Over the years, India has gained a lot of attention globally for its tourism diversity. India has got all the elements to attract tourists. Medical tourism is one of the hidden treasures which the nation has recently started promoting aggressively. India has emerged as one of the most cost effective destinations with skilled manpower and advanced infrastructure for the medical tourism segment. Healthcare and wellness has become one of the largest sectors of India - both in terms of revenue and employment comprising hospitals, clinical trials, outsourcing, telemedicine, wellness, health insurance and medical tourism etc. The Indian healthcare sector is growing at a brisk pace due to its cost effectiveness, strengthening coverage, services and increasing expenditure by public as well private players. With healthcare cost in developed countries increasing, cost consciousness among patients seeking treatment and availability of accredited facilities has given rise to many global medical tourism corridors. Among these, India is one of the countries which have a large number of accredited facilities.
A latest knowledge paper by FICCI and QuintilesIMS shows over 5,00,000 foreign patients seek treatment in India each year. SAARC countries such as Bangladesh, Afghanistan, and Maldives are the major sources of medical value travel, followed by African countries such as Nigeria, South Africa and Kenya. Proximity, cultural connect and connectivity are the key reasons for inflow of patients to India from these regions.
Medical tourists to India typically seek joint replacement surgeries, heart, liver and bone marrow transplants, spine and brain surgeries, cancer and kidney treatments, and in vitro fertilisation (IVF). According to various study, treatment costs in India start at around one-tenth of the price of comparable treatment in the United States or the United Kingdom. Speaking earlier to T3 about the scope of orthopaedic surgeries under medical tourism, Dr. Darius Soonawala, Orthopaedic and Joint replacement surgeon, Jaslok Hospital said, “Orthopaedic is very ideal and relevant for medical tourism in India. It is a fast track surgery with less complications and speedy recovery rate. In United Stated an average hip or knee replacement costs around Rs. 35 lakhs, in UK close to Rs. 15 lakhs and in India the surgery can be done in Rs. 3.5 lakhs. Companies in India should tie-up with insurance companies abroad and tap this segment.”
Medical tourism in India is projected to be a US$9 billion opportunity by 2020. Currently, medical tourism industry is pegged at US$3 billion. Globally, the medical tourism market is estimated at around US$40-60 billion. According to the Confederation of Indian Industries (CII), the primary reason that attracts medical value travel to India is cost-effectiveness, and treatment from accredited facilities at par with developed countries at much lower cost.
India currently ranks 5th on the Medical Tourism Index globally and 2nd in Asia as per the International Healthcare and Research Centre statistics. This portrays a potential opportunity for India in becoming a future leader in medical tourism given the fact that it focuses on building infrastructure, technology & services, and a seamless experience for buyers.
Speaking about the current status of this sector, E.M. Najeeb Founder and Chairman, ATE Group of Companies and an expert in this segment stated, “Medical Tourism in India is on a faster pace of growth compared to the previous years. The growth percentage is almost 25 per cent in Medical Tourism. The specialising hospitals in India also are gearing up their Patients Relations Protocols to make the patient experience comfortable. The official figure of the Ministry of Tourism suggests that there was an increase of 1,27,142 foreign patients during 2016 compare to the figures of 2015. In 2016, Medical Tourism arrivals was 3,61,060. The Indian Medical Tourism Industry is expected to grow to US$8 billion by 2020 from the US$3.9 billion of 2016.”
Echoing similar opinion, Somnath Shetty, Head – International Business Vertical, Wockhardt Hospitals said, “India has one of the finest medical infrastructure when it comes to treating patients in terms of quality with best in class equipment’s, doctors and nurses. We do have excellent infrastructure. Maybe some work needs to be done in few areas on logistics and translators. Visa issues for patients do exist but the govt. is willing to work around it to smoothen the medical visa process. It is a booming industry in the current scenario and growing at 13 per cent CAGR.”
