UAE - Thailand Profits From Health Care to Arab Patients

DUBAI — Last year, 125,000 Arab patients came to Bumrungrad International Hospital in Thailand to seek medical treatment.

Yet just a few years ago the sight of a woman wearing a burqa was such a rarity that it would scare the nurses at night.

The hospital, in central Bangkok, now makes a point of catering to the specific needs of patients from the Middle East. Its facilities include a kitchen preparing halal meals and the presence of 80 Arabic translators and three resident Arabic-speaking doctors on call.

“Today, our hospital eating area looks like you’re in Dubai,” Dr. Peter Morley, Bumrungrad’s international medical director, said late last month at the Arab Health Congress here. “We make it a point to find staff who deal well with diversity. A lot of our patients have Thai backgrounds, but so many come from the Gulf as well.”

According to data provided by the hospital, Bumrungrad treated fewer than 10,000 Arab patients a year before Sept. 11, 2001, when the United States tightened security and immigration laws, cracking down on travel from the Middle East in the wake of the terrorist attacks. By 2003 the number had risen to 22,000 and the trend has continued steadily since, with increases in patient numbers averaging 15 percent a year over the past three years

Part of the attraction is that treatment in Asian facilities like Bumrungrad costs less than in comparable European or North American hospitals.

Governments in the six countries that make up the Gulf Cooperation Council “almost always pay for citizens to receive treatment abroad,” Mansur Ali, the managing director in Dubai of the private Kuwaiti company Kleos Healthcare, said by telephone. “Now we’re seeing ministries sending some patients to facilities like Bumrungrad in Asia as one way to manage costs.”

About 7,000 patients a year from the United Arab Emirates alone travel abroad to seek medical care, according to research from the consulting firm Booz & Co. based on 2008 figures released in December 2011. Data from G.C.C. health authorities is patchy and closely held, but analysts say the numbers are rising. The cost burden for overseas medical treatment on the U.A.E. government in 2008 was in excess of $500 million, up from less than $200 million in 2003, the Booz report said. In addition to financing medical treatment, a patient’s travel and accommodation are covered and a daily allowance is provided for the patient and an accompanying relative.

The amount varies by country. For example, a Kuwaiti citizen with an accompanying relative sent abroad for treatment each receives $250 per day for living expenses and a round-trip business class ticket allowance of up to $5,000, depending on the destination.

The main reason for seeking health care abroad is a lack of specific treatment in the home country, or poor quality of care even when it is available. Analysts say most of the hospitals and clinics in the Gulf council countries were set up in the 1970s and 1980s, when standards were lower. Facilities are said to be ill equipped and badly staffed, and many are not internationally accredited. As a result, patients often travel to Germany, Britain, Thailand and India for treatment in specialities like oncology, neurology, orthopedics and cardiology.

According to data from Kleos, the average cost of sending a patient, with accompanying relative, overseas is $200,000. This places a strain on government budgets. Kleos calculates that the total amount of money expected to leave the G.C.C. for overseas health care this year, including medical, travel and living expenses, will be around $12 billion: $10 billion from the public sector, and $2 billion from the private sector, which includes patients paying from their own pockets or through private health insurance companies. The main recipient countries will be the United States, Britain, Germany, Egypt and Thailand.

To address what some call the patient-drain problem, G.C.C. health authorities have set up medical tourism committees to screen cases going abroad. They have also started to bring foreign health care providers and doctors into the region and to invest heavily in local facilities to reduce costs, said Mr. Ali, of Kleos.

From 2007 to 2011, Bumrungrad managed the Mafraq Hospital in Abu Dhabi for the emirate’s health authority, though it decided not to renew the contract last year, preferring to concentrate on developing its activities in Thailand, the hospital’s business development director, Kenneth Mays, wrote in an e-mail.

Meanwhile, the Cleveland Clinic, based in Ohio, is set to open its first facility outside North America next year on Sowwah Island, also in Abu Dhabi. The $1.9 billion hospital, offering specializations including neurological and cardiovascular treatments, will be built and owned by Mubadala, the investment arm of the Abu Dhabi government, with Cleveland as the operator.

In Saudi Arabia, too, the King Fahd Medical Center in Riyadh has ordered $77 million in equipment for a proposed proton therapy center, of which there are only 37 in the world. The new center would be the first of its kind in Saudi Arabia to treat certain cancers.

“A center like this will save the government hundreds of millions per year, whereas now Saudis that need proton therapy must be sent abroad for treatment,” said Jad Bitar, a consultant at Booz & Co. who focuses on health care. “Treatment itself is expensive and can last for months.”

He added that governments were also investing in medical studies at Gulf universities. In Qatar, Hamad Medical Corp. provides training for doctors and nurses as a way to build a sustainable labor force for the health care sector. Today, 93 percent of Abu Dhabi’s health care system is staffed by foreigners, Mr. Bitar said.

“It’s also about national security. Imagine if these people suddenly had to leave, our health care system would fall apart,” he said. “Sustainable labor is definitely something governments are conscious about.”

The private sector needs to play a bigger role in investing in health care, the Booz report said, to relieve part of the burden on government finances. Limiting the dominant position of government health authorities in care provision would improve the opportunities for private investors to set up operations and compete, which in turn would improve the quality of health care in the region, it said.

“We constantly need to anticipate what the needs will be in 10 years, and what we’re doing now is still not enough,” said Mr. Ali, of Kleos. “It’s a constant battle of trying to keep up.”

SARA HAMDAN

The New York Times

Middle East

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