As the recent trend towards health tourism becomes ever more popular International Investment looks at whether getting treatment abroad will become par for the course
As overseas travel becomes cheaper and easier, so too does the opportunity for so-called health tourism. This does not include emergency treatment abroad, but is when individuals actively opt and arrange to go abroad to have their hip replaced or have a heart bypass operation.
The NHS itself gave health tourism something of a boost in publicity a few years ago when a series of pilot schemes to send NHS patients abroad for treatment found "patients' reactions to be very positive." The Department of Health (DoH) claims treating patients in the European Economic Union is comparable with patients being treated in the UK private sector.
Now, NHS primary care trusts can arrange for NHS patients to receive treatment in the EU if they think that this is the best way to help reduce waiting times for their local population. Almost 600 NHS patients were referred for treatment in France, Germany and Belgium, between 2002 and 2004 - the majority for orthopaedic and some cardiac procedures.
The choice of location is indicative of the concern that travel times be kept to a minimum in order to prevent post-operative complications with the DoH suggests a three-hour maximum flight time.
Private provision is a different matter it seems. Norwich Union (NU) recently reported 74% of GPs admit British patients who travel abroad for medical treatment do so because they are fed up with UK waiting lists. NU also reports the treatment these patients are seeking most commonly are hip replacements and cardiac surgery.
NU's report sums up the objections often cited against opting for treatment abroad. Firstly it can be difficult to obtain information about foreign hospitals and consultants, and language barriers could be a problem, especially when discussing complicated medical procedures.
Travelling with an existing condition could also increase the risk of developing further symptoms such as thrombosis and if there are complications, patients could be stranded abroad for longer than they had intended to stay originally.
Also, unless the patient is going to go alone, there is the cost of catering and accommodation for a friend or the family to travel.
Finally, on return to the UK it may not be easy for the individual's GP to provide care if they are unaware of the treatment the patient has had, if they are not able to decipher foreign medical records or get easy access to x-rays or blood test results.
Insurers are, on the surface, relaxed about the competition created by patients taking their custom abroad. They argue if individuals have PMI they do not need to go abroad to seek treatment because they can generally take out PMI to ensure they can get treatment quickly and easily in the UK and that has to be the preferable option.
Some insurers will still be flexible enough to cover the costs, the medical costs at any rate, if a policyholder can make a case for going abroad. PatientChoice says its policyholders have complete freedom to source their treatment overseas and it will help them source that treatment if they want to.
This obviously adds an extra level of security for the policyholder. "We are happy for people to go abroad," says Thom van Every, chief medical officer at PatientChoice. "We reserve the right to decline to let them go to a certain hospital if we do not think it is up to standard." The group uses third parties who specialise in outsourcing treatment for people who do not have insurance.
Such treatment sourcing firms are Medplex, which sources treatment to Singapore and Medical Care Direct, which has arranged treatment in France and South Africa.
Choosing the right packager will obviously depend on the operation needed and preferred location for treatment. While treatment costs may compare attractively with private costs in the UK, the additional costs of travel and accommodation will also have to be met.
covering the costs
While WPA and Clinicare will pay for operations abroad, policyholders thinking of going overseas cannot always rely on their insurer helping out. Bupa, for example, will not provide cover, although it is looking into the situation and may add a bolt-on option in the future. However, even those willing to cover treatment costs admit the need has rarely arisen. When it has, it has been because the treatment or specialist care they require is not available in the UK.
Charlie MacEwan, head of communications at WPA confirms: "The only reason our customers go abroad is because the treatment they need is not available in the UK."
on a budget
Of those individuals with medical insurance, the ones most likely to consider getting an operation abroad are those with an interest in saving costs, such as those with a shared responsibility or self-pay policy.
"With traditional indemnity insurance the policyholder has no interest in how much the treatment costs, there is no incentive for them to get the same quality treatment at a lower price overseas," says van Every. "But policies that allocate a budget for the policyholder to spend on their respective operations and allow them to keep what they don't spend, change the dynamic completely."
NHS gave health tourism a boost sending some 600 patients to France, Germany and Belgium during 2002-04.
Dept of Health suggests three hour maximum air travel for patients going abroad but many Britons go much further afield than this.
Most Britons going abroad are fed up of UK waiting lists and want hip replacements or cardiac surgery.
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