A

Project Report

on

“Scope and Awareness about Medical Tourism In India”

For the partial fulfillment of the requirement

for the award of

Master in Business Administration

(2010-2012)

International School Of Informatics and management, Jaipur.

Submitted To: Submitted By:

Ms. Bhumija Chouhan Paras Sarawgi

Lecturer ISIM , MBA Sem 2nd

(MBA/10/1794)

Table of contents

S.NO CONTENTSPAGE NO.

1ACKNOWLEDGEMENT 3

2 PREFACE 4

3 RESEARCH AND METHODOLOGY 5

4 EXECUTIVE SUMMARY 6

5 AN INTRODUCTION 8

6 MEDICAL TOURISM IN INDIA 15

7 SWOT ANALYSIS 23

8 WHAT IS INDIA OFFERING 25

9 SCOPE AND OPPORTUNITY 31

10 INDIA’S FUTURE PROSPECTS 32

11 COST COMPARISION 35

12 MAJOR PLAYERS 37

13MEDICAL PACKAGES

43

14 CONCLUSION 46

15 RECOMMENDATIONS 47

16 BIBLIOGRAPHY 48

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ACKNOWLEDGEMENT

The beatitude, bliss and euphoria that accompany successful completion of any task would not be complete without the expression of appreciation of simple virtues to the people who made it possible. So, with reverence, veneration honor I acknowledge all those whose guidance and encouragement has made successful in winding up this.

I take this opportunity to thank Ms. Bhumija Chouhan for her support and encouragement, which helped me in the completion of this report.

I extend my gratitude and thankfulness to International School of informatics and management , jaipur.

I am also grateful to my family members and wellwishers for providing me the continuous support to motivate me to successfully complete my report.

Date:- Submitted By:

Place: Jaipur Paras Sarawgi

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PREFACE

The underlying aim of the seminar on contemporary issue as an integral part of MBA programme is to give presentation by the students on the issue. The topic of my project report is “Medical Tourism”.

This report is all about the current scenario where Medical Tourism is no doubt a rapidily growing and attractive sector. Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries

This report covers the scope and emerging trends of medical tourism along with its detailed description and SWOT analysis in Indian context.

This project includes my sincere efforts, and I affirm the findings in this project are independent and original to the best of my knowledge and belief. I sincerely hope that this report proves to be useful to the organization and also to its readers.

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RESEARCH METHODOLOGY

Research Objectives:-

Macro Objectives:

To find out the satisfaction level of the patients in the multi-specialty hospitals.

To find out the factors, why NRIs are attracted towards taking medical treatments in India.

To find out which kind of medical treatment is mostly preferred by the NRIs to take in India.

Micro Objectives:

• To make aware the administration department of the particular hospitals regarding acceptance of facilities and services provided by them to the patients.

Nature of Research:-

Research will be descriptive and explorative in nature.

Research will be done mainly to understand the satisfaction level of the patients and by this way can understands the competition and also need gaps so that better services can be develop.

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EXECUTIVE SUMMARY

Medical tourism (also called medical travel, health tourism or global healthcare) is a term initially coined by travel agencies and the mass media to describe the rapidly-growing practice of travelling across international borders to obtain health care. It also refers pejoratively to the practice of healthcare providers travelling internationally to deliver healthcare Medical tourism – the process of “leaving home” for treatments and care abroad or elsewhere domestically – is an emerging phenomenon in the health.

Tourism: An Indian overview

Tourism is the largest service industry in India, with a contribution of 6.23% to the national GDP and 8.78% of the total employment in India. India witnesses’ more than 5 million annual foreign tourist arrivals and 562 million domestic tourism visits. The tourism industry in India generated about US$100 billion in 2008 and that is expected to increase to US$275.5 billion by 2018 at a 9.4% annual growth rate. The Ministry of Tourism is the nodal agency for the development and promotion of tourism in India and maintains the "Incredible India" campaign.

Tourism will expand greatly in future mainly due to the revolution that is taking place on both the demand and supply side. The changing population structure, improvement in living standard, more disposable income, fewer working hours and long leisure time, better educated people, ageing population and more curious youth in the developed as well as developing countries, all will fuel the tourism industry growth. The arrival of a large number of customers, better educated and more sophisticated, will compel the tourist industry to launch new products and brands and re-invents traditional markets. The established traditional destinations founded on sun-sea-sand products will have to re-engineer their products. They must diversify and improve the criteria for destinations and qualities of their traditional offers. Alongside beach tourism, the tourism sector will register a steady development of new products based on natural rural business, leisure and art and culture. Thus the study of

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new markets and emerging markets and necessity of diversified products are the basis of our strategy, which can enhance and sustain, existing and capture new markets.

It is India’s vastness that challenges the imagination: the sub-continent, 3200km (2000 miles) from the mountainous vastness of the Himalayas in the north to the tropical lushness of Kerala in the south, is home to one sixth of the world’s population, a diverse culture and an intoxicatingly rich history. Desert in Rajasthan, tropical forests in the north eastern states, arid mountains in the delta region of Maharashtra and Karnataka and vast fertile planes in northern states of Uttar Pradesh, Haryana etc are just some of the geographical diversity that can be observed. We have a wealth of archeological sites and historical monuments. Manpower costs in the Indian hotel industry are one of the lowest in the world. This provides better margins for any industry which relies on man power.

One of the fascinations of India is the juxtaposition of old and new; centuries of history – from the pre-historic Indus civilization to the British Raj – rub shoulders with the computer age; and Bangalore's ‘Silicon Valley’ is as much a part of the world's largest democracy as the remotest village is.

The Deloitte 2009 Survey of Health Care Consumers, a nationally representative, online survey of more than 3,000 Americans, found that outbound medical tourism is expected to experience explosive growth over the next three to five years. Consider the following:

Health care costs are increasing at eight percent per year – well above the Consumer Price Index (CPI), thus eating into corporate profits and household disposable income.

The safety and quality of care available in many offshore settings is no longer an issue: Organizations including the Joint Commission International (JCI) and others are accrediting these facilities.

Consumers are willing to travel to obtain care that is both safe and less costly. In fact, two in five survey respondents said they would be

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interested in pursuing treatment abroad if quality was comparable and the savings were 50 percent or more.

By contrast, inbound medical tourism and medical tourism across state lines will continue to be an interesting opportunity for specialty hubs with treatments unavailable elsewhere in the world or in a community setting.

Medical Tourism: Consumers in Search of Value is Deloitte’s latest report about innovations that might be considered disruptive to some in the U.S. health care system. Recent reports spotlighting retail clinics, the medical home payment model and other innovations point to a common theme – CHANGE.

AN INTRODUCTION

History:-

The concept of medical tourism is not a new one. The first recorded instance of medical tourism dates back thousands of years to when Greek

pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism.

Spa towns and sanitariums may be considered an early form of medical tourism. In eighteenth century England, for example, medtrotters visited spas

because they were places with supposedly health-giving mineral waters, treating diseases from gout to liver disorders and bronchitis.

Description

Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.

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Medical tourists can come from anywhere in the First World, including Europe, the Middle East, Japan, the United States, and Canada. This is because of their large populations, comparatively high wealth, the high expense of health care or lack of health care options locally, and increasingly high expectations of their populations with respect to health care. An authority at the Harvard Business School recently stated that "medical tourism is promoted much more heavily in the United Kingdom than in the United States".

A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non-urgent medical care. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in New Zealand, Costa Rica, Singapore, Hong Kong, Thailand, Cuba, Colombia, Philippines or India, a patient could feasibly have an operation the day after their arrival.

