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Is medical tourism worth the risk?  Oct 21, 2008

British NHS dentists were accused this week of over-treating patients to maximise profits. A recent poll found that 7.4 million of us can't find an NHS dentist and the cost of private treatment is enough to make us grind our teeth. Is it any wonder then that more and more Brits seem to be travelling abroad for dental care?

They're more than happy with the treatment they're getting from Hungarian, Polish and Cypriot dentists, according to the first in-depth survey of British “health tourists”, which shows that 75 per cent are “very satisfied” with the treatment and results. But while the survey results are overwhelmingly positive, there are still concerns from British health bodies that pursuit of economy could put us at risk, and that many packages do not make adequate provision if something goes wrong.

Ten years ago virtually no one had heard of health tourism, but now there's such interest that the website Treatment Abroad (www.treatment, established in 2005 as a portal to help UK patients navigate private health treatment overseas, gets a remarkable 50,000 visitors a month. Its survey of 650 health tourists who had used its website found that dental treatment is the main reason for Brits travelling abroad, driven mainly by the need to save on the cost of UK treatment (a crown in Hungary is half the British cost). “There was no NHS dentist available and I wanted the quickest treatment at the lowest cost,” one survey respondent said.

But it isn't just dentistry that's attracting Britons abroad. Clinics and hospitals from all over the world offer packages and treatments in dentistry, cosmetic surgery, fertility treatment and conventional surgery, from heart bypasses to knee replacements, and about 40 of them will be selling their services at the first Health Tourism Show at Olympia, West London, which opens next Saturday. Some of the most popular destinations are Belgium (convenient), Spain (familiar to Brits), India (marketing very hard), and Cyprus (a good holiday destination).

Surgery costs can be much lower

According to the survey, the main motivation for visiting any of these countries is not the excellence of their care but cost savings. Nose reshaping treatment costs £1,500 in Croatia (before factoring in airfare and accommodation) compared with £3,000 here, and nearly a fifth of those going abroad for either conventional surgery or dental treatment believed that they had saved about £10,000 on what the procedure would have cost in the UK. So even in the face of a world financial crisis, health tourism may be a business that continues to boom. One health tourism agency, the Taj Medical Group, says that it organises surgery packages in India for about 40 Britons every month.

Cleaner clinics

The Treatment Abroad survey reveals increasing confidence among British people in standards of cleanliness and clinical efficiency of foreign clinics, alongside disillusionment about British hospital hygiene. Nearly 40 per cent of those questioned said that worries about hospital infections in Britain influenced their decision to seek treatment abroad. But an impressive 83 per cent said that they were satisfied with the surgery they had received abroad and only 5 per cent said that they were dissatisfied, a rating any NHS hospital would be delighted with. Nine out of ten respondents were very satisfied or quite satisfied with their experience of treatment abroad generally.

Lack of research

If the survey paints an unexpectedly positive picture about health tourism, its findings also have to be viewed with some caution. Those polled were volunteers rather than a truly representative cross section. There is still an enormous knowledge gap about travelling abroad, with Britons having to rely on largely anecdotal accounts from past visitors and claims from clinics. Body&Soul identified the problem two years ago, when it published a health tourism supplement highlighting that no independent body was collecting information on the quality of treatment overseas. That is still the case. The best we have is a survey from Treatment Abroad, a commercial venture, and its gradually growing online database of patient experiences.

British doctors remain wary

Professional bodies such as the British Medical Association and the British Dental Association are still wary of British patients going abroad for treatment, and stress the importance of talking to home doctors/dentists. Some of the patient quotations in the new survey support their caution: “Very little information was given upfront,” said one; “It can feel lonely if you're there on your own,” said another.

It's up to the individual patient to assess the hospital or clinic's reputation, the surgeon's qualifications, what sort of insurance, aftercare and follow-up is on offer, and whether there will be any language difficulties. “Patients should investigate the health and safety standards of the facilities where they are to be treated and the potential impact of long-distance travel on their recovery,” the BMA says.

British dentists too are concerned that Britons' enthusiasm for their overseas treatment might be tempered later when things start to go wrong with their filling, bridge or crown. The British Dental Association says that some of its members have had to carry out remedial work - which the patient will have to pay for.

