Banking on the “low-cost, high-quality” facilities available at various hospitals across the country, the Government of India is promoting medical tourism in a big way. But the Madhya Pradesh government seems to have not woken up to the opportunity although it has a potential medical tourism destination – Indore – which has the best possible combination of super-speciality medical services and a number of tourist spots in the region.
A CII-McKinsey survey on medical tourism “Healthcare in India: The road ahead” about two years ago estimated the medical tourism industry in India to be worth $ 333 million. It estimates that India can earn foreign exchange worth Rs 5,000-10,000 crore by 2012. It is mainly the uninsured and the underinsured persons in the western countries who come to avail themselves of packages offered by countries like India. For instance, estimated cost for a typical heart surgery is about $30,000 in the US while the same can be performed in a Mumbai hospital for about $6,000.
The concept already has many takers in Indian cities like Mumbai, New Delhi and Chennai. Even Hyderabad and Bangalore are fast catching up and more and more hospitals are getting ready to treat patients coming from the developed countries. Even some states are officially taking interest in promoting medical tourism. For instance, Maharashtra has already formed a ‘Medical Tourism Council’ to tap the potential in a big way. But apparently not ready to acknowledge the concept and its potential in the state, the Madhya Pradesh government has no policy in place for medical tourism.
Health Minister Ajay Vishnoi says there is no need of such a policy as “there is no scope for medical tourism in the state.” However, he has expressed willingness to help private hospitals if they come up with a proposal regarding this. (See interview)
If medical tourism has to take off in the state, two things have to go hand in hand – latest world-class medical services and the governmental framework, which would be helpful in forming suitable policies and providing infrastructure to cater to the requirement. Sadly, much has to be done on the second front.
But going by the age-old saying that the sun will rise even if the cock has not crowed, big hospitals in Indore are waking up slowly to the opportunity and gearing themselves up so as not to miss the bus. Awareness about the concept at the medical fraternity level is rising and a few hospitals have already started taking steps towards this direction even as there are many who have not given a serious thought to the potential.
Blessed with a unique geographical location, Indore is already a regional hub for all things medical. M Y Hospital, the state’s largest government-run facility, is in fact a referral centre for the entire western Madhya Pradesh. Then there are a number of private hospitals of all sizes which either concentrate on a singular service or cater to a range of services including the latest super-speciality techniques and procedures. And all these at rates that are 3-5 times cheaper than metros.
The four big hospitals — Bombay Hospital, Indore; Choithram Hospital and Research Centre; CHL Apollo Hospitals and Sri Aurobindo Institute of Medical Sciences & Bhandari Hospital and Research Centre — and a number of private clinics and medium size (100-bedded) hospitals boast of world-class facilities with the state-of-the-art equipment and trained manpower who also have international exposure.
“You name it and Indore has it. Be it the facility for advanced coronary-problems related surgery or knee replacement surgery, steriotactic surgery or even acoustic neuroma, everything is being already done at Indore,” says Dr Amit Bhat, Asst Director (Medical Services) at Choithram.
“Add to it the success rate. For any given surgery, we claim a higher success rate than our western counterparts. For instance, at our Hospital, the success rate in heart care is 97 per cent,” Dr Bhat adds.
Agrees Bombay Hospital GM (Administration) Rahul Parashar, “We have all the latest facilities under one roof. The range speaks for itself – we have the latest technology and procedures in cardiac care, the cardio-vascular and thoracic surgeries, neurology, nephrology, urology, gastro-enterology, orthopaedics, plastic surgeries and many others. And the best part is,most of these are 2 to 3 times cheaper than what it would cost in Mumbai.”
That is the essence of medical tourism: International patients come looking for a cheaper alternative but do not want to compromise on quality.
Indian hospitals (this is true for most of the Asian hospitals too) score high on world-class infrastructure, highly trained doctors and most importantly, staff attitude. The four Indore hospitals put together offer almost every latest equipment and facility. The list can go on and on but a quick look can give an idea what all is available.
So what stops Indore from becoming a hub for medical tourism? The most glaring shortcomings are poor infrastructure, lack of direct international air connectivity, and under-developed tourist spots in and around Indore.