Additionally, patients are finding that insurance either does not cover orthopedic surgery (such as knee/hip replacement) or imposes unreasonable restrictions on the choice of the facility, surgeon, or prosthetics to be used. Medical tourism for knee/hip replacements has emerged as one of the more widely accepted procedures because of the lower cost and minimal difficulties associated with the traveling to/from the surgery. Colombia provides a knee replacement for about $5,000 USD, including all associated fees, such as FDA-approved prosthetics and hospital stay-over expenses. However, many clinics quote prices that are not all inclusive and include only the surgeon fees associated with the procedure.

According to an article by the University of Delaware publication, UDaily:

The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the US, for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the US costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye

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surgery worth $3,700 in the US is available in many other countries for only $730. Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the US runs about $1,250 in South Africa.

Popular medical travel worldwide destinations include: Argentina, Brunei, Cuba, Colombia, Costa Rica, Hong Kong, Hungary, India, Jordan, Lithuania, Malaysia, The Philippines, Singapore, South Africa, Thailand, and recently, Saudi Arabia, UAE, Tunisia and New Zealand.

Popular cosmetic surgery travel destinations include: Argentina, Bolivia, Brazil, Colombia, Costa Rica, Cuba, Mexico and Turkey. In South America, countries such as Argentina, Bolivia, Brazil and Colombia lead on plastic surgery medical skills relying on their experienced plastic surgeons. In Bolivia and Colombia, plastic surgery has also become quite common. According to the "Sociedad Boliviana de Cirugia Plastica y Reconstructiva", more than 70% of middle and upper class women in the country have had some form of plastic surgery. Colombia also provides advanced care in cardiovascular and transplant surgery.

In Europe Belgium, Poland and Slovakia are also breaking into the business. South Africa is taking the term "medical tourism" very literally by promoting their "medical safaris".

A specialized subset of medical tourism is reproductive tourism and reproductive outsourcing, which is the practice of traveling abroad to undergo in-vitro fertilization, surrogate pregnancy and other assisted reproductive technology

treatments including freezing embryos for retro-production

However, perceptions of medical tourism are not always positive. In places like the US, which has high standards of quality, medical tourism is viewed as risky. In some parts of the world, wider political issues can influence where medical tourists will choose to seek out health care.

Health tourism providers have developed as intermediaries to unite potential medical tourists with provider hospitals and other organisations. Companies are beginning to offer global health care options that will enable North American and European patients to access world health care at a fraction of the cost of domestic care. Companies that focus on medical value travel typically provide nurse case managers to assist patients with pre- and post-travel

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medical issues. They also help provide resources for follow-up care upon the patient's return.

Process

The typical process is as follows: the person seeking medical treatment abroad contacts a medical tourism

provider. The provider usually requires the patient to provide a medical report,

including the nature of ailment, local doctor’s opinion, medical history, and diagnosis, and may request additional information.

Certified medical doctors or consultants then advise on the medical treatment. The approximate expenditure, choice of hospitals and tourist destinations, and duration of stay, etc., is discussed. After signing consent bonds and agreements, the patient is given recommendation letters for a medical visa, to be procured from the concerned embassy.

The patient travels to the destination country, where the medical tourism provider assigns a case executive, who takes care of the patient's accommodation, treatment and any other form of care.

Once the treatment is done, the patient can remain in the tourist destination or return home.

International healthcare accreditation

Because standards are important when it comes to health care, there are parallel issues around medical tourism, international healthcare accreditation, evidence-based medicine and quality assurance.

In the United States, the best known accreditation group is the Joint Commission International (JCI). They have been inspecting and accrediting health care facilities and hospitals outside of the United States since 1999 and are a trusted source for American medical tourists. Many international hospitals today see obtaining JCI accreditation as a way to attract American patients.

In the UK and Hong Kong, the Trent International Accreditation Scheme is a key player. The different international healthcare accreditation schemes vary in quality, size, cost, intent and the skill and intensity of their marketing. They also vary in terms of cost to hospitals and healthcare institutions making

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use of them. A forecast by Deloitte Consulting regarding medical tourism published in August 2008 noted the value of accreditation in ensuring quality of healthcare and specifically mentioned JCI, ISQUA and Trent.

Increasingly, some hospitals are looking towards dual international accreditation, perhaps having both JCI to cover potential US clientele and Trent for potential British and European clientele. As a result of competition between clinics for American medical tourists, there have been initiatives to rank hospitals based on patient-reported metrics.

Other relevant organizations include:

The Society for International Healthcare Accreditation (SOFIHA), a free-to-join group providing a forum for discussion and for the sharing of ideas and good practice by providers of international healthcare accreditation and users of the same. The primary role of this organisation is to promote a safe hospital environment for patients.

HealthCare Tourism International, the first US-based non-profit to accredit the non-clinical aspects of health tourism, such as language issues, business practices, and false or misleading advertising prevention. The group provides accreditation for all major groups involved in the health tourism industry including hotels, recovery facilities, and medical tourism booking agencies.

The United Kingdom Accreditation Forum (UKAF) is an established network of accreditation organisations with the intention of sharing experience good practice and new ideas around the methodology for accreditation programmes, covering issues such as developing healthcare quality standards, implementation of standards within healthcare organisations, assessment by peer review and exploration of the peer review techniques to include the recruitment, training, monitoring and evaluation of peer reviewers and the mechanisms for awards of accredited status to organisations.

The International Medical Travel Association, (IMTA, based in Singapore), is a nonprofit association formed to help address quality standards, liability issues, continuity of care, and other issues.

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Medical Tourism Association, is a nonprofit association focusing on transparency in quality and pricing.

Risks:-

Medical tourism carries some risks that locally-provided medical care does not. Some countries, such as India, Malaysia, or Thailand have very different infectious disease-related epidemiology to Europe and North America. Exposure to diseases without having built up natural immunity can be a hazard for weakened individuals, specifically with respect to gastrointestinal diseases (e.g. Hepatitis A, amoebic dysentery, paratyphoid) which could weaken progress, mosquito-transmitted diseases, influenza, and tuberculosis. However, because in poor tropical nations diseases run the gamut, doctors seem to be more open to the possibility of considering any infectious disease, including HIV, TB, and typhoid, while there are cases in the West where patients were consistently misdiagnosed for years because such diseases are perceived to be "rare" in the West.

The quality of post-operative care can also vary dramatically, depending on the hospital and country, and may be different from US or European standards. However, JCI and Trent fulfill the role of accreditation by assessing the standards in the healthcare in the countries like India, China and Thailand. Also, traveling long distances soon after surgery can increase the risk of complications. Long flights and decreased mobility in a cramped airline cabin are a known risk factor for developing blood clots in the legs such as venous thrombosis or pulmonary embolus economy class syndrome. Other vacation activities can be problematic as well — for example, scars may become darker and more noticeable if they sunburn while healing. To minimise these problems, medical tourism patients often combine their medical trips with vacation time set aside for rest and recovery in the destination country.

Also, health facilities treating medical tourists may lack an adequate complaints policy to deal appropriately and fairly with complaints made by dissatisfied patients.

Differences in healthcare provider standards around the world have been recognised by the World Health Organization, and in 2004 it launched the World

Alliance for Patient Safety. This body assists hospitals and government around the

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world in setting patient safety policy and practices that can become particularly relevant when providing medical tourism services

Legal issues:-

By traveling outside their home country for medical care, medical tourists may encounter unfamiliar ethical and legal issues. The limited nature of litigation in non-US countries is one reason for the lower cost of care overseas. While some countries currently presenting themselves as attractive medical tourism destinations provide some form of legal remedies for medical malpractice, these legal avenues may be unappealing to the medical tourist. Should problems arise, patients might not be covered by adequate personal insurance or might be unable to seek compensation via malpractice lawsuits. Hospitals and/or doctors in some countries may be unable to pay the financial damages awarded by a court to a patient who has sued them, owing to the hospital and/or the doctor not possessing appropriate insurance cover and/or medical indemnity. However new insurance products are available that protect the patient should an alleged medical malpractice occur overseas.

