Medical Tourism in Singapore
Medical tourism is expanding rapidly in Singapore. There are many reasons for this, not least the evolution in technology and the increasing affordability of travel. The World Health Organisation recently ranked this small city state as having the world's sixth-best health care system, and Asia's highest. The Singaporean government has ambitious plans to maintain this trend, aiming to attract an annual turnover of a million patients.
The visitors attending Singapore's facilities from neighbouring countries include rising numbers from Indonesia, Indochina and Malaysia. It is testament to the services on offer that patients continue to arrive from the UK and the USA.
The healthcare services on offer are varied. Singapore launched the National University Heart Centre – the region's first cardiology clinic aimed specifically at women. In addition to first class cardiac surgery, other specialities include gastroenterology, neurology, oncology, orthopaedics and stem cell therapy, as well as general surgery.
Parkway Pantai Ltd (PPL), part of the IHH Healthcare Berhad Group, one of Asia's largest and most prestigious private health groups, operate several establishments in Singapore. All accredited by Joint Commission International, these include Gleneagles Hospital, Mount Elizabeth Hospital and Parkway East Hospital, and are staffed by upwards of 1,200 fully-qualified medical specialists.
Reasons for medical tourism
There are two fundamental reasons for the rise in medical tourists visiting Singapore. Firstly, the most important aspect of the healthcare being offered is its sheer quality rather than any cost issues. Secondly, the market offering the clearest signs of potential growth is no longer the long-established route emanating from Western Europe or North America, but the newer and rapidly-expanding areas of Asia and Eastern Europe.
Singapore's renowned expertise in specialist care and high-end surgical procedures has also promoted a steady rise in the influx of visitors from neighbouring countries. PPL now report that those enquiring about places in any of their institutions are now just as likely to be calling from anywhere around the Java Sea and the surrounds.
The Raffles Medical Group (RMG), one of Singapore's most striking success stories, began with just two clinics in 1976. They now boast over a million patients and 6,500 corporate clients, including government agencies and local and multi-national corporations. RMG reported an increase of more than 25% in their medical tourist admissions last year. The overwhelming majority of these were from Indonesia.
Singapore's location is central to its attraction. For Indonesians seeking to take advantage of its reasonably-priced healthcare, its world-class facilities are one flight away. There is any number of reasons given by medical tourists for making the short journey over the Java Sea. In one example, when relating his experiences of his nearby hospital in Jakarta, 54-year-old heart patient Widjil Trionggo stated: “They wanted to cut into my chest first then specify the cost afterwards”. The recommended procedure also included tackling his blocked arteries with balloon angioplasty, where the surgeons would insert stents into the vessels. Widjill noted his local doctors didn't know exactly how many stents would be required. Disillusioned by the levels of Indonesian expertise, he flew out to Malaysia, where the recommendation was a heart bypass.
Widjill's experience of contrasting diagnoses is typical. Another Indonesian medical tourist, Siaw Kian, aged 57, gave straightforward reasons for booking into a Singaporean clinic. This was a far more preferable option to enduring the healthcare offered by her local hospital in Jambi: “Service is fast. We had good information on what the doctors wanted to do and the charges were almost similar or even cheaper than if we had gone to hospitals (at home)”.
The large numbers of medical tourists coming from Indonesia owes much to word of mouth recommendations. A marketing manager for PPL, Suwandi Leo, cites patient referrals as being key to building trust in Singaporean healthcare: “The best spokespeople are the patients”.
Leo acknowledges the invaluable contribution of medical tourists to the success of his institution, with foreign patients accounting for over one-third of all admissions. Indonesians choosing to visit do so at their own initiative; or when compelled to do so by their own doctors. Admission statistics ingathered since 2009 demonstrate that the three hospitals in the PPL have been treating an average of 37 Indonesian patients per day, with each staying for an average of 3.7 days. They are being treated for diverse conditions; as straightforward as routine check-ups or as complex as strokes, cancer or heart disease remedies.
What makes the large figures for Indonesian medical tourism even more interesting is the fact that, compared to the costs of health care in Indonesia, treatment in Singapore is relatively high. Additionally, because Indonesians are not always guaranteed to be covered by private health policies, they tend to pay for their visits to Singapore out of their own pocket.