This is when it enjoys a unique geographical location: Indore lies at the centre of the triangle formed by Omkareshwar, Ujjain and Dhar. With two jyotirlingas and an ancient Bhojshala and Mandav near Dhar, Indore, which already has Ahilyabai Holkar’s legacy to boast of, can well be the spiritual capital of Madhya Pradesh.
“World-class medical facilities with spiritual rejuvenation” can well be the promotion line for Indore to become the medical tourism hub in the state, says an administrator at one of the hospital. Bored with pursuing the material goals, westerners are attracted to the orient for fulfilling their spiritual needs. But the state government seems to be oblivious of the situation.
“Where is the infrastructure needed to tap this kind of potential?” asks Dr Archana Mahajan, CHL Apollo Hospitals Medical Superintendent. “To start with, there is no international airport here. So the patient cannot come here directly. Then there are no proper roads, and basic amenities like public urinals…the city has grown haphazardly,” she says. Moreover, except for Rajwada and Lal bagh, there is no proper place to go sightseeing. What can you show these foreigners? ” she complains.
Indian Medical Association Indore unit president Dr Arun Agrawal says, “The marketing should be through proper channels. Whatever efforts are being made at the national level to promote medical tourism, MP should also find a place in that.” However, he said the IMA has not yet approached the government with any proposal for the same, as the doctors are still apprehensive about the concept’s viability owing to government apathy.
Chairman of Aurobindo group of Hospitals Dr Vinod Bhandari says, “We have a tie-up with foreign medical centres and also invite foreign faculties to work here. So marketing should not be a problem once we decide to go for it.”
There is no five star hotel in the City. Sayaji Hotel and Fortune Landmark are the only properties which can be compared with a five star hotel to some extent. But even these hotels are generally booked, and foreigners may not find readily available accommodation in case they decide to visit Indore for medical treatment.
But the problem is not only the lack of infrastructural facilities. The hospitals need accreditation by some international healthcare body and market Indore at the global level.
The encouraging thing, however, is that the four major hospitals have realised what is to be done. While the Choithram hospital has already started standardisation of its procedures and also the internal process for accreditation, Bombay Hospital has in principal agreed to go ahead with necessary procedures in this direction.
The CHL Apollo, unlike its parent organisation, has not given a thought about exploiting the opportunity but may soon take steps in this direction.
Accreditation from JCI, the international arm of the US based accreditation body — the Joint Commission on Accreditation for Healthcare Organisations (JCAHO) — is the most sought after by global hospitals as it is considered as the highest benchmark. However, according to a report in Asian Healthcare and Hospital Management journal, JCI accreditation can set back a hospital by about $100,000 and this does not include expenses incurred on upgrading its facilities to meet the high standards.
On similar lines, theCentre has set up a National Association Board for Hospital and Health Service Providers in 2005 for accreditation of hospitals in the country.
Doctors realise that getting accreditations and aggressive marketing would be tough. Hence I will have to be a team work or something will have to be done at institutional level. Dr Pushpa Verma, an ophthalmologist points out how 33 doctors from Indore, Ujjain and Bhopal pooled resources to open the state-of-the-art Lasik Centre, which has the modern poster segment real time angiography facility among others.
Dr Vinod Andhare of the Indian Dental Association’s Indore unit says, “Some beginning has been made in the sense NRIs, particularly relatives of Indoreans who have settled abroad, are consulting doctors here. I myself have treated several NRIs.
The Bombay hospital sources said over 100 NRIs had been treated at the hospital over the past three years. In fact, about ten days back, a Pakistani girl, who was in India on a pilgrimage, was operated for a defective heart valve at the CHL Apollo Hospital.
Some doctors are, however, not very happy with the trend. “I don’t think we should care to get international patients too much as the facilities are not enough for even locals,” says Dr Mahajan of Apollo.
Dr D K Jain, Superintendent of the government-run M Y Hospital, however, does not agree with him. “Poor patients in any case do not go to these private hospitals. They come to us.”
The difference in doctors’ perception notwithstanding, it seems what has started as the NRI trickle, may well turn into a steady stream of foreign nationals in a few years time.
(With inputs from Manoj Ahuja and Aditya Singh Parmar)