures. For dental treatment, patients seek implants, whitening, crown filling, orthodontic procedures and smile correction Partly to take advantage of the demand for cosmetic surgery tourism, Apollo Hospitals is expanding by adding cosmetic clinics in Delhi, Kolkata and Ahmedabad in addition to its clinics in Chennai and Hyderabad. Dental tourism to IndiaTo attract the foreign market, Chennai-based Dentistree has tied up with Parveen Travels to help international patients from West Asia on travel and accommodation. Nearly 20% of the dental chain's patients are foreigners. The group has one dental hospital and 11 clinics, with plans to expand across India.

NIGERIA: Nigerian government acts to stop medical tourism

Fri, 16 Sep 2011 17:25:35 GMT

If Nigerians who travel abroad for medical services can stay and be treated at home, US$200 million, a substantial sum compared to the national health budget, could be saved annually. This estimate is in the latest national economic plan from minister of finance, Dr. Ngozi Okonjo-Iweala.But the document “Creating jobs: A short to medium-term agenda,” does not give a breakdown of the amount. The minister explains that since good health contributed to economic growth, there is a need for the federal government to increase investment in the sector. She argues that poor health reduces the efficiency and output of workers, adding that one of the priority areas of the government will be finding ways to address the challenges of the sector, “Good health contributes to economic growth and poor health reduces workforce efficiency and output. Nigeria can save $200 million from medical services abroad.” She also emphasizes that the health sector has potential for job creation. New president Goodluck Jonathan at the 50th anniversary of the Nigerian Medical Association, said that the federal government is no longer prepared to pay for officials or politicians to have medical treatment in foreign countries as this practice had over recent years led to loss of the nation's scarce foreign exchange through unnecessary and overly expensive trips abroad by officials seeking medical care. The money saved will be channelled into developing local hospitals to international standards. The House of Representatives has recently decried the culture of affluence among Nigerians seeking medical services overseas. It said the trend is not only detrimental to the improvement of health care services locally, but a drain on the nation's scarce resources. It, therefore, tasked the Federal Ministry of Health to elevate the quality of medical services available in local health institutions and discourage what it said had now become medical tourism by the Nigerian elite. Anyone seeking local or national office, or expecting to do business with the government, is now going to have to think very carefully before even using their own money to pay for foreign treatment; it could damage their prospects. In the past, government officials have given support and encouragement to medical tourism agencies sending Nigerians to South Africa and India for treatment. The new stance from the top changes that. If the politicians keep their promises, and Nigeria is able to use the income from natural products to fund good local hospitals, the ban on official medical tourism and gentle persuasion on better off locals, could trickle down to all those who go to another country for treatment.

USA: Satori World Medical CEO's chequered past brings end to Hartford medical tourism deal

Fri, 16 Sep 2011 14:40:10 GMT

The chequered past of Satori Wold Medical's CEO, Steven Lash, has resulted in the cancellation of Satori's contract with the US city of Hartford to provide discounted surgery in Puerto Rico for city and board of education employees, before a single employee has gone abroad. In a July press release Satori claimed that Hartford was the first major city in the United States to offer this innovative medical travel benefit to their employees and dependents. Local newspaper, the Hartford Courant ran a feature on the Satori medical tourism scheme entitled 'City's New Benefit: 'Medical Tourism'. The columnist, Kevin Rennie, a lawyer and a former Republican state legislator wrote: “It's all in the hands of Satori, which won the competitive bid for the Hartford contract. Satori president Steven Lash has a wide array of experience. He was sentenced to 51 months in federal prison in 2004 and ordered to pay $36 million in restitution for his role in a $60 million fraud prosecution involving a physician network management company, according to newspaper reports. This is omitted from his extensive online company profile. After executing a pump and dump stock scheme, Lash will not fear employees' Connecticut primary care physicians who cavil at patients flying to San Juan for sophisticated treatment” City spokeswoman Sarah Barr said, ”The city decided to cancel the contract because of fraudulent behavior that was brought to light in lawyer Kevin Rennie's opinion column. When Satori World Medical Inc. was confronted about Steven Lash's prior convictions, the city was not satisfied with the answers it received and the contract was terminated." The city has invoked a 90-day cancellation clause in the contract. There has been no criticism of the hospitals in Puerto Rico. The contract proposed that Hartford employees could go to Puerto Rico for hip, knee or shoulder replacement surgery, a coronary artery bypass, or other treatment at one of Satori's network hospitals in Puerto Rico. Satori would provide airfare to Puerto Rico, ground transport, luxury hotel accommodation, and a $250 debit card to individuals willing to seek one of 70 approved operations outside the United States. The medical travel package also included airfare for the patient and a companion and several days of post-hospital rest at a luxury hotel. The Steven Lash conviction was originally reported by the San Diego Union Tribune in 2004: “A federal judge sentenced Steven Mark Lash, the former chief financial officer of FPA Medical Management, to 51 months in custody and ordered him to pay restitution of more than $36 million for his role in defrauding shareholders and lenders of the once-high-flying but now-bankrupt company. U.S. District Judge Marilyn Huff in San Diego further ordered Lash to undergo three years of supervised release ....... The jury found that Lash artificially inflated the San Diego company's earnings and misrepresented that FPA had positive cash flow from operations. Positioned as a middleman between insurance companies and physicians, FPA promised doctors it could simplify practice management by coordinating the payments from multiple health insurers. The company's revenue rocketed from $18 million in 1994 to more than $1 billion in 1997. Shortly after reporting its eighth consecutive quarter of record earnings in 1998, the company filed for bankruptcy. U.S. Attorney Carol Lam said she hoped the conviction would send a message - "Corporate officers who use their position to commit massive frauds are being held accountable and Steven Lash is no exception." The San Diego Reader has followed up with a blog post entitled “Local Ex-Medical Fraudster Loses Contract”. Whether the contract cancellation will affect any other existing or potential business for Satori remains to be seen. Nevertheless, the highlighting of the Satori CEO's past and the cancellation of the contract will do little to advance the cause of Satori and the medical tourism industry in general.

