Sun, sea and surgeons. Andrew Woolnough explores the growing trend of medical tourism as more people combine holidays with an opportunity to receive high quality health treatment abroad
There was a day when many UK residents would have quickly rejected the idea of going abroad to get medical treatment. The thought of receiving care in a hospital or clinic close to home provided a feeling of security at a time of dependency and doubt.
But that is no longer the case. As hospital waiting lists remain lengthy in many parts of the UK, costs of individual treatments are soaring and superbugs are stronger than the drugs created to stop them. The thought of gaining treatment at a hospital close to home is not quite so comforting after all.
The average person is voting with their feet - in increasing numbers - using their savings to get to far-flung regions for their dental care or elective and cosmetic surgery. The medical insurance industry has a lot to contend with.
Medical tourism, although not new, is starting to boom. The appeal is getting easier to understand with clean hospitals more akin to luxurious hotels, highly skilled surgeons and care staff often trained in the UK or US, no waiting lists, a period of time to convalesce in a beautiful climate and - the initial pull for many - considerably lower treatment costs.
According to Overseas Patient Services, the global medical tourism market is estimated at over £10bn and is growing at 25% a year. And it is not just a one-way street - the Russians are coming to London, the British are going to Spain and the Arabs are travelling to Bangkok or Singapore, let alone all those who come to the UK for NHS treatment. More and more Americans are seeking alternative destinations because of expensive health insurance.
Around 50,000 British people went abroad for treatment last year. On top of that, over five million people will soon retire and could lose company medical insurance benefits.
Peter Baillie-Hamilton, managing director of Overseas Patients Services UK, initially founded the organisation on the observation that private healthcare costs could be halved by visiting continental Europe and halved again by travelling to the Far East. "What ultimately makes a difference to our clients is not cost, but safety, comfort and welfare," he says. The company visits every hospital before it is accepted onto its portfolio and only if its medical team audit is completely satisfied. It then provides practical help for patients to travel overseas to the medical centres.
But Overseas Patients Services UK is not trying to undermine UK healthcare provision. "We simply give options, including promoting the UK as a centre of excellence in the private sector. On the positive side, medical tourism can help remove stress from the NHS - as well as help individuals to feel better faster. Why wait a year for a hip operation if it can be done quickly and safely elsewhere?"
Insurance companies and their consultants are able to tap into foreign clinics that offer readily available state-of-the-art minimal or completely non-invasive surgery. Access is available to multi scanning devices, which create high-resolution three dimensional colour images of major organs, giving surgeons a bird's eye view prior to surgery. Heart bypass, using minimally evasive robotic surgery, can reduce recovery time and costs. With the development of robotic equipment such as cyber knife, surgeons can perform non-invasive brain surgery, which is especially useful for reaching deep-rooted cancerous cells that cannot be accessed by conventional surgery.
Baillie-Hamilton believes medical tourism can be divided into two different categories; off-chance, when an individual goes away on holiday and receives minor treatment - possibly a medical check-up or teeth whitening or; planned medical travel - when people choose a destination specifically because of the treatment or medicine they can receive there.
He talks about a businessman who had a full health check-up while on holiday in Thailand, testing for myriad potential problems with powerful medical equipment. His Thai consultant told him they had found a polyp on a vital organ and, although it was nothing to worry about, it was something that needed monitoring annually. When the businessman returned to his native US home, his own consultant was staggered with the detail of the report. The businessman now has a check-up in Thailand every year and if he requires follow up surgery, he would be happy for the procedure to take place there.
But how does this affect insurance, both for individuals and corporates? Is the insurance industry starting to accept these procedures as a reality?
Charlie MacEwan, corporate communications director at WPA, explains: "If you are ill in the UK, you have two choices - you either go to the NHS or you pay for your own treatment. If you're going to self-pay, two options are buying insurance to avoid large bills or going abroad as and when required. There are an infinite number of other options."
Baillie-Hamilton adds: "It is the people who travel for medical treatment that insurance companies should be much more aware of. Providers need to understand the way the market is going and how they fit in. They can look at organisations like ours as being a provider they can tap into for advice. They can offer their customers more choice and can save costs directly from their own bottom line."
Taking advantage
Medical tourism is an area of increasing importance for the Jelf Group, a full-service consultancy and healthcare specialist.
Wayne Pontin, business development director at Jelf Wellbeing, says with national newspapers regularly covering the topic, individuals are increasingly aware of medical tourism. If the advantages start outweighing the disadvantages for potential patients, will they begin to object to pay for traditional medical insurance?
Some UK insurers are starting to provide the option for customers to go abroad for treatment, realising they can keep their claim costs down as well as provide high-quality care. Pontin explains: "If insurers find it distinctly cheaper to send customers to France, for example, for good care rather than treating them here, it says something about our industry. With the market statistically proving to move rapidly, it could affect us all business-wise, if not personally."
MacEwan talks about a customer who was diagnosed four years ago with a rare tumour that would end her life. Her family did not accept this and searched the world for a reputable, recommended specialist. After finding one, WPA paid for her treatment abroad and several years later she is now fit, able and very much alive. "We don't mind where our customers get their treatment - we exist to help our customers fund their healthcare in the hope they can return to a similar or better state of health as before."
He continues: "The choices now available appeal to different types of customers. There are those who do not want to buy medical insurance or use the NHS, but will happily visit a Goan hospital on good recommendation to have an important operation, have a few weeks holiday, and then come home at a significantly reduced cost to going private and paying for treatment in the UK."
Medical tourism threatens two groups - the health consultants, who often advise against this way of getting treatment. And the medical insurance industry, involved in the sale of domestic or international private medical insurance.
Time for a rethink
The most important element - for the insurance industry at least - is to research the market to separate the good treatment offering from the bad, to make sure it understands and adjusts its processes to suit market needs.
In Jelf's search for underwriters to work with medical tourism organisations like Overseas Patients Services UK, Pontin believes insurers need to work closely with intermediaries who offer a distribution platform with a corporate and individual client base of sufficient size.
It sees medical tourism as a new business opportunity that fits well into its employee benefit culture and, potentially, its flexible benefit product range. Tobin Coles, head of flexible benefits at Jelf, says: "There has been a historical assumption that care in the UK is better than anywhere else, but that needs to be considered case by case. When it comes to benefits, you could ask the question, are businesses failing employees by not covering the cost of treatment overseas if the treatment is limited or not available in the UK, particularly if the quality of the treatment can be guaranteed?"
- Andrew Woolnough is flexible benefits distribution manager at Jelf Group.
