low cost makes
Middle East Health visited several leading hospitals in key cities in India
to assess the current
status of health tourism to the sub-continent. We discovered that although the
struggles with widespread poverty and pervasive pollution – two hindrances to
patients from overseas – a number of top hospitals do manage to attract patients
largely because they have the medical expertise and the cost of specialist
is very competitive compared to other countries where advanced healthcare is
India is a vast country with a population in
excess of one billion people. It rivals China
for the country with the largest population
in the world. This is manifest in several
congested mega cities – Delhi, the capital,
Mumbai on the west coast, and Chennai
and Kolkata on the east coast. There are
others, but these are the ones we visited.
The first-time visitor from the developed
world is usually in for a bit of a shock. From
their perspective the country can appear
extremely congested, chaotic, polluted,
unhygienic and generally in a state of disrepair
– none of which is conducive to
attracting people in ill health from economically
advanced countries like the US,
Canada or those in Western Europe. But
with such a large population and a rapidly
growing middle class, does India need to attract foreign patients? In reality
answer is no – as several doctors told us on
our tour of the country. They have more
than enough local patients to fill their
hospital beds – even in the private sector.
Doctors and marketing managers we
spoke to at most of the hospitals we visited
said they had initially tried to attract
patients from the United States and
Europe using the massive price differential
for treatment as the key attraction, but had
given up on this idea after not achieving
much success. However, most said that
they were receiving foreign patients and
that the numbers were growing exponentially
year on year – but the patients mostly
came from the developing world, from
countries lacking good quality healthcare.
“They come from the Middle East and several African countries, as well as from
Russia and the former soviet states to the north
and Bangladesh to the east,” we were told.
All the hospitals we spoke to have established
International Patient Services
departments offering – with varying degree
– a complete package of services for
prospective patients, including initial
consultation with the patient while still in
their home country, flight and medical visa
arrangements, airport pick-up, accommodation
for accompanying relatives, hospital
admission procedures, co-ordination with
the patient’s insurance for billing – if the
patient is not paying out of pocket (most
foreign patients do pay out of pocket) –
hospital discharge , follow-up (with video
conferencing) with the patient and their
doctor in their home country.
So it clearly a combination of the available
expertise and the cost-effectiveness of
treatment, that is attracting patients to
India, particularly those from the developing
world where good healthcare is not
readily available. However, patients from
economically advanced countries tend to
avoid India – even though the cost of
healthcare may be extremely attractive –
because of the general malaise from which
Indian cities suffer as a whole – that is population
congestion and pervasive pollution.
Nonetheless, it is a vast country and there
is a large choice of excellent hospitals
which, combined, cover all healthcare
specialties – from heart transplant to world-class
cancer care. Once you have entered
the domain of one of these fine hospitals,
you can put the ills of India behind you and
you could well imagine you’re in a hospital
on par with the best in Europe.
Following is a brief look at some of the
private hospitals we visited.
The Hospital Tour
S.L. Raheja Hospital
We started our journey in Mumbai at the S.L. Raheja Hospital – a 140-bed, multi-specialty
tertiary care facility. The hospital
is part of the large India-wide Fortis
Group. We spoke to George Alex, the
head of sales and marketing.
He explained that although the hospital
did have an International Patient Services
setup, only about 2% of the hospital’s
patients came from other countries for
S. L. Raheja Hospital is one of India’s
leading hospitals for advanced management
in diabetes and oncology, as well as
trauma and cardiology. S.L. Raheja is a
Centre of Excellence for oncology with
some of India’s leading cancer specialists,
such as Dr Suresh Advani, practicing at
the hospital. The hospital is also a Centre
of Excellence for diabetes. In this regard,
Alex pointed out that gastric bypass
surgery – for weight loss and as a cure for
diabetes – has become increasingly popular
at the hospital.
“[International] business has not
picked up in the past five years,” Alex
explained, adding that foreign patients
were now no longer a key focus for them.
“We are in two minds about marketing
internationally or investing locally. In
the past 3 to 5 years quite a few corporate
hospitals have sprung up in the city.
There is a lot of demand locally.”
S.L. Raheja Hospital
Our next point of call was Wockhardt
Hospital in Mumbai. This state-of-the-art
hospital is one of eight Wockhardt hospitals
in India and is part of Wockhardt
Limited, one of India’s largest pharmaceutical
This ‘super-specialty’ hospital network
works closely with Harvard Medicine
which serves as the hospital’s clinical and
technical partner, according to Leo
Varghese, assistant manager, marketing for Wockhardt hospitals.
Discussing health tourism, he explained
that most of their patients are domestic with
only around 3-4% visiting from abroad.
“They come mainly from Africa,” he
said, “from countries such as Nigeria,
Kenya, Tanzania, Zimbabwe and the
Democratic Republic of Congo.”