GLOBAL: Call for academic papers on medical tourism and global healthcare

Fri, 16 Sep 2011 14:36:59 GMT

The Global Healthcare Management Network of the Association of University Programs in Health Administration (AUPHA) is calling for academic papers for a special themed issue of the Journal of Health Administration Education: Global Healthcare Management. The special issue on global healthcare management will look at the increasing globalization of health services, including medical tourism, as well as health services management in developing nations and how these developments will or should impact health administration education. An introductory paper will be invited and will consider what is meant by global healthcare management. There has been much interest in comparative health systems and global health in recent years. Now there is interest in better managing health facilities and health systems (coordination, communication, resource development) in foreign environments, but there is little experience or information in the professional literature to draw on. These issues will be discussed in an overview of the themed issue. Papers to be submitted should consider best models and state-of-the-art practices in international settings. Submissions that include an international team of authors will be given stronger consideration. For example, an American faculty member would need to find an international counterpart to put the value of health management practices in the perspective of an international location. This is more of an outside-in approach where an American health administration faculty will learn from key international setting examples. All relevant papers will be considered for submission and some possible topics include:• International health services. To what extent has medical tourism been successful or not successful, and what can we learn from these experiences? Examples of how this information has been incorporated into coursework would be beneficial.• Key lessons on how to manage an international hospital/clinic in a foreign environment including partnerships with non-government agencies, government ministries, corporations and other key stakeholders. • Public health management. International hospitals in developing nations are often quite involved in community health. What are some key ways to better link hospitals/clinics and population health? What examples are there of better health outcomes as a result of strong health services management practices? What implications do these findings have for healthcare management education in North America and how can educational processes benefit from this knowledge?• What can we learn from the differences between domestic (US) and international health competencies in: a) finance/accounting, b) cross-cultural management, c) health supply chain, d) human resources management, e) accreditation, and others. What implications do these differences have for education of domestic versus international students? A final invited conclusion paper will review key points from the invited papers and put them in the context of what global healthcare management is. It will assess the benefit global healthcare management brings to other professional pursuits of global health and the implications for health administration education. Submissions should follow the general instructions for submitting manuscripts outlined on the AUPHA website. Manuscripts will be reviewed as they are received using the Journal of Health Administration education review process. Deadline for submission is January 1, 2012. Publication date for this themed issue is anticipated to be mid-2012.

INDIA: Medvarsity launches medical tourism certification training course

Fri, 16 Sep 2011 14:36:46 GMT

On the basis that medical tourism in India is at an all time high and will grow over the next few years, Medvarsity has launched a certification course in medical tourism. Medvarsity, in collaboration with the Apollo group of hospitals, has introduced this course to impart knowledge about medical tourism to healthcare and medical professionals in India. The certificate course covers subjects including travel management, accommodation booking, hospital treatment and medical packaging services. Students from pharmacy, tourism, nursing and life sciences can take this course online. The course structure aims at imparting the latest knowledge and training to the students. The new course lasts for 6 months. Medical tourism is full of challenges and professionals taking up this course can prepare themselves to take over these challenges in their jobs. The course has been divided into various modules to make sure every topic is covered in detail. Students can look forward to making their career in medical tourism. Job opportunities in the medical tourism sector will see growth in coming years and this will be the time when professionals can put the acquired knowledge to use. The national government is encouraging medical tourism in India and also ensuring many aspects of India's healthcare are better regulated and licenced. As yet there are no moves to seek certification for those involved in medical tourism, but as the government is introducing legislation in ancillary healthcare, and other countries require travel agents to be licenced, there would be logic in requiring all involved in Indian medical tourism to either have medical and / or specialist qualifications. Medvarsity Online works with Apollo Hospitals to offer a range of diploma, fellowship and certificate courses for medical and healthcare professionals. India's first Medical e-learning venture was established in April 2000.

GLOBAL: Wellness Tourism 2020 report

Fri, 16 Sep 2011 14:36:33 GMT

Wellness Tourism Worldwide (WTW) has issued the main findings from Phase 2 of the “4WR: Wellness for Whom, Where and What?” project. The full report will be available for purchase soon. The objective of this research is to identify the main global and regional trends experts may envision in health-motivated travel by 2020. The findings are based on data collected from 140 individuals and organizations in over 50 countries-connected with wellness, tourism, spas and healthcare. The report argues that in the future, the supply of wellness services will be quite different by 2020 than it is now. Lifestyle approaches such as yoga will dominate the supply of wellness services in North America and Northern Europe. Wellness hotels and resorts are forecast to become the most popular wellness destinations in Africa, South America, Central America, Australia and New Zealand. In Central and Eastern Europe therapeutic services and treatment based on natural assets such as thermal spas will become the most important. The downside is that as beauty treatment, day spas, massage and saunas become more widespread globally there may be less need for people to travel overseas. The report looks at the possible changing popularity of saunas, psychological therapies, massage, beauty treatment, alternative therapies, natural products, ecospas, day spas, adventure spas, wellness and spa cruises, hot life retreats, mehotels, spa living environments, budget spas myspas, eco-fit resorts, dreamscapes, and well-working environments. Some of these may be unfamiliar and there are detailed explanations in the flyer. Wellness tourism preferences are analysed for certain sectors- leisure and recreational spas, therapeutic services, medical services, wellness hotels/spa resorts, wellness/lifestyle services, holistic services, spiritual services, adventure spas, eco spas, and wellness/spa cruises. Wellness tourism is one of the fastest growing forms of international and domestic tourism and is expected to continue for at least the next five years and probably for the next ten years. The globalization of standard and uniform products could pose a major risk. The report provides predictions of -• Which wellness tourism products and services will become popular?• How the popularity will differ by continent.• Which wellness tourism products and services will decline?• How the decline will differ by continent.• Which lesser known products present an opportunity for market growth.• Strengths, weaknesses, opportunities and threats.• What are the market sectors by age and gender?• How it is and will it be funded. A note of caution on the results is that with a smallish sample size of 140 respondents spread over 50 countries, the statistical accuracy is not robust. And with any report looking a decade into the future, the views will be strongly influenced by the current business of respondents. And as with any future predictions, a host of unknown elements can rapidly make nonsense of what seemed sensible at the time; two years ago could anyone have predicted the Arab Spring, earthquakes in New Zealand and Japan, the European ash clouds closing airports, or Qatar being awarded the World Cup?