In terms of technology, India is one of the most advanced nations with all the start-of-the-art medical equipments. But promotion is the need of the hour, the tourism board along with key stakeholders need to promote it aggressively in the international markets. Speaking earlier in a conference Dr. Nikhil Parchure, Cardiologist, Apollo Hospital said, “Awareness is a key challenge for the Indian market. For example, a cardiovascular surgery in the United States costs around Rs. 80 lakhs, whereas in India it is between Rs. four to five lakhs. Also, in US the mortality rate in during a bypass surgery is around 2-2.5 per cent, and in India it is as low as 0.5 to 0.7 per cent. Most aren’t aware that we also perform Robotic surgeries in India. It is very popular in south India. We have done a lot of Robotic surgeries for people from the Middle-East, US, UK, etc. We also do a lot of heart transplants for people from Russia.”
The Ministries of Health, External Affairs, Tourism and Culture are working to increase the number of medical tourists. The government provides online visas, multiple entries, extensions of stay, and accreditation to more hospitals. Several other measures are under way, according to the Indian Medical Association (IMA).
Earlier this year, e-Visa has further been sub-divided into three categories i.e. e-tourist visa, e-Business visa and e-Medical visa. The scope of e-tourist visa has been expanded to include short- term medical treatment. Separate immigration counters and facilitation desks have also been planned at major Indian airports to boost the medical travel industry. Separate immigration counters and facilitation desks to assist medical tourist have been provided at Indian airports namely, Delhi, Mumbai, Kolkata, Chennai, Bengaluru and Hyderbad.
Recently, the Union Ministry of Commerce and Industry along with ministries of Tourism and Health has launched a website designed to promote India as a premier healthcare destination. The website is a single-source platform providing a comprehensive information to medical travellers on the top healthcare institutions spread across major cities of the nation —highlighting its speciality in various medical treatment, wellness and rejuvenation, and Ayurveda & Alternative medicine. “Over the years, India has grown to become a top-notch destination for medical value travel because it scores high over a range of factors that determines the overall quality of care,” the website, indiahealthcaretourism.com reads that also supports Arabic, Russian and French languages.
Mahesh Sharma, Former Union Tourism Minister (I/C), Govt. of India had said, “India in today’s time is specifically known for medical tourism. We are trying to address all issues related to medical tourism through a single clearance window. India now has a simplified e-medical visa facility which allows you three visits to the country. We will try to address more issues in time to come, like standardisation and accreditation of services. We want to make the processes transparent, to rationalise services and make them all of them available in a transparent manner so that no one is deprived of much needed healthcare services.”
The triple entry multiple visa for medical tourists has attracted newer destinations. Also, Government is carrying out campaigns to increase more awareness about the medical e-visa. Appreciating the efforts by Government Najeeb said, “From the part of the government there is a combined effort to develop medical tourism in the country. Ministries of Tourism, Health and External Affairs are putting their efforts together to increase the flow of Medical Tourists. The online Visas, multiple entry Visas and accreditation of hospitals etc make travel easier for the travelling patients. ”
He further said, “The ‘e-Visa-on-Arrival’ Scheme for tourists from select countries facilitate foreign nationals stay in India for 30 days for Medical reasons. In 2016, citizens of Bangladesh, Afghanistan, Maldives, Republic of Korea and Nigeria availed maximum number of Medical visas. The Union Government and most of the state Governments are supporting Medical Tourism, and are carrying out campaigns.”
Earlier, the Ministry has formed a Medical and Wellness Tourism Board with a seed capital of Rs two Crore to make this segment more organised.
Key focus markets
Traditionally, India has been attracting a lot of medical travellers from its neighbours in the Indian subcontinent. One of the primary reasons for this traction is the cost-effectiveness and lack of medical infrastructure in these nations. According to a CII-Grant Thornton report, Bangladeshis and Afghans accounted for 34 per cent of foreign patients, the maximum share, primarily due to their close proximity with India and poor healthcare infrastructure. Russia and the Commonwealth of Independent States (CIS) accounted for 30 per cent share of foreign medical tourist arrivals. This trend has been changing over the years and now a lot of new source markets have been created.
