Manorama Bakshi
Introduction
Impact and Policy Research Institute held an online national summer school program on the topic Health Sector Management and Governance: An Indian Perspective. During this course Dr Manorama Bakshi gave an in-depth knowledge about medical tourism in India.
Dr Bakshi is a seasoned Public Health and Development Professional with an illustrious 24+ years of career and currently serving as the Director and Head of Healthcare and Advocacy at Consocia Advisory, and also the founder and director of Trilok Raj Foundation (TRF). Dr.Bakshi compared why India in spite of providing cheap healthcare facilities is not able to progress in this sector.Dr Bakshi gave a SWOT analysis of it to understand the overall strength, weakness and opportunity of India’s medical tourism and how it can be improved (IMPRI).
What is Medical Tourism?
Dr Manorama Bakshi describes medical tourism as activities related to traveling and hosting a tourist who stays at least one night at the destination region for the purpose of maintaining, improving or restoring health through medical interventions. Essentially it refers to a person who would travel to some other country so that he/she can get a better treatment than the country in which the person stays.
Medical tourism is not only limited to surgeries for heart, knee or hip but also for beauty enhancement of the person for example cosmetic surgery for hair,skin , face and body which can change the looks of a person. Apart from it, many tourists prefer to come just to relax for a few days and be away from the hustle bustle of daily life. This type of tourism can also be called wellness tourism which can be defined as travel that focuses on improving or maintaining personal well-being( Global Wellness Institute) . This type of tourism not only makes a person fit and fine but also as the person visits various tourist places it provides income to the country.
History of Medical Tourism
As Dr Bakshi explored the historical roots of medical tourism, she noted that it is not a recent phenomenon in India, having originated as early as the time of the Charakhas. As Dr Bakshi explored the historical roots of medical tourism,she noted that this is not a recent phenomena. The Great Indian Medical Practitioners, Charkha and Sushruta developed medical and surgical procedures much before the world knew about medicine for many diseases. India is known as the mother land for alternate medicinal practices like Ayurveda, Unani and Nature Cure.
Our ancient indian medical practitioners performed complicated surgical procedures with equipment available naturally in those times (MEDICAL TOURISM IN INDIA) as a result attracted a large number of tourists in India. This development of medical tourism continued even into the Mughal period where there were development of hospitals,development of a pharmacopeia, and the introduction of refined surgical tools and procedures (Vaia)
Global Overview of Medical Tourism
Medical tourism has emerged as a cornerstone of global healthcare, valued at over $100 billion USD and growing at an annual rate of 15 to 20 percent. Leading destinations for medical tourism include Thailand, Mexico,U.S.A, Singapore, India, , Brazil, Turkey and Taiwan. Dr Bakshi while citing examples from other countries mentioned that Thailand has the highest number of medical tourists. It attracts more than 2,500,000 tourists annually up until the year 2018.
According to an online article, the top six reasons for the rise in medical tourism in Thailand are primarily its lower costs compared to the U.S.A. The availability of well trained and qualified doctors, many of whom hold degrees from United Kingdom, the presence of numerous JCI-accredited hospitals, a straightforward visa process for medical tourist, continuous promotion of medical tourism that has garnered global attention, and lastly, its popular tourist destinations( Personal Banking).
Medical Tourism In India
Dr Bakshi highlighted that in India in the year 2016 the number of people who visited for the purpose of medical tourism reached 4.3 lakhs which increased in the year 2019 to 7 lakhs. This represents a notable increase of nearly 63% in just three years, indicating India’s growing reputation as a global destination for affordable, high-quality healthcare. As per the recent data for the year 2024 there were 7.3 million medical tourists in India(Hindustan Times).This dramatic jump signals an exponential growth in the sector, with over a tenfold increase in medical tourists between 2019 and 2014.
India’s ranking as 10th in the Medical Tourism Index, out of 46 global destinations, by the Medical Tourism Association is a testament to the country’s growing prominence in the healthcare sector. Bangladesh remains a dominant source of medical tourists to India, with 54% of medical tourists in India coming from the country. In 2023 alone, 449,570 medical tourists from Bangladesh traveled to India for healthcare services(Business Standard).
According to the report of the Ministry of Tourism, Government of India, India has emerged as a premier destination for medical value travel over the years, owing to its excellence across various key factors that determines the overall quality of care. India’s advanced healthcare system is on par with the best in the world. Complex surgical procedures are performed in a world-class global hospital by acclaimed medical specialists at a significantly lower cost than in other countries. India has also become a favored destination for Yoga and Wellness with its focus on traditional therapies through AYUSH(National Strategy and Roadmap for Medical and Wellness Tourism.pdf).