Ethical issues:-

There can be major ethical issues around medical tourism. For example, the illegal purchase of organs and tissues for transplantation has been alleged in countries such as India and China.

Medical tourism may raise broader ethical issues for the countries in which it is promoted. For example in India, some argue that a "policy of 'medical tourism for the classes and health missions for the masses' will lead to a deepening of the inequities" already embedded in the health care system.] In Thailand, in 2008 it was stated that, "Doctors in Thailand have become so busy with foreigners that Thai patients are having trouble getting care".

MEDICAL TOURISM IN INDIA

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Medical tourism in India has emerged as the fastest growing segment of tourism industry despite the global economic downturn. High cost of treatments in the developed countries, particularly the USA and UK, has been forcing patients from such regions to look for alternative and cost-effective destinations to get their treatments done. The Indian medical tourism industry is presently at a nascent stage, but has an enormous potential for future growth and development.

Satisfaction Level of the Patients:-

The major purpose to come in India are social gathering, treatment and tourism. The findings suggest that patients are coming majorly for the cardiac diseases, orthopedic diseases and for gastro intestinal diseases. Most of the patients select the Hospital or Doctors on the bases of the advice of their relatives or friends and from web sites. The major attraction for the patients are doctor’s specialization and low treatment charges. Patients gave their first priority to the treatment, followed by financial expenses, hospitality and accommodation. Most of the patients are satisfied with the treatment and facilities available in the hospital. Majority of the patients show their eagerness to visit the same hospital again in the future if there will be any need arise.

Current Scenario in Indian Tourism

Tourism is the largest service industry in India, with a contribution of 6.23% to the national GDP and 8.78% of the total employment in India.

India witnesses more than 5 million annual foreign tourist arrivals and 562 million domestic tourism visits.

The tourism industry in India generated about US$100 billion in 2008 and that is expected to increase to US$275.5 billion by 2018 at a 9.4% annual growth rate.

The Ministry of Tourism is the nodal agency for the development and promotion of tourism in India and maintains the "Incredible India" campaign.

According to World Travel and Tourism Council, India will be a tourism hotspot from 2009-2018, having the highest 10-year growth potential.

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The Travel & Tourism Competitiveness Report 2007 ranked tourism in India 6th in terms of price competitiveness and 39th in terms of safety and security.

Despite short- and medium-term setbacks, such as shortage of hotel rooms, tourism revenues are expected to surge by 42% from 2007 to 2017.

India has a growing medical tourism sector. The 2010 Commonwealth Games in Delhi has significantly boosted tourism in India.

Hill Stations:-

Several hill stations served as summer capitals of Indian provinces, princely states, or, in the case of Shimla, of British India itself. Since Indian Independence, the role of these hill stations as summer capitals has largely ended, but many hill stations remain popular summer resorts. Most famous hill stations are:

Pachmarhi, Madhya Pradesh - It is also known as The Queen of Satpura.

Araku, Andhra Pradesh

Gulmarg, Srinagar and Laddakh in Jammu and Kashmir

Darjeeling in West Bengal

Munnar in Kerala

Ooty and Kodaikanal in Tamil Nadu

Shillong in Meghalaya

Shimla, Kullu in Himachal Pradesh

Nainital in Uttarakhand

Gangtok in Sikkim

Mussoorie in Uttarakhand

In addition to the bustling hill stations and summer capitals of yore, there are several serene and peaceful nature retreats and places of interest to visit for a nature lover. These range from the stunning moonscapes of Leh and Ladhak, to small, exclusive nature retreats such as Dunagiri, Binsar,

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Mukteshwar in the Himalayas, to rolling vistas of Western Ghats to numerous private retreats in the rolling hills of Kerala.

Beaches:-

Elephants and camels rides are common on Indian beaches. Shown here is Havelock Island, part of the Andaman and Nicobar Islands India offers a wide range of tropical beaches with silver/golden sand to coral beaches of Lakshadweep. States like Kerala and Goa have exploited the potential of beaches to the fullest. However, there are a lot many unexploited beaches in the states of Andhra Pradesh, Gujarat, Maharastra, Tamil Nadu and Karnataka. These states have very high potential to be develop them as future destinations for prospective tourists. Some of the famous tourist beaches are:

Beaches of Vizag, Andhra Pradesh

Beaches of Puri, Orissa

Beaches of Digha, West Bengal

Beaches of Goa

Kovalam Beach, Kerala

Marina Beach, Chennai

Beaches of Mahabalipuram

Beaches in Mumbai

Beaches of Diu

Beaches of Midnapore, West Bengal

Andaman and Nicobar Islands

Lakshadweep Islands

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A Country Forever... A Story Forever

With Tourism being one of the foremost avenues to put India on the global map, it is heartening to see that the Travel and Tourism Competitiveness Report of 2010 from the World Economic Forum, has ranked India as 11th in the Asia Pacific region and 62nd overall, moving up three places on the list of the world’s most attractive destinations. It also ranked 14th best tourist destination for its natural resources and 24th for its cultural resources, owing to many World Heritage sites, rich flora and fauna, and strong creative industry. The Indian tourism industry ranked 5th in long-term growth and the report also expects it to become the second largest employer in the world by the year 2019.

The Tourism Ministry has claimed that tourism in India has already started showing signs of early recovery from the impact of global economic meltdown and in December 2010 tourists arrivals grew substantially by 21% registering a growth of over 8% over the arrivals in December 2007 which was actually a year of high growth.

In spite of the global economic recession in 2008 and 2009, the Indian economy has continued to have good growth. India’s GDP in 2008-09 grew by 6.7%.

During April-September, 2010 India’s GDP has seen a growth of 7%, whereas the global economy is estimated to have a negative growth in 2009. The quantum jump in Foreign Direct Investment (FDI) in the Hotel & Tourism sector in the year 2009 and 2010 is also indicative of the positive scenario.

Indicating a turnaround, foreign tourist arrivals into the country grew by 21 percent in December 2010, over the corresponding month in 2009.

Foreign Tourist Arrivals 2010

Estimates of foreign tourists arrivals (FTAs) and foreign exchange earnings (FEEs) are important indicators of the tourism sectors. FEEs in USD terms during the month of November 2010 were USD 1.2 billion as compared to USD 1 billion in November 2008.

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FTAs during 2010 were 5.11 million with a growth rate of (-) 3.3% as compared to the FTAs of 5.28 million and growth rate of 4% during 2008.

FTAs during the Month of December 2010 were 6.46 lakh as compared to FTAs of 5.34 lakh in December 2009 and 5.97 lakh in December 2008.

Foreign Exchange Earnings 2010

FEEs in Rupee terms during 2010 were Rs. 54960 crore as compared to Rs. 50730 crore in 2009.

The growth rate in FEEs in Rupee terms during 2010 was 8.3% as compared to 2009, and 14.4% during 2009 as compared to 2008.

In spite of the negative growth rate of 3.3% in FTAs, FEEs in rupee terms observed a positive growth rate of about 8% during 2010.

FEEs during 2010 were USD 11.39 billion as compared to USD 11.75 billion during 2009.

FTAs in January 2011

FTAs during the month of January 2011 were 4.91 lakh as compared to FTAs of 4.22 lakh during the month of January 2010 and 5.12 lakh in January 2009.

FEEs in January 2010

FEEs during the month of January 2011 were Rs. 5593 crore as compared to Rs. 4598 crore in January 2010 and Rs. 5438 crore in January 2009.

