Health and Medical Tourism
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Health and Medical Tourism Presentation to NW Tourism Lekgotla Dr Tshepo P. Maaka Serokolo Health Tourism (Pty) Ltd 10 Sept 2009. Presentation Layout. What is medical tourism? Segments of Health Tourism Who are health and medical tourists Why do they travel and where do they travel from?

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Health and Medical Tourism

Presentation to NW Tourism Lekgotla

Dr Tshepo P. Maaka

Serokolo Health Tourism (Pty) Ltd

10 Sept 2009

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Presentation Layout

  • What is medical tourism?

    • Segments of Health Tourism

    • Who are health and medical tourists

    • Why do they travel and where do they travel from?

  • How big is Medical tourism internationally and locally?

  • Why SA as a medical tourism destination?

  • Serokolo Health Tourism

    • Case Study- Creating a medical tourism experience

  • Summary:

    • Who is in the value chain of medical tourism

    • Benefits of medical tourism

    • Growth and Development Challenges

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What is Medical Tourism?

Industry where people from all around the world are travelling to other countries to obtain medical, dental and surgical care while at the same time touring, vacationing and fully experiencing the attractions of the country they are visiting”

It is all about the experience!!!!

Medical tourism began primarily with elective and cosmetic surgery generally not covered by medical insurance, but growing numbers now travel for life-saving and medically-necessary procedures such as cardiac surgery.

Furthermore people combine medical check-ups with travel both internationally and locally

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Segments of Health Tourism

  • Medical Tourism

  • Dental Tourism

  • Spa Tourism

  • Wellness Tourism (health tourism)

  • Culinary Tourism

  • Sports Tourism

  • Accessible Tourism

  • Assisted Residential Tourism (Ambient Assisted Living Abroad)

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Life-saving procedures

Elective and necessary procedures

Stay longer, min 10 days

Minimal tourism activities

Travel with companion

International (can be local)

Quoted on medical history


Health seekers

Dental and cosmetic surgeries

Medical check-ups/Screening

Packages: Spa therapy and revitalization/wellness

Short-stay < 1/52

Combine health travel with lots of tourism activities, golf, safari, shopping, food

Travel alone

Local and international


Who are these tourists?

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Emerging medical tourists

  • Indonesia, Africa,

  • Unavailability of required medical services in

  • own country

  • Quality and safety concerns of medical services

  • in own country

  • Relatively high costs of medical and health

  • services

  • Exclusions and non-coverage of services by medical insurance companies

  • May be able or unable to pay

  • Usual services purchased are life-saving and medically-necessary procedures

  • May purchase elective procedures

  • Tourism aspect of offering may not be important

Traditional medical tourists are residents of industrialised countries…

Traditional medical tourists

  • USA, Canada, Great Britain, Western Europe, Australia and Middle East

Countries of origin

  • Rise in life expectancy and surging demand for healthcare services in own country

  • Rise in non-communicable diseases that require specialised services

  • Increasing burden on healthcare services leading to long waiting periods*

  • High costs of medical and health services

  • Exclusions and non-coverage of services by medical insurance companies

  • High malpractice insurance fees

Reasons for medical travel

  • Generally able to pay

  • Disposable income

  • Usual services purchased are elective procedures especially cosmetic surgery

  • Combine medical service with a vacation


…but these are being joined by people from other countries including from developing countries.

Note: according to the UK Patient Association in the UK more than 1 million UK citizens are waiting for hospital treatment and the maximum waiting time for an NHS operation is set

at 6 months in 2005.

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Medical tourism is a rapidly growing industry with various factors contributing to its increasing popularity

High health care costs in industrialised countries

Decreasing levels of medical insurance coverage

Ease and affordability of international travel

Advancement in telecommunications

International/bilateral trade agreements

Proven safety of healthcare in select foreign countries

Rapidly improving technology and standards of care in may countries of the world

High standards and quality of care in developing countries that now offer world-class medical services

Lower costs

Rapid access and privacy

Favourable currency exchange rates in the global economy

Medical tourism is a product of the globalisation of medical and health care services

Medical tourism is a result of customer driven demands for healthcare services

Medical tourism presents an affordable, enjoyable and safe alternative to having medical, dental and surgical procedures done in the home country.

