Monday, 1 December 2014

Special issue in Social Science and Medicine on transnational health care

David Bell, Ruth Holliday, Meghann Ormond and Tomas Mainil edited a special issue for the journal Social Science and Medicine on transnational health care. This special issue will be released in January 2015 and comprises a collection of papers resulting from the conference we organised in June 2013: Transnational Health Care: A Cross-Border Symposium

Papers published in the special issue include:

  • Bell, David, Holliday, Ruth, Ormond, Meghann and Mainil, Tomas - 'Introduction: Transnational health care, cross-border perspectives' -
    • Growing numbers of people are going abroad in pursuit of healthcare, and the social, political and economic significance of these flows at a range of levels cannot be ignored. This special issue brings together papers from a key international conference held in June 2013, Transnational Healthcare: a Cross-border Symposium – an event that was itself transnational, with hosting shared by institutions in two countries: first in Wageningen, The Netherlands, with delegates then travelling to Leeds, UK, for further presentations and discussion. The aim of this symposium was consider the impacts of ‘medical tourism’ in a range of different contexts, and it brought together scholars involved in cutting-edge empirical and conceptual studies of the transnational pursuit and provision of medical care. It included findings from small-scale as well as large, multi-site research projects. In this introduction, we outline the articles’ main themes and highlight priorities and agendas for the vital shared project of empirically and conceptually investigating the multi-scalar relational geographies -- from the macro/national to the local/embodied – that are currently transforming policies, economies, professions and patient experiences of what some scholars suggest might more appropriately be called ‘international medical travel’ (Kangas 2007) or ‘transnational healthcare practices’ (Stan, this issue) instead of ‘medical tourism’. In recognition of the array of initiatives around the world that challenge and move beyond attempts at self-sufficiency in healthcare at the national level, this special issue draws attention to the breadth of regional capacity-building, forms of governance, relations and identities forged through both high-profile, long-distance pursuits of ‘medical tourists’ and more ‘everyday’ cross-border and intra-regional health-motivated flows (Ormond 2013b). The diversity of case studies presented in the special issue is intended to reflect the many forms of movement that together constitute transnational healthcare practices (though there remains much work to fully map these practices). In the remainder of this introduction, we draw out some of the themes and issues raised in the papers that prompt us to rethink ‘medical tourism’

