OUTLINE

1. MEDICAL TOURISM AND INVESTMENT OPTIONS IN NIGERIA HEALTH SYSTEM- THE ROLE OF NMA AND OTHER STAKEHOLDERS JOSEPH KOLO JAMES MBBS, DA, MHPM

2. OUTLINE Definition History Reasons for travel Destinations/Reasons for the destinations Types of medical tourism Investment opportunities Role of NMA Role of other stakeholders Conclusion

3. Definition Act of travelling to another country to seek specialized or economical medical care, wellbeing and recuperation of acceptable quality with the help of support system. Process of “leaving home” for treatments and care abroad or elsewhere domestically- is an emerging phenomenon in the health care industry. Patient movement from highly developed nations to less developed areas of the world for medical care bypassing services offered in their own communities.

4. History The first recorded instance of medical tourism dates back thousands of years to when Greek pilgrims from all over the Mediterranean go to the small territory in the Saronic Gulf called Epidauria Epidauria is the sanctuary of the healing god Asklepios In eighteenth century England, patient visited Spas because they were places with supposedly health giving mineral for treating diseases from gout to liver disorder.

5. REASONS FOR MEDICAL TOURISM Better quality of care Waiting time Cost saving Confidentiality Unavailability of service in the country

6. Over 50 countries have identified medical tourism as a national industry. Top ten include: India Malaysia Turkey Singapore Brazil Costa Rica Korea Taiwan Thailand South Africa Hungary Gulf States.

7. Why these destinations Government and private sector investment in health care infrastructure. Broad commitment to international accreditation, quality assurance, and transparency of outcomes. Potential for cost saving.

8. Why these destinations contd Political transparency and stability Ease of access to tourism infrastructure. Sustained reputation for specialty excellence History of healthcare innovation and achievement. Availability of internationally travelled experience medical staff.

9. Types of medical tourism Outbound- Nigerians travelling to other countries to receive medical care. Inbound- Patients from other countries travelling to Nigeria to receive medical care. Intra-bound- Patients travelling within Nigeria to receive medical care outside their geographical area, typically to a centre of excellence in another state/region.

10. Market drivers for medical tourism Cost Savings Comparable or better quality care Shorter waiting periods, thus quicker access to care

11. Successful positioning for medical tourism by some countries The department of health in the Philippines has produced a medical tourism guidebook. The Korean Medical tourism promotion policy has led to the planning of new medical institution for international patients. In Taiwan, the government has announced a $318 Million project to help further develop the country’s medical services.

12. Successful positioning for medical tourism by some countries Contd The government of Singapore has formed a collaboration of industry and governmental representatives to create a medical hub in Singapore. In Malaysia, the government has increased the allowed stay under a medical visa from 30days to six months. India has also introduced a medical visa.

13. Global Market for medical tourism World medical tourism market is estimated to be over $100 Billion in 2010. Nigeria spent over N81billion in 2010. Over 35 countries are serving around a million medical tourist annually.

14. Competing in the global market quality This is a primary consideration for patients Traditionally, academic medical centres (AMCs) have been viewed as “the best” but data reflect comparable performance in community-based setting for certain services. Strategic positioning by community based setting has focused on continuity of care and uniquely packaged price, quality and service features.

15. Competing in the global market quality contd In order to be able to compete internationally, there are some bodies recognized in health care market for accreditation Hospital JCI- Joint commission international ISQUA- The international society for quality in health care b. Quality NCQA- National Committee for Quality Assurance. ISO- International Organization for Standardization. ESQH-European Society for quality in Health Care c. Other bodies Trent Accreditation Scheme (UK) Quality of Health New Zealand Netherlands Institute for Accreditation of Hospitals Council for Health Service Accreditation of Southern Africa

16. Drivers for venturing into international operations Pressure due to falling profit margins as a result of high number of domestic managed care patients. Potential of doing high-value medical procedures

17. Role of NMA Review legislations on medical advertisement by medical doctors Active participation in accreditation of hospitals at state and national level. Encourage members to go into partnership Collaboration of medical institutions with private hospitals

18. Role of other stakeholders Government Provision of enabling environment i.e power, security, social amenities, legislations. Establishment of “True” centres of excellence

19. Role of other stakeholders contd Business Community Loan by Banks Tony Elumelu led Ministerial committee on Private Sector Healthcare initiative for the unlocking of Private Sector entrepreneurship in Nigeria health sector. The goal is to have at least one world class private sector hospital in each geo-political zone in order to drastically reduce the exodus amongst health care professionals and citizens

20. Conclusion Medical tourism is a great business venture that has come to stay There are great opportunities for health workers to invest in Health care business in Nigeria Standard Health care business is capital intensive and therefore there is a need for joint partnership Health facilities/personel should endeavor to obtain international accreditation in order to compete favourably in the global market Need for a review in the current legislation on medical practice as a business

21. Thank you.