CHINA: China promotes medical tourism

Fri, 09 Sep 2011 13:54:16 GMT

Florida based medical tourism agency China Health Today and the US office of Chinese travel organization China Travel and China Tours have organized an October, 2011 tour of Shanghai and Beijing hospitals and international patient centers. The 12 hospitals are all accustomed to treating international patients. The tour is open to any individual, organization or enterprise interested in a patient care, professional or business relationship. The China Tour dates are October 15th through October 23rd. The tour, limited to 15 people, includes time to enjoy Shanghai and Beijing attractions and experiences. China Health Today specialises in medical travel to China, Taiwan, Korea and Hong Kong. It uses 9 providers in China and 2 in Taiwan. Staff members are fluent in English and Chinese. China has recently become the second largest economy in the world, and is one of the top global tourist destinations. People going to China do need a visa, which allows them to stay in the country for up to 60 days. Terry Farrell & Partners (TFP) and Ryder Architecture have a new joint venture to take advantage of opportunities in China's emerging healthcare market. The joint company, TFP Ryder Healthcare, has already been awarded its first commission in north-east China to develop an international medical city by 2020. The project will create a medical tourism resort and major acute hospital with stem cell and organ transplantation centres. It will also have residential, eco-tourism, cultural and entertainment facilities. Under the joint venture Ryder, which specialises in healthcare projects, will work closely with the Hong Kong office of Farrells, which was established in 1991. Farrells is planning to open two further offices in China this year in Beijing and Shanghai.The joint venture follows the practices' collaboration on a public hospital project in Tin Shui Wai, Hong Kong, earlier this year. China's 12th five-year plan includes the construction of 20,000 new hospital and healthcare facilities. With 20 % of the global population, China is home to one in every five people on this planet with1.3 billion people in the country. China has 60 cities with a population of one million or more, and by 2030 experts believe that number will reach 220, including 24 megacities of over five million inhabitants. The McKinsey Global Institute suggests that as their cities grow over the next two decades, the Chinese alone will build 50,000 skyscrapers, millions of apartment buildings, and hundreds of thousands of schools, community centres, fire stations, and hospitals, not to mention the roads, highways, and other infrastructure needed to accommodate millions of cars.

KOREA: Korea welcomes Japanese seeking a new look through cosmetic surgery

Fri, 09 Sep 2011 12:14:38 GMT

Across parts of Asia, many women and some men want to look like their favourite film, television or music star. They buy the clothes, DVDs, make up and accessories to make them look like their favourite. They style their hair and make up the same way. Thousands use cosmetic surgery to change their face and body to become as like their favourite as possible. South Korea has become the Asian centre for Oriental medical tourism. The Korean Wave has spread from music and TV dramas to surgery. Many Korean shops appeal directly to Japanese visitors with their signs. For Japanese tourists, cosmetic surgery is just as popular as shopping. Some local clinics get so many Japanese patients that they employ their own professional interpreters. It is not all about looking like the stars, as Japanese women also seek fertility treatment, cosmetic surgery or diet programmes based on Korean Oriental medicine. Other popular treatments are acupuncture sessions that help break down fat, as well wine fire treatments that burn off toxins. The increasing number of foreign tourists seeking oriental medical treatment has led to some clinics offering programmes exclusively geared towards foreigners, with information booklets in different languages and advertising in overseas magazines. According to local clinics, the first half of 2011 alone has seen a dramatic increase in numbers compared to last year. For some clinics, Japanese patients make up most of the foreign patients. While Japan has some knowledge of Oriental medicine, there are few clinics or hospitals there that actually specialize. So many Japanese go to Korea because it has many specialized clinics. Medical tourists from the USA and Europe are also going to Korea in search of Oriental style health and beauty. Some clinics employ interpreters for Chinese and Japanese patients. As they are seeing a growing number of patients from the United States, Russia and other European countries, the next problem to solve is finding enough interpreters. There is a downside to this explosive growth in demand. People who are either medically qualified but not in cosmetic surgery, or with no qualifications at all are offering cut-price treatment. According to local media reports, although in theory only certified cosmetic surgeons are authorized to perform cosmetic surgery locally, there are ways to sidestep the regulations. Some practitioners promote their business as a beauty clinic or aesthetic clinic that happens to offer cosmetic surgery. This somehow allows these practitioners to get around the rules. There are officially 26,000 clinics nationwide, but only 4,400 are run by certified cosmetic surgeons. But unofficial estimates say that by adding other places such as dental clinics that offer cosmetic surgery and treatment-with no licensed cosmetic surgeon, the real number is nearer 50,000. More and more patients from China, Japan, Russia, Mongolia, Hong Kong, France and Australia are going to Korea for cosmetic surgery. One clinic reports that many companies have started giving foreign buyers free cosmetic surgery for their family or wife, rather than other inducements.

COSTA RICA: Update on medical tourism in Costa Rica

Fri, 09 Sep 2011 12:12:12 GMT

The government and medical tourism industry regularly say 30,000 people go to Costa Rica each year for medical or cosmetic treatment. The problem is that while both say that numbers are rising fast, they have been using this 30,000 figure since 2009 and well before the global recession. Others argue that 20,000 is probably more accurate, but there is no hard evidence to support the claim. The Costa Rican Institute of Tourism says that cosmetic surgery tourism is rising by about 15% a year. Cosmetic surgeon Cristian Rivera says that most foreign patients are women over 50 seeking cosmetic dentistry and cosmetic surgery. The surgeon took part in a Radio Reloj radio programme where he estimated that medical tourism generates 20.000 jobs each year in Costa Rica and has great potential for further growth. But apart from the closing down of fertility centres, there are other problems. The Houston Independent School District is hiring an independent auditor to examine the district's procurement operations, and particularly allegations of members showing favouritism in awarding contracts, including negotiating a no-bid consulting contract for sending staff to Costa Rica for treatment, in a contract worth up to $640,000 with a local doctor who is linked to a Costa Rican medical tourism agency. Dr. German Moreno was arrested in 2005 on charges ranging from indecency with a child to sexual assault, and before trial he fled Texas. Since then, he has been operating a medical clinic in a tourism spot in Costa Rica. Now, Moreno has been arrested after a teen came forward in Costa Rica to say that Moreno had molested him. Costa Rica won't allow Texas to bring Moreno to trial in the USA, saying the country's law shields him from extradition. Moreno had worked as a family doctor in the Houston area. With the growth of medical tourism in Costa Rica comes the growth of facilities that cater to individuals who have had surgery and require a quiet place to rest and recover. In addition, wellness centers and addition recovery centers are appearing in Costa Rica to cater for Americans. The Paradise Cosmetic Inn in the Escazu suburb of San Jose caters to surgical patients who require aftercare. As part of the Best Western chain, this hotel provides its visitors with on-site professional nursing care. It gets patients from Clinica Biblica. Room rates are all-inclusive and range from $75 a person to $195 for the presidential suite that accommodates the patient and a companion. The CheTica Medical Recovery Ranch in the San Jose Central Valley provides recovering patients with independent cottage accommodation in a quiet rural location. In addition, meals are provided, and help with getting to and from doctor appointments can be arranged. The private cottages are fully equipped. Costa Rica also has rehab centres that focus on alcohol and drug addiction recovery. Cost Rica Recovery offers group and individual therapy, 12-step meetings and some recreational trips. The Tropical Oasis is an English-speaking recovery centre that offers rehabilitation programs for alcohol, drug addition and depression.