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Cost comparison factors contributing to its increasing popularity

SA Costs

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Summary of countries participating in medical tourism factors contributing to its increasing popularity

Source: Mckinsey Study summary

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Where do medical tourists go? factors contributing to its increasing popularity

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Just how big is this industry? factors contributing to its increasing popularity

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Converging forces in medical Tourism factors contributing to its increasing popularity


Medical Traveler Convergence Point

Medical Travel GDP Growth

$ 60bn in 2006 and $100bn

global industry by 2012

(???Recession figures)

Health and Medical Services

Hotels and Resorts

Adapted from Globalysis 2006

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What about SA?? factors contributing to its increasing popularity

  • Total visitors to SA in 2007/ 8 = Approximately 10 million

  • 4.5% are medical visitors (Monitor, 2001 report) = 450,000

  • 50% treated in Joburg (conservative assumption) = 200,000

  • Each accompanied by one companion

  • Ave length of stay is 10 days (5 in hospital, 5 days out)

  • Ave medical procedure R25,000 (i.e. 5 days in hospital)

  • Ave out of hospital spend is R1,250 x 5 days = R6,250

  • 1 private health group sees 200 per month in 5 hospitals

  • Estimated total revenue per annum R9.8 billion

Adapted from City of Joburg 2009

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Why should we promote SA as a medical tourism destination? factors contributing to its increasing popularity

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SA is a medical pioneer: factors contributing to its increasing popularity

The world’s first heart transplant was done in SA on the 3rd of December 1967

CAT was co-developed by a South African born Physicist Allan Cormack in 1972

SA has the world’s first surrogate grandmother, who gave birth in October 1987

The world’s oldest surviving sextuplets were born in SA on Jan 11, 1974

SA has the medical infrastructure

Our private healthcare systems was ranked 4th in the world in 2004

We have the largest ARV programme in the world

Part of a global HIV Vaccine Initiative

Our medical institutions have international accreditation

World renowned medical and surgical specialists

Single digits infection rates

Clinical outcomes comparable to USA and UK, and even better

Most of our private wards sit at 65% occupancy rates

Centres of excellence (excellence drived medical tourism

The Endometriosis Institute of Southern Africa

iThemba Labs Medical Radiation Group - only hadron therapy centre in Africa

The Walter Sisulu Paediatric Heart Institute

Fertility Clinics

Sports Institutes

1/…medical facts

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2/… factors contributing to its increasing popularity

  • Medical tourism improves health delivery systems

    • strengthens public health delivery systems

      • We have the only 64-slice CT scan in Africa

      • We have most MRI and CT scans in Africa

      • SA is seen as a hub for international travel for Africa

      • SA seen as a hub for medical care in sub-Saharan Africa

    • Reverses the brain drain

    • Keeps medical resources within the African continent

    • Improves healthcare delivery systems for locals

    • NEPAD

    • Proximal to most African countries South of the Sahara

    • Medical tourism allows for “Africans to do sth for themselves”

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Serokolo Health Tourism (Pty) Ltd factors contributing to its increasing popularity

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2008 to date factors contributing to its increasing popularity

International membership

Global client base

Diversified product offering- consulting, training

Diversified client base

Solid operations

Solid local tourism partnerships

The History....


Partnership with all hospital groups in SA

Partnership with laboratory and radiology


Partnership with GTA

  • 2006

  • Registration Serokolo Health Nigeria

  • 1st foreign Government contract for services

  • 1st medical tourism conference SA


1st medical tourist (Canada)


Serokolo Health South Africa founded

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Our services factors contributing to its increasing popularity

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Creating the Medical Tourism experience..... factors contributing to its increasing popularity

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A Case Study factors contributing to its increasing popularity(1)

  • Nigerian:

    • “Lost confidence in own national healthcare delivery system” Prof Babatunde Oshotimehin , Minister of Health

    • Previously looked to the US and UK for medical care

      • Seasoned traveller

      • Medically aware

      • Affluent

    • Knows the “perception” SA has about Nigerians

    • Perceives SA to be like the “rest of Africa”

    • Does not know you!!!!!