This conclusion has been underscored by Kamaljeet Singh Gill, a marketing executive at PPL, who has commented that the numbers of overseas medical tourists arriving in Singapore is continuing to rise. “We have foreign patients from as far as Finland, but Indonesia is our largest foreign-based market country”.
American and British tourists were traditionally the likeliest candidates for taking advantage of Singapore's healthcare system, but with lower prices in neighbouring countries, particularly India, Malaysia and Thailand, more and more tourists are coming from Asia. In fact, as localised economies have begun to outstrip healthcare developments, there has been a considerable demographic shift in medical tourists visiting Singapore. Those foreign patients who have been inspired to take advantage of its enviable healthcare services now account for the top five health visitor nationalities. Almost half of all foreign patients now hail from Indonesia, with neighbouring Malaysians tallying at around 12%. Next are Bangladeshis at 5%, Vietnamese at 4% and Burmese at 3%.
The worldwide financial downturn at the end of 2009 undoubtedly caused a sharp dip in Singapore's medical tourist trade. However, there are strong indications that the plucky city state is bouncing back. According to Singapore's highest-selling newspaper, The Straits Times, the total figures of international patients is rising again. The government have reiterated this observation; indeed, the Ministry of Health, along with the Singapore Tourism Board, have published some startling findings. In 2011 Singapore welcomed almost 36,000 medical tourists. This influx helped boost the city state's economy to the tune of almost S$1 billion (US$806.9 million).
Medical tourists tend to book into private hospitals for treatment where procedures are not so expensive (foreign patients don't enjoy any subsidies at Singapore's public facilities). While a lot of these tourists are attracted to specialist services, the majority undergo general surgery.
But there are even more compelling reasons for patients gravitating towards Singapore, not least the fact that over one-third of its residents are English-speaking. This extrapolates to even higher numbers in the medical community, indicating just how developed the Asian city state has become.
The Singaporean government has been quick to capitalise on the potential investment opportunities afforded by tens of thousands of medical tourists flooding into the country. They have set out bold plans to attract one million medical tourists and statistics ingathered by the Singapore Tourist Board have indicated they are well on the way to realising this, with the 2012 tally sitting at 850,000. (The one note of caution acknowledged by the Board is the fact that these overall totals do not differentiate between actual medical tourists and holiday or business travellers who have used the facilities).
Westerners once provided a steady turnover of patients seeking cheap but effective treatment from Singapore healthcare professionals. Nowadays visitors are arriving for completely different reasons. While money remains a concern, more visitors are coming because they know they will receive excellent medical service. India, Malaysia and Thailand are now increasingly competitive in many areas, such as ballooning and stenting of blocked arteries, heart surgery and cataract operations. This state of the art surgical care extends to organ transplants and cancer treatments.
The costs of health screening in Singapore can be anything between 500 and 2,000 Singapore dollars (equivalent to between 400 and 1,600 US dollars). These are not unduly high figures; however, for the PPL hospitals they represent tens of thousands of paying patients per annum. PPL offer treatment packages to help prospective patients to decide the best course of action. These packages even cover the trickier procedures, such as liver transplants. Prior to any operation, the patient and the medical staff will discuss the costs of various procedures, ensuring patients get a good idea of the bill that will be presented to them at the conclusion.
If the various Singapore healthcare institutions can rely on patient testimonials to spread the word on their superb services, technology is also providing excellent marketing tools.
Social media is being harnessed to promote the benefits of the healthcare institutions run by PPL, the RMG and others. Marketing executives are now targeting prospective customers in neighbouring countries, with virtual campaigns being unleashed across Facebook or Twitter. Indonesians are particularly susceptible to this type of advertising, as they are amongst the globe's most enthusiastic and prolific users of social media.
Similarly, mobile phone apps are being deployed to attract would-be medical tourists across the Java Sea. Again, these are proving to be an effective tool for gaining the attention of customers in Indonesia, a country with a high percentage of mobile phone users.
Healthcare institutions are adopting visual media as a way of hooking-in interested parties. It is one thing to receive a glowing report about the standards of service in Singapore from a former patient, but to actually be able to witness aspects of this care in an informative film is even better.
Potential Indonesian medical tourists might also be influenced as part of a broader e-learning initiative. Computer-based and web-based instruction courses will emphasise the cutting edge technology that is being championed by Singapore's medical establishments.