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Government Initiatives :-

Realising that the true potential of tourism lies in responsible practices on both the demand and supply sides of the tourism chain, the Ministry of Tourism has adopted the ‘sustainable tourism’ route and incorporated it into the innovative Rural Tourism Project.

Projects and Sanctioned Budgets

Development of tourism is primarily undertaken by the State Governments/Union Territory Administrations and the Ministry of Tourism provides financial assistance for tourism projects based on the proposals received from them subject to availability of funds and priority.

The Tourism Ministry had sanctioned numerous projects across the nation for enhancing the tourism infrastructure; many of them were sanctioned during the year 2009.

After the silicon rush India is now considered as the golden spot for treating patients mostly from the developed countries and far east for ailments and procedures of relatively high cost and complexity.

India is also aggressively promoting medical tourism in the current years -and slowly now it is moving into a new area of "medical outsourcing," where subcontractors provide services to the overburdened medical care systems in western countries. India's National Health Policy declares that treatment of foreign patients is legally an "export" and deemed "eligible for all fiscal incentives extended to export earnings."

Government and private sector studies in India estimate that medical tourism couldbring between $1 billion and $2 billion US into the country by 2012. Going by the Statistics various studies it can be easily said that indiawould be the leader in medical tourism within the next decade if only it could improve the infrastructure and tour attractions.

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Medical tourism: A G lobal perspective

Medical tourism happens when patients go to a different country for either urgent or elective medical procedures. This phenomenon is fast becoming a worldwide, multibillion-dollar industry. The reasons patients travel for treatment vary. Many medical tourists from the United States are seeking treatment at a quarter or sometimes even a 10th of the cost at home. From Canada, it is often people who are frustrated by long waiting times.

From Great Britain, the patient can't wait for treatment by the National Health Service but also can't afford to see a physician in private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with elective or plastic surgery. And moreover patients are coming from poorer countries such as Bangladesh where treatment may not be available and going for surgery in European or western developed countries is expensive.

Thailand

While, so far, India has attracted patients from Europe, the Middle East and Canada, Thailand has been the goal for Americans. India initially attracted people who had left that country for the West; Thailand treated western expatriates across Southeast Asia. Many of them worked for western companies and had the advantage of flexible, worldwide medical insurance plans geared specifically at the expatriate and overseas corporate markets.With the growth of medical-related travel and aggressive marketing, Bangkok became a centre for medical tourism. Bangkok's International Medical Centre offers services in 26 languages, recognizes cultural and religious dietary restrictions and has a special wing for Japanese patientsThe medical tour companies that serve Thailand often put emphasis on the vacation aspects, offering post-recovery resort stays

.South Africa

South Africa also draws many cosmetic surgery patients, especially from Europe, and many South African clinics offer packages that include personal assistants, visits with trained therapists, trips to top beauty salons, post-

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operative care in luxury hotels and safaris or other vacation incentives. Because the South African rand has such a longstanding low rate on the foreign-exchange market, medical tourism packages there tendto be perpetual bargains as well.

Argentina

Argentina ranks high for plastic surgery, and Hungary draws large numbers of patients from Western Europe and the U.S. for high-quality cosmetic and dental procedures that cost half of what they would in Germany and America.

DubaiLastly, Dubai--a destination already known as a luxury vacation paradise--is scheduled to open the Dubai Healthcare City by 2010. Situated on the Red Sea, this clinic will be the largest international medical center between Europe and Southeast Asia. Slated to include a new branch of the Harvard Medical School, it also may be the most prestigious foreign clinic on the horizon.

Other countries

Other countries interested in medical tourism tended to start offering care to specific markets but have expanded their services as the demand grows around the world. Cuba, for example, first aimed its services at well-off patients from Central and South America and now attracts patients from Canada, Germany and Italy. Malaysia attracts patients from surrounding Southeast Asian countries; Jordan serves patients from the Middle East. Israel caters to both Jewish patients and people from some nearbycountries. One Israeli hospital advertises worldwide services, specializing in both male and female infertility, in-vitro fertilization and high-risk pregnancies. South Africa offers package medical holiday deals with stays at either luxury hotels or safaris.

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SWOT ANALYSIS

STRENGTHS:

Low cost surgeries and medical treatments such as complex Bone Marrow transplant, liver transplant, kidney transplant, specialized cardiac/heart surgery, surgeries for hip joint replacement, knee joint replacement, dental surgery, and cosmetic surgeries, to mention a few. All these surgical procedures are carried out by expert doctors.

India has various state-of-the-art medical institutes and hospitals of international standards.

People all around the world are eager to see the diversity and unity of India. So, when they get the advantage of medical treatment along with a dual advantage of getting to travel India, they choose India over others.

Comparatively the cost of surgery in India is estimated to be one-tenth of that in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the US, for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly there are other such surgical procedures that cost less in India.

Chennai (formerly known as Madras), the capital city of the Indian state of Tamil Nadu, has been declared India's Health Capital, as it nets in 48% of health tourists from abroad and 37-41% of domestic health tourists.

WEAKNESSES:

Lack of adequate infrastructure is the biggest problem that India faces.The aviation industry in India, for example, is inefficient and does not provide even the basic facilities at airports.

The road condition in India is very worse. The population has grown exponentially since 1947 but we still use the same rail system constructed by theBritish.

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The government spends next to nothing on proper marketing of India’s tourism abroad. As a result foreigners still think of India as a country ridden by poverty, superstition, and diseases with snake charmers and sadhus at every nook and cranny.

Case in point Thailand; where in spite of the huge problem of bird flu disease the tourists arrival only dropped by less then 15% where as in India when cases of plague started occurring in Surat in 1994 the arrival of foreign tourists in India decreased byalmost 36%

OPPORTUNITIES:

More proactive role from the government of India in terms of framing policies.

Allowing entry of more multinational companies into the country giving us a global perspective.

Growth of domestic tourism. The advantage here is that domestic tourism and international tourism can

be segregated easily owing to the different in the period of holidays.

THREATS:

Political turbulence within India in Kashmir and Gujarat has also reduced tourist traffic. Not only that fear of epidemics such as for malaria, cholera, dengue, plague etc are foremost in the mind of European and America patients.

Aggressive strategies adopted by other countries like Australia, Singapore in promoting tourism are also not helping.

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WHAT IS INDIA OFFERING:

AYURVEDA:-

India has a rich heritage in the areas of traditional and natural medicines. The earliest mention of Indian medical practices can be found in the Vedas and Samhitas of Charaka, Bhela and Shusruta. A systematic and scientific approach was adopted by the sages of the time leading to the development of a system that is relevant even today.

India is the land of Ayurveda. It believes in removing the cause of illness and not just curing the disease itself. It is based on herbals and herbal components without having side effects.

Ayurveda considers that the base of life lies in the five primary elements; ether (space), air, fire, water and earth. And the individual is made up of a unique proportion of the five elements in unique combinations to form three doshas (vata, pita and kapha). When any of these doshas become accute, a person falls ill. Ayurveda recommends a special life style and nutritional guidelines supplemented with herbal medicines. If toxins are abundant, then a cleaning process known as Panchkarma is recommended to eliminate those unwanted toxins and revitalize both mind and body. Ayurveda offers treatments for ailments such as arthritis, paralysis, obesity, sinusitis, migraine, premature aging and general health care. Kerala is a world tourist destination and part of the reasons lies with the well- known stress-releasing therapies of famed Ayurvedic research centers. The climate along with the blessing of nature has turned Kerala into the ideal place for ayurvedic, curative and rejuvenating treatments

.