  • Bochaton, Audrey - 'Cross-border mobility and social mobility: Laotians seeking medical treatment along the Thai border' -
    • Drawing upon research conducted on cross-border patients living in Laos and seeking care in Thailand, this paper examines the important role played by social networks in patients' decision-making and on the itineraries they choose to seek treatment on the Thai side of the border. Due to the vastly contrasting situations between the two countries in terms of healthcare supply, and considering Laotians' increasing demand for high quality healthcare, a number of them have managed to satisfy their needs by combining cross-border treatment with the use of the healthcare facilities provided by their own country. This study consisted first of household surveys conducted in five border areas (2006–2007) in Laos in order to quantify and map out cross-border healthcare-related travel patterns. Afterwards, interviews were conducted with cross-border patients (55), Laotian and Thai medical doctors (6), Thai social workers (5), and officials working in public institutions (12). While socioeconomic and spatial factors partly explain cross-border mobility, patients' social networks significantly influence treatment itineraries throughout the decision-making process, including logistical and financial considerations. The social networks existing at different geographical levels (neighbourhood, regional and global) are therefore a powerful analytical tool not only for understanding the emergence of these cross-border movements but also for justifying them in an authoritarian political environment such as Lao PDR's.
  • Connell, John - 'From medical tourism to transnational health care? An epilogue for the future' -
    • In the past two decades, medical tourism has seemed to define cross-border travel for medical care. An ebullient expression of late capitalism, in the heady days before the Global Financial Crisis it also seemed remarkably glamorous. Most accounts of medical tourism, certainly in the popular media, centre on cosmetic changes, often dramatic, sometimes problematic, but capable of transforming lives (Jones 2008). Yet, as this special issue has well demonstrated, much of medical tourism is quite prosaic and functional, and transnational health care is very much more than simply medical tourism. These papers have combined to add significantly to collective knowledge of international medical travel, reveal its diversity, and develop an agenda for the future.
  • Crush, Jonathan and Abel Chikanda - 'South-South medical tourism and the quest for health in Southern Africa’ –
    • Intra-regional South-South medical tourism is a vastly understudied subject despite its significance in many parts of the Global South. This paper takes issue with the conventional notion of South Africa purely as a high-end “surgeon and safari” destination for medical tourists from the Global North. It argues that South-South movement to South Africa for medical treatment is far more significant, numerically and financially, than North-South movement. The general lack of access to medical diagnosis and treatment in SADC countries has led to a growing temporary movement of people across borders to seek help at South African institutions in border towns and in the major cities. These movements are both formal (institutional) and informal (individual) in nature. In some cases, patients go to South Africa for procedures that are not offered in their own countries. In others, patients are referred by doctors and hospitals to South African facilities. But the majority of the movement is motivated by lack of access to basic healthcare at home. The high demand and large informal flow of patients from countries neighbouring South Africa has prompted the South African government to try and formalise arrangements for medical travel to its public hospitals and clinics through inter-country agreements in order to recover the cost of treating non-residents. The danger, for ‘disenfranchised’ medical tourists who fall outside these agreements, is that medical xenophobia in South Africa may lead to increasing exclusion and denial of treatment. Medical tourism in this region and South-South medical tourism in general are areas that require much additional research.
  • Hanefeld, Johanna, Neil Lunt, Richard Smith and Daniel Horsfall - 'Why do medical tourists travel to where they do? The role of networks in determining medical travel' -
    • Evidence on medical tourism, including patient motivation, is increasing. Existing studies have focused on identifying push and pull factors across different types of treatment, for example cosmetic or bariatric surgery, or on groups, such as diaspora patients returning 'home' for treatment. Less attention has been on why individuals travel to specific locations or providers and on how this decision is made. The paper focused on the role of networks, defined as linkages e formal and informal e between individual providers, patients and facilitators to explain why and where patients travel. Findings are based on a recently completed, two year research project, which examined the effects of medical tourism on the UK NHS. Research included in-depth interviews with 77 returning medical tourists and over sixty managers, medical travel facilitators, clinicians and providers of medical tourism in recipient countries to understand the medical tourism industry. Interviews were conducted between 2011 and 2012, recorded and transcribed, or documented through note taking. Authors undertook a thematic analysis of interviews to identify treatment pathways by patients, and professional linkages between clinicians and facilitators to understand choice of treatment destination. The results highlight that across a large sample of patients travelling for a variety of conditions from dental treatment, cosmetic and bariatric surgery, through to specialist care the role of networks is critical to understand choice of treatment, provider and destination. While distance, costs, expertise and availability of treatment all were factors influencing patients' decision to travel, choice of destination and provider was largely the result of informal networks, including web fora, personal recommendations and support groups. Where patients were referred by UK clinicians or facilitators these followed informal networks. In conclusion, investigating medical travel through focus on networks of patients and providers opens up novel conception of medical tourism, deepening understanding of patterns of travel by combining investigation of industry with patient motivation.