USA: Miami hospitals seek medical tourists

Fri, 09 Sep 2011 12:10:37 GMT

Miami, Florida hospitals are partnering with the Greater Miami Convention & Visitors Bureau (GMCVB) to market Miami as a destination for international patients. Deloitte estimated in 2008 that 400,000 international patients go to the US for medical care, but since then other sources have suggested it is much higher and the current figure could be around 750,000. Ironically, the country most targeted by overseas destinations, the USA, now probably has more inbound medical tourists than there are Americans going overseas. In the 1990s Miami, attempted to market the city as a medical tourism destination, but the campaign collapsed as hospitals became more concerned about competing with each other for international business than working together to promote the region. Much has happened in medical tourism since then, including the rise of domestic US medical tourism. Two years ago, Greater Miami Chamber of Commerce's healthcare group approached the GMCVB about helping them develop a sales and marketing plan that promoted medical tourism, for all the hospitals in the area. The bureau has created a brochure in English and Spanish which is also being translated into Portuguese, and created the website Miami Health. GMCVB is negotiating with Miami International Airport to make the entry process for international patients as simple as possible. Miami hospital Baptist Health South Florida has been actively involved in medical tourism for 13 years. The hospital cleverly tailors which services it promotes depending on the country of origin. In some countries, oncology is important, while in others the key concern is cardiology. Self-pay patients are the majority of international patients, but the hospital is targeting overseas insurance companies and getting some success. Patients mainly come from Latin America, the Caribbean and Canada. The hospital appreciates that patients traveling to another country need more looking after than domestic patients, so it offers concierge services to help the patient and any accompanying family with arranging accommodation, transport and other needs. It has one of the largest hospital-based international programmes in America. Thousands of people each year travel to Miami from around the world to visit so it has multilingual staff to assist with medical and travel needs. Miami Children's Hospital (MCH) treats overseas children who come with at least one parent so have to help with arranging affordable hotels plus transport to and from the hospital. Children who are have serious or critical problems may need long-term treatment so families need cheap accommodation. Special corporate rates have been negotiated for international patients and their families with hotels and apartments. MCH has a Lifeflight Team, whose helicopters pick up critically ill children from Latin American countries and the Caribbean. International alliances such as one with the Moscow Center for Pediatric Craniofacial Surgery and Neurology in Moscow also bring patients. MCH provides specialised medical care to thousands of international patients a year. It diagnoses and treats life-threatening heart problems, brain tumours, kidney disease, congenital disorders and other complex conditions. Baptist International recently signed an agreement with the government of Aruba to help it improve medical service in its country, and is acting as consultants on construction of a new hospital. MCH has a research alliance in Colombia that is expected to eventually bring medical tourists in.

UAE: Health Authority paying for Emiratis to go abroad for treatment

Fri, 09 Sep 2011 12:08:53 GMT

The UAE, and in particular Dubai, invests significantly in promoting the excellence of its health services to try to attract medical tourists. Nevertheless, the number of patients that the state sends abroad for treatment is rising. The Health Authority Abu Dhabi (HAAD) says that the most common medical condition of Emiratis for whom it has paid for overseas treatment is a malignant tumour, followed by pediatric heart surgery, spine surgery, orthopedic surgery, rehabilitation therapy and heart diseases. General surgery, eye diseases and bone marrow transplant are also common reasons for choosing to seek medical assistance abroad. More than 8,000 Emiratis across Abu Dhabi have chosen to seek medical treatment abroad between 2008 and mid 2011, with Germany being the most poplar country, followed by the UK, US, Thailand, and Singapore. HAAD is very concerned about the rising number of patients seeking medical services outside the UAE, and has set up a medical board committee of nine consultants, to determine if cases are be treated abroad. The committee holds weekly meetings to consider medical reports brought to their attention. The number of Emirati patients sent for medical treatment abroad in 2008 was 2,643, 2,526 in 2009, 2,825 in 2010 and 724 in the first quarter of 2011. In addition to these paid for by HAAD there are independent travellers paying for their own treatment. Earlier figures suggest 30,000 Emiratis a year spend an average of $250,000 per visit. A survey among residents in the UAE said that a majority of Asians prefer to seek medical treatment back in their home countries, citing the high cost locally and lack of confidence in the health care system. The Federal National Council recently asked Dr Hanif Hassan, Minister of Health, why there is such a lack of trust in the local health care system. It called for swift wide-ranging reforms in the healthcare system. A large Chinese medical group plans to tap the market in the UAE and will set up a clinic offering traditional Chinese medicine and Western medicine. Boai Group suggests that 70,000 people from the Gulf Cooperation Council area travel for treatment abroad, mainly to Thailand or Malaysia. The company wants to promote China as a cheaper destination, with treatment in China costing a quarter of what it would cost in Dubai, or two-thirds of the cost in Thailand. The largest number of patients that go to Boai group's hospitals in China are cancer patients; Boai hospitals offer Chinese traditional treatment along with western mode of treatment and claims a 70 % rate of success.

JORDAN: Regional turmoil impacts on medical tourism

Fri, 09 Sep 2011 12:07:54 GMT

After several years of steady growth, good marketing and success, Jordan's medical tourism sector is witnessing a dramatic drop in revenue and patient numbers caused by the “Arab Spring”. The highest number reported was 240,000 patients from across the world, although this figure is reduced considerably when taking out people who are not medical tourists such as expatriates, embassy staff, holiday makers and business travellers. According to Awni Bashir of the Private Hospitals Association (PHA), the number of patients seeking care in the Kingdom's hospitals and accompanying visitors is expected to drop by 25 % by the end of this year. But other sources say that this puts a very optimistic slant on the expected drop in numbers which may be temporary but may also be permanent .The basic problem is that many of the countries who sent people to Jordan are in turmoil, or are a powder keg waiting to explode. Europeans and others seeing the destruction and 50,000 plus death toll in Libya on their screen, as well as regular reports of trouble in other countries- are taking a simplistic attitude. In the minds of most Western Europeans and Americans, they see North Africa, The Middle East and the Gulf States just as one area that is fill of violence, political turmoil, and other problems. Those from Eastern Europe and Asia have a more detailed understanding of the differences between the various locations. Jordan is not alone as other countries are also suffering declining numbers, but are not as open as Jordan about it. Jordan and others may try to market themselves as free from trouble, but the poor geographical grasp of the majority of the world's population makes it hard to get people to understand that it is not just one problem area. Traditionally, Jordan obtained the vast majority of its patients from Yemen and Libya. The business from Libya has dried up to zero. Yemen is down to a trickle. Jordan, which used to be a major regional medical tourism destination, has been severely affected by regional instability. The PHA is trying to market Jordan to other nearby countries including Kazakhstan but success will take time and may have to wait until all the countries in the region are stable and quiet. Bashir admits that other traditional markets have problems too, with the number of patients from Iraq and Kurdistan not encouraging. The low number from Kurdistan and some other countries is because patients are finding it difficult to obtain visas to travel to Jordan. Minister of health Abdul Latif Wreikat says the ministry has set up a medical tourism unit to help promote the business and identify areas that the government can change to make it easier for overseas medical tourists to go to Jordan. An office will be set up soon at the Queen Alia International Airport to assist those arriving to seek medical treatment in the country's hospitals. The ministry is appointing health attaches at some of the Kingdom's embassies overseas to help ease procedures for patients seeking treatment in Jordan. Jordan is working hard, but the real problems are caused by events over which it could not predict and where it has no control.

