Media

THE INDEPENDENT
09 August 2004

If you needed an operation, would you rather join the queue here in Britain
- or get the job done in India and make a holiday of it?

When Sarah Paris injured her right shoulder while doing DIY, she had no idea how much pain the injury would cause her - or that she would find herself seeking medical treatment in India. Initially, Paris's injury didn't seem too serious. But over a period of months, the pain got worse until she couldn't move her arm at all. "I've got a young family and need to be getting on with things - I couldn't drive, I couldn't sleep, I was getting more and more angry with my kids, because I was in so much pain. I was also taking a barge-load of painkillers," she says. Paris, 43, a former police officer from Devon, tried physiotherapy, but found it didn't help. Eventually, her GP referred her to hospital and she was told that there was an operation that could help her. But there was a problem: "I was told I would have to wait a year for surgery even if they booked me in for it, which they were very reluctant to do.

"In June of this year I looked into getting surgery in India, which I had read about in a newspaper. It was all arranged within a week of my first email, and I travelled to Chennai - formerly Madras - to one of the Apollo
hospitals. I was on the operating table three days later."

Rather than face a lengthy wait for treatment on the NHS, those that can afford it often turn to private healthcare for major procedures such as heart surgery, joint replacement, plastic surgery or IVF. And increasingly, the savvier among them eschew expensive UK hospitals, instead seeking treatment abroad, from EU members such as France and Germany to more far-flung locations like the USA and South Africa. But if the Indian government has its way, India will become the global hub of "medical tourism" within the next 20 years. Though India may not be the first place that springs to mind for high-quality healthcare, increasing numbers of Britons are joining the steady flow of global visitors attracted by state-of-the-art private hospitals which offer a range of treatments at a fraction of the cost of their UK equivalents. Add the sweetener of recuperation in a luxurious Ayurvedic health spa, or a trip to one of India's many tourist attractions, and it's a very tempting proposition. But cost is the killer factor, and India's private hospitals are keen to publicise their exceptionally low prices. For example, a heart bypass in the UK costs around £12,000, but the operation can be obtained for just £2,000 in India. And in this country, a thorough men's health check-up, including blood tests, electrocardiogram tests, chest X-rays, lung tests and abdominal ultrasound costs £345, but is a mere £45 in India.

Thus far, the main demand for medical tourism comes from the 20 million Indians who live abroad, but a growing number of non-Asian Britons are heading to India for fast, inexpensive treatment. Recent high-profile medical tourists include Scot James Campbell, 69, who had a successful double knee replacement in Ahmedabad, western India. This would have cost him at least £20,000 in the UK, but he snapped up the surgery, flights and a seven-week stay for less than £8,000. Another Scot, 55-year-old Alex Cooperwhite, flew to Goa for surgery to heal a back complaint the NHS told him was incurable. He paid just £1,500 for surgery, intensive care and physiotherapy - and his "incurable" problem was cured immediately. George Eapen is chief executive of Apollo Hospitals, one of India's major private hospital chains. He claims that his hospitals have treated over 60,000 foreigners from 55 countries since 1998. And Eapen is convinced that the country will attract an increasing number of patients like Campbell and Cooperwhite: "India can become the healthcare destination of the world," he declares. "We have two great advantages: highly skilled manpower and substantially lower costs."

Harpal Singh, chairman of medical corporation Fortis Healthcare, argues that cost is not the only advantage his country has to offer: "The cost advantages are a no-brainer," he says, "but some of the services offered, such as cardiac work, knee and hip replacements, are superior to those in UK hospitals. The combination of lesser cost with equal, if not better, quality provides a very compelling argument."

Sarah Paris was very impressed with the standard of treatment on offer. "They put me under general anaesthetic, then drilled a few little holes in my shoulder, cleared all the muck out, gave me a steroid injection, then fully manipulated it under general anaesthetic. You couldn't have done that without the general, as it would have been too painful, but that's what got it all moving."

"Before I had the operation, they did really exhaustive health checks on me, like blood tests, chest X-rays, heart monitoring, cholesterol checks and two MRI scans. In England, the MRI scans alone are £500 each privately. My hospital bill for my shoulder was £1,500. My flight was £550 and I paid an extra £200 to the hospital for cardiology, root canal work and a ceramic crown on my tooth. I was really, really chuffed with it.

"The thing that impressed me most was how caring they were. They gave me a 24-hour nurse, who was really sweet. If I went anywhere, they'd send a driver, a security guard and a nurse - I felt a bit like a celebrity! "Then I stayed in a spa afterwards and had a great time. It was a five-star hotel with Ayurvedic treatment, which was fantastic and a fraction of the price it would be here. I felt bad in some ways, because there was so much poverty, but on the other hand I was bringing in foreign currency and helping the economy. I think in the long term, medical tourism will be beneficial to India."

Another example of the low-cost plus high-quality formula is in fertility treatment. With the chronic shortage of egg donors in the UK, many specialists are now sending their patients abroad, to where eggs are in far greater supply. Dr Paul Rainsbury, of the Rainsbury Clinic in Ilford, Essex, is a strong advocate of "fertility tourism". In addition to Spain and the USA, he has also referred patients to India: "I sent a couple to Bombay for fertility treatment, partly because they had relatives there, so they combined it with a holiday," he says. "They had the work-up in the UK, which takes about a month, then they were sent to Bombay for egg recovery and fertilisation." And did he have any worries about the quality of care on offer? "No, I didn't have any concerns, because one of my staff had been to their laboratory, and reported that it was a good standard. Although the treatment wasn't successful - you can never guarantee a pregnancy - the couple were very happy with the way they were treated, as was I."

An increasing number of travel companies are now looking to cash in on India's medical tourism boom, offering a package that includes flights, treatment and post-operative recuperation in a health spa. Both Thomas Cook and high-end operator Cox and Kings are currently developing bespoke medical tourism services, while UK-based Raptor Adventures is one step ahead. Its Med de Tour service will whisk you from the UK to Manipal Hospital in Bangalore, south India, then provide a custom-built holiday afterwards. Sample prices include £2,750 for a hip replacement, £1,650 for cataract surgery and £2,350 for rhinoplasty. This buys you pre-surgery consultations, medical treatment and a stay in the hospital in a private room for as long as necessary, a one-week rejuvenating holiday, a final consultation with the doctor before departure and ongoing follow-up consultancy online.

Dr Venatramana, head of neurosurgery at Manipal Hospital, believes that UK patients employing Med de Tour's services won't be disappointed: "We take care of patients right from their arrival, and our facilities and technology are state-of-the-art,"he says. "I recently had a British patient with spinal-cord compression, who was told it would take nine months for surgery on the NHS. He was worried that it might deteriorate during that time, so came over here, had the operation immediately and went home happy." If the Indian government's prediction is correct, many more of us will choose its health system as an affordable alternative to the overburdened NHS. And a post-operative week of Ayurvedic massage and beach-basking in Kerala or Gujarat beats a Dettol-suffused hospital ward in chilly Blighty hands down.

Med de Tour: e-mail doctor@meddetour.com

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