Najeeb stated, “In India, 34 per cent of the total Medical Value Travel is from Bangladesh and Afghanistan. Africa, GCC and CIS regions constituting 30 per cent of current share, create maximum opportunity for the Indian Health care sector. Medical Tourists from these countries favour the South-East Asian Medical Corridors. For Kerala, the GCC countries and Maldives are major sources. The CII White Paper suggests to attract the African, Asian and Middle East Patients and also the domestic Medical Tourist from other regions of the country through effective marketing campaigns supported by the Government.”
Speaking about the traditional source markets for hospitals Shetty, “Traditional sources has been geographies like SAARC (Bangladesh, Afghanistan, Myanmar, Pakistan )countries, Middle East (Oman, Yemen, Saudi Arabia, UAE, Iraq) , CIS (Kazakhstan, Kyrgyzstan, Russia, Ukraine) and Africa (Kenya, Tanzania, Ethiopia, Nigeria, Sudan, Zimbabwe, Zambia, Congo). Also these travellers come for specific treatments in India. Some of the popular treatments are Orthopaedics (knee and hip replacements), Cardiac (angioplasty and CABG) Spine surgeries, Oncology treatment ,Urology procedures, gastro procedures ,transplants and cosmetic surgeries including bariatric and metabolic surgeries.”
Major metro cities with excellent infrastructure have already started reaping benefits of this niche segment. Apart from these some of the Tier II cities are also competing for a share of the pie. According to statistics, 27 per cent of medical tourism in India happens in Maharashtra with Mumbai leading from the front with 80 per cent. Chennai has emerged as the next biggest destination with 15 per cent. “In India out of the major Medical Tourism attracting locations like Chennai, Mumbai, Hyderabad, National Capital region and Kerala all these places have very high potentials to grow in this sector. Among these locations the State of Kerala stands high in growth potential. Kerala is emerging with a focus on increasing its visibility as a healthcare destination. Kerala attracts about five to seven per cent of the Medical Tourists coming to India and has the potential to increase its share to a 10-12 per cent with a focused marketing strategy. Kerala already has 26 NABH accredited hospitals. Moreover Kerala is one of the most preferred tourist destinations in the country. Among the destinations India competes with Singapore, Thailand, Malaysia, Taiwan, Mexico, and Costa Rica,” Najeeb said.
The potential of the medical tourism in India and making India a hub is still at the nascent stage. The stakeholders and the government have only been able to scratch the tip of the iceberg. Promoting and spreading awareness about the facilities has been one of the major challenges India is facing. Also a lot of new destinations have posed strong competition to India.
Throwing light on challenges, Shetty opined, “Medical visa issuances process has been a difficulty till now. Hope there is some ease in this front. In the recent years, a lot of new competition has come up from new territories such as Malaysia, Poland, few South American countries with low cost option. Few countries are entering into capacity building and resisting on allowing patients to travel and in the process creating policies against medical travel, which is again a challenge. In India, there is a lack of cohesiveness amongst the major players in the industry to come together and represent India on a world platform to acquire newer geographies. Apart from these, Inconsistent fee structure and lack of transparency in billing to foreign patients, and absurdly high margins to trade to refer patients are some of the challenges.”
Najeeb believes that Medical Tourism has a great future and is evident from the figures and projections we need to have facilities of world standard with national and international accreditation. He added, “Government should give more support to this industry. I suggest that Hospitals should be given industry status for power, import of machinery and equipment to make it cost effective. Public Private Participation (PPP) Model should be followed in promoting Medical Tourism. Central Government should help popularise Medical Tourism through Embassies, and Health Ministries in various foreign countries. Special efforts should be targeted at SAARC countries. We have to do the needful to develop reliable referral contacts to route travellers from across the globe. Top priority should be given to the safety and security of the travellers.”