SUN, SEA, SAND ... AND SURGERY

THE GUARDIAN

(This article has been edited for length. The original article can be found here.)

Faced with a choice between NHS waiting lists and expensive private clinics, says Joanna Moorhead, more and more Britons are opting to go abroad for treatment - with a holiday thrown in.

We travel for business. We travel for pleasure. And now, increasingly, we travel for our health as well. The health tourism industry is still in its infancy and hard figures are difficult to come by, but last year an estimated 50,000 "medi-tourists" are thought to have travelled overseas from the UK for an extraordinary range of check-ups, treatments and operations, to countries as far afield as Thailand, South Africa, India and Cuba.

"Word is getting around," says Leslie, a medical insurance broker who matches UK patients with hospitals and surgeons abroad. "The idea is out there and people are investigating. This month I had four times as many internet hits on keywords like 'surgery abroad' as I had the month before".

Paul, who runs a similar business helping to organise surgery in, among other places, Thailand, Singapore and Istanbul - agrees. "Virtually every country is thinking it can offer this kind of service," he says. "Tourist boards are putting out literature saying, 'Come here for a safari, or a spell at the beach, or an operation.' If you're going to feel rotten you might as well feel rotten somewhere sunny, so you can at least enjoy nice weather as you recuperate".

The main reason cited for looking abroad is NHS waiting lists. "In this country we are used to a high level of free healthcare, but the fact is there are long waiting lists for some very nasty conditions - hip replacements, for example. What you find is that people are in a lot of pain and they have expectations of efficiency in the health service. They are appalled when they are told how long they're going to have to endure their suffering before they can be fixed.

"They're often older people, so they have a reasonable disposable income. They've got children who have backpacked round the world and who have maybe seen at first hand the medical facilities in places such as Asia and South Africa and can testify to how good they are". The real crunch comes when they decide to dip into their savings and go private, and start phoning around UK private health providers to see how much a new hip or knee is going to set them back. "They're horrified at the prices," says Leslie.

"Then someone tells them about a company like ours, or they talk to someone else who knows someone who has had surgery abroad, and they realise that prices abroad are cheaper, even taking into account travel and accommodation for a partner or friend. On average, I'd say most people are able to save around a third by going abroad".

For most patients, initial fears about language difficulties and the logistics of travelling overseas are allayed by linking up with a company experienced in putting health trips together. Some, such as Surgical Attractions in South Africa, even offer add-on "recuperation holidays". "A lot of our clients come here for cosmetic surgery," says Ingrid Lomas, who runs the company. "They have liposuction or breast augmentation and combine coming to Cape Town or Johannesburg for the surgery with the chance to take a holiday. Typically, they would fly over, have the procedure, rest for a few days in one of our hotels or guest lodges, and then have a wineland tour or go on safari.

"As it's cosmetic surgery, the incognito factor is huge. But the big draw has to be the exchange rate, which makes it very good value indeed." Some of her clients, says Lomas, are able to have their surgery and a holiday for less than the cost of the surgery alone in the UK. "It's a growing phenomenon - I'm getting more and more calls," she says. "At the moment we've got around 10 people a month travelling here from the UK - I'd say around four men to every six women".

The majority of patients going overseas for surgery at the moment are self-financing. Those who have private medical insurance are usually only able to use their payout at approved hospitals which, at the moment anyway, are mostly within the UK. For NHS patients, the opportunities are limited - but they do exist, in some areas at least. For the last nine months Dominic has been project manager of a pilot scheme offering certain patients awaiting orthopaedic surgery the chance to have treatment in Belgium.

But it is in the private sector that the effects of health tourism are likely to be most deeply felt. Leslie says he has already had UK surgeons contacting him who are prepared to undercut European colleagues to attract business to their clinics. The insurance companies too, he says, are watching developments keenly, and the overall effect of cheaper prices on the continent could well push bills for private medicine down here in the medium term.

Meanwhile, says Paul, going abroad is likely to become more and more acceptable. And it won't just be for operations, he says. People will increasingly think of combining an MOT-type general health check with a beach holiday, and companies looking after overstressed execs are already thinking in terms of combining a health check with a spa or seaside hotel overseas.