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YOGA:-

If Ayurveda is the science of body, yoga is the science of the mind. Practiced together they can go a long way in making an individual fit. The word yoga means to join together. The ultimate aim of yoga is to unite the human soul with the universal spirit.

Yoga was developed 5000 years ago and the base of yoga is described in the Yoga Sutra of Patanjali. This describes eight stages of yoga. These are Yam (universal moral commands), Niyam (self purification), Asana (posture), Pranayama (breathing control), Prathyahara (withdrawal of mind from external objects), Dharana (concentration), Dhyana (meditation), and Samadhi (state of superconsciousness). To get the benefits of yoga, one has to practice Asana, Pranayama and Yoganidra. With the regular practice of asanas one can 327 control cholesterol level, reduce weight, normalize blood pressure and improve cardiac performance.

Pranayama helps to release tensions, develop relaxed state of mind and Yoganidra is a form of meditation that relaxes both physiological and psychological systems. Today, yoga has become popular in India and abroad and in a number of places including urban and rural areas yoga is taught and practiced.

SPA TREATMENT:-

Most of the other parts of the world have their own therapies and treatment that are no doubt effective in restoring wellness and beauty. New kinds of health tours that are gaining popularity in India are spa tours. Spas offer the unique advantages of taking the best from the west and the east combining them with the indigenous system and offering best of the two worlds. In hydropathy, Swedish massages work with the Javanese Mandy, lulur, aromatherapy, reflexology and traditional ayurveda procedures to help keep the tourist healthy and enhance beauty. Combining these therapies with meditation, yoga and pranayama make the spa experience in India a new destination for medical tourism. The spas are very useful for controlling blood pressure,

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insomnia, cure tension, depression, paralysis and number of other deadly diseases. Ananda Resort in Rishikesh, Angsana Resort, Golden Palm Spa and Ayurgram in Bangalore offer ayurveda, naturopathy, yoga and meditation packages. (Gaur Kanchilal) Allopathy India has made rapid strides in advanced health care systems, which provides worldclass allopathic treatment. This has become possible because of the emergence of the private sector in a big way in this field. More and more foreign tourists are realizing that India is an ideal place for stopover treatment. Indian Multi-specialty hospitals are providing worldclass treatment at an amazingly economical cost as compared to the west. Quality services and low price factor primarily go in favour of India. The cardiocare, bone marrow transplantation, dialysis, kidney transplant, neuron–surgery, joint replacement surgery, urology, osteoporosis and numerous diseases are treated at Indian hospitals with full professional expertise. Apollo hospital group, Escorts in Delhi, Jason Hospital, Global Hospital, and Max Health Care are catering to medical care for international patients in the areas of diagnostic, disease management, preventive health care and incisive surgeries.

The tourism department has devised websites in order to provide information. Many Ayurveda health resorts that are owned by traditional Ayurveda Institutes have come up. Ayurgram is a novel concept that not only offers heritage accommodation but also offers a whole range of Ayurvedic treatments and rejuvenating packages.

SPIRITUAL TOURISM:-

Globally people are increasingly mentally disturbed and looking for solace in spiritual reading, meditation and moments of divine ecstasy. Our country has been known as the seat of spiritualism and India’s cosmopolitan nature is best reflected in its pilgrim centres. Religion is the life-blood for followers of major religion and sects. Hinduism, Islam, Buddhism, Jainism, Zoroastrianism and Christianity have lived here for centuries.

The visible outpouring of religious fervor is witnessed in the architecturally lavish temples, mosques, monasteries and Churches spreads across the length and breadth of the country. India is not only known as a place rich in its culture with varied attractions but also for many places of worship,

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present itself as embodiments of compassion where one get peace of mind. Thus India has been respected as a destination for spiritual tourism for domestic and international tourists. Spiritual tourism is also termed as religious heritage tourism. It includes all the religions mentioned above; religious places associated with, emotional attachment to these centers and infrastructure facilities for the tourists. This can also be referred to as pilgrimage tourism, as clientsare not looking for luxury but arduous journeys to meet the divine goal or simple life.

ADVENTURE TOURISM:-

Youth tourism has been identified as one of the largest segments of global and domestic tourism. The young travellers are primarily experience seekers, collecting, enquiring unique experiences. Adventure and risk have a special role to play in the behaviour and attitudes of young travellers. The growing number of young travellers is being fuelled by a number of factors such as increased participation in higher education, falling level of youth unemployment, increased travel budget through parental contribution, search for an even more exciting and unique experience and cheaper long distance travel.Youth and adventure tourism appears to have considerable growth potential.

The rising income in some major potential source markets such as the Central and Eastern Europe, Asia and Latin America, combined with the lower travel cost, growing student populations around the world particularly in developing countries, has fuelled the demand. India: a heaven for adventure tourism India has been an attraction for travellers from all over the world. Though in the field of international tourism, the segment of adventure tourism in India is getting only a fraction of such traffic. The trend has been showing an increased movement year after year with the development of facilities and greater awareness about adventure tourism options.

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RURAL TOURISM:-

Rural tourism has been identified as one of the priority areas for development of Indian tourism. Rural tourism experience should be attractive to the tourists and sustainable for the host community. The Ninth Plan identified basic objectives of rural tourism as: -• Improve the quality of life of rural people• Provide good experience to the tourist• Maintain the quality of environment.Indian villages have the potential for tourism development. With attractive and unique traditional way of life, rich culture, nature, crafts, folk-lore and livelihood of Indian villages are a promising destination for the tourist. It also provides tourism facilities in terms of accessibility, accommodation, sanitation and security. Rural tourism can be used as a means to:-• Improve the well being of the rural poor• Empower the rural people• Empower the women• Enhance the rural infrastructure• Participate in decision-making and implementing tourism policies• Interaction with the outside world• Improve the social condition of lower sections of the society.• Protection of culture, heritage, and nature.

To tap the immense opportunities, coordinated actives of all agencies involved in the development are required. A carefully planned and properly implemented development will definitely benefit the community economically and improve the quality of life in the villages.

The success of such development depends upon the people’s participation at grass root level for the development of tourist facilities and for creating a tourist friendly atmosphere. Development of rural tourism is fast and trade in hotels and restaurants is growing rapidly. Increase in the share of earnings through rural tourism will no doubt; provide an attractive means of livelihood to the poor rural community. It increases the purchasing power at all levels of community and strengthens the rural economy. Development of infrastructure facilities such as rail, electricity, water, health and sanitation will definitely improve the quality of life.

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Why the world is moving towards medical tourism

Medical tourists have good cause to seek out care beyond the United States for many reasons. In some regions of the world, state-of-the-art medical facilities are hard to come by, if they exist at all; in other countries, the public health-care system is so overburdened that it can take years to get needed care.

In Britain and Canada, forinstance, the waiting period for a hip replacement can be a year or more, while in Bangkok or Bangalore, a patient can be in the operating room the morning after getting off a plane.

For many medical tourists, though, the real attraction is price. The cost of surgery in India, Thailand or South Africa can be one-tenth of what it is in the United States or Western Europe, and sometimes even less.

A heart-valve replacement that would cost $200,000 or more in the U.S., for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly, a metal-free dental bridge worth $5,500 in the U.S. costs $500 in India, a knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the States, and Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730.

Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa. The savings sound very attractive, but a good new hip and a nice new face don’t seem like the sort of things anyone would want to bargain with. How does the balance of savings versus risk pay off in terms of success rates.

Inferior medical care would not be worth having at any price, and some skeptics warn that Third World surgery cannot possibly be as good as that available in the United States. In fact, there have been cases of botched plastic surgery, particularly from Mexican clinics in the days before anyone figured out what a gold mine cheap, highquality care could be for the developing countries.