    • Heard about the good steaks at the “Meat and Co”

    • Loves shopping and the “glitz and glamour” of Sandton City

    • Was told about Sun City

    • Church activities “part and parcel” of his weekly routines

    • Carries no credit cards or medical aid card

    • Has two to three cell phones- poor internet connectivity

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Where am I going? factors contributing to its increasing popularity

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Contact from doctor or patient factors contributing to its increasing popularity

Patient information form completed and sent to SHT

Specialist sourced and quote finalized




Final arrangements are made upon receipt of payment and reflection in our bank account (within 72 hours of receipt of payment)

Quote is sent to patient (global estimate quote)



Patient arrives in South Africa

SHT representative meets the patient at the airport

Patient is transported to hospital and handed overto treating specialist




Patient in hospital - SHT visit and case management

Arrangements are made for patient to leave South Africa

Accommodation for recuperation is arranged prior to patient’s discharge from hospital

Accommodation for family member

Tours for family /spouse



Medical records, report and service review


©Step-by- Step Process

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  • Establish rapport factors contributing to its increasing popularity

    • Prompt response- within 4 hours ideal, 24 hours sufficient (call centre)

    • Use local contact as you are a “faceless person” in SA

    • Provide a medical tourism itinerary upfront

    • Provide CVs of Drs if requested

    • Aesthetics

    • Speak the same language:

      • Medical aid, medical insurance-

      • Discovery, Bonitas, Hygeia HMO, BUPA, Aetna

    • Have a medical services welcome gift!!

  • Seamless process

    • Done through medical tourism facilitators or service providers

    • Simplify the process

    • Forex

    • Negotiate convenient appointments with surgeons upfront

    • Full integration of all service providers in the value chain

    • Reduce time spend between clinical service providers

  • Consistent in Pricing

    • Provide Pricing upfront and in USD (with a rand equivalent)

    • Be very transparent

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Which currency???? factors contributing to its increasing popularity

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  • Provide an All in one experience(Two many hands spoil the broth)

    • Vitalab Clinic

    • Concierge desks in hospitals

    • “Medical tourism precincts, zones”

  • Provide more information

    • Invest in doctor-patient relationship in a short space of time

    • Spend time with the patient daily (Drs be visible)

    • Explain concepts thoroughly

    • Keep the referring Doctor and family updated

  • Provide comprehensive clinical services

    • Hip surgery+ comprehensive check-up

  • Be culturally sensitive

  • Provide interpreters if no Portuguese, French, Spanish or Russian Dr to send patient to


    • Indemnity & Insurance

    • Post-op care

    • Processes for complaints

    • Structured Tours!!

    • Recuperate in an accommodation not too far from medical services

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Medical tourism value chain services broth)

Courtesy of City of JHB 2009

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Benefits of Medical tourism broth)

  • Medical visitors

    • tend to stay longer – 5X longer

    • Combine hospital stay with convalescence, plus leisure & shopping

    • Often accompanied by one or more persons

    • More likely to be higher-income individuals - higher per capita spend

  • Hospitals & clinics

    • Increased capacity & demand contributes toward retention of medical staff and procurement of state of the art technology

    • Reinvestment in SA rather than offshore

    • Improvement public health care facilities e.g. Folateng units in Academic Institutions

  • Accommodation, Retail, Entertainment , transport

    • Medical tourists spend more time in metropoles and spend more per capita

    • Employment opportunities for semi-skilled sector, esp. women and young people

  • SMME Sector

    • Low barriers to entry in tourism sector (guided tours, taxi services, B&Bs, etc)

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Growth and Development Challenges broth)

  • Negative perceptions of the some parts of the country both internationally and locally (crime, energy, HIV)

  • Lack of information from a visitor perspective of world-class medical expertise, facilities

  • Air accessibility is currently priced at the higher end of the spectrum.

  • RSA long haul destination for visitors from UK, USA & Europe

  • Visa and immigration issues are a disincentive for the African market.

  • Restrictions on medical practitioners promoting themselves

  • SAMA regulations prohibit commercial brokers from recommending patients to any doctor

  • SA Tourism currently under-estimates the significance and potential ROI of medical tourism

  • Cottage industry mentality among existing players in the sector

  • High priced intl. insurance products / lack of local products

  • Dept of Health legislation on private health care pricing

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Thank you for the opportunity!!!!!!! broth)

Dr Tshepo P. Maaka

[email protected]

“We’ll treat you well”