He said they do receive some patients
from the Middle East, which accounts for
about 5% of their total number of international
Varghese told Middle East Health a new Wockhardt Hospital was due to open
around November this year in downtown
Mumbai. The 23-storey hospital “will be
a state-of-the-art, hi-tech hospital, with a focus on stem cell regenerative
among other specialties.
He said the Wockhardt Hospital in Goa,
was making a concerted effort to attract
international patients – “in line with what
Bumrungrad hospital in Bangkok is doing so
successfully”. Bumrungrad is well known for
its success in medical tourism.
Wockhardt in Mumbai specialises in
cardiology, cardiac surgery, neurology,
neurosurgery, orthopaedics, joint
replacement surgery, and cosmetic
The hospital targets patients in
Africa, the United States and
Canada, according to Varghese.
He explained that before offering
a price for certain procedures, the
hospital requests all medical reports
from the prospective international
patient. Based on these the doctor
can determine the treatment and
estimate the price.
Still in Mumbai, we visited Kokilaben
Dhirubhai Ambani Hospital & Medical
Research Institute. The 750-bed hospital
has more than 103 full-time doctors and 520
nurses. It is new, having been inaugurated in
2009 and has several centres of excellence
including the Centre for Brain and Nervous
System, the Centre for Cancer, the Centre
for Cardiac Sciences, and the Children’s
Heart Centre, among others.
The hospital is ideal for health tourism.
It’s clean, modern and has the clinical
“We have an intraoperative MRI for
brain tumour operations and we have a
very good spine unit,” Zubin Daruwalla,
vice president, marketing & business
development at the hospital, told Middle
East Health. He said the hospital is well
known for its paediatric heart surgery and
is considered a place of choice in India for
congenital heart disease treatment. “We
can operate on children as young as one
day old,” he emphasised.
The hospital is conveniently situated
near Mumbai’s Sahar International airport
and, for accompanying relatives, it is close
to beaches, parks and shopping malls.
The hospital’s International Patient
Services department is well established
and has a strong online presence.
Although the web has been used more for
facilitation purposes, Daruwalla explained
that this year they intended to embark on
a more active marketing strategy. “Up to
this point we have mostly relied on ‘wordof-
mouth’ and the web to attract foreign
patients,” he said.
Ambani Hospital International
In Delhi we visited Batra Hospital and
Medical Research Centre and spoke to
Sanoj Kumar, the deputy general manager
and Saba Zareen Khan, marketing co-ordinator.
They explained that they get around
1,000 foreign patients a year from Africa,
Afghanistan, Iraq and Iran as well as from
neighbouring countries like Nepal.
“The hospital opened in 1987, so it has
had time to establish its good reputation and is now well respected in India.
Awareness of the hospital is high,”
explained Kumar. He said foreign patients
mostly visited for cardiac surgery,
oncology, plastic surgery, dental procedures
The multi-specialty hospital has 495
beds, 14 operation theatres, 112 ICU beds,
24x7 emergency facilities, a full range of
state-of-the-art diagnostic laboratories and
comprehensive rehabilitation facilities.
The hospital has a well-established
International Patient Services department
which provides the complete ‘concierge’
service for foreign patients.
“We even have a guest house on the
grounds of the hospital for relatives
accompanying the patient,” said Kumar.
“We also provide a dedicated guest relations
officer to accompany and guide the
patient throughout their stay at the
The hospital has a strong presence on
the web and this serves as a key portal for
potential foreign patients to get in touch
with the hospital.
“For marketing we travel and provide
consultancy services overseas. We also
attend health tourism exhibitions and
conferences around the world in an effort to
promote Batra Hospital,” Kumar explained.
“We were the first private hospital in
Delhi to do heart bypass surgery,” Kumar
adds proudly, “as well as the first private
hospital in the city to do renal transplants.”
Batra Hospital in Delhi
Max Healthcare Institute
Max Hospital in Delhi opened in 2004. As
a relatively new hospital its design is
modern, giving it the same look and feel of
modern hospitals in economically advanced
countries. At Max we spoke to Arpita
Mukherjee who told us around 8-10% of
their patient population are foreigners who
come to India specifically to seek healthcare.
“Most of our foreign patients come
from Iraq, Afghanistan, Libya, Bangladesh
and Pakistan. We do get some patients from
Africa and from Oman,” he said.
There are 10 hospitals in the network
spread across 5 states. The network has a
total of 1,800 beds and is completely digitised
including Electronic Medical Records.
He said foreign patients account for
about 10% of their revenue.
“Max is the exclusive hospital recommended
by foreign embassies in the city for
their employees or travellers who need
emergency healthcare. These embassies
include Canada, Australia, New Zealand
and the United States,” he said.