BERMUDA: Government wants Bermuda to cash in on medical tourism

Fri, 02 Sep 2011 10:06:26 GMT

The Bermuda government is considering pursuing medical tourism. Tourism minister Patrice Minors is actively exploring the expansion of medical tourism as a way to fill Bermuda's empty hotel beds. Minors sees medical tourism as a revenue generator that can boost the economy, and particularly local hotels. Cashing in on medical tourists as well as their families and doctors looks set to be one of the recommendations of the new national tourism plan that seeks to revive the local tourism industry that has been badly hit by the global recession. Much depends on whether or not the health ministry is prepared to use scarce resources to promote it. Medical tourism was introduced at King Edward VII Memorial Hospital last year with a new prostate cancer treatment that is unavailable in the USA. But the government is now working planning to take things further by actively promoting Bermuda as a medical destination. It is hoped that Bermuda's struggling tourism industry will reap the benefits of large numbers of people coming for lengthy stays. Bermuda's proximity to the US and the offer of recovering in a beachside setting are hoped to make Bermuda an attractive destination for US patients. The Bermuda Hospitals Board says that the High Intensity Focused Ultrasound (HIFU) generated 1000 bed nights for local hotels in its first nine months as since the start of this year 45 HIFU patients have been welcomed to KEMH. HIFU is a non-invasive alternative to chemotherapy, advertised on a video promoting Bermuda as a paradise island. KEMH is described in the video as a beautiful facility with state-of-the-art operating rooms and well-respected medical staff. If medical tourism is broadened, other procedures could include cosmetic surgery, joint replacement, fertility treatment, cardiac surgery and even dental treatment. Premier Paula Cox argues that medical tourism could offer a boost to the island's economy. Not everyone agrees with the proposal. Shadow tourism minister Patricia Gordon-agrees that there should be a new tourism authority, but says it should study medical tourism before anything else is done. She was quoted in the local The Royal Gazette: “It is important that our recommendation preclude ambulance-chasing or any procedure that is not supported by local medical bodies. In the absence of expert knowledge in this field by either the minister of tourism or the minister of health, the health board of a tourism authority could explore the viability of this initiative, with appropriate practitioners in the health field. It is also critical that jurisdictional integrity is not compromised, as we must ensure that a patient does not end up with a toe where his eye should have been, and say it was done in Bermuda” Shadow health minister Kathy Michelmore points out that at present local medical tourism consists of Bermuda residents going overseas to obtain medical care not available on the Island. “I would be opposed to provision of services in Bermuda which do not represent internationally recognised good practice. We must also ensure that there is sufficient capacity within our medical system to absorb increased numbers of medical tourists. Bermuda has a duty to provide safe and effective healthcare for our residents. If an influx of medical tourists will take up hospital beds, adversely impact waiting times for appointments and procedures, and drain resources available to locals, this would obviously be undesirable. An assessment of current capacity and resources is essential, as is a plan which anticipates the growth, direction and impact of medical tourism on our community”. The Bermuda Hospitals Board says medical tourism is an exciting area to be involved in and that it is seeking new opportunities,” From a quality perspective, BHB will only consider offering treatments and procedures to medical tourists that are evidence-based and meet the standard of appropriate bodies. This means we review potential medical tourism opportunities extremely carefully. However, the potential is there to benefit the hospital and Bermuda”. BHB argues that by fully using operating rooms, it could earn revenue by using them for medical tourism without stressing the local healthcare economy. Local reaction is mixed, with some people saying that the specialist treatment offered by KEMH is not approved for use in the USA, which is the only reason Americans come. Although a new building is underway, space and resources at KEMH are limited.

INDIA: An international case study on assisted reproductive technologies

Fri, 02 Sep 2011 09:58:29 GMT

India is rapidly becoming a global centre for assisted reproductive technologies (ARTs) for a multitude of reasons. A new academic study 'Globalisation of Birth Markets: A Case Study of Assisted Reproductive Technologies in India' places the biogenetic industry within the larger political economy framework of globalisation and privatisation, as this framework has direct and significant bearings on the ART industry in India. The authors argue, “As markets for human organs, tissues and reproductive body parts experience unprecedented growth, the limits of what can or should be bought and sold continue to be pushed. As such, bodies have emerged as sale-worthy economic capital. Commercial flows of reproductive material create and deploy the division of the body into parts over which ownership is claimed, in the process following 'modern routes of capital' and raising issues of structural inequality.” This paper presents a brief picture of India's fertility industry with specific focus on its ground-level operation, nature and growth. It aims to explore the industry dimensions of ARTs, by highlighting the macro picture of health care markets and medical tourism in India, the proliferation of the ART industry, market features such as the social imperative to mother, costs, promotion and marketing, unverified claims, inflated success rates, deals and offers, involved organisations and collaborations in this area, and finally, the absence of standards. This paper presents findings from the research 'Constructing Conceptions: The Mapping of Assisted Reproductive Technologies in India', by Sama, a Delhi-based resource group working on gender, health and rights. This research was conducted from 2008 to 2010 in the three states of Uttar Pradesh, Orissa and Tamil Nadu in India, and is one of the first of its kind, highlighting what the authors claim to be unethical medical practices and making a case for the regulation of the ART industry. The research forms a significant part of Sama's ongoing work on women and health. Sama is an Indian autonomous women's movement and seeks to locate the concerns of women's health and well being in the larger context of socio-historical, economic and political realities. Sama considers health a fundamental human right and believes that the provision of quality and affordable health care to every citizen is the responsibility of the state. Sama believes that equality and empowerment can be ensured only when poverty, curtailment of capabilities, lack of livelihood rights, lack of health services and access to health care, illiteracy and multiple forms of discrimination based on caste, class, gender religion, ethnicity, sexual orientation and many other rubrics are structurally challenged. The word Sama means equality in Sanskrit, Hindustani and other Indian languages. The article repeats Sama's desire for a comprehensive legal framework. In the proposed Draft Assisted Reproductive Technology (Regulation) Bill and Rules-2010, prepared by the Indian Council of Medical Research (ICMR), a substantial section is devoted towards regulating surrogacy arrangements. Though a welcome step, Sama argues that significant gaps in the protection of surrogate women and children still remain. With recent and controversial cases of international surrogacy that have resulted in legal battles for citizenship status for the child/ren, the Bill has made provisions to address this issue. The draft Bill now makes it mandatory for foreign couples to produce a certificate from their countries declaring that the respective countries permit surrogacy, and that the child will be considered a legal citizen. As an increasing number of couples from other countries access surrogacy services in India, such a provision will be a useful legal framework. Sama argues that while legislation to regulate the untrammeled commercialism of ARTs and surrogacy in India is a much-needed step towards checking unethical medical practice, the human rights of the surrogate and the children - legal, financial, and health-related - need to be better protected. Authors- Sarojini N, Vrinda Marwah, Anjali Shenoi'Globalisation of Birth Markets: A Case Study of Assisted Reproductive Technologies in India'Journal: Globalization and Health 2011, 7:27 - published on: 2011-08-12

