EU Cross-border Healthcare Directive boosts health tourism

The new EU Cross-border Healthcare Directive which is to be announced today intends to lift restrictions on patients travelling for treatment in other EU countries. Patients wishing to travel to other EU countries for medical treatment will be able to reclaim the cost of treatment from the NHS and will only have to pay their travel and accommodation costs, plus any top-up fees if charges in the foreign hospitals are higher than the NHS cost.

The directive could revolutionise the way we experience healthcare in the UK and throughout the rest of Europe. The directive will take the concept of patient choice to a new level. Competition from European hospitals could prompt much needed changes within the NHS. Successive UK governments have made token gestures to introduce market forces within the NHS; ranked 17th out of 29 European countries in the recent Euro Health Consumer Index, the NHS now faces real competition in the European marketplace.

The Directive will provide a framework for cross border healthcare and will deal with issues such as quality of care, patient safety, method of funding and transfer of patient information. There are also plans to introduce "European reference networks" which would bring together medical expertise across Europe and encourage greater collaboaration between centres of excellence.

Dental tourism....without going abroad?

This week sees news that two buy-to-let-property development millionaires plan to open a series of drive-in dental centres close to motorway junctions around the UK. Having seen the growth of dental tourism in the UK, they have decided to bring overseas dentists to the British patient, offering prices for dental treatment which will be competitive with those in countries such as Poland and Hungary.

They plan to set up a national chain charging the same or less than NHS clinics. Thie service will be staffed by dentists from Eastern Europe who will receive free housing but will only get salaries in line with what they would earn back in Eastern Europe.

Whether this idea will get off the ground remains to be seen. Will they be able to find overseas dentists who are prepared to work at Eastern Europe salary rates when they are based in the UK? How will they attract the best overseas dentists to work at these rates? And how will they select the dentists?

If it works....perhaps we'll see the UK becoming a dental tourism destination?

British patient wins NHS payment for treatment abroad

Another British patient has succeeded in recouping the cost of treatment abroad from the NHS.

Ann Belshaw of Suffolk took the Suffolk Primary Care Trust to court to pay for a scan at a private clinic in Germany. The NHS originally told her that she would have to wait a year for a scan on her back at the Addenbrookes Hospital in Cambridge.

A three-year legal battle then ensued to force her local NHS Health Trust to pay for her private treatment abroad. The Trust has now agreed to pay the £350 cost of the scan and Mrs Belshaw's legal costs , just as the the case was to go before London's High Court. Had it gone to the High Court, there is little doubt that the European Court of Justice ruling on cross border treatment (the Yvonne Watts case) would have applied.

This legal precedent combined with the forthcoming EU proposals on cross-border healthcare could lead to significant growth in medical tourism from the UK.

EU proposals promise boost to medical tourism

European Commission proposals to be released next week will increase patient mobility within the EU and give NHS patients access to hospitals across the Continent; patients in other EU countries will will also have access to NHS hospitals.

The proposals will confirm the ruling of the European Court of Justice on overseas treatment for waiting list patients who are suffering "undue delay". Yvonne Watts, a British patient who was on a waiting list for hip replacement paid to go to a French hospital for her hip operation; she then went to the European Court of Justice to claim the costs of the operation from the NHS. The Court confirmed the legal right of patients to seek treatment in another EU state, if they have to suffer "undue delay" in their country of residence.

The new proposals could result in a boom in NHS sponsored health tourism. Patients would pay for travel and accommodation costs, but the NHS would foot the bill for the treatment.

Details of the new proposals are expected to be made available this week.

Cosmetic surgery abroad under fire in the UK press

The growth of medical tourism is attracting more and more attention to issues such as quality of treatment, accreditation of surgeons and dentists, hospitals and clinics.

The British Association of Aesthetic Plastic Surgeons this week launched an attack on “botched cosmetic work” carried out by surgeons overseas, based on a “study” of 36 UK plastic surgeons who reported having to correct surgery carried out abroad. The “study” resulted in headlines such as these:

• Operations done abroad fail to cut it – Daily Telegraph
  
• Plastic surgeons attack botched holiday surgery – The Guardian
  
• UK surgeons 'fix overseas blunders' - Channel 4 News
  
• More fly off for bargain facelift holidays - then seek repairs back home – The Times

Recently, dental tourism was also criticised, by the British Dental Health Foundation, resulting in headlines such as this:

• How my smile was ruined by a dodgy dentist

Now....you have to bear in mind the motives of the British Association of Aesthetic Plastic Surgeons and other professional associations in publicising such issues. They and their PR agencies represent the interests of UK surgeons, dentists and medical professionals. It's bad for business if people start travelling for treatment!

Let's take the "dodgy dentist story". The British Dental Health Foundation reported there has been "a significant increase in calls to its helpline from people who have had bad experiences of dental tourism". In fact, they receive around 40 calls per month about medical tourism out of 3,500 calls in total. Of the 40 calls, 5 are from patients reporting problems or who are unhappy with their treatment. And given the growth of medical tourism, you might expect an increase....

