many people in the business dislike the term ‘medical tourism', there is no
getting away from the fact that it is a niche within the global tourism market.
The latest international tourism figures show a global recovery in travel.
Expecting medical tourism to grow as rapidly as it did before the recession is
optimistic. Expecting the business to restart from where it was in 2007 is
simplistic, as the business, the world, and consumers have all changed.
International tourist figures
six months of 2010 saw international tourist arrivals grow by 7% according to
the World Tourism Organisation’s UNWTO World Tourism Barometer. This result
confirms the recovery trend beginning in the last quarter of 2009 and is
expected to continue.
the Pacific (+14%) and the Middle East (+20%), continue to lead growth in the
first half of 2010 with the majority of destinations in both regions posting
double-digit growth rates. Asia in particular is experiencing a very dynamic
rebound, with strong results from Sri Lanka (+49%), Japan (+36%), Vietnam
(+35%), Myanmar (+35%), Hong Kong (China) (+23%), Macao (China) (+23%), Singapore
(+23%), Fiji (+22%) and the Maldives (+21%). Thailand (+14%) posted encouraging
results in spite of the political unrest early this year. In the Americas
(+7%), Central and South America show steady growth, as does North America.
Growth has been slower in the Caribbean but results are still improved compared
to 2008 and 2009. Europe (+2%) shows the slowest recovery but results from
recent months are more positive.
tourism receipts are affected as travellers travel closer to home, for shorter
periods of time and seek value for money, while on the supply side increased
competition has been driving prices down.
international tourist arrivals totalled 421 million during the first six months
of 2010, up 7% on 2009, but still 2% below that of the record year of 2008 (428
million arrivals). These results follow one of the toughest years for the
tourism sector with international tourist arrivals declining by 4.2% in 2009 to
880 million and international tourism receipts falling in real terms of 5.7%.
unemployment continues to be a major cause of concern and the austerity
measures as well as the rise in taxation implemented in several advanced
economies to fight public deficits represent a clear challenge to many leading
outbound markets. Taleb Rifai of UNWTO says. “In the USA and some major
European markets, economic recovery has still to consolidate. ” A large
majority of international travel takes place within the traveller’s own region,
with around four out of five arrivals worldwide originating from the same
region. The remarkable rebound of Asia is to a large extent a reflection of the
strength of the regional outbound markets. Domestic tourism is of equal
importance. Worldwide the number of domestic arrivals is estimated to exceed
some four times the number of international arrivals.
ten international tourism countries are; France, USA, Spain, China, Italy, UK,
Turkey, Germany, Malaysia and Mexico. Most have been in the top ten for a few
years, but Turkey is a newcomer. Europe accounts for half of all international
trips, and four out of five of these are within Europe.
also looked at domestic tourism. Márcio Favilla of UNWTO comments,” With
consumers tending to travel closer to home in times of downturns, domestic
tourism has been experiencing significant growth. Coupled with regional
tourism, domestic tourism can serve as an important driver of development and
growth, in particular during times of economic uncertainty.”
Medical tourism figures
and early 2009 countries fell over each other in a rush to tell us how fast
their medical tourism numbers were growing. From late 2009 and onwards, most
fell silent, perhaps not wanting to admit how badly numbers had fallen, and how
far off predicted targets current numbers were. Even the handful now issuing
figures are often at great pains to give encouraging news for 2010, while
referring back to 2007 or earlier for comparisons. It is as though 2008 and
2009 figures have been wiped from the collective memory. Some current figures
are based on solid research; and although not perfect, the way the UK counts
medical tourism separately from spa and wellness tourism, and as one of a dozen
niche categories in inbound tourism, gives a good benchmark. The interesting
thing about the UK figures is that they are complied by independent researchers
who are not promoting tourism. For most country’s figures we have to rely on
government or other bodies that are specifically promoting tourism and medical
tourism, so have a vested interest in painting the best picture possible. The
worst recent case of this is the claims of
the UAE where the claimed medical tourism figures are so exaggerated as
to be pure fantasy.
tourism likes to think it is not tourism, but it needs to work with national
and international tourist bodies who produce reliable figures. Then we might get
a real view on numbers globally and by country. Real statistics may show up the
data from some highly promoted destinations as works of fiction. I suspect that
if we had more real European country figures, several countries now claiming to
be top destinations, would be shown to be way down the number list.
figures only count visits with one or more night’s accommodation. So they
exclude day visits. This means that domestic tourism numbers are understated.
It also means that medical tourism trips with no overnight stay, e.g. across
the Mexican border or from the UK to Poland, may not be counted.
to consumer trend analysts trendwatching.com, travel customers look for instant
gratification. If something online is too slow or too cumbersome or too boring,
then an alternative site is only a second away. 57% of US customers will wait
three seconds or less before abandoning a website. The post-recession consumer has changed.
Customers are not willing to pay full price for anything and are prepared to
spend time seeking the best deal. This does not mean they look just for the
lowest price, as they are looking to save money without sacrificing quality. It
has become the norm to look at customer comments on websites and social media,
types of travel and tourism, and all sectors from hotels to airlines, suppliers
have had to cut prices and improve the quality of their product to get
business. Medical tourism providers have to compete with each other and with
What this means for medical tourism
The industry should be working to get medical tourism counted as a niche
tourism sector. To do this it needs to decide whether medical tourism and
health tourism are the same or different animals. It is convenient for
some countries to include them both in medical tourism figures as it
boosts figures, but others use a strict definition of medical tourism. No
other tourism niche seeks to go it alone on country-by-country figures; so
why do we ignore existing figure collectors who have been doing it for
There are now many more competitor countries, hospitals and agencies than
five years ago. Trading on low prices only, or expecting customers to pay
a premium to come to you are now both defunct strategies. People want high
quality but a good price too. Medical tourism has to first persuade people
to travel, and only then persuade them where to go; hospitals just
promoting their brand totally misunderstand how sales and marketing work.
These have to be slick, interesting and inter-active. Fewer potential
customers will bother to phone or email for details of costs, they want
instant information or will go elsewhere. It is vital to offer real
customer reviews, to monitor what is said about you on social networking
sites, and to give a genuine response to complaints. Attacking people who
say ‘bad’ things is totally counter-productive (Indian government please
Some people will still travel long-distances for treatment. But the vast
majority will only travel within their region, or even only within their
own country. Agencies, countries and hospitals have to decide their target
market/s; blanket global promotion is wasteful. Almost all governments are
struggling on healthcare costs. More responsibility is being put on to
individuals to look after their own health. So targeting governments or
other official bodies in the hope they will spend money they no longer
have to send people to your country, is almost always going to be a waste
of time and effort.
recovery in tourism numbers offers great hopes for medical tourism. But growth
will be slow, and annual increases much smaller than before. The industry is
settling down as a developing niche sector. Increasing competition and changes
in customer wants and behaviour mean that only the most professional hospitals,
agencies and clinics will prosper. The days of sitting back and expecting
customers to rush at you are gone forever. All business will be hard won, and
many in the business will be found wanting and fall by the wayside.
Ian Youngman is a writer and researcher specialising in insurance and health. He writes regularly for a variety of magazines, newsletters, and on-line services. He also publishes a range of insurance reports and undertakes research for companies. An ACII, with an honours degree in Economics from the University of Liverpool, Ian was a co-founder of The General Insurance Market Research Association. He also has widespread experience within the insurance industry at management level, working for brokers, a bank and an insurance company.
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