UAE - Medical tourism in the UAE experiences growing pains

DUBAI //While providers of private health care are gearing up to promote the country as a hub for medical tourism, health experts warn the efforts may be premature.

Private-sector hospitals and medical centres in the capital and Dubai have reported an increase in the number of patients coming from abroad to seek medical treatment.

Dubai Healthcare City (DHCC) has noted a sharp growth in medical tourism over the past three years. Of 502,000 patients last year, about 15 per cent were medical tourists, compared with 10 per cent of its 412,000 patients in 2010, and an estimated 5 per cent of its 231,000 patients in 2009.

The private healthcare provider is preparing the first Middle East edition of Patients Beyond Borders, a book that will feature the medical services at DHCC, to be distributed internationally. It is to be launched in May.

The City Hospital in Dubai receives 10 to 15 patients from abroad every month, compared with five a month in 2009. And nearly 15 per cent of inpatients at Al Noor Hospital in Abu Dhabi are from abroad.

Most patients come from neighbouring countries seeking surgical procedures, including cardiac and orthopaedic treatment, that are not available in their home countries. Patients from the West, however, usually seek elective procedures while they are on holiday in the UAE.

"People usually travel abroad because the treatment is cheaper, because of better quality, or for the sake of privacy," said Dr Ionnis Michael Salivaras, chief medical officer at the American Academy of Cosmetic Surgery Hospital in Dubai.

"But here, it's a little different. Our costs are not all significantly lower. So most people who travel here first look for access to quality health care, followed by privacy, and their last concern would be costs."

While the field is showing promise, doctors warn that the infrastructure of the health system still does not provide a solid foundation for growth.

While Dr Taha Ibrahim, the director of Al Noor Hospital, described the UAE's medical tourism industry as prosperous, he also said legislation covering the area needs revisiting.

"Medicine can have a lot of outcomes, including complications and side effects," he said. "Are we ready from a legislation point of view to cover these kinds of shortcomings? I don't think so."

Countries where medical tourism is booming, such as Germany and Thailand, have legal contracts between patients and hospitals that are monitored by health authorities, Dr Ibrahim said.

"This is extremely important, because [uncovered liabilities] could not only hurt the reputation of the institution, but also the reputation of the country."

Doctors said such laws should cover not only potential complications, but also require hospitals to ensure follow-up care for patients after they return to their home countries.

Dr Essa Al Mansouri, acting director of external and international organisations at the Ministry of Health (MoH), acknowledged the lack of medical tourism legislation and said the ministry would take doctors' recommendations into consideration.

He said the ministry is also looking at setting up medical visit visas, similar to those available in the US and the UK, to monitor and protect patients.

Meanwhile, the Dubai Health Authority (DHA) said it is working on a set of guidelines that would govern medical tourism.

Facilities would be categorised by cost, with minimum standards and customer protection rules in place.

However, legislation is not the only missing piece of the puzzle.

David Hadley, chief executive of EHL Management Services, which manages The City Hospital and Welcare Hospital, said the UAE was lacking two key factors for successful medical tourism: highly specialised services not available elsewhere and significantly lower pricing.

Mr Hadley attributed the lack of specialists to the country's young population and its large number of expatriates.

"Most of these expatriates return to their home country once they reach retirement age," he said. "As such, the demand for highly specialised healthcare facilities, which are normally associated with an aged population, is very low.

"One cannot offer highly specialised services and technology if they are not supported through demand. Firstly, the doctor's skills will not survive the lower volume and secondly the business case will not work, whether in the private or the public sector."

Laila Al Jassmi, chief executive of health policy and strategy at the DHA, said the question lies more on the issue of access than demand, as the authority's private and public hospitals are operating at 80 per cent capacity.

"We've got a high life expectancy of 78 years in the UAE as compared to 58 to 60 years in most developing countries in South Asia and the Mena region," she said. "A part of the solution here is the insurance mandate, which is currently under discussion, as this will widen the net of patients with access to quality medical care."

Ms Al Jassmi said many factors helped contribute to lower costs in other countries such as cost of living and salaries and the availability of qualified medical professionals.

"In countries like Singapore and Thailand, the same doctors see patients paying varied medical fees depending on their levels of coverage and affordability," she said. "We have to be mindful that the systems they have in place are much older and have been developed and matured over the last 40 to 50 years built on home-grown clinical expertise."

With an average of 19 physicians per 10,000 residents in the UAE, compared with 33 in the US and 38 in Germany, experts have said the UAE still has a long way to go.

"I believe we should focus on [the local] market first," Mr Hadley said. "Medical tourism opportunities in my view are thus limited in the UAE for the next few years."

Manal Ismail

The National (UAE)

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