The British Association of Aesthetic Plastic Surgeons story is based on a study of 36 members.

"Half the surgeons who took part in a survey have seen at least “a little more” repair work than last year, while a third have seen “much more” repair work as increasing numbers of Britons opt for cheap surgery abroad"

Given that the number of UK cosmetic surgery procedures rose by 40% last year and medical tourism based cosmetic surgery probably rose by around 100%, you might expect there to be more problems seen?

At Treatment Abroad, we are pursuing several initiatives to counter such criticisms and promote the concept of medical tourism. Our current survey of medical tourist experiences of treatment abroad is one of these initiatives.

Another initiative is the development of a “Code of Practice for Medical Tourism”. You can find out more about what we are trying to achieve on the Code of Practice page on Treatment Abroad.

New health index means good news for medical tourism companies

The recently published Euro Health Consumer Index provides some interesting insights into the state of the UK health services and some encouragement for those who see the UK as a developing market for outbound medical tourists. The Index rates the public healthcare systems in 29 European countries on many factors such as clinical outcomes, quality of care, access to health services and patient information.

Austria emerges as the 2007 winner of the Euro Health Consumer Index, followed by the Netherlands, France, Switzerland and Germany.

The UK comes a very disappointing 17th out of the 29 countries; its score is dragged down by waiting lists and uneven quality performance. Medical tourism destinations such as France, Belgium, Estonia, Cyprus, Spain and the Czech Republic all outscore the UK.

As a separate exercise, the Euro Health Consumer Index 2007 included a value for money adjusted score, the "Bang-For-the-Buck adjusted score", which attempts to measure the value for money which the consumer gets from the healthcare system allowing for the spend on public healthcare in the country.

More bad news for the UK National Health Service.....

The UK sinks to 26th out of 29. Only Bulgaria, Poland and Latvia do worse.

Despite the efforts of successive UK governments, the NHS continues to deliver value for money to UK health consumers.

And that's probably good news for medical tourism companies!

UK media gives medical tourism a favourable press

The UK press continues to provide plenty of coverage for medical tourism, the vast majority of which is incredibly positive. Whereas the media are usually quick to find the "bad news" story, this has certainly not been the case with medical tourism. The recent exception was this story "How my smile was ruined by a dodgy dentist" in the Daily Mail.

However, the UK media is, in general, giving medical tourism a favourable press:

• Record numbers go abroad for health treatment with 70,000 escaping NHS - Daily Mail
• 70,000 Brits have ops overseas - The Sun
• Fears and frustrations driving patients abroad - Sunday Telegraph
• Long distance surgery is a snip - The Times

The recent increases in UK patients traveling abroad are becoming somewhat of an enbarrassment for a Labour government which has invested significantly in the NHS in recent years. The Tory party have seen the opportunity:

"Andrew Lansley, the shadow health secretary, said the figures were a "terrible indictment" of government policies that were undermining the efforts of NHS staff to provide quality services."

Waiting times for operations, lack of access to new treatments and fears of MRSA and hospital infections are significant problems in the UK NHS.

And they all factors which will encourage more people to travel abroad for treatment......

Resources
You can see a regularly updated list of medical tourism news stories on Treatment Abroad.

How many medical tourists are there?

There has always been speculation about the true number of medical tourists travelling from the UK for treatment abroad.

We've just completed the first ever survey of medical tourism providers, and have come up with some interesting data on the medical tourism market. The Treatment Abroad Medical Tourism Survey 2007 (www.treatmentabroad.net), reveals that over 50,000 people travelled abroad for treatment last year, and spent £161 million on medical tourism. The number of medical tourists increased by 25% over the 12 months and will continue to grow over the next 6-12 months.

Dentistry is the most popular service with dental treatments such as crowns, dental implants, bridges and veneers leading the way. Over 20,000 Brits travel abroad for their teeth, spending around £2,500 each, with an estimated market value of over £50 million per annum.

Cosmetic surgery is a close second with around 14,500 patients travelling outside the UK. Breast augmentation, tummy tuck, liposuction and facelift are popular choices; patients spend around £3,500 each, creating an estimated market size of £50 million.

The most common types of elective surgery for patients travelling abroad are hip replacement, knee replacement, laser eye surgery and cataract removal, with some 10,000 patients spending £37 million in 2007.

New association formed for medical tourism

At the recent World Health Tourism Congress in Cyprus, the launch of the International Medical Travel Association (IMTA) was announced.

The IMTA seeks to represent the interests of medical travellers and the medical travel industry including healthcare providers and medical travel facilitators. The association currently has 26 registered members from across the world. Dr Steven Tucker, Medical Director of the West Clinic Excellence Cancer Centre in Singapor, is the President of the IMTA.

How successful the organisation will be in developing internationally accepted standards and codes of conduct for medical tourism.....who knows?

The medical tourism market is very fragmented consisting of many minor players such as doctors, dentists and individual clinics and various medical tourism "facilitators"and hospital groups. As yet, no one company has attempted to take a really significant share of the market. It's likely that those who take the lead in this fast emerging market will be the standard setters which others will follow.