Mukherjee said they plan to build a
university for medical research which will
be operated in collaboration with Harvard
Medicine. It is due to open in 2015.
Max is well recognised for neuro-spinal
surgery; orthopaedics and joint replacement;
paediatric cardiology and cardiac
surgery; kidney transplants; and aesthetic
and reconstructive surgery.
“In bariatric and weightloss surgery we
have Dr Pradeep Chowbe who is considered
one of the top laparoscopic surgeons
in the country,” he added.
He explained that with regards marketing
the hospital network to potential foreign
patients they focus on the internet and use
Search Engine Optimisation techniques to
raise their profile in internet search engines
such as Google.
“We also network with embassies and
work closely with healthcare facilitators.”
Healthcare facilitators act as agents to
bring patients from foreign countries to
hospitals in India. As independent operators
they try to match a patient’s medical needs
with the most suitable hospital in India. Mukherjee said they plan to set up our
own facilitator operations in other countries
to direct even more foreign patients
to their network.
The hospital has a fully-fledged
International Patient Services department
with a specific team that takes care of
foreign patients including interpreter services
He said they have experienced remarkable
growth in foreign patient numbers.
“In 2010-2011 foreign patients grew
between 50-60% over the previous year.
In Delhi we also visited the Apollo
Hospital which receives around 100
foreign patients a day, according to Raj
Rainer, of International Patient Services at
“Rather than medical tourism, we prefer
to call it Medical Value Travel,” he
He said their foreign patients tend to
come from countries in Africa such as
Kenya and Nigeria as well as the former
CIS countries and Afghanistan.
The Apollo Hospitals Group is one of
the largest healthcare groups in Asia with
more than 8,500 beds across 54 hospitals
within and outside India.
He said the hospital is recognised for its
high quality standards and was the first
hospital in India to receive the prestigious
Joint Commission International (JCI)
“Of the 54 hospitals in the network,
seven now have JCI accreditation,” Rainer
noted. “There is also an Apollo hospital in
Dhaka, Bangladesh with JCI accreditation.
We also have a hospital in Sana’a, Yemen,
and one in Mauritius.”
“We have leading doctors and clinicians
and all major specialties,” he said.
Apollo Hospitals has dedicated centres
of excellence for several key specialties and superspecialties, including
orthopaedics, transplant institutes, and
spine surgery, among others.
“We have excellent infrastructure and use
the latest technology,” Rainer pointed out.
Apollo Hospitals has established the
Apollo Institute of Robotic Surgery in
collaboration with the Vattikuti
Foundation of Michigan, USA. Robotoc
surgery is currently available at Apollo
Hospitals Chennai and Gleneagles Apollo
hospitals Kolkata. This multi-speciality,
multi-modality institute offers roboticassisted
surgeries – with the Da Vinci
robotic surgical system – of world-class
standards at costs which are just a fraction
of what is charged in hospitals in economically
He explained that for marketing to
foreigners they use healthcare facilitators
based in various countries. The group has
a comprehensive International Patient
Services division and this is well represented
on their website – with explanations
of how to plan your visit, the
specialties they offer, the facilities they
have and the insurance companies they
While in Delhi we visited Medanta, the
medicity, which is one of India's largest
multi-super specialty institutes located in
Gurgaon, on the outskirts of the city.
This is an impressive facility – modern,
clean and sophisticated. It has been envisioned
with the aim of bringing to India the
highest standards of medical care along with
clinical research, education and training.
We spoke to Brijash, a representative of
the hospital, who told us that around 18-20%
of their patients originate from overseas.
Spread across 43 acres, the institute
includes a research centre, medical and
nursing school. It has 1,250 beds and over
350 critical care beds with 45 operation
theatres catering to over 20 specialties. Medanta houses six centres of excellence.
The medicity has the following institutes:
the Heart Institute; the Institute of
Neurosciences; Bone and Joint Institute;
Kidney and Urology Institute; Cancer
Institute; and the Institute of Critical Care
The hospital has a comprehensive
International Patient Services department
and makes use of a ‘buddy’ system where a
hospital representative remains at the side
of each foreign patient and serves as their
translator and go-between for all interactions
in the hospital.
“Our International Patient Services will organise your treatment packages, visa
assistance, airport pick up, hotel reservations
and any sightseeing trips you may
want to add after your recovery. These
services include coordinating scheduling
of appointments, medical care and advice
and ensuring your comfort and wellbeing,”
Information about their International
Patient Services is available on their
Also located in Gurgaon is Medanta www.medanta.org
Artemis Health Institute
Also located in Gurgaon is Artemis
Hospital. This is another impressive
facility which has been treating foreign
patients for the past four years through its
International Patient Services division
and has acquired a very good
“Most of our foreign patients
come from Iraq,” Deepak Chawla,
the team leader of the
International Team at the hospital,
told Middle East Health.
