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Wednesday, February 20, 2008

Is medical tourism the only answer to Ireland's health famine?

After years of fulminating against the Irish health service, I finally put my money where my mouth is.

For a long time, I have headed across the border to the North anytime I needed a check up, some primary care, or some minor emergency treatment. Who wouldn't, given the opportunity, since the British NHS is actually free? No fifty quid to see a doc, no fifty quid to get into A+E. Free to those who need it.

Not to mention shorter A+E queues, cleaner hospitals, more English-speaking staff, fewer flesh-eating bugs, etc, etc.

But I have needed a small operation on my toe for some years now. It wasn't the sort of thing you would get done quickly in the Irish health service, as I wasn't actually bleeding to death and don't have a VHI Plan E insurance card.

But increasingly, it was impeding my ability to walk. It's been years since I could kick a football. And because it is an existing complaint, even if I did sign up for private health insurance that I can't afford, the VHI or their corporate rivals wouldn't pay for the op.

I costed the operation in Ireland, and was quoted a significant four figure sum from a very well known private hospital in the greater Dublin area. This is a lot of money to me. So I decided to keep on suffering.

But the pain got progressively worse, so I looked further afield. In Britain, a number of private hospitals appeared able to do the minor operation required. They were, however, reticent to quote a price without my actually coming to them to be assessed. I can understand this need to assess first, but it is a very simple operation.

A doctor of my acquaintance warned me that it should be as easy to quote for such an operation as it would to quote for, say, laser eye surgery. He also warned that due to increasing medical tourism from Irish patients, and a perception that Irish patients are all loaded, some UK hospitals might possibly be guilty of inflating prices for Irish patients to the upper end of the scales.

Then I came across the Bumrungrad hospital in Bangkok. Go look at their website. This hospital is as good as anything anywhere on earth. Their doctors are nearly all American or UK trained. The facilities are second to none. Ex-pats living all over Asia flock to it when they need medical treatment.

And they're cheap. My operation took an hour and cost 230 euro. In perfect sterile conditions, by highly qualified staffd, and complete with two follow-up examinations and post-operative medication.

While I was there, I met a lad whose cousin tragically succumbed to a drug overdose and has been in a coma in intensive care at the hospital for seven months. A doctor relative had told the lad I spoke to that he didn't believe the patient would have survived in Britain (or, by extension, Ireland) because the quality of care at Bumrungrad so greatly exceeded what was available back home.

I can believe that.

On the one hand, I feel cheap and tawdry for using what little financial clout I have to fly away from the car crash of the Irish health service to avail of proper world class medical facilities. I feel sad for those who can't afford to do likewise, for all those poor people trapped in squalor on trollies in our crowded and dangerous A+E wards.

On the other hand, I was never going to get my operation if I hadn't flown to Thailand to have it done.

Today, Newstalk Radio are holding a themed broadcast day about the Irish health service, which they've rightly entitled the 'Health Famine.' They've been asking people to call in with their stories. I don't do call ins, so I'm putting my story here instead.

This country is infinitely richer than Thailand, yet we cannot even approach the quality of care available there, at a fraction of the cost of healthcare in Ireland. That fact alone ought to have long since accounted for Mary Harney's political career. Why it hasn't is simply beyond me.

Perhaps the people of Ireland are too complacent and accepting of appalling healthcare to demand better. Or perhaps I should fly back to Bangkok and have my head examined.

God knows, it would be inexpensive and the quality of care would be magnificent.

My toe's grand now, by the way. Thanks for asking.


Twenty Major said...

Plus you got the perfect cover for trip, you randy old sex tourist.

Twenty Major said...

your trip, of course.

JC Skinner said...

Spam from health service spammers has been deleted. And if more of it arrives, it'll be deleted too.

Caelen said...

I think you do the health service in Ireland an injustice. In my experience it has plenty of failings but it has lot going for it as well.

I've been treated abroad several times including Singapore, Thailand and the states and I would absolutely agree with your point about the quality of care that is available. Also your point about the cost is also correct. However it is slightly unfair to compare the cost of treatment in Thailand directly to the cost of treatment in Ireland without also comparing the costs of other goods in the two countries. For example I can get a great meal in bangkok for €3. But the same thing in Ireland would cost about €12. So it is reasonable to expect that the cost of medical care in Ireland would be 400% of that in Ireland.

Also when talking about Ireland's health system we should take into consideration that the bulk of our health system (all €15 Billion) is public (my 2 year old daughter recently crushed her finger and need plastic surgery to repair the name bed - all done in 24 hours - albeit with a lot of waiting around - but all done on the public system). However Thailand's public health system is shockingly poor (note that Singapore's is very good).

South East Asia has been very pro-active in developing themselves as a health tourist destination and successfully leverage their low cost base and their tourism infrastructure. However it is an 'industry' not a public service. What this means is that you need a treatment that they don't provide then they won't treat you. Our system is totally different.

Having said all of that I don't think there is anything wrong with the concept of travelling for medical attention. In fact it may be prudent for a small country, such as Ireland, to embrace medical tourism within the health system for non-time sensitive treatments that where we simply don't have the scale to provide the treatment effectively.

Thanks for the article - it has spark load of thoughs

JC Skinner said...

400% would be a reasonable expectation. However, the differential was closer to 2000%.
I wasn't seeking to equate the public health care systems of Ireland and Thailand. Effectively, there IS no public healthcare in South East Asia. I have noticed, however, that the public systems in places like Hungary greatly supercede our own.
What I was pointing out was that even PRIVATE healthcare here is overpriced and underachieves compared to what's available in places like Thailand. If you can fly to Thailand, or South Africa, receive better treatment in better conditions with equal or better doctors, have a holiday while you recover, and come home still having saved around 50% of the Irish asking price, then something's very wrong.
Thanks for the comment. It too was thought-provoking.