The blocked artery that limited blood flow to her legs meant a rapid decline in quality of life for Mavis Childs, a 67-year-old retired wages clerk. “I could walk maybe 10 yards (9m) before I’d have to stop, and was relying on crutches or a wheelchair,” she recalls in her home in Wombourne, near Wolverhampton. “It made me very dependent on other people and I didn’t like that at all. But though the doctors knew what was wrong and could do something about it, all I was getting was appointments to attend hospital every six months without getting any treatment.”
Her condition was diagnosed in May 2003. Yet, she says, it took the NHS more than two years — until August 31, 2005 — to schedule the aorto-bifemoral bypass surgery that could have put things right. Even then, two weeks before she was due to be treated, the hospital abruptly cancelled the operation without explanation or the offer of a replacement date. “By coincidence, my husband and I had read an article about an agency which arranges medical treatment abroad,” Childs recalls. “So we asked them for a quote and a week later we were on our way to India.”
For about £5,000 — plus the cost of flights and a week’s hotel accommodation for two — Childs had successful surgery at the Apollo Hospital in New Delhi, one of a growing number of private hospitals catering for the booming market in health tourism. “We could not have afforded private treatment in the UK, which we were given to believe would have cost about £20,000,” she says.
“Obviously we had some trepidation, never having known anyone who had been to India, but the treatment was fantastic. I had a day nurse and a night nurse, who weren’t allowed to touch another patient so that there could be no cross-infection, and the cleaners were in the room three times a day. My anaesthetist had just returned from a six-month stint at Walsgrave Hospital, in Coventry, and the three surgeons had practised in this country. I’ve no complaints. I’m as right as ever now.”
Faced with NHS waiting lists, thousands of British patients are seeking medical treatment abroad each year as a cheaper alternative to private UK care. Thousands more are going abroad for treatments — cosmetic surgery, for example — that they would never get on the NHS and would be unable to afford privately in this country but are within their reach abroad.
It is impossible to know exactly how many of us are admitting ourselves as health tourists — by their unregulated nature, these treatments go unrecorded by government statisticians — but in the past two years, inquiries have risen sharply at private agencies that offer to arrange surgical, dental or even cosmetic treatments anywhere in the world, from Turkey to Thailand.
These agencies — with names such as Mediescape and Surgeon & Safari — typically offer all-inclusive packages that include surgery, travel, visas and recovery time in a local hotel for the patient and a friend or relative, all for a fraction of the cost of private care in Britain. In India alone, medical tourism is forecast to be a £1.2 billion business within six years, according to the consultants McKinsey&Company.
Yet this is still a largely unregulated industry, often recruiting patients through slick marketing presentations in hotels or using hard-sell websites. Concern is growing among British healthcare specialists that patients are exposing themselves to unexpected risks in the rush for a bargain.
“No procedure is risk-free, and you have to ask yourself what happens if something goes wrong,” says a spokeswoman for the British Medical Association. “Will you even be able to speak the language?” Post-operative care is another concern: if a treatment has side-effects, or if there are unexpected complications, it will often be left to the British health services to pick up the pieces. Other worries being debated on the pages of the medical press range from the legal — how would a patient seek redress for malpractice? — to the ethical: with profitable medical tourism redirecting healthcare resources away from local populations, won’t it be poor Indians and Thais who ultimately suffer? For the moment, such concerns are doing little to dampen the rapid growth of the sector. India is actively marketing itself as a “global health destination”, with government backing to organise exhibitions abroad and to offer prospective patients one-year medical visas. Last November, India’s tourism ministry and Healthcare Federation even introduced common price bands for treatment of foreign tourists in oncology, cardiology, orthopaedics and some types of surgery. Private hospitals in 15 cities, including the Apollo, Escorts, Fortis and Wockhardt chains, have agreed to keep to rates that can be anywhere from a third to a tenth of prices in Western Europe and North America.
For British patients considering private treatment, the cost savings are remarkable. A heart operation, such as a pacemaker replacement, may cost £20,000 in Britain; in India it can be arranged for less than £4,000, plus travel and accommodation. Knee surgery in the UK costs £20,000 privately, but may cost £8,000 in India; a £3,000 dental package can be arranged for £600.
No wonder British patients are joining continental Europeans, North Americans and Middle Easterners in their hundreds of thousands each year to take advantage of such price differentials. India is estimated to have treated 150,000 foreign patients in 2004, a figure rising at 15 to 30 per cent a year. Hospitals in Singapore are attracting more than 200,000 a year, and Thailand at least 600,000. So customer-focused is this industry that Bangkok’s International Medical Centre offers assistance in 26 languages.
Overseas clinics are targeting not only diagnosed health conditions. Cosmetic surgery is booming, with clinics from South Africa to Malaysia heavily undercutting British prices for tummy tucks, breast enlargements and facelifts. For laser eye-correction surgery, the Lexum Eye Clinic in Prague promises to undercut the UK price by up to 75 per cent. Hungarian and Polish dentists advertise guaranteed quality crowns at a third to a quarter of Western European prices. And for IVF fertility treatments at a fraction of UK prices, dozens of clinics in Eastern Europe are standing by for your call. Their success rates are as good as, if not better than, UK clinics, and in some instances you can specify an implanted embryo’s gender, a practice forbidden here.
But what if something goes wrong? The British Association of Aesthetic Plastic Surgeons regularly describes cases of patients being “permanently disfigured” after foreign cut-price nips and tucks. The association does have its members’ interests to protect, but occasional high-profile instances of disaster underline its warnings: last October, Stella Obasanjo, wife of the Nigerian President, died in Marbella after problems associated with a reported “tummy tuck” operation.
