Is medical tourism welcome?

As the world grows smaller and globalisation becomes commonplace, medical services will increasingly escape national borders. A health feature in The Times (US Consumers Face Rising Medical Debt, August 22) quotes Reuters as saying: "An estimated 72 million Americans... had trouble paying for medical care in 2007". In fact, high prices at home have led to one million Americans searching surgery abroad last year. According to consultancy firm Deloitte (The Economist, August 16-22), this figure is set to rise to 10 million by 2012.

American insurers and even employers offering medical cover to their employees are looking outside the US for cheaper medical services. Deloitte estimate that the average surgical procedure costs 85 per cent less in Asia than in the US. This trend in medical tourism is also, albeit to a lesser extent, occurring in Europe. In 2006, 50,000 Britons opted for medical care abroad. Patients from north Africa and the Middle East similarly are increasingly looking to travel abroad for surgery, in their case in search of a better quality of care than at home.

There is no doubt that the market is there. And Malta is favourably situated to enter it. Our doctors enjoy an excellent worldwide reputation; our hospitals, both state-run and private, are of the highest standards; practically the entire population is English-speaking and Malta itself offers first-class hospitality and leisure facilities.

The question which arises, however, is: Should we welcome medical tourism to Malta? Our main state hospital, while offering an excellent service, is already overloaded. Especially during the winter months there are little, if any, hospital beds to spare. Medical and nursing staff are also at a premium and their unions insist that they struggle to cope with the existing local patient load.

However, the other chronic problem with the national health service is lack of funds. Tapping into the medical tourism market will provide welcome revenue which, in turn, can be utilised to improve salaries. This will encourage young people to seek and pursue a career with the national health service. Recruiting more nursing and medical staff will help reduce waiting lists!

Private organisations are also actively looking into the prospects of medical tourism. While not directly competing with locals for bed space, private medical tourism may lead to an "internal" brain drain, with nurses and doctors leaving the national health service for better-paid private jobs.

What we need to look at now is creating a framework for medical tourism to happen in a manner which is beneficial to all. Private medical tourism operators will "use" state-trained doctors, nurses and paramedical staff. The state should therefore in turn introduce a windfall tax on private medical tourism to compensate for the years of expensive training. Alternatively, private medical tourism operators can "sponsor" training of medical staff in state institutions.

The state should only go into the medical tourism field once it has set itself rigorous guidelines for service to local patients. Namely, a patient charter which stipulates maximum waiting times for out-patient appointments and surgical interventions. This must, of course, be backed with the necessary infrastructure and manpower. Once this is guaranteed, Malta can only benefit from the expanding trend of medical tourism.