Medical Tourism is a growing phenomenon. Overseas travel is widely affordable: boarding a brightly coloured airline bound for the fringes of Europe is the work of a weekend, and, as consumers become more accustomed to travel, individuals are increasingly being seduced by lower prices for medical procedures at foreign clinics. It is difficult to get a handle on the true growth and value of the market, as figures may be exaggerated or difficult to collate. However, it has clearly become an additional, and as yet unregulated, tier of the healthcare system.
There are some shocking stories of botched operations on record, and in our work we often deal with clients who have suffered extensive damage. Nonetheless, foreign surgery is not always a bad thing; a great many of the clinics across Europe are no doubt carrying out treatment to a very high standard. Prospective patients simply need to be alive to the legal implications and practical difficulties of making a claim against an overseas clinic or practitioner, and that ultimately, if their treatment fails, they may be left in a very difficult place and with no means of achieving redress. Add to this that some patients undergoing cosmetic surgery are vulnerable, sometimes suffering from some form of body dysmorphia, and the consequences become more complex.
The term ‘medical tourism’ is, arguably, an inappropriate one, and ‘medical travel’ has become the preferred term. Patients with a range of complex medical problems, treatment for which may be expensive or unavailable in their country of origin, travel abroad with intentions that are hardly commensurate with sightseeing. For example, major procedures such as bariatric surgery (weight loss procedures including gastric bypasses) are widely advertised at foreign clinics, at more affordable prices. Lower costs are only one factor; some prospective patients travel to skip lengthy waiting lists at home, or to seek greater freedom of choice (the more controversial side of this is so-called ‘Circumvention Tourism’, where individuals travel to access services that are banned or restricted in their own country). Many procedures available abroad are experimental or unproven.
Political arguments as to whether a service such as the NHS benefits or suffers from medical tourism also remain unresolved. While it is the case that the NHS frequently foots the bill for returning victims of failed surgery, there is interest in the potential revenue for the health service from in-bound medical tourists seeking treatment at our leading hospitals. Some commentators argue that the best services will be reserved for fee-paying medical tourists; others, that the overall improvement of our facilities as a lure to foreign patients will have a positive effect. Some recent programmes designed to attract foreign patients have met with limited success, and such initiatives remain tentative.
Whatever name it goes by, it is an expanding industry, resulting in the inevitable price wars and bewildering array of choices that characterize any marketplace. The lure of cheaper treatment often overshadows its potential dangers; we talk to many clients who have deliberated carefully over the decision to undergo a procedure, but then seem to jump in without further thought when choosing a foreign clinic.
Our experience shows that foreign clinics and doctors are often uninsured, and the clinics not regulated to satisfactory standards. There are also concerns over the regulation of the devices used in these operations, such as breast implants. The PIP scandal is one recent example, where the implants used were found to be unacceptably prone to rupture in the body (leaving aside the anecdotal evidence that UK clinics were in fact keener to use PIP implants than their European counterparts).
My experience is that, when faced with the threat of legal action, clinics and surgeons often seek to take advantage of the discrepancies in national laws, as well as jurisdictional hurdles for the claimant, in an attempt to escape liability and shift the blame. In many of these cases where foreign treatment has failed, sometimes with disastrous results, it can be difficult, if not impossible, for us to obtain compensation for the client. Meanwhile, the victim of a failed procedure has to live with the unintended results. As with so many goods and services, you get what you pay for and nowhere is this more important than in medical treatment. Where an operation on offer at a bargain rate seems too good to be true, that may turn out to be just the case.