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Trends in medical tourism in the near future:-

Some important trends guarantee that the market for medical tourism will continue to expand in the years ahead. By 2015, the health of the vast Baby Boom generation will have begun its slow, final decline, and, with more than 220 million Boomers in the United States, Canada, Europe, Australia and New Zealand, this represents a significant market for inexpensive, high-quality medical care.

Medical tourism will be particularly attractive in the United States, where an estimated 43 million people are without health insurance and 120 million without dental coverage--numbers that are both likely to grow. Patients in Britain, Canada and other countries with long waiting lists for major surgery will be just as eager to take advantage of foreign health-care options.

SCOPE & OPPORTUNITIES

Though the service sector has considerable contribution in India’s GDP, it is negligible on the export front with only around 25 per cent of total export. Value added services generally exceed 60 per cent of total output in the high income industrialised economy.

In the global scenario, India’s share of services export is only 1.3 per cent (2003) i.e USD 20.7 billion which has gone up from 0.57 per cent (1990). Overall service export growth rate in India is 8 per cent (2002) against a global growth rate of 5 per cent. It had a tremendous impact on India’s Forex reserve.

Forex reserve rise to USD 118.628 on May, 2004 in comparison to USD 79.22 for the same period in 2003. Being a service sector member, medical and tourism services export can further rise India’s Forex Reserve along with a major contribution from software exports. In India, international tourist rose 15.3 per cent between January and December, 2003.

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Though tourism and travel industry contribution is 2.5 per cent to our countries GDP (international ranking 124) but recent initiative from the government like liberalised open sky policy to increase flight capacity, lower and attractive fares, increase in hotel room capacity by nearly 80 per cent (from 2000) and better connectivity between major tourist destination (Express Highway project) has helped India to rank among the top five international holiday destination when independent traveler conducted a poll in 134 countries. Healthcare industry has shown considerable growth in last few years. Emergence of top notch corporate hospitals and continuous effort for improvement of quality of care has placed Indian private healthcare in a respectable position on the global map. High ratio of foreign qualified medical practitioners and well-trained nursing and paramedical staff have developed confidence amongst the people who are seeking medical care from Indian Hospitals.

INDIA’S FUTURE PROSPECTUS

There are several characteristics that make India an appealing destination for visitors seeking health services. These include its well-trained health practitioners; a large populace of good English speaking doctors, guides and medical staff; availability of super-specialty centres that excel in cardiology and cardio-thoracic surgery, joint replacements, transplants, cosmetic treatments, dental care, orthopaedic surgery and more; hospitals that provide the full gamut of health services which include full body pathology, comprehensive physical and gynaecological examinations, echo Doppler, high strength MRI etc. using latest, technologically advanced diagnostic equipments; and finally, and more importantly the availability of these premium services at prices that are extremely reasonable for the foreign tourist.

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Emerging Trends of Medical Tourism in India

Medical tourism was a silver lining for those millions of Uninsured, underinsured and those who were forced to postpone treatments due to long waiting lists.  What seemed like a boon to patients from Western countries like US, UK and Canada is now a twilight of hope for those countries who are deemed as Medical Tourism hubs.  In popular medical tourism destinations like India, Singapore and Thailand, Medical Tourism is a fast growing industry where millions of dollars are being pumped in rigorously. 

In order to cope with the growing demand for medical care, hospitals, medical practitioners and even governments have taken measures to promote health care in India. 

When it comes to health care, safety is the foremost concern.   The hospitals in India are well equipped with the latest technology and houses highly qualified and experienced staff who can provide timely and quality medical treatment to patients.  As a move in promoting medical tourism, many hospitals are deemed as “corporate hospitals” that specially cater to the needs of medical tourists in India.  Apart from offering world class treatments, they offer various services that make medical tourists’ stay in India hassle free.  Many hospitals in India have international accreditations that certify the quality of health care service. 

Indian Government has acknowledged the growth of medical tourism in India and is now offering Medical Visas.  The initial period for a medical visa may be up to a period of one year or the period of treatment whichever less, which can be extended for a further period up to one year be the State Government/ FRROs on the production of medical certificate/ advice from the reputed/ recognized/ specialized hospitals in the country. Any further extension will be granted by the Ministry of Home Affairs only on the recommendations of the State Government/ FRROs supported by appropriate Medical documents. Such visa will be valid for maximum three entries during one year.

India is a big player in the medical tourism industry.  In fact, it has been ranked the most popular medical tourism destination by many.  Apart from

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the contribution of government and hospitals in improving the health care service in India, what truly gives that edge to India over other medical tourism destinations is the innumerable rejuvenation options it offers and the easiness of stay in India.

India is the birth place of Yoga, which is one of the most popular forms of exercise and rejuvenation today.  There are almost an infinite number of Spa and rejuvenation centers in India that could uplift the mood and enhance health of medical tourists.  India is a tourist’s paradise and when in India for medical treatment, tourism comes as a co-benefit of medical tourism.  Unlike other exotic destinations in the world, it is surprisingly easy to commute, stay and converse in India.  People in India are extremely warm and have a sound command over English.   All these factors make India the sought after destinations for medical tourism and India is now equipped to cater to the fast growing demand for health care in India.

A new report, "Booming Medical Tourism in India”, provides an insight into the Indian medical tourism market. It evaluates the past, present and future scenario of the Indian medical tourism market and discusses the key factors that are making India a favorable medical tourism destination. Both statistics and trends regarding market size, tourist arrivals, infrastructure, accreditations, drivers and restraints have been thoroughly discussed in the report.

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COST COMPARISON

The competitive cost of medical treatment in India has been the main catalyst for the growth of medical tourism in the country.

The costs of comparable treatment in India are on average one eighth to one fifth of those in the West. For instance, a cardiac procedure costs anywhere between US$ 40,000 - 60,000 in the United States, US$ 30,000 in Singapore, US$ 12,000 - 15,000 in Thailand and only US$ 3,000 - 6,000 in India. Likewise, the associated costs of surgery are also low. India also has the potential to emerge as a hub for preventive health screening in view of the availability of low-cost diagnostic tests. At a private clinic in London a health check-up for men that includes blood tests, electro-cardiogram tests, chest X-Rays, lung tests and abdominal ultrasound costs around £350. In comparison, a comparable check-up at a clinic operated by Delhi-based healthcare company Max Healthcare costs US$ 84. A Magnetic Resonance Imaging (MRI) scan costs US$ 60 at Escorts Hospital in Delhi, compared with roughly US$ 700 in New York.

A study done by the India Brand Equity Foundation (IBEF) in 2004 showed that India is more cost-competitive as compared to other leading medical tourism destination like Thailand. Thailand has a cost advantage over India in only two categories: plastic surgery and breast augmentation. India is cheaper than Thailand across a whole range of other—and more serious — surgery categories as the following chart indicates.

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Surgery Thailand IndiaBone Marrow Transplant US$ 62500 US$ 30000Liver Transplant US$ 75000 US$ 40000Open Heart Surgery (CABG)

US$ 14250 US$ 4400

Hip Replacement US$ 6900 US$ 4500Knee Surgery US$ 7000 US$ 4500Hysterectomy US$ 2012 US$ 511Gall Bladder removal US$ 1755 US$ 555* cost in US$

The health services in India have the additional advantage of providing a good mix of allopathic and alternative systems of medicine. For instance, while New Delhi has emerged as a prime destination for cardiac care; Chennai has established a niche for quality eye care; Kerala and Karnataka have emerged as hubs for state-of-the-art ayurvedic healing.