“Anyone thinking about having dental treatment overseas must make sure that they are aware of the potential risks and the hidden costs,” said John Hilsdon, a BDA spokesman.

Keith Pollard, the founder of Treatment Abroad, agrees that people need to do their research before booking, for example finding out about the accrediting bodies for doctors and dentists in the relevant country (they can be found on the Treatment Abroad website). But he points out the irony that this is something we would never do if seeking treatment in this country. “Maybe health tourism has something to tell us about being more diligent about checking qualifications in the UK too,” he said.

Whatever the risk, British patients are packing their suitcases and voting for overseas treatment with their feet. Let's just hope that they are consulting more than a Let's Go travel guide before booking.

The Health Tourism Show runs from October 25-26 at London's Olympia. For more details, log on to

Dental treatment

Top three destinations

Hungary, Poland, Turkey

Satisfied 91.2%

Dissatisfied 9.8%

Most popular treatment: dental implant

UK cost £2,000

Turkey £570

Poland £750

Hungary £827

Cosmetic surgery

Top three destinations

Spain, Belgium, Cyprus

Satisfied 86.8%

Dissatisfied 13.2%

Most popular treatment: breast enlargement

UK cost £4,350

Belgium £1,833,

Cyprus £2,652,

Spain £3,240


Top three destinations

Belgium, Spain, India

Satisfied 94.9%

Dissatisfied 5.1%

Most popular treatment: Hip replacement

UK cost £8,000

India £3,537

Belgium £5,585

Spain £5,695

Fertility treatment

Top three destinations

Spain, Cyprus, Turkey

Satisfied 84.6%

Dissatisfied 15.4%

Most popular treatment: One cycle of IVF

UK cost £4,000-£8,000

Spain £2,368

Cyprus £2,200

Turkey £1,500


Cost is for treatment only, not travel and accommodation

What to check before you go

Do as much research as possible. Read all you can and talk to people who have had surgery abroad.

Speak to your GP or dentist about going abroad for treatment.

Think about how far you want to travel. Choosing a location closer to home means less time off work, and less distance to travel if you need follow-up treatment.

Compare the costs, credentials and services of clinics. Ask how they measure success rates. This is especially important if you're considering IVF treatment.

Ask to speak to former patients. Good clinics will allow you to do this. Question the clinic on possible complications. If you are having cosmetic treatment, ask to see before-and-after pictures of other patients.

Check the fine print. Make sure that you fully understand what you will and won't be paying for, and what happens if a complication arises or surgery is cancelled.

Check the qualifications of the doctor or dentist. Find out what are needed in the country where you will be having treatment.

Ask if the clinic has an intensive care unit and “crash cart” for resuscitation.

Think about taking a friend or family member with you. It will bump up costs but the extra support may make a big difference.

Make sure that all your questions are answered before you go. Check every detail of the agreement, and ask someone else to look over it.

Trust your instincts. If you are unhappy with the clinic or it seems unwilling to provide information, don't go.

What happens if something goes wrong?

Clarify with the clinic exactly what will happen if something goes wrong after you've returned home. Will it pay for flights? Does it have a UK representative or clinic that will be able to deal with any post-treatment problems or complications?

The NHS will treat life-threatening complications, but any other problems will have to be fixed by you, either by going back to the clinic where you had treatment, or paying for private treatment in the UK.

If you resort to legal action, this will have to be done through the local authorities in the country where you received treatment.

More information at, , ,

The Treatment Abroad survey of medical tourists reveals the highs and lows of health tourism (the responses were anonymous):

“Dentist had basic language skills, but the proprietor was fluent in English and was able to communicate very efficiently at all levels”

“Apart from the discomfort of over two hours of drilling on my first appointment, I had very few problems”

“An excellent way to obtain treatment at a sensible price”

“Felt like they were mostly interested in your money and getting you out the door”

“The clinics were very caring, not just technically good. I wish my own dentist was half as interested in his patients”

“I e-mailed the surgeon telling him I was concerned about the droopiness of my eyelids and never received a reply”

“As a nurse of many years I can, with a high degree of knowledge, say that I have never been in a more dangerous situation”

“The company did not state on its website that the price you pay is dependant on the exchange rate, so I ended up paying more than originally quoted”

Is medical tourism worth the risk?
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