INDONESIA, MALAYSIA: International standards the key to medical tourism

Fri, 02 Sep 2011 09:51:45 GMT

In Indonesia, the Ministry of Health plans to transform the island's largest hospital, Sanglah Hospital, into an international hospital offering services in accordance to benchmarks set by the US-based accreditation body, Joint Commission International (JCI). As a first step, Sanglah has received a certificate of accreditation from the National Committee for Hospital Accreditation [KARS). The aim is that by 2012 Sanglah will become the first international hospital in Indonesia. Key benchmarks are excellent customer care, patient safety, and hospital management. The ministry admits that customer care and customer-related services are a general weakness of Indonesian hospitals. It believes that this, not cost, is why many Indonesians seek medical treatment overseas. The ministry wants hospital staff to improve their communication skills and their ability to be sympathetic to patients. It believes that on equipment, technology and medical expertise, Indonesian hospitals are on a par with overseas counterparts. The plan for international accreditation will ensure that international standard services will be available for local and foreign patients. The ministry aims to have seven hospitals with the international standard accreditation. Four hospitals - Sanglah, Cipto Mangunkusumo, Wahidin and Pertamina have already rolled out improvement programmes while three hospitals are preparing to launch the programme. In Malaysia, the Penang state government plans to develop and promote Penang as the medical city of the region. Patients from within ASEAN countries and further afield will be able to go to Penang to seek a holistic and cost-effective healthcare once everything is in place. The local government says that out of Malaysia's total medical tourism receipts, Penang contributed 57% in 2009 and 66% in 2010. Penang has some seven speciality hospitals, which have formed the Penang Health Association to jointly promote Penang as a destination of choice for medical tourism. Other business sectors, including tour and travel agencies, hotels, transport and restaurants will also be involved in efforts to develop Penang into a medical city. Located off the northern coast of Peninsular Malaysia in the Andaman Sea, Penang, and in particular its capital city of George Town, has become a destination for medical tourism. Penang offers a combination of hospitals, clinics, medical specialists and other healthcare providers, with medical treatment and services offered at considerably lower costs compared to Australia, Europe, UK or USA. These are further enhanced by a dynamic economy, stable government, and a well-educated and multi-lingual workforce. Penang has earned a growing reputation for quality medical services for visitors from around the world. PenangHealth is an alliance of seven hospitals in the state working together to meet this growing international demand:• Gleneagles Medical Centre• Hospital Lam Wah Ee• Island Hospital• Loh Guan Lye Specialists Centre• Mount Miriam Cancer Hospital• Pantai Hospital Penang• Penang Adventist Hospital PenangHealth combines and coordinates the resources of all seven medical facilities to provide a comprehensive range of general, secondary and tertiary services at competitive rates.

CAYMAN ISLANDS: Shetty medical tourism hospital finds a site

Fri, 02 Sep 2011 09:37:57 GMT

Developers of the Shetty medical tourism hospital plan to build it on a site that was earmarked for an East End seaport development that has been scrapped. Gene Thompson, local director of the Narayana group that proposes building the 2,000-bed hospital, and Joseph Imparato, owner of the land, said an agreement had been reached to locate Dr. Devi Shetty's Narayana Cayman University Medical Centre on a 600-acre site. The $2 billion medical centre is to be built in stages during the next 15 years, with the first phase consisting of 140 beds. The developers of the hospital say the site is an ideal one for the project as it is big enough to allow for future expansion for the hospital and its related infrastructure needs. Work on the hospital site will begin later this year Premier McKeeva Bush commented, “I believe that the advent of the Shetty hospital bodes well. It is one of the most significant to happen in this country for years. Caymanians will be able to care there. I believe that site is one of the best sites available on the island.” For road access to the hospital, the government intends to go ahead as planned to build an east-west corridor from George Town to East End only when Cayman has the money to do so, but not yet. The developers of the Shetty hospital will have to pay for and build its own feeder roads to the site, just like any other developer. Captain Bryan Ebanks of the Save Cayman campaign is worried about the Shetty hospital and is concerned that that the laws of Cayman had been changed on the request of Dr. Shetty, as this sets a precedent for future investors and developers. The Cayman Islands government passed a number of laws to help pave the way for the establishment of the hospital, including the Health Practice Law, which enables medical staff trained in India and other overseas countries to practise in Cayman; the Tax Concessions (Amendment) Law, which exempts companies from potential future taxes; and the Medical Negligence (Non-Economic Damages) (Amendment) Law, which caps pain and suffering damages awarded in medical malpractice cases to $500,000. A final piece of legislation, which will allow human organ and tissue donations and transplants to be done in Cayman, is being drafted and is expected to be tabled later this year.