The scope for profit in this sector has encouraged several large corporations, such as pharmaceuticals and industrial companies, and several non-resident Indians (NRIs) to invest money in setting up super-specialty hospitals such as Apollo, Medinova, CDR, Mediciti in Hyderabad; Hindujas and Wockhardt in Mumbai; Max, Escorts, Apollo in Delhi etc.8 These facilities now dominate the upper end of the private sector and cater predominantly to medical tourists and affluent sections of the society. These establishments have created a niche job market for health professionals predominantly trained in public sector institutes.

Even the Government of India has responded promptly to tap the potential of this sector. In its effort to capitalize on this opportunity the Government has untaken measures to promote India as a “global health destination”. The National Health Policy 2002 strongly encourages medical facilities to provide services to users from overseas. It states that “providers of such services to patients from overseas will be encouraged by extending to their foreign exchange, all fiscal incentives, including the status of “deemed exports”, which are available to other exporters of goods and services”.

The Indian Ministry of Tourism has started a new category of visas for the medical tourists. These visas called the “M” or medical-visas are valid for one year but can be extended up to three years and are issued for a patient along with a companion. Efforts have also been undertaken to improve the airport infrastructure to ensure smooth arrival and departure of the health tourists. A brochure of the ministry predicts a “phenomenal expansion” of the Indian health-care industry in the coming years.

These factors have favored the recent spurt of growth of medical tourism in India. Official figures indicate that medical tourists from 55 different countries come to India for treatment. While most of these patients are from

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developed countries, India is also seeing a surge of patients from countries in Africa and South and West Asia that lack adequate healthcare infrastructure. Among others, foreign health travelers to India comprise of a large number of non-resident Indians (NRIs). If the present trend continues trade in health and health-services will become one of the biggest sectors in India. However, there are several challenges that could impede the growth of medical tourism in India, more importantly the growth of this sector poses a threat to the already crippled public health system in India.

MAJOR PLAYERS

Major players offering Medical Tourism packages

Indian corporate hospitals excel in cardiology and cardiothoracic surgery, joint replacement, orthopedic surgery, gastroenterology, ophthalmology, transplants and urology to name a few. The various specialties covered are Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology, Endocrinology, ENT, Pediatrics, Pediatric Surgery, Pediatric Neurology, Urology, Nephrology, Dermatology, Dentistry, Plastic Surgery, Gynecology, Pulmonology, Psychiatry, General Medicine & General Surgery The various facilities in India include full body pathology, comprehensive physical and gynecological examinations, dental checkup, eye checkup, diet consultation, audiometry, spirometry, stress & lifestyle management, pap smear, digital Chest X-ray, 12 lead ECG, 2D echo colour doppler, gold standard DXA bone densitometry, body fat analysis, coronary risk markers, cancer risk markers, carotid colour doppler, spiral CT scan and high strength MRI. Each test is carried out by professional M.D. physicians, and is comprehensive yet pain-free.

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Industry Players:-

Thomas Cook India Ltd.

Company Information:-

Thomas Cook (India) Ltd. is the largest integrated Travel and Travel related

Financial Services Company in the country offering a broad spectrum of

services that include Foreign Exchange, Corporate Travel, Leisure Travel, and

Insurance. The Company launched its Indian operations in 1881 and is

celebrating its 127 years of world-class service in India. Thomas Cook (India)

operates in the following areas of business, namely: Leisure Travel, Corporate

Travel Management, MICE, Foreign Exchange, SWIFT Network, Travel

Insurance, Credit Cards, Pre-Paid Cards, Life Insurance and E-Business.

Post March 31st 2008, Thomas Cook (India) Limited (TCIL) is a part of Thomas Cook Group

plc UK (TCG). On March 7th 2008, TCG announced its decision to acquire TCIL from

Dubai Investment Group. Thomas Cook Group plc is one of the largest travel groups in the

world with a market capitalization of approximately US$6 Billion.

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In June 2006, Thomas Cook (India) acquired LKP Forex Limited and Travel Corporation

(India) Pvt. Ltd. (TCI).

TCIL presently operates in over 72 cities across over 180 locations. The company has

overseas operations in Sri Lanka which is a branch of TCIL and Mauritius which is a

subsidiary of Thomas Cook (India). The Company employs over 2,200 resources and is listed

on both the Bombay Stock Exchange as well as the National Stock Exchange.

Thomas Cook (India), over the years has received several prestigious awards such as the

Golden Peacock Award for excellence in Corporate Governance and the Pacific Asia Travel

Association (PATA) Golden Award for Best Travel. Recently, the Company won the Best

Tour Operator at the CNBC Awaaz Travel Awards 2008 and was also accredited the P1

rating which is the highest financial rating given by Crisil.

Founded in 2007

Headquarters in Peterborough, England, UK

Key people are Thomas Middlehoff (Chairman), Michael Beckett (Deputy Chairman),

Manny Fontenla-Novoa (CEO)

IT is a travel industry

Its products are Package Holidays

Employees are 31000

SOTC - India's Leading Tour operator

SOTC is Kuoni India's key outbound travel brand. SOTC, India’s largest

outbound tour operator was acquired by Kuoni Travels - World's leading

premium Tour Operator in the year 1996 and is a leader in all segments, namely

Escorted Tours, Free Individual Travel, Special Interest Tours and Domestic

Holidays amongst others.

Till date, SOTC has escorted over 4 lakh passengers across the globe to various

destinations including Europe, USA, Australia, New Zealand, Far East, Africa

and many more.

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They have served travelers for years and won their smiles and hearts. SOTC’s

vast array of holiday services is taking holidaying to an entirely new level.

SOTC has been voted "Best Outbound Tour Operator" five times in a row by

the Galileo Express Travel & Tourism Awards Committee.

The company has not only fully utilized the existing market potential but has

also created new markets through innovative packages namely ‘BhramanMandal’

brand which is dedicated for the Marathi speaking population and  'Gurjar

Vishwadarshan' brand that is dedicated for the Gujarati speaking population.

SOTC Corporate (MICE) tours offer the following services to customers:

Research and development of complete program

Identification and reservation of location

Venue and accommodation selection

Planning, organisation and equipping of location area

Contracting and negotiation of services

Organisation of pre and post tour programs, spouse programs, social

programs and   arrangements for accompanying guests

Specialized exclusive theme dinners

Audiovisual recording of the event

Shows and special entertainments

Special evening venues

Transportation - meet and greet services during all arrivals

Security

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Visa application services

SOTC Trade Fair Tours:-

SOTC Trade Fair Tours is a division that caters exclusively to the needs

and requirements of the keen businessman visiting or exhibiting in International

trade fairs. 

Increase in the number of Indian participants & visitors to various

International exhibitions to compete at a global level confirm huge potential for

Group Outbound Travel. In the past few years SOTC Trade Fair Tours has

successfully organised delegations to various International trade fairs, which has

helped in creating awareness and earning a reputation in the market. The efforts

and strength in offering the best quality services have been recognized by the

'Indo German Chamber of Commerce', Industry Associations and International

Exhibition Organizers, etc by appointing SOTC Trade Fair Tours as their

exclusive official agent in India. SOTC Trade Fair Tours has given a new

dimension to the trade fair visitors by providing value added services such as

confirmed accommodation during the fair period, Indian meals, option to pay in

easy monthly installments, factory visits etc - all this and more at extremely

attractive and competitive prices.

