Expat Focus International Healthcare Update May 2023
New Thai Hospital Will ‘Attract Billions From Foreigners’
The Songklanagarind Phuket Hospital is aiming to generate B1.6 billion from foreign visitors when it is completed, the Thai press announced this month. This will form part of the Andaman International Health Centre Project. Aiming at research in health sciences as well as treating patients, the hospital will run medical training courses in order to provide a platform for future health professionals in the country.
With 500 beds, the emphasis remains on both in-patients (it aims to treat around 25,000 per year) and out-patients (300,000), including referrals from elsewhere in the country for specialist care. Medical tourism is high on the hospital’s agenda, with plans to earn back some of the B3bn+ spent on construction from overseas visitors. The aim is to complete the hospital by 2027.
China: Direct Settlement Insurance System is Put in Place
China has been trying to streamline its national health insurance system recently, with a cross-regional direct settlement system put into place at the start of this year. At present, the system is based on the health insurance payment policies of your point of origin plus the list of insured treatments at the point at which you receive care. Domestic medical tourism has become a phenomenon in China as citizens try to navigate a complex and diverse healthcare system, which, like in many nations, is struggling due to an ageing population. Expats livng in China are advised to take out private cover instead of relying on the public system.
Medical Tourists Return to Singapore
The lifting of restrictions after the pandemic is beginning to have an impact on the number of medical tourists entering Singapore, the Straits Times reported in early May. Before the Covid-19 pandemic, around 40,000 people on average visited Singapore each year in search of private medical treatment, ranging from plastic surgery procedures to chemotherapy. Medical tourism in Singapore was hit hard during the pandemic, but in February restrictions were lifted and the industry has now recovered.
Raffles Hospital reports that their medical tourism services have returned to pre-pandemic levels, with 25% of patients coming from overseas, mainly from Indonesia, China and Indochina. The IHH group, which runs the Mount Elizabeth hospitals, says that they experienced a surge in 2022 but numbers have since dropped to below the pre-pandemic average. However, patients are paying more for their treatment, so although patient numbers have fallen, revenue has increased.
Singapore is a popular destination for Indonesians, many of whom visit in order to rectify procedures which have been poorly carried out in their own country. The increase in the numbers of medical tourists may have added to Singapore’s hospital bed problem, but the Ministry of Health says that overseas patients still only comprise 0.5% of patients overall and the real problem – causing many of Mount Elizabeth’s available beds to be out of commission – is the shortage of nurses. Hospital managers say that more needs to be done to encourage nurses from overseas to work and remain in the state. There have also been calls for extra training among Singaporean healthcare workers and carers. Healthcare employees have been urged to contact their unions about their own healthcare and work/life balance, with some calling for a four-day week.
Singapore is not alone in experiencing these problems. A global shortage of nurses has been evident for some time. A recent report from the International Council of Nurses argues that investment in training nurses is crucial and that governments should focus on this rather than relying on the ‘quick fix’ of attracting foreign personnel.
At present, the global north has an advantage over other, poorer nations, which also lack nursing staff but can’t pay equivalent salaries to the USA or UK, for instance. The WHO has a list of countries from which nurses should not be recruited, such as Ghana, Nigeria and Nepal. The Philippines has a nursing shortage of around 350,000.
The ICN says that even prior to the pandemic, there was an estimated shortage of 30 million nurses globally in 2019 (including midwives). The pandemic made this problem significantly worse. Nurses felt (justifiably) that they were on the front lines. The death toll among nursing staff was high in some nations, and burn-out in what was already a difficult and demanding profession reached record levels.
The President of the ICN, Pamela Cipriano, says:
“Nurses are the professionals who can lead us out of this post-pandemic slump in healthcare, but they can only do that if there are enough of them, if they are properly supported and paid, and if the fragile health systems they work in are rejuvenated with large investments from governments everywhere.”
WHO Redefines Covid-19 Status
The WHO Director-General, Tedros Adhanom Ghebreyesus, stated in early May that Covid-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC). Weekly reported deaths and hospitalizations have decreased, and the virus is no longer held to be a global emergency.
However, the organisation has expressed concern about pandemic fatigue and inequality of access to life-saving intervention. The Director-General says that the pandemic is not yet over, and has concerns about developing nations which do not have sufficient access to vaccines. There are hopes in the WHO that the Chinese outbreak at the beginning of the year – which halted plans by the organisation to describe the pandemic as over in January – is the last surge of Covid-19 that we will see for some time to come.
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