In recent years, the world has witnessed a significant rise in the phenomenon of medical tourism, and Sri Lanka is no exception to this trend. To gain insight into this industry and its potential to help boost our economy, The Sunday Morning Brunch spoke to Ministry of Health Organisation Development Director Dr. Thilina Wanigasekera.
Medical tourism, a rising star in the global travel industry, is capturing the world’s attention. While Asia-Pacific leads the charge, Sri Lanka is just beginning to tap into its vast potential.
Following are excerpts of the interview:
What is the scope of medical tourism?
Tourism has long been a dynamic source of foreign currency for many countries, and Sri Lanka is strategically positioning itself to tap into this lucrative market. With an action plan developed by authorities such as the Sri Lanka Tourism Development Authority (SLTDA), the country aims to harness the potential of medical tourism from 2022 to 2025.
In a world grappling with economic crises, tourists are increasingly seeking low-cost, high-convenience destinations. South Asia, particularly Sri Lanka, has become a favoured choice for those in search of affordable medical care. The allure of medical tourism lies in its promise of wellness experiences and medical treatments that meet tourists’ expectations, including cost-effectiveness.
However, this industry is not without complexities. Travellers base their decisions on factors like value for money, healthcare standards, hospitality, service quality, and ease of communication. Environmental factors, weather, and local culture also play a role in choosing a destination.
Efficient healthcare workforces are a significant draw for clients, and access to well-trained staff is a key factor in attracting medical tourists. Additionally, factors such as universal languages, user-friendly regulations, 24/7 access to banking services, flexible laws, cost-effective standard services, and service-oriented citizens contribute to a country’s success in medical tourism. The recognition of this sector’s importance cannot be overstated, as it is a crucial source of foreign currency generation.
It is important to note that medical tourism is not a new venture for Sri Lanka. Historically, this country has been renowned as a hub for medical tourism, dating back to ancient times when it was recognised for its healing practices.
Health tourism has several aspects that could be categorised in many ways, reflecting the need and the demand. It must be geared towards a multidisciplinary approach. Health tourism encompasses a multitude of dimensions that cater to various needs and demands. This multifaceted approach goes beyond simple service management and includes:
- Seeking medical treatments
- Shopping for medical products, especially wellness and herbal products
- Seeking medical opinions and investigations
- Pursuing short-term education for hands-on medical experience
- Exploring cultural values combined with therapeutic rituals
- Offering customised and personalised treatments
- Developing alternative medical practices and practitioners
Who are the key stakeholders?
The success of the medical tourism industry depends on key stakeholders. These include tourists, healthcare providers (both public and private), government agencies, facilitators, accreditation bodies, healthcare marketers, insurance agencies, infrastructure developers, and designers. Collaboration between these stakeholders is essential for creating value and enhancing the client experience.
Value co-creation in health tourism occurs at different levels of service provision, including micro-system level (individuals), meso-system level (healthcare organisations), and macro-system level (health system and government policies). This collaboration involves both monetary and non-monetary aspects and contributes to improved healthcare services, client satisfaction, and brand loyalty.
Health tourism can be domestic or international, serving different purposes for clients. The scope varies based on factors such as gender, age, economic status, and country of origin. This segmentation has led to the emergence of targeted care tourism, allowing countries to cater to specific customer needs, set different service costs, and adapt to varying price levels.
Are there any risks involved in the medical tourism industry and if so, how do we mitigate them?
Yes, despite its benefits, medical tourism poses risks to both clients and host countries. Risks due to the long flying hours, such as Deep Vein Thrombosis (DVT), pulmonary embolism, and risk of infection due to the procedures are the main areas of concern.
The risk of infection is associated with the competency of the health services in the host country. At the point of entry, there should be a well-planned mechanism to screen the passengers for communicable and non-communicable diseases and allergies, which need medical management.
Screening before surgical procedures and short premedication time may have an impact on the outcome. This could be minimised with a digitalised and networked data system at the point of entry.
There are problems with the accreditation certificates of certain institutions and laboratories, as they may have certificates not issued by the competent standard licensed authorities.