Major Hospitals:-

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All medical investigations are conducted on the latest, technologically advanceddiagnostic equipment. Stringent quality assurance exercises ensure reliable and high quality test results The chief cities attracting foreign patients to India are Mumbai, Bangalore, Hyderabad, Kolkata and Chennai. Similarly, the speciality hospitals excelling in the medical tourism industry in the country are:

* Escorts Heart Institute and Research Centre Limited, New Delhi

* All India Institute of Medical Sciences, Delhi

* Manipal Heart Foundation, Bangalore

* B. M. Birla Heart Research Centre, Kolkata

* Breach Candy Hospital, Mumbai

* Wockhardt Hospitals

* Christian Medical College, Vellore

* Asian Heart Institute, Mumbai

* PD Hinduja National Hospital and Medical Research Centre, Mumbai

* Jaslok Hospital, Mumbai

* Apollo Hospital, Delhi

* Apollo Cancer Hospital, Chennai

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MEDICAL PACKAGES

The health care sector in India has witnessed an enormous growth in infrastructure in the private and voluntary sector. The private sector which was very modest in the early stages, has now become a flourishing industry equipped with the most modern state-of the- art technology at its disposal. It is estimated that 75-80% of health care services and investments in India are now provided by the private sector. An added plus had been that India has one of the largest pharmaceutical industries in the world. It is self sufficient in drug production and exports drugs to more than 180 countries.

* Bone Marrow Transplant* Brain Surgery* Cancer Procedures (Oncology)* Cardiac Care* Cosmetic Surgery* Dialysis and Kidney Transplant* Drug Rehabilitation* Gynaecology & Obstetrics* Health Checkups* Internal/Digestive Procedures* Joint Replacement Surgery* Nuclear Medicine* Neurosurgery & Trauma Surgery* Preventive Health Care* Refractive Surgery* Osteoporosis* Spine Related* Urology* Vascular Surgery* Gall Bladder stones surgery ( Laparoscopic Cholecystectomy )* Hernia surgery ( Laparoscopic mesh repair )* Piles ( Stapled Hemorrhoidectomy )* Varicose Veins surgery* Endoscopic Thoracic Sympathectomy for Hyperhidrosis

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* Laparoscopic Appendicectomy* Laparoscopic Adrenalectomy* Laparoscopic Fundoplication for Hiatus Hernia* Laparoscopic Banding of stomach for Morbid Obesity* Laparoscopic splenectomy

Other packages include:

· Hip-Knee replacement surgeries and other orthopedic surgeries.· Bone marrow transplantation surgery.· Heart surgery packages like Cardiac Surgery And Cardiology, Open Heart Surgery, Angiographies and Angioplasties.· Treatments of different skin problems including skin grafting.

The services provided by the host country’s hospital/ organisation are:-

Put in touch with aworld class Private hospital or Nursing home and the doctor & fix up an appointment with the doctor at the hospital.

Receive you at the airport and provide transportation to the hotel and for the rest of the days during your stay here.

Provide accommodation in a hotel as per your choice and budget near the Nursing Home or the Private hospital.

We can arrange for another place to stay or a rejuvenating sight-seeing tour while your mother recovers after the treatment.

In addition to the increasingly top class medical care, a big draw for foreign patients is also the very minimal or hardly any waitlist as is common in European or American hospitals. In fact, priority treatment is provided today in Indian hospitals.

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STEPS OF SEEKING TREATMENT WITH MEDICAL TOURISM:-

1. Is the medical ailment suitable for treatment in a country different from yours the patients own country. The answer to this question will be based on combined information from your own doctor and the overseas doctor.

2. Ailments that require a one shot treatment like surgery for gall stones, hernia, piles, varicose veins, hysterectomy, adrenalectomy, nephrectomy, thyroidectomy, joint replacement etc are more suitable for medical tourism.

3. The ailment should be such that a follow up should not be necessary and you should not need to visit the country again to ‘ tie up loose ends.

4. The patient/ tourist should be otherwise well enough to be able to utilize the tourism part of it. Other wise you could just go to the hospital directly for treatment.

5. Mostly planned elective surgery for which there may be a long waiting list in your country is best suited for medical tourism.

6. Decide on the country, hospital and doctor who would be treating . This information would be available through the net or from recommendation by another patient. Visit the website of the hospital and doctor is the next step. Writing and asking about their training and experience in the procedure along with the cost implications is vital.

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CONCLUSION

Who would have thought that in just five years, medical tourism in India will build a remarkable repute as one of the countries most often visited by foreign patients for affordable plastic surgery and other health care treatments? Not long ago when medical travel was something scary and unrealistic, now American patients are wondering why they haven’t thought of flying to other countries like India where plastic surgery cost is extremely cheap.

According to proponents, plastic surgery in India is comparable to much that is available in the U.S. but with great difference in plastic surgery cost. Because of India’s preferable exchange rate with dollar, official figures indicate that among the 55 countries that comes to the country for affordable plastic surgery, the biggest growth in business comes from the UK and United States.

Frustrated by long waiting list and high plastic surgery cost, patients began considering the option of going abroad for medical care treatments In 2003, James Campbell, a resident from Aberdeenshire, went to Ahmedabad for a double knee replacement at less than half the cost of private treatment in the UK, after organizing the trip and treatment himself because of the tremendous waiting list before he can get his surgery. If patients like James who wants immediate operations, they will usually pay an additional 20-50 percent of the UK cost for prompt surgeries. A single knee replacement in the UK costs about £9,000 but a Madras clinic quotes the operation at £2,150. The number of foreign patients that come for plastic surgery in India increases year after year. To sustain the nation’s operation to offer high quality and affordable plastic surgery, private healthcare companies in India invested about £50 million to acquire state of the art equipments in the past decade. The quality of medical facilities and staff in India is increasingly rated interCationally and 75 percent of healthcare services in India are now in private sector and advanced private hospitals have been established in the major cities of the country.

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Today, plastic surgery in India is one of the respected assets of medical tourism. In fact, a Confederation of Indian Industry report predicts that medical tourism will be worth $1 billion to the economy by 2012.

To know more about plastic surgery in India, please visit GoSculptura India and get your free surgeon consultation and a free preview of how you will look like after the surgery. Gosculptura offers medical vacation packages and will take care of all your primary needs in India.

RECOMMENDATIONS

1. Majority of the patients come from US, UK and Africa. So hospital should

try to capture the number of patients from other than these country.

2. The majority of the patients are come for the Cardiac, Orthopaedic and

Gastro Enterological diseases, so our hospitals should develop super

specialty ward and department to capture more number of patients.

3. Our hospitals should develop alternative therapy ward or department like

Ayurveda, Yunani, Spa and Yoga along with the rehabilitation centres.

4. To increase the Advertisement of the Hospitals by using different media.

5. As most of the patients are satisfied with the Treatment and Facilities

provided by the hospitals, so hospitals should maintain them.

6. For patients who are dissatisfied with the treatment and facilities, hospitals

should try to know the reasons behind the dissatisfaction.

7. Hospital should reduced the Professional Attitude towards the NRIs

patients.

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8. Increase travel facility for the foreign tourists

9. visa-on-arrival facility for tourists from selected countries.

10. Improve and modernize airport infrastructure and services.

11. Make more and more advertisement by using different medias to capture

more market shares.

12. Create public awareness about economic and social benefits of tourism.

BIBLIOGRAPHY / WEBLIOGRAPHY –

1) "TB Often Misdiagnosed" . American Lung Association of Illinois. http://www.lungil.org/il/copd/TBMisdiagnosed.asp. Retrieved on 2007-03-10.

2) http://www.worldhospitalmonitor.com 3) "Health Tourism 2.0" . World Health Tourism Congress.

http://www.medtrotter.com/publications/WHTC_2007.pdf. Retrieved on 2007-04-13.

4) SOFIHA - Welcome to SOFIHA 5) Healthcare Tourism International 6) United Kingdom Accreditation Forum 7) Medical Tourism Association 8) "Incision Care" , American Academy of Family Physicians, July, 2005,

retrieved September 18, 20069) World Alliance for Patient Safety 10) Ahc | Hot Topics

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THANK YOU

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