Foreign patients account for
around 20-25% of their total
The 300-bed multi-specialty
hospital is well known for neuro-spinal surgery (treating brain
tumours, performing spinal fusions, for
example), for cardiology and oncology, as
well as for orthopaedic surgery and joint
replacement. It has recently launched a
liver transplant centre.
A new tower with a further 250 beds is
being built and is expected to be completed
in about two years, according to Chawla.
The institution is equipped with the
latest technology in preventive, diagnostic
and therapeutic imaging, along with the
highest levels of in-patient monitoring,
and a paperless and filmless Hospital
Artemis provides an intelligent critical
patient monitoring system with clinical
decision support application backed by
portal imaging technology. Other highlights
include: Functional MRI scanning
using Non-Contrast Imaging for Cancers
(DWIBS). It is the first hospital in India to
install state-of-the-art Image Guided
Radiation Therapy for cancer treatment.
Artemis has a technology tie-up with
Philips Healthcare which enables early
and exclusive access to the latest global
imaging and monitoring equipment.
Its top procedures are: liver transplant,
angioplasty, cardiac artery bypass surgery,
kidney transplant, knee joint replacement,
spine surgery, hip replacement, gastric
bypass surgery and lap band surgery.
It offers a long list of specialties – which
are outlined on its website.
Appealing to international patients, the
hospital offers globally benchmarked
healthcare services administered by
surgeons and physicians trained in international
medical practices. Additionally, the
hospital offers a host of exclusive services
for international patients including teleconsulting
with specialists, all necessary
travel arrangements, airport pickup and
hospital transfer services, availability of
international cuisines, arranging lodging
for attendants, connectivity through
mobile phones and wifi environment
within the hospital.
Artemis Health Institute
We stopped at Chennai on the coast of
southeast India and visited the Fortis
Malar Hospital, formerly the wellknown
Malar Hospital which was
acquired by the Fortis Group.
We spoke to Sneha S.,
International Business, and
Dr Sajan Nair, the medical
director, who told Middle
East Health that the
Services department was
setup three years ago.
“Most of our patients
come from Iraq and
Sudan,” Sneha said. “It’s
a booming market.”
She said they see around 100 international patients per month.
Fortis Malar Hospital provides comprehensive medical care in
the areas of cardiology, cardiac surgery, neurology, neurosurgery,
orthopaedics, nephrology, gynaecology, gastroenterology, paediatrics
The hospital is particularly well known for its paediatric cardiology.
The renowned Dr KR Balakrishnan is the chief cardiothoracic
surgeon at the hospital.
“Many international patients come to see him,” explained Dr
Nair. “And he travels regularly to Africa to do consultations and
“In particular, he sees kids with congenital heart disease.
Around 50% of them will need cardiac intervention. Even though
the surgeries are sometimes small, they are generally complicated.
“We have set up a charity, so we can keep the cost of these interventions
really low – and generally charge only US$1,000-$2,000 for
these surgeries. The balance is paid by the charity for patients that
cannot afford it. The surgery would normally cost around $7,000.
“From 2009-2011 more than 400 children were provided this
surgery under the charitable – Aishwarya Trust. Twenty-one of
these children came from Burundi, for example,” Dr Nair told
Middle East Health.
The hospital also specialises in surgery for epilepsy and says that
between 30% and 40% of epilepsy cases can be cured with neurosurgery.
Here too, the hospital has established an epilepsy foundation
to help offset some of the costs of this complicated treatment.
Fortis Malar Hospital
Apollo Gleneagles Hospitals
In Kolkata we checked in on the 425-bed Apollo Gleneagles
Hospitals. This is a campus of several hospitals with many centres
of excellence, including cardiology, gastroenterology, neurology &
neurosurgery, orthopaedics, oncology (at the Apollo Gleneagles
Cancer Hospital, which also houses the bone marrow transplant
unit), nephrology and more.
The campus was established as a joint venture between the
Apollo Group and Singapore’s Parkway Group, which has a
network of hospitals throughout Asia and provides more than
70% of private healthcare in Singapore.
Apollo Gleneagles Hospital, Kolkata is the only hospital in
Eastern India to be accredited by Joint Commission International.
Being part of the wider Apollo Hospitals Group, the Apollo
Gleneagles Hospital, shares the group’s International Patient
Services division, providing comprehensive medical concierge
services to visiting foreign patients.
The hospital recently opened the Apollo Gleneagles Children’s
Centre. This multi-specialty centre, within the campus of Apollo
Gleneagles Hospitals, provides a range of services in the specialties of
cardiology, neurology, nephrology, orthopaedics, paediatric surgery,
neonatal medicine, adolescent medicine, radiology and dentistry for
newborns, children and adolescents all under a single roof.
Apollo Gleneagles Hospital
of upload: 26th Jul 2012