There is a lot of room for improvement. India needs more patients from Europe, Africa and Central Asia.
India’s reputation as a producer of quality vaccines and pharmaceuticals received a boost during the pandemic. Therefore, India should strive to increase its share of the global wellness tourism market. Medical Value Travel (MVT) in India is expected to grow to $13 billion by 2026. Medical tourism refers to people from abroad coming to India for treatment of body and mind. It includes allopathy, natural healing such as Ayurveda/yoga and spiritual Indian philosophy.
What is India’s advantage? Quality medical care, lower price, doctors speak English and a rich tradition of wellness. In 2019, foreign tourist arrivals (FTOs) to India on medical visa account were 697,000 (2017: 4,95,056). According to statistics, India receives most of its medical tourists from Afghanistan, Oman, Bangladesh, Maldives, Nigeria, Kenya and Iraq.
According to the Ministry of Tourism Statistics Pg. 59, in 2020 FTAs were 186,644. West Asia and Africa are significant contributors. To the countries above, add Sudan, Tanzania and Yemen. There is room for improvement. India needs more patients from Europe, Africa and Central Asia. After all, just look at the cost difference.
A former diplomat who worked in the Netherlands in the early 2000s told this author that it takes months to get appointments for non-life-threatening illnesses, unlike in India, where there is virtually no waiting time for any procedure. According to a former diplomat who worked in Africa, India should strive to help those at the bottom of the pyramid. An Indian-origin doctor who works in Nairobi shared insights into Kenya’s healthcare sector.
He said every Kenyan should pay into the NHIF (National Health Insurance Fund). In order to travel, they must present a certificate from a local doctor that Kenya has no facilities to treat this disease. However, the rich prefer to travel overseas for treatment.
The cost of treatment in Kenya is 4-5 times higher than in India. Confidence in Indian doctors is high. Service levels in Kenya are lower than in India. Kenya has 4-5 medical colleges in different sectors.
MVT should also be viewed through the lens of foreign policy and economic benefits. State governments should realize the multiplier effect of MVT and support it. Here are some ideas on what India can do to promote VET.
Medical tourism requires joint efforts of the ministry and public-private partnership. The Ministry of Health, External Affairs, Ayush, Tourism and Civil Aviation should work together with private hospitals and state governments. Joint efforts and regular interaction between ministries and hospitals would build an element of trust that is essential if the potential is to be realised.
- Patients should only be given visas when treated only at the National Accreditation Board for Hospitals and Healthcare Providers (NABH). This will ensure better treatment and patients will not be influenced by agents of unaccredited hospitals. MVT should include Indian forms of wellness such as Ayurveda, Yoga, Siddha, spiritual philosophy, etc.
- Visas take time, sometimes over three months. Can a visa system be designed so that the visa comes in a maximum of seven working days? To speed up the process, the visa can be city-specific.
- Hospitals in certain cities like Mumbai, NCR, Kolkata, Bengaluru and Chennai that have international connectivity can cater to medical tourists.
By focusing on several cities, it will enable the construction and sharing of standardized infrastructure such as hotels and guesthouses. However, wellness centers may be outside the metro. - Airport help desks have to cater to all customer needs, be it medical, transport, visa, ambulance, lost baggage and cash handling.
- As each patient has to visit the FRRO (Foreign Regional Registration Office) once, it would be helpful if an MVT person is attached to the respective office.
- The Central Complaints Commission of the Ministry of Health is the place where all patients can file complaints.
- MVT needs a one stop portal which provides all information about available hospitals, treatment offered with indicative prices, referrals, Ayurveda and Yoga rejuvenation and study centers and colleges to study Indian philosophy.
Patients should be encouraged to provide feedback on the portal and rate their hospital experience. A dedicated multilingual helpline would help. - The ambassadors of each country should establish the medical treatment system in the host country and identify the gaps just as the former diplomat, based on experience, did so above. The MEA can share this information with the Ministry of Health and Tourism, which should work with partners to tap this market.
- The Ministry of Health should, on receipt of information from NABH, prepare a paper on the services India offers and its competitiveness. This document should be shared with the Ministry of Foreign Affairs.
- The MEA should have an annual budget to subsidize the cost of medical treatment for residents, for example African and Central Asian countries. (Dynamic List)
This move will increase the number of medical tourists and create goodwill for India. The concept is similar to the PLI (Production Linked Incentive) scheme, which seeks to increase investment and employment in the manufacturing sector. MVT thus became an integral part of India’s foreign policy. - According to a former diplomat who worked in Africa, the subsidy could help wealthier people, not those at the bottom of the pyramid. So to help the poor, he suggested that Indian hospital chains could improve local skills through training and secondly, set up hospitals in African countries.
- If India is willing to make these countries Atma Nirbhar, it could allow Indian medical colleges to open branches in selected countries.
- Indian hospital chains setting up hospitals, for example in Africa and Central Asia, need to get credit lines from EXIM Bank ie. loans at a preferential interest rate.
- Indian MNCs like the Tatas could provide medical insurance in India for their employees from companies like Jaguar and Tata Steel Europe. A tie-up with the Air India/Vistara group company can provide discounted airfares.
- India can help the United Kingdom (UK) by offering medical services to its citizens in India.
While the exact nature of the service could be decided, the logistics would not be easy. A technology platform that is integrated with airlines and service providers can make this idea fly. - Patients come from countries in Africa and the Middle East, as well as India’s neighboring countries. They are invariably accompanied by a caretaker who acts as a translator and in return expects a commission from the hospital.
Although commission payment is a reality, every effort should be made for direct contact between consulate, patient and hospital. For each patient referred by the embassy, the hospital has to pay a management fee, at a predetermined percentage, to the Government of India for the services rendered. - Hospitals should hire local translators who know the language of the patient’s country and enable the hiring of a caregiver.
- The Home Office should be involved to the extent that the MVT does not become a tool for illegal immigration.
The Heal in India initiative aims to position the country as a global hub for medical and wellness tourism.
We need to think big and in an integrated cross-functional innovative way. Quality healthcare at an affordable cost can be India’s bottom line.
Sanjeev Nayyar is a Chartered Accountant and founder of www.esamskriti.com Twitter @nayyarsanjeev