The Government must enhance the accreditation process and this requires urgent attention from leaders who need to evaluate these areas. The current mechanism is inadequate to track the expected outcomes, and there is no means to assess the outcome indicators of treatments or procedures due to the lack of a follow-up system for managed patients.
The public sector is unprepared to offer services because the Ministry of Health lacks an updated mechanism for appropriate billing. Existing policies also do not sufficiently support the potential income generation opportunities within Government institutions. Therefore, numerous aspects must be addressed to kickstart medical tourism in the public sector, including improving the ethical conduct of employees and the readiness of service organisations to provide care.
How do you propose we grow this industry?
Medical tourism is driven by several factors, including cost savings, quality of service, accessibility, responsiveness, insurance schemes, and timely access to information through the web. Cost savings are particularly attractive to European travellers who can receive better care at lower costs abroad. Collaboration with the private sector, foreign investors, and technology transfer from renowned hospitals can enhance a country’s healthcare facilities and reputation.
Long waiting times in hospitals deter medical tourists, emphasising the need for faster and more reliable alternatives. Access to transportation infrastructure is also crucial, and budget-friendly options should be regulated by governments. Real-time information and insurance policies tailored to medical tourism are essential to minimise barriers.
Medical tourism is highly competitive, with opportunities for customised service delivery. Public-private partnerships can play a significant role in enhancing a country’s reputation and attracting medical tourists. Optimal diagnostic services, accredited laboratories, reputable drug brands, and insurance options must be available to instil trust in clients.
Managing travel-related illness risks, ensuring secure and safe services, and addressing legal and ethical concerns are vital. Governments have a pivotal role in regulating and coordinating medical tourism to protect both citizens and clients. International collaboration is essential to establish a global governance mechanism for the industry.
There is a need for a Medical Tourism Policy. Sri Lanka lacks robust legal and ethical safeguards and governing mechanisms at the moment. Some countries have initiated practices like relaxed visa policies for medical patients, but ensuring the safety and privileges of travellers is vital.
The insurance sector has started incorporating medical tourism as an option, but often charges unexpectedly high amounts, citing issues with the tourism policies of other countries. It is imperative to establish a global agreement on a unified policy for all countries to ensure the sector adequately serves client expectations.
The competitive nature of business activities within the tourism industry demands a customised service approach. Many countries have opportunities to expand their hospital brands abroad, benefiting both the hosting country and the tourists. Diagnostic services and accredited laboratory chains are crucial for medical tourists, as they may require services from multiple hospitals. The availability of reputable pharmaceutical brands and medical devices can enhance consumer trust.
Insurance providers must consider alternative options to meet the needs of clients seeking medical tourism, offering wider coverage and flexible payment regulations to mitigate currency and financial disparities. Managing travel-related illnesses between the host and residence countries is essential, especially during epidemics or pandemics, requiring secure and safe services to minimise the risk of cross-transmission of communicable diseases.
What is the role of the government in the medical tourism industry?
The government has a dual role in the medical tourism industry, involving safeguarding its citizens’ health and ensuring the safety of clients. It should uphold the standards of medical education and accreditation of healthcare institutions while regulating intermediary services such as brokering agencies and supportive agencies. Procedures illegal in the home country should generally be prohibited in the host country unless deemed life-threatening. Gaps in laws against medical malpractice should be addressed, and monitoring teams should be appointed.
In conclusion, medical tourism has emerged as a significant industry with vast potential for Sri Lanka. To harness its benefits while mitigating risks, comprehensive policies, transparent regulations, and strong collaboration among stakeholders are essential. By offering quality, cost-effective healthcare services, Sri Lanka can establish itself as a top destination for medical tourism, contributing to its economic growth and global reputation in healthcare.
(The writer, MBBS, MSc, MCGP, PhD, is a Senior Lecturer at the Department of Anatomy Genetics and Biomedical Informatics of the Faculty of Medicine, University of Colombo)
Fractions of health tourism industry (Sunny Sun, 2022)
Types of tourists
Ministry of Health Organisation Development Director Dr. Thilina Wanigasekera