The internationalisation of UK healthcare…. and the challenge for medical tourism destinations

Many countries across Europe want to attract patients from the UK seeking treatment abroad. But freedom of movement for healthcare workers and the attractions of the UK mean that the UK patient can now access “international healthcare” in their local private or NHS hospital.

My recent experience as a patient in a UK private hospital, and of the healthcare staff who provided my care, highlights the challenge faced by overseas providers in retaining the staff they need to deliver services to the international patient.

Would a UK patient travel abroad for hernia surgery?

As a keen (but ageing!) sportsman, it was only a matter of time before I became one of the 25% of males who need surgery for an inguinal hernia. The waiting time for this surgery at my local NHS hospital is 14 weeks. Not too long to wait, but I have private health insurance through AXA PPP and this enabled me to choose a consultant (Mr Abhay Chophada) and a hospital (BMI Clementine Churchill Hospital) that I felt were best for my needs.

Would a UK patient travel abroad for inguinal hernia surgery? Very few would consider this. A UK patient can opt to wait for free NHS treatment, use private health insurance (if they have it) or can seek surgery on a “fixed price” basis. Most UK private hospitals will offer a fixed price, all inclusive package for hernia surgery. Prices range from around £1,800 to £2,500 depending on the hospital and the surgeon. This price includes pre-operative assessment, post operative follow up, the surgeon and anaesthetist fees, all hospital related costs and a guarantee.

A UK care team… from India, Serbia, Portugal, Lithuania, Egypt, Romania, Turkey and Russia

What is interesting about my patient journey is how UK healthcare is being delivered by an international healthcare team.

Let’s start with the surgeon. Abhay Chophada undertook his medical training in India, gaining his MBBS and Master’s degree in Surgery from the University of Pune. He then moved to the UK gaining further qualifications and experience at the University of London, and University College London Hospital. He holds an NHS Consultant position at Ealing Hospital NHS Trust and has a thriving private practice.

When I went for my pre-operative assessment:

  • The nurse was from Serbia. She moved to the UK to gain experience and to earn four times the wage she would earn in Serbia.
  • The phlebotomist was a first generation member of an Indian family.
  • The cardiac physiologist was Portuguese. She had trained at the Coimbra University Hospital and moved to the UK to earn three times the salary.

The care team during my operation on Saturday comprised:

  • A nurse from Lithuania.
  • A nurse from Romania.
  • A nurse form Turkey
  • A physiotherapist from Egypt.

On entering theatre for the operation, I bumped into Sergei Vagonov, a Russian anaesthetist who had been a guest speaker at our “Future of Harley Street” event.

The UK healthcare system’s reliance on international staff

My patient journey highlighted the extent to which healthcare professionals overseas are attracted to the UK’s private healthcare system. But it’s not unique to the private healthcare sector. Data from the Health and Social Care Information Centre (HSCIC), show that 11% of all staff who work for the NHS and in community health services are not British. 26% of NHS doctors are non-British. India provides the highest number of doctors from overseas. The Philippines provides the highest number of overseas qualified nursing, midwifery and health visiting staff. Poland, Nigeria, Zimbabwe, Portugal, Pakistan, Spain and Germany also feature highly.

For a full analysis, see this interesting infographic from the Guardian.

The challenge for medical tourism destinations

The harsh reality for countries that seek to become medical tourism destinations is that they are losing their best staff to the countries that they see as a source of patients. For healthcare systems such as the UK where there is pressure on staff and resources, the immediate solution is not to export patients… it is to import doctors and care givers.

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As Editor in Chief of International Medical Travel Journal (IMTJ) and a Healthcare Consultant for LaingBuisson, Keith Pollard is one of Europe’s leading experts on private healthcare, medical tourism and cross border healthcare, providing consultancy and research services, and attending and contributing to major conferences across the world on the subject. He has been involved in private healthcare, medical travel and cross border healthcare since the 1990s. His career has embraced the management of private hospitals in the UK, research and feasibility studies for healthcare ventures, the marketing and business development aspects of healthcare and medical travel and publishing, research and consultancy on cross border healthcare.