First five steps

Ukraineis looking for ways to reform its medical system. No unique recipe seems to have been found. By contrast, the outside world is taking an innovational approach to medical reform by combining healthcare and recreation. Medical tourism is a new but rather progressive and promising direction. The US, Israel, Germany, and Turkey are considered leaders in this field. How does this system work and how can it be established? Overall 24 well-known Ukrainian doctors received answers to this and other questions in the course of a week-long tour organized by the Turkish Healthcare Travel Council (THTC) and Turkish Airlines, one of the largest air companies on the Ukrainian market, to study Turkey’s medical experience. During this visit, The Day managed to communicate with Emin Cakmak, founding president of the Global Healthcare Travel Council (GHTC), and chairman of the THTC board. He told us in an exclusive interview about what Turkey had begun with, what difficulties it faced, and said that Ukraine could emerge as a European leader in medical tourism if it used Turkish experience.

Would you tell us about the basic trends of medical tourism development in the world?

“Medical tourism is growing at an average annual rate of 12-15 percent. It embraces about 100 million people worldwide. I think the number will rise to at least 250 million in five years’ time. Medical tourism will be fetching about 500 billion dollars a year and 2.5 trillion dollars five years later. What causes this growth? The world is being globalized, migration is on the rise. People want not only to see the world, but also, if necessary, improve their health at the same time. It is not always possible to do so in one isolated country.”

Medical tourism is annually growing by 25 percent in Turkey. It is one of the world’s highest rates. What did the development of this direction begin with? How did the state help establish the sector?

“Active medical tourism began to develop only 10 years ago. It became possible when heavy investments came to the sector. At first the Turkish government pumped tremendous funds in the development of the public health system: at least a billion dollars was annually earmarked to this end. The money was invested in the development of the system of medical clinics and universities. Both private and state-run clinics were opened for all people. It was possible to set fair prices for medical services largely owing to the establishment of a nationwide medical insurance system. The state opted for this step because the quality of service in state-run hospitals was very low. Moreover, state-run clinics were barely able to meet the demand for medical treatment. The state has invested 10 billion dollars in the past 10 years, with the private sector contributing another 20 billion. This made Turkey the leader of medical tourism in its region. Every Turk has now access to the cutting-edge technologies of curing various diseases, up-to-date clinics, and sophisticated equipment.

“It was also possible to create all this because the state made things easier for the investor. For example, land is provided free of charge for the construction of clinics, there are temporary profit tax exemptions for hospitals, etc. Besides, the state partially makes up for expenses linked to participation in international exhibitions for the promotion of Turkish travel companies’ potential.”

What was the most difficult thing on this way?

“It was very difficult to explain to and persuade the clinics’ staff and management why it is necessary to develop medical tourism, purchase the new equipment, and invest hundreds of millions of dollars in the construction of clinics, promotion, etc. It was difficult indeed. But when they saw the great advantages of attracting patients from the EU, Africa, and Central Asia, they began to develop this direction on their own.”

What is medical tourism in today’s Turkey?

“There are about 1,500 functional clinics today (they mostly specialize in oncology, orthopedics, organ transplantation, and plastic surgery), a half of which are private. In addition to clinics, there is a fast growth of spas and thermal water outlets (about 1,900). This attracted 670,000 foreign healthcare tourists from 160 countries in 2012, which brought in about 6 billion dollars (4.2 billion from medicine and 1.8 as tourist sector earnings).”

As far as I know, a Turkish delegation visited Ukraine last year to study our experience in medical tourism. What do you think you can learn from Ukraine?

“Ukraine has an enormous potential in the field of health tourism. It is this experience that Turkey can borrow from you. Last year I visited Truskavets and saw al lot of good health centers, resorts, and professionals there. But nobody in the world knows this. I have never seen exhibitions advertising precisely this aspect of medical tourism in Ukraine. I am sure that if these places are properly advertised, the country will receive 100,000 patients and earn half a billion dollars within five years. On the average, one tourist brings along a company of four or five, and they spend about 5,000 dollars. This figure can rise with every passing year, while the state should work to help business to develop. This requires a concrete strategy of developing medical tourism in Ukraine. All participants in this process should follow the strategy step by step, promoting the medical brand of Ukraine in the world. If Ukraine makes use of the Turkish experience and pursues an active marketing policy, it will additionally attract a million tourists and reap a 5-billion-dollar-worth medical tourism profit in 10 years’ time. Ten years later, Ukraine may become one of the top 10 EU countries that practice medical tourism. You have everything to be able to do so.”

Is Ukrainian-Turkish cooperation possible in medical tourism?

“Yes. The first step has already been taken: Ukraine has joined the World Medical Tourism Association. The Ukrainian Medical Tourism Association is now being registered.”

Will any joint ventures be launched in this field?

“Many Turkish hospitals would like to invest in Ukraine, but what hinders this today is instability. For this reason, many investors have taken a wait-and-see stand. Business expects the state to meet it halfway – for example, to provide land free of charge for the construction of hospitals.”

What else would you advise Ukraine to do to develop medical tourism?

“Ukraine should take several steps to develop medical tourism: to open up to investors, to ease all business launch and conduct processes, to offer tax preferences, for example, for importing medical equipment or the construction items that are not produced in Ukraine, and think over tax exemptions. Why is this important? A one-off investment in medical tourism facilities is at least 15 million dollars. What is more, this money is to be repaid in ten years’ time at the earliest. Therefore, the government should provide business with some privileges – for example, to exempt it from paying the profit tax until the facilities have been repaid. This is the only way to develop this field.”

And are there incentives in Turkey, too?

“To begin with, we have opened our border for everybody, and one needs no visas to enter our country. It will take you just a day to register a company. It is very simple and progressive – no red tape at all. Business is afraid of red tape. If there is red tape in a country, companies will never go to work there.”

What Ukrainian regions are interesting for joint business development?

“To start with, there is now a tremendous potential of commercial cooperation between our countries. My forecast is that trade links between Ukraine and Turkey will grow to 10 billion dollars in three years’ time. As for medical tourism, Turkey is interested in investing in this variety of tourism in every big city of Ukraine. When will this investment begin? This will depend on how soon the Ukrainian government meets the investors halfway.”

Is the association negotiating with any cities on this matter?

“Yes, with the Crimea. But Ukraine’s Ministry of Public Health has not yet come into contact. We have sent letters of intent about cooperation. But there have been no answers yet. It is about the construction of a 400-bed clinic in Simferopol. It will be run by the state and, hence, open to all. It is supposed to meet all the European standards. The British and Turkish investors are prepared to contribute 100 million dollars to this project. The construction will start once there is an answer from the official authorities.”

And, in conclusion, why did you choose medical tourism instead of following in the footsteps of your great-grandfather who was one of the most successful senior officers in the army of the Turkish reformer president Kemal Ataturk?

“I want to bring peace to Earth. It’s not interesting to fight a war. I can see no future in wars. We must seek the future in the world, in wellness, and in economic development.”