  • Holliday, Ruth, David Bell, Olive Cheung, Meredith Jones and Elspeth Probyn - 'Brief encounters: Assembling cosmetic surgery tourism' - 
    • This paper reports findings from a large-scale, multi-disciplinary, mixed methods project which explores empirically and theoretically the rapidly growing but poorly understood (and barely regulated) phenomenon of cosmetic surgery tourism (CST). We explore CST by drawing on theories of flows, networks and assemblages, aiming to produce a fuller and more nuanced account of e and accounting for e CST. This enables us to conceptualise CST as an interplay of places, people, things, ideas and practices. Through specific instances of assembling cosmetic surgery that we encountered in the field, and that we illustrate with material from interviews with patients, facilitators and surgeons, our analysis advances understandings and theorisations of medical mobilities, globalisation and assemblage thinking.
  • Lozanski, Kristin - 'Transnational surrogacy: Canada's contradictions' 
    • Transnational commercial surrogacy represents a form of medical tourism undertaken byintended parents who seek to hire women in other countries, increasingly often in the global South, as surrogates. While much of the scholarly literature focuses on the conditions of surrogacy within host countries, such as India, there has been limited analysis of transnational surrogacy focused upon origin countries. In this article, I build upon the scholarship that explores the impact of host country structures on transnational surrogacy, with special attention to the significance of Canadian citizenship policy through analysis of legislation and policy vis-à-vis transnational commercial surrogacy. The Canadian case demonstrates clear contradictions between the legislation and policy that is enacted domestically to prohibit commercial surrogacy within Canada and legislation and policy that implicitly sanctions commercial surrogacy through the straightforward provision of citizenship for children born of such arrangements abroad. The ethical underpinnings of Canada's domestic prohibition of commercial surrogacy, which is presumed to exploit women and children and to impede gender equality, are violated in Canada's bureaucratic willingness to accept children born of transnational commercial surrogacy as citizens. Thus, the ethical discourses apply only to Canadian citizens within Canadian geography. The failure of the Canadian government to hold Canadian citizens who participate in transnational commercial surrogacy to the normative imperatives that prohibit the practice within the country, or to undertake a more nuanced, and necessarily controversial, discussion of commercial surrogacy reinforces transnational disparities in terms of whose bodies may be commodified as a measure of gendered inequality.
  • Lunt, Neil, Mark Exworthy, Johanna Hanefeld and Richard D. Smith - 'International patients within the NHS: A case of public sector entrepreneurialism' -
    • Many public health systems in high- and middle-income countries are under increasing financial pressures as a result of ageing populations, a rise in chronic and non-communicable diseases and shrinking public resources. At the same time the rise in patient mobility and concomitant market in medical tourism provides opportunities for additional income. This is especially the case where public sector hospitals have a reputation as global centres of excellence. Yet, this requires public sector entrepreneurship which, given the unique features of the public sector, means a change to professional culture. This paper examines how and under what conditions public sector entrepreneurship develops, drawing on the example of international patients in the UK NHS. It reports on a subset of data from a wider study of UK medical tourism, and explores inward flows and NHS responses through the lens of public entrepreneurship. Interviews in the English NHS were conducted with managers of Foundation Trusts with interest in international patient work. Data is from seven Foundation Trusts, based on indepth, semi-structured interviews with a range of NHS managers, and three other key stakeholders (n ¼ 16). Interviews were analysed using a framework on entrepreneurship developed from academic literature. Empirical findings showed that Trust managers were actively pursuing a strategy of expanding international patient activity. Respondents emphasised that this was in the context of the current financial climate for the NHS. International patients were seen as a possible route to ameliorating pressure on stretched NHS resources. The analysis of interviews revealed that public entrepreneurial behaviour requires an organisational managerial or political context in order to develop, such as currently in the UK. Public sector workers engaged in this process develop entrepreneurship - melding political, commercial and stakeholder insights - as a coping mechanism to health system constraints.
  • Ormond, Meghann – ‘Solidarity by demand? Exit and voice in international medical travel – The case of Indonesia’ -
    • Globally, more patients are intentionally travelling abroad as consumers for medical care. However, while scholars have begun to examine international medical travel's (IMT) impacts on the people and places that receive medical travellers, study of its impacts on medical travellers' home contexts has been negligible and largely speculative. While proponents praise IMT's potential to make home health systems more responsive to the needs of market-savvy healthcare consumers, critics identify it as away to further de-politicise the satisfaction of healthcare needs. This article draws from work on political consumerism, health advocacy and social movements to argue for a reframing of IMT not as a 'one-off' statement about or an event external to struggles over access, rights and recognition within medical travellers' home health systems but rather as one of a range of critical forms of on-going engagement embedded within these struggles. To do this, the