SWOTAnalysis of Medical Tourism In India
Dr Manorama Bakshi presented a critical analysis of the strengths , weaknesses , opportunities and threats to India’s medical tourism which is as follows;
- Strength
A. Cost Advantage:
( Souce; Vol. 33 No. 2- MEDICAL TOURISM IN INDIA: A SWOT ANALYSIS)
The above table represents how cost effective it is to get a medical surgery done in India as compared to other countries like Thailand, Singapore and the U.S.A.India is offering medical procedures at a fraction of the cost compared to industrialized nations, often saving patients 60-80% even after accounting for travel expenses (Out Loud Blog – Times of India BlogB. Skilled Doctors:
As we know, many Indian students pursue their studies abroad, including medical degrees. Upon returning to India, these doctors are highly qualified and have honed their skills through their exposure abroad. This can provide a sense of reassurance to foreign tourists, who may feel more secure knowing that these medical practitioners have received their training in international settings. - Weakness
A. Issue of Cleanliness:
Despite being cost-effective, India struggles to attract tourists from developed countries, such as those in Europe. As of 2023, European medical tourists account for only 22.7% of the total medical tourism in India (National Strategy and Roadmap for Medical and Wellness Tourism.pdf)The challenge lies in cleanliness. Despite the government’s ongoing efforts to promote clean hospitals through the Swachh Bharat Scheme, many hospitals in Delhi still present concerning conditions. Visitors may encounter overflowing ‘dhalaos’ filled with decaying medical and general waste, puddle-riddled roads that serve as breeding grounds for mosquitoes, unkempt toilets, and corridors transformed into makeshift ‘dhobi-ghats’ with clothes hung out to dry. Additionally, rampant illegal encroachment around hospital premises further detracts from the environment, creating an unsettling experience for patients and their families (The Hindu) .B. Lack of NABHAccredited Hospitals:
The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is an entity that provides accreditation to healthcare institutions in India that adhere to defined quality standards. The limited number of accredited hospitals contributes to a lack of trust among tourists regarding Indian healthcare facilities.C. Regulatory and Bureaucratic Hurdles:
The Visa process for medical tourists is lengthy and complex procedures can be time-consuming and cumbersome for patients and their families, resulting in delays and potential cancellations(The Hurdle of Indian Medical Visas!).The lack of well-defined and uniform regulations surrounding medical tourism can lead to confusion. Patients may find it challenging to comprehend the treatment requirements, which can differ markedly from one state or hospital to another, resulting in frustration and uncertainty(Medical value travel in India). These hurdles discourage tourists from coming to India for medical treatment.
D. Safety Concerns:
India has been ranked 116 globally out of 163 countries in global peace index (Gupta, 2024) making it not so safe for the tourist as they always live in fear of crimes like rape, theft ,murder and similar henious crimes. It is also a fact that India lacks in the matter of women safety. In the year between 2016 and 2022, 148 rape cases in which victims are foreigners have been recorded in India (The Hindu). So, when families visit India they often find it difficult to bring their wife or daughters along with them due to safety issues and are constantly worried about how they are in their home country. - Opportunity
A. Aging Population:
A variety of countries are witnessing a decrease in their population, which is leading to a persistent contraction of the workforce in all sectors, including the medical field. This trend could serve as a valuable opportunity for India to attract visitors from these nations.B. Bilateral Agreements:
Bilateral agreements often include provisions for simplified visa processes, such as e-visas or visa waivers. This makes it easier for patients from partner countries to travel to India for medical treatment, reducing bureaucratic hurdles and encouraging more visitorsAgreements can serve to strengthen collaborations between hospitals in India and those in other countries, promoting knowledge sharing, the exchange of best practices, and the development of referral networks. For instance, initiatives like the B2B meetings organized by Indian embassies are designed to connect healthcare providers across borders, thereby boosting patient referrals (Embassy of India, Astana, Kazakhstan). One example is the bilateral agreement between India and Bangladesh which has increased medical tourists from Bangladesh to India.C. Encouraging Joint Ventures:
Promoting partnerships between local and international healthcare providers would attract more tourists. Such partnerships can generate significant value for patients, delivering a holistic experience that addresses the diverse elements of their healthcare journey. Renowned Indian hospital chains, including Apollo and Fortis, have initiated International Patient Assistance Centers across various countries. They collaborate with local healthcare providers, travel agencies, diplomatic entities, and wellness tourism firms to facilitate a seamless experience for those seeking medical treatment abroad( Invest India) . These ventures frequently unite the specialized knowledge of global healthcare providers with local medical institutions. This partnership can facilitate the implementation of cutting-edge medical technologies and optimal patient care practices, ultimately improving the quality of services available to medical tourists( Health Policy and Planning | Oxford Academic).D. Regulatory Support:
Adopting international standards of healthcare would attract more medical tourists in India. Also there is a need for more advertising to spread the facilities provided by India for its medical tourists.In the contemporary world, people are constantly exposed to mass media, which can play a significant role in advertising medical tourism in India. By reaching a broad audience, these advertisements can encourage individuals to seek medical treatment in India.E. Insurance Coverage:
There must be medical insurances which cover these tourists so that the process is more hassle free.The comprehensive healthcare coverage provided by medical tourism insurance includes support for pre-existing conditions, surgical procedures, treatments, and may also encompass travel and lodging costs related to the medical treatment( Karetrip: Get Information About Everything On Medical Tourism in India)
Policy Recommendations For Improving Medical Tourism In India
The implementation of the following policies could boost medical tourism in India:
1.Focus on three market segments namely
a. SAARCcountries, Middle East, Africa, CIS countries
b.Parts of South East Asia
c.Europe and America.
