Medical tourism could be good for India's health

Published on Monday 16 February 2009 20:51

I HAD the opportunity to visit India for the first time recently, and, because I have had at least one patient who has travelled to that country for surgical treatment, I was curious about Indian healthcare.

First impressions were of a polluted and poorly sanitised country. The air in Delhi was a cough-inducing smog and open sewers were apparent in several parts of the city.

No wonder the World Health Organisation records almost a million deaths per year in India from air and water pollution.

While there is no starvation in India, there is considerable undernourishment, with about half of Indian children underweight, according to the World Bank.

The beggars on the street also demonstrate that, sadly, crippling infections such as polio are still present in many parts of northern India.

The country clearly has its problems – a rapidly expanding population (currently more than a billion people) with the number of doctors per head of population falling as medical qualifications cannot keep pace with the rising population.

On the drive from the airport, I passed through the medical quarter and saw a variety of new specialisms advertised on billboards. There was an oncosurgeon, an implantologist, a pulmonologist and a limb amputator offering their services, together with numerous sexologists.

Indeed, in one rural area of the county I observed a doctor advertising his qualifications with the word "failed" in brackets after one set of initials.

Very much a case of never mind the content, see the length of what I've got!

At the coal face, however, I have nothing but praise for Indian healthcare. A member of our party fell acutely ill in the early hours of the morning. Medical care was requested, the doctor arrived promptly, conducted an appropriate examination, diagnosed and treated the patient with two injections, and the patient recovered sufficiently to be able to resume activities later.

The bill, when it arrived, was for 700 rupees (about 11), which included the medication. This illustrates why we in Scotland, and the UK, are able to attract doctors and nurses from abroad to work in our out-of-hours services and in our nursing homes. The rewards for these doctors compared to back home are phenomenal, and yet the standards are equally good.

Which brings me back to medical tourism. By that, I mean going abroad to have an operation or some kind of investigation.

This was popular a few years ago, and, as you will recall, about a decade ago, you could wait a year to see your consultant and then another year to get your operation. Now we are moving to a maximum wait of 18 weeks.

This has reduced the pressure on overseas treatments, but often health boards have to buy the treatments from private-sector hospitals to comply with the waiting-time guarantee.

Perhaps they could look abroad – you can get a total knee replacement for about 2,500 in an internationally recognised hospital in India, compared with at least double that in the private sector back home.

Of course, there are difficulties to overcome – international standards, availability of safe blood, continuity of care, billing and transport that must run smoothly.

Medical tourism wouldn't only have to benefit the UK. Buying abroad could encourage doctors to stay in their own country where they are needed, and, with the influx of NHS money, they could earn an improved income.

Perhaps a small tax on treatments purchased in this way could provide a small contribution to the health economy of that particular country.

However, a real change to the health of India's burgeoning population will come not only from more doctors and nurses, but also from clean water and a sewage system.

&#149 Dr John Garner is a member of the British Medical Association's Scottish Council and a practising GP.