Quality care is now international

By BBC Doctor Colin Thomas

You might assume that healthcare in a first world country such as the United Kingdom would be far superior to that offered in a poorer country.

This was indeed the case many years ago, and wealthy people from such countries used to strive to get seen in Harley Street or the top hospitals in the United States, because quite simply these facilities didn't exist in their home country.

It is still true to say that overall such countries tend to have less well developed medical facilities, but for those who can pay, the healthcare available can rival, or even exceed, the care available now in a 'first world' country.

Last week I saw a patient who had suffered a heart attack whilst in India.

He developed what he thought was indigestion, but luckily he was close to a top hospital in Delhi and went for a check-up.

A good thing he did! The ECG showed signs of a heart attack, and he underwent emergency coronary blood vessel investigations which showed a blockage of one of his coronary arteries.

The blockage was dealt with and he made an uneventful recovery, and all this was explained on a very impressive and informative discharge summary which was neatly printed onto a laminated pocket card containing all the relevant medical details.

Reverse flow

So today the flow of patients has reversed. People from first world countries are waking-up to the fact that healthcare in less developed countries is actually very good, and the icing on the cake is that it is much less expensive, so they are voting with their feet.

Equipment costs are about the same, but the major charge, certainly when you go into hospital in the UK, is the wage bill which includes everyone from the nurses and technicians down to the cleaners.

So in a poorer country you get more for your medical dollar because quite simply wage costs are much less.

I remember my brother in law, who lives in Hong Kong, laughing out loud at the bill for £125 from his anaesthetist when he was operated on in this country, which he thought was ridiculously cheap - but the fee in India would have been even less than this.

My patient hadn't gone specifically to India to have a heart attack, but as is already happening so called health tourists will be taking advantage of the fantastic facilities in developing countries, the lack of waiting time, and low cost, to improve their health.

As he went on to explain, you could pay for the flight, treatment, and have a nice holiday afterwards, all for significantly less than having the same thing done over here.

He said: "Thank goodness I was in India. I don't think I'd have got quite as good treatment here."

And although I wanted to disagree with him, I found myself curiously unable to do so.