India must increase its share in wellness tourism market

There is a lot of scope for improvement. India needs more patients from Europe, Africa and Central Asia.

India’s reputation as a producer of quality vaccines and pharma products got a boost during the pandemic. India should thus look to increase its share in the world wellness tourism market. The Medical Value Travel (MVT) in India is expected to grow to $ 13 billion by 2026. Medical Tourism means people from abroad coming to India for treatment of the body and mind. It includes allopathy, nature cure like Ayurveda/Yoga and spiritual Indic philosophy.

What is India’s advantage? Quality medical care, lower cost, doctors are fluent in English and a rich tradition of wellness. In 2019, foreign tourist arrivals (FTAs) in India on account of medical visa was 697,000 (2017 4,95,056). According to statistics, India receives most of its medical tourists from Afghanistan, Oman, Bangladesh, Maldives, Nigeria, Kenya and Iraq.
According to Ministry of Tourism Statistics Pg. 59, in 2020 FTAs were 186,644. West Asia and Africa are significant contributors. To the countries above add Sudan, Tanzania and Yemen. There is scope for improvement. India needs more patients from Europe, Africa and Central Asia. After all just look at the cost differential.
A former diplomat who worked in Netherlands in the early 2000s told this author that getting appointments for non-life threatening diseases took months unlike India where there is virtually zero waiting time for any procedure. According to a former diplomat who worked in Africa, India must look to help those at the bottom of the pyramid. An Indian origin doctor who works in Nairobi shared insights of Kenya’s healthcare sector.
He said that every Kenyan has to contribute to the NHIF (National Health Insurance Fund). To travel they have to produce a certificate from a local doctor that Kenya does not have facilities to treat that illness. The rich, however, prefer to travel overseas for treatment.
The cost of treatment in Kenya is 4-5 times that of India. Trust in Indian doctors is high. Service levels in Kenya are lower than India. Kenya has 4-5 medical colleges across sectors.
MVT must also be looked at through the prism of foreign policy and economic benefits. State governments must realize multiplier effect of MVT and support it. Here are some ideas on what India can do to promote MVT.
Medical Tourism requires a Cross Ministry and Public-private partnership effort. The ministry of health, external affairs, Ayush, tourism and civil aviation need to work together with private hospitals and state governments. A collaborative effort and regular interaction between ministries and hospitals would build an element of trust essential if potential has to be realized.

1. Patients should be given visas only when treated only at National Accreditation Board for Hospitals & Healthcare Providers (NABH). This will ensure better treatment and patient shall not get swayed by agents of unaccredited hospitals. MVT should include Indian forms like of wellness like Ayurveda, Yoga, Siddha, Spiritual Philosophy etc.
2. Visas take time, sometimes over three months. Can a visa system be designed such that a visa comes in a maximum of seven working days? To speed up the process visa can be city specific.
3. Hospitals in designated cities like Mumbai, NCR, Kolkata, Bengaluru and Chennai that have international connectivity, can cater to medical tourists.
   By focussing on a few cities, it shall enable building and sharing of standardised infrastructure like hotels and guest-houses. Wellness hubs though, could be outside of the metros.
4. Help-desk at airports must cater to all customer needs be it medical, transport, visa, ambulance, baggage loss and handling of cash.
5. Since every patient has to visit the FRRO (Foreign Regional Registration Office) once, it would help if an MVT person is attached to the concerned office.
6. Central Grievance Committee, under the Ministry of Health, is where all patients can make complaints.
7. MVT needs a one stop portal that provides all information on available hospitals, treatment offered with indicative prices, testimonials, Ayurveda and Yoga rejuvenation and learning centres and colleges to learn Indic philosophy.
   Patients should be encouraged to give feedback on the portal and rate their hospital experience. A dedicated multi-lingual helpline would help.
8. Ambassadors of each country must ascertain the medical treatment system in their host country and identify gaps just like the former diplomat, based on experience, did so above. MEA could share this information with ministry of health and tourism who should work with partners to tap that market.
9. The ministry of health must on receipt of inputs from NABH, prepare a Paper on the services India offers and its competitiveness. This paper must be shared with the ministry of external affairs.
10. The MEA must have an annual budget for subsidising the cost of medical treatment for residents e.g. countries of Africa and Central Asia. (Dynamic list)
    This move shall increase the number of medical tourists and generate goodwill for India. Concept is similar to the PLI (Production Linked Incentive) scheme that seeks to enhance investment and employment in the manufacturing sector. Thus, MVT becomes an integral part of India’s foreign policy.
11. According to a former diplomat who worked in Africa the subsidy might help the more well-to-do people and not those at the bottom of the pyramid. So to help the poor he suggested that Indian hospital chains could one, enhance local skills through training and two, set up hospitals in African countries.
12. If India wishes to make these countries Atma Nirbhar it could allow Indian medical colleges to open branches in select countries.
13. Indian hospital chains who set up hospitals in say Africa and Central Asia must be provided Lines of Credit by EXIM Bank i.e. loans at a concessional rate of interest.
14. Indian MNCs like Tatas could for their employees, of companies like Jaguar and Tata Steel Europe, provide for medical insurance in India. A tie up with group-company Air India/Vistara could provide discounted air-fares.
15. India could help United Kingdom (UK) by offering medical services for its citizens in India.
    Whilst the exact nature of service can be decided, logistics would not be easy. A technology based platform that is integrated with airlines and service providers might make this idea fly.
16. Patients come from African and Middle Eastern countries and India’s neighbourhood. They are invariably accompanied by a caretaker who doubles up as an interpreter and in return expects a commission from the hospital.
    Whilst payment of commission is a reality, every effort must be made for direct contact between Consulate, Patient and Hospital. For every patient referred by the Embassy the hospital must pay a management fee, at a pre-determined percentage, to the Government of India for services rendered.
17. Hospitals must hire local interpreters who know the language of patient’s country and give an option of hiring a caretaker.
18. The Home Ministry should be involved to the extent that MVT does not become a tool for illegal immigration.
    The “Heal in India” initiative aims to position the country as a global hub for medical and wellness tourism.
    We need to think big and in an integrated cross-functional innovative way. Quality Medical Care at an affordable price could be India’s byline.
    Sanjeev Nayyar is a Chartered Accountant and founder www.esamskriti.com Twitter @nayyarsanjeev