It is important to focus these three market segments as it is projected that India’s medical tourism market will grow from $9 billion in 2022 to approximately $13 billion by 2026, driven by an increasing volume of international patients looking for affordable and high-quality healthcare options(Factors Influencing Medical Tourism in India: A Critical Review).The attraction of visitors from Europe and the SAARC region may further enhance this revenue opportunity.
2. Focus on Healthcare Investments(FDI through PPP)
Many hospitals and healthcare facilities in Thailand have sought strategic partnerships with international healthcare providers to enhance their capabilities and attract more international patients. These partnerships often involve the exchange of knowledge, technology, and best practices. Some M&A activities in the Thailand medical tourism market have aimed to strengthen the competitive position of participating entities.
By consolidating resources and expertise, organizations can enhance their market presence and competitive advantage. Moreover, the government of Thailand has been introducing favorable policies to support medical tourism in the country. For instance,Thailand launched USD 14,000 medical coverage for tourists. This step reassured the patient’s safety in the Asian country, ensuring proper care(Grand View Research) .Even India can plan something like this to attract medical tourists.
3.Simplified Visa Processes
In India the visa process is time consuming and this discourages medical tourists who then prefer to go to Thailand in spite of its high cost as the visa process there is simple. In Thailand there is Short waiting times for healthcare services in Thailand are an appealing point for foreigners visiting for treatments. Foreign patients can go for walk-in appointments, and enjoy access to online healthcare services and hospital booking systems, just like Thai citizens (Future Market Insights).
4. Development of AYUSH Healthcare Centres
AYUSH is the acronym of the medical systems that are being practiced in India such as Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy. These systems are based on definite medical philosophies and represent a way of healthy living with established concepts on prevention of diseases and promotion of health ( india.gov.in).
Heal in India is an Initiative of the Government to promote the Medical Tourism in the country. Under this initiative,the Ministry of Health and Family Welfare and Ministry of Ayush has been working with Centre for Development of Advanced Computing (CDAC) and Services Export Promotion Council (SEPC)for developing a ‘One Step’ Heal in India portal for Promotion of Medical Value Travel (Government to promote AYUSH treatment through health tourism).
Conclusion
India is performing exceptionally well in the medical tourism sector; however, there remains significant room for improvement.The first step that requires focus is to create a safe place for tourists. It is understandable that tourists won’t prefer to come to a destination where safety concerns arise due to fear of crime. Next step would be to make the system of medical tourism smooth by ensuring a smooth visa process without any bureaucratic hurdles. Further India must also try to attract more European and American tourists and one of the ways to attract them is to maintain cleanliness in hospitals and have more accredited hospitals.
Medical tourism is an area where India has significant potential for improvement, and enhancing this industry could provide a substantial boost to the country’s overall economy. The need of the hour is to implement policies which are tourist friendly and ensure strict implementation of it.
References
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About The Author: The article has been written by Arohi Sanyal, a research intern at Impact and Policy Research Institute. She has completed Masters in Gender Studies from Dr.B.R.Ambedkar University,Delhi
Disclaimer: All views expressed in the article belong solely to the author and not necessarily to the organisation.
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Acknowledgment: The author would like to thank Dr.Arjun Kumar, Vaishali Singh and Samprikta for their continuous support and valuable feedback and suggestions for the article.
This article was posted by Reetwika Mallick, a Visiting Researcher and Assistant Editor at IMPRI.