GLOBAL: ISAPS...Patients have a right to safe surgery

Fri, 02 Sep 2011 09:31:02 GMT

The rise in cosmetic medical tourism has put into question the foundation of the patient-doctor relationship and is endangering many who seek low cost surgery, argues the International Society of Aesthetic Plastic Surgery (ISAPS). That the organization is both protecting its members, most of whom only work on domestic customers, and seeks to sell a range of insurances - may make their views less than impartial. Catherine Foss of ISAPS says, "We see travel agencies brokering surgery for their clients with surgeons they have never met. The patients have no assurance that their surgeon is properly trained or qualified to perform the procedure they will undergo, and all too often little attention is paid to post-surgical care. Complication rates for surgeries performed under these circumstances are alarming.” The patient safety diamond devised by ISAPS in 2010 bases the concept of safe surgery on four factors: the patient, the surgeon, the procedure and the facility. The patient should be a good candidate for the requested surgery. The surgeon must be properly trained and credentialed. The procedure should be appropriate for the patient. The surgical facility should be an accredited and a proven safe venue with properly trained staff and emergency preparedness. The World Health Organization (WHO) introduced a safe surgery saves lives initiative with a surgical safety checklist that ISAPS endorses. Catherine Foss of ISAPS explains, "There is a misconception that any doctor can safely perform any surgical procedure. Legislation around the world is changing to reflect a growing concern that patients are being treated surgically by incompetent and untrained individuals who may not even be doctors. Several countries including Italy, Russia, Mexico, Colombia and Canada are leading the way with new regulations controlling who can perform what specific procedure on which patients and in what facility. This is also the case in Denmark, a front-runner in strict regulation of all private medical clinics and surgical facilities - closing some that were sub-standard. Germany and France have had strict regulations for many years. The Comité Européen de Normalisation (CEN), is progressing a Europe-wide effort to set standards that will protect cosmetic surgery patients.” Surgery Shield, a new insurance policy developed in the UK, endorsed by ISAPS and underwritten by Lloyd's of London, provides complications insurance for ISAPS member surgeons globally to help protect their patients. A directory of surgeons participating is now available online. A second insurance product for patients is about to be launched in the UK and will expand to other countries later. Cover will include travel insurance and will respond in cases of complications from cosmetic surgery either at home or abroad. This new insurance requires that patients are screened at home before traveling abroad for surgery to be sure they are appropriate candidates for the procedure they seek. The intention is that a consultation with a surgeon at home will provide counseling against travel for complicated surgical procedures. The insurance will only respond if surgical complications of surgery by one ISAPS member surgeon are treated either by that same surgeon or by another ISAPS member surgeon. A patient requiring remedial or corrective treatment once back in their country of residence will be directed to an ISAPS surgeon approved to carry out the specific treatment indicated. The International Society of Aesthetic Plastic Surgery is the largest international society of individual cosmetic surgeons with 2000 members in 92 countries. Surgeons undergo a strict application process to determine their qualifications to join the society. The ISAPS mission is twofold: the continuing education of surgeons in latest techniques in the field of cosmetic surgery and medicine - and the promotion of patient safety.

THAILAND: Record number of tourism arrivals expected

Fri, 02 Sep 2011 09:25:10 GMT

According to the Finance Ministry, as long as there are no political disturbances, Thailand will see international tourist arrivals surpass the previous 16.5 million record, with 19.5 million visitors expected by the end of this year. The Tourism and Sports Ministry puts the total number of international arrivals during the first seven months of this year at 11 million; 25% higher than the same period last year. The top 10 source countries for visitors are China, Japan, Korea, Russia, India, UK, Australia, USA, Singapore and Germany. The highest spending visitors are from the UK, followed by Australia, Malaysia, the USA and China. Within these tourist numbers are an unknown number of medical tourists, but it is highly probable that these numbers have increased too. Medical tourism is a focus, with more than 60% coming for treatment from the Middle East. Other major markets are China, Japan, Korea, Russia, and Australia. The Tourism Authority of Thailand (TAT) is planning to launch medical tourism guidebooks in English and Arabic, within the next two months. Oman Air has joined with Piyavate Hospital to offer passengers flying from Muscat, the capital of Oman, a 50% discount off the regular cost of the hospital's check-up programmes. In addition, they will receive up to 20% discount for other treatment. The offer is valid for Oman Air passengers until the end of 2011. Oman Air offers daily flights between Muscat and Bangkok. Centara Hotels will open its first property in Khon Kaen at the end of this year. Called Centara Hotel Khon Kaen, it is a 12-storey hotel owned by Khon Kaen Buri Company and will be managed by Centara. The hotel will feature 196 rooms, a spa and a fitness centre. It is about 15 minutes from Khon Kaen Airport.

INDIA: Growth for Indian medical tourism

Fri, 26 Aug 2011 13:17:11 GMT

The number of medical tourists in India is likely to reach 3.2 million by 2015 from the current 850,000 if it continues to grow at the current compounded annual growth rate of 40%, suggests a report by the Associated Chambers of Commerce and Industry of India (ASSOCHAM) - 'Emerging Trends in Domestic Medical Tourism Sector'. DS Rawat of ASSOCHAM says, "Top-notch healthcare facilities in sectors like cardiology, joint replacement, orthopedic surgery, ophthalmology, transplants and urology, at low prices are certain key factors making India a favoured destination for medical tourism. High quality medical care at a fraction of a price people would traditionally pay in developed countries is the basic reason behind this surge in number of patients flocking to India for treatment. Apart from yoga, ayurveda is increasingly gaining popularity as a non-surgical treatment for various ailments among foreign patients. High costs of medical treatments in other countries have compelled patients to look for alternative, cost-effective destinations.” The report says that the states of Andhra Pradesh, Karnataka, Kerela, Tamil Nadu, Maharashtra, West Bengal and New Delhi are emerging as India's key medical destinations as they all have many hospitals and clinics targeting medical tourists. The main source countries for medical tourists are the Middle East followed by the USA, Europe and people from neighbouring countries including Bangladesh, Nepal, Pakistan, and Afghanistan. It warns that the country is facing tough competition from Australia, Belgium, Cuba, Costa Rica, Hungary, Greece, Malaysia, Poland, Singapore, South Africa and Thailand, which are actively promoting healthcare tourism worldwide. ASSOCHAM has also proposed setting up 10 'health cities' in Ahmedabad, Bangalore, Chandigarh, Chennai, Hyderabad, Jaipur, Kochi, New Delhi, Pudducherry and Pune – based on the public-private-partnership model. DS Rawat says, “This will not only help India secure a bigger share of the market but will also encourage reverse brain drain by attracting non-resident Indian doctors and experts settled abroad.” The report argues that both central and state governments need to play roles and act as catalysts both to promote medical tourism and build these cities. It also wants the government to use overseas various embassies and high commissions to encourage overseas health ministries to send people to India. ASSOCHAM also calls for financial and tax concessions for the healthcare industry to help it build hospitals and develop medical tourism Other reports have put annual growth at 30% a year –but both this new report and earlier reports are based purely on guestimates as there are no actual figures. This report also has no grounds other than guesswork for assuming that historic annual growth has been 40% a year, or that growth will be so high in the next five years. A pre-recession 2009 report from ASSOCHAM estimated that annual increase until 2015 would be only 22 to 25% a year from some 330,000 medical tourists in 2009. A clue as to why the report is very optimistic on current and future numbers is that the organization, and businesses that support it, are seeking local and national government finance to set up the ten health cities that would include large hospitals offering low cost care to medical tourists. Over the last few years, many proposals for medical cities have been made, but most plans are gathering dust as hospital groups are not prepared to pay for them unless private investors and government shares the huge costs of setting them up.

