French government to stimulate inbound medical tourism

Health and foreign ministries working to promote French healthcare abroad and cut red tape for foreigners. France wants to open its hospitals to private medical tourists. It will be a massive change for France, where the stretched healthcare system is usually asked to cut costs, rather than try to court new patients.

The Socialist government, struggling to revive a stalled economy, now wants to play catch-up in medical tourism. Hospitals are undergoing a radical shift to attract high-end clientele that speak English, want concierge services and demand competitive rates without administrative hassles.

The health and foreign ministries have been working to promote French healthcare abroad and cut red tape for foreigners.

A government report highlighted France’s strengths as a top tourist destination and mostly excellent French healthcare. The report claims that medical tourism could help the country attract €2 billion of extra revenue by 2020 and create 30,000 jobs.

Health economist Jean de Kervasdoué recommends creating an umbrella organization, Medical-France, to help hospitals draw up all-inclusive packages for foreign patients, launch a web portal in six languages (including Arabic, Russian and Chinese) and promote French healthcare in embassies worldwide.

In a complete turn round from their historic indifference and antagonism to even considering medical tourism, the government welcomed the suggestions and set up a task force of public and private hospital federations with the mission to make serious progress on the topic by the end of 2015.

In his report Kervasdoué attempted to quantify the number of foreign patients seeking treatment in France. He found that numbers are so small that they do not impact the quality of healthcare French patients currently receive, and on increasing numbers argues, ”The number of French residents grows 1% every two years. If one day we have 1% of foreign patients, it is not going to change things or the world.”

A planned brochure will put the spotlight on up to 40 French hospitals, grouped by specialty, that have proved they are able and willing to cater to foreign patients. The list will include private not-for-profit hospitals such as cancer centre Gustave Roussy and the American Hospital of Paris, as well as the Assistance publique-Hôpitaux de Paris (AP-HP) public hospital group, France’s largest.

François Madelmont of SPH Conseil is coordinator of the new medical tourism task force and comments. “ It is a cultural revolution. Many hospitals are eager to be on the list and to take in more foreign patients. Some already do it discretely, others advertise and make it part of their strategy.”

France Stratégie, a government think tank, says that 7 million patients from all over the world travel abroad for surgery each year, but France is nowhere, as less than 9,000 non-residents schedule treatment in French hospitals each year — under 0.1 % of all patients.

France has yet to agree target sectors or countries, but the report suggested Saudi Arabia and former colonies in Africa are likely targets for the French market.

It is all well and good to decide to promote medical tourism but the French healthcare system has a reputation of not being user-friendly. France Surgery is medical tourism agent in Toulouse that has directed about 200 foreign patients to French clinics since it was founded four years ago. France Surgery picks up patients at the airport, books their hotel rooms, schedules their medical appointments and, when needed, provides interpreters. Co-founder Carine Hilaire says, “Foreigners see the French system as an excellent but very exclusive club.”

The Kervasdoué report points out the problems-

  • Many hospital workers lack basic skills in English.
  • There are lengthy administrative procedures.
  • It takes three weeks to get a medical visa for France, compared to one day in Germany.
  • The food and accommodation offered is too basic.
  • Billing systems are complicated
  • Prices are not advertised or packaged.

The AP-HP public hospital group in Paris has launched an English online course for its staff, from front desk agents to nurses, and is seeking to develop concierge services for all patients, whether foreign or French. AP-HP is also working on improving its billing system and drawing up competitive packages. It already has contracts with the United Arab Emirates embassy and the Kuwait Oil Company.

More controversially, AP-HP applies an automatic 30% mark-up to non-EU residents who schedule treatment at its hospitals. This should have given it an extra €10 million of revenue in 2014, but only €5 million was actually paid. As a public hospital it has a less tough billing system than private hospitals. AP-HP says that in 2014 patients residing outside France, and their insurers, left it with €120 million of unpaid hospital bills; among the worst offenders were Algerians, Moroccans and Americans (The US unpaid bills total €5.5 million). AP-HP now ask non-resident patients pay upfront before treatment.

AP-HP has also run into opposition from doctors and other healthcare workers. When an AP-HP hospital in Paris privatized an entire floor for a wealthy patient from the Gulf, doctors rebelled against a two-tier healthcare system.

Christophe Prudhomme of the doctors professional body Association des Médecins Urgentistes de France, comments, “It is an outrage to see France, the nation of free and generous healthcare for all, going out of its way to attract princes and oligarchs while French patients cram into overcrowded ER waiting rooms. In France, healthcare has never been a business; it is a public service. What the government is trying to sell us will kill this system.”

In a national radio interview Kervasdoué replied, “In no way do I want a two-tier medical system. I simply want foreigners who come here to have the kind of accommodation that they are used to. We are not talking about medical care, but about accommodation that can be much better than it is now. The government has insisted that it wants to preserve equal access to healthcare.”

Whether the initial government surge of interest in medical tourism will survive public and medical professional criticism is an unknown while France has many hurdles to overcome before it can compete with Belgium, Germany and the UK.