TURKEY: Health tourism development in Turkey

Fri, 26 Aug 2011 12:27:57 GMT

The Turkish government has laid down some rules on health tourism, while foreign investors see potential in Turkish hospitals. According to the Turkish Health Tourism Association, Turkey has become a leading provider of high-quality health services in recent years and has become a destination for health tourism in the region. Many new hospitals have and will be built both for locals and medical tourists. The Ministry of Health has laid down new rules on treating people in Turkey if they live abroad -• Health services can be provided to foreign citizens at different prices to locals in all Ministry of Health hospitals.• Foreign patient provincial coordination centres will be established first in 7 provinces (Istanbul, Ankara, İzmir, Antalya, Muğla, Aydın and Gaziantep) under health directorates.• Foreign patient units will be established in various hospitals in a total of 15 provinces.• Personnel speaking foreign languages will be assigned to these new units.• Foreign patients will be able to apply to provincial coordination centres individually or through a consultant firm or travel agency for advanced examinations and treatments (brain surgery, cardiovascular surgery, oncology treatments, etc.) as health tourists. • To answer patient complaint calls of foreign patients, English, German, Arabic, Russian language translators will be employed.• For health services to be provided to foreign patients, the ministry has established a health tourism coordination department. Parkway Holdings, Fortis Healthcare International and Life Healthcare Group are among groups interested in buying a stake in Turkey's largest hospital chain, Acibadem Healthcare Group. Acıbadem operates 11 general hospitals and 8 medical centres. The international patient centre is a centralized service for patients visiting hospitals from countries outside Turkey. Venture capital groups are also looking at the potential to buy cheaply now and sell for a profit within five years. Dubai-based Abraaj Capital, which owns 46% of Acibadem, has hired Goldman Sachs and Merrill Lynch to study options for the stake. Abraaj may prefer to sell the shares in the Istanbul-based hospital operator to another healthcare company rather than an investor.

VIETNAM: Fortis Healthcare on international acquisition trail

Fri, 26 Aug 2011 11:46:37 GMT

Fortis Healthcare International, the Singapore-based holding company owned by India's billionaire Singh brothers, Malvinder and Shivinder, has agreed to buy a 65% stake in Vietnam's Hoan My Medical Corporation for USD 64 million, as part of Fortis' plans to expand its healthcare business in Asia and Australia. Malvinder Mohan Singh of Fortis says, "This acquisition is an important step for Fortis Healthcare International to establish its presence in one of Asia's fastest growing regions. Hoan My Medical Corporation has a strong foundation in Vietnam, which we will strengthen further with our group's experience of more than 20 years in operating hospitals.” The acquisition will bolster Fortis International in creating an integrated healthcare delivery system across all segments including primary care, specialty day care, diagnostics and hospitals in the Asia-Pacific region. Established in 1997, Hoan My Medical Corporation is one of Vietnam's largest private healthcare provider groups with 700 beds across five hospitals. It will open a 200-bed care hospital in Ho Chi Minh City in November 2011. Vietnam is the 13th most populous country in the world, with a population of around 89 million, and it is a fast growing economy with a huge opportunity to consolidate and establish a high-quality, patient-centric hospital network. It is the company's sixth investment in eight months and is an important step in consolidating its presence in the healthcare market in the Asia-Pacific region. Fortis completed the acquisition of Quality Healthcare, the largest primary healthcare network in Hong Kong, in November, 2010. In January, 2011, it acquired 30 % of Australia's largest dental care chain Dental Corporation Holdings. Other international healthcare groups see Vietnam as having potential. Happy Hospital owned by Singapore's Thomson Medical Centre, is planning to expand investment in Vietnam. Vien Dong Co Ltd invested in the France-Viet Nam Hospital in HCM City. Singapore is considered the country with the greatest potential among foreign investors involved in Vietnam's health service. Recently, Parkway Health of Singapore, entered the Vietnamese market by becoming manager of the HCM City high-tech health centre. Parkway is a leading healthcare group based in Singapore, operating 16 hospitals with more than 3000 beds in Asia. The international network spans Asia, Europe and the Middle East with patient assistance centres in Bangladesh, Brunei, Cambodia, China, India, Indonesia, Malaysia, Mongolia, Myanmar, Pakistan, the Philippines, Russia, Saudi Arabia, Sri Lanka, Ukraine, United Arab Emirates and Vietnam. While Fortis and Parkway are concentrating on global expansion primarily aimed at treating local people, their ever-expanding global networks will increasingly be used as multinational medical tourism destinations where customers can always find a hospital that shares their culture and language. In due course, both global giants will have great international brand values that they can capitalise on with marketing and advertising power and international patient centres - that will remove small medical tourism agencies from the process.

CZECH REPUBLIC: Bathe in wine, beer and chocolate at Czech spas

Fri, 26 Aug 2011 11:36:20 GMT

The spas around Prague, in the Czech Republic are out to prove that spa treatment is more than drinking from healing springs and mud wraps. The Czech Republic offers bathing in chocolate or beer, or a massage with real pearls. At Buchlovice Spa, chocolate lovers can treat themselves to relaxing chocolate and honey massages and other wellness treatments full of chocolate. At the Moravian spa of Luhačovicethere is a local chocolate treatment that is said to make skin rejuvenated, softer, and the body rid of excess toxins. The Czech Republic has a reputation for strong pure beers. Czechs are good at production and consumption of beer (they are the number one beer drinkers in the world). In the Karlovy Vary region is Chodová Planá at the Chodovar family brewery offering beer baths to guests. The bath, at a temperature of 35°C and with characteristic caramel-coloured beer froth, is an excellent treatment against psoriasis, acne and cellulite. Every tub has a beer tap, so guests can drink during treatment. Beer baths are popular among spa-goers, and these have been introduced by a number of other small family breweries-such as at the Svatováclavský microbrewery in Olomouc. There are other beer spas in Rožnov pod Radhoštěm, Štramberk, and Harrachov. For those preferring wine to beer the wine spa in Lednice offers wine treatment and even a bath in champagne. The alcohol-free champagne extract has a beneficial effect on skin and hair. It is anti-inflammatory, eliminates free radicals, and replenishes energy. Pearl massages and silk therapy are on offer at Chateau Mcely, originally a hunting lodge, about an hour's drive from Prague. Cranberry massage is available at the Jeseník Spa where the high vitamin C and E content of cranberries have regenerative and anti-oxidizing effects. The Libverda Spa uses a full-body wrap of banana leaves, while Lázně Bohdaneč offers the beneficial effects of cinnamon. Even cold can be healing and relaxing by alleviating pain as well as chronic troubles including stress and fatigue, at the Teplice and Bečvou Spa which has a cryogenic chamber. This therapy is also offered to guests of Spa Darkov. Cold treatments are also available at Čeladná in the Beskids Mountains. Czech spas are among the oldest in Europe and there are 37 spa towns in the Czech Republic, many with natural healing springs, be these mineral springs, gases or peloids. Wellness programmes are also offered by specialised modern resorts -in the mountains, in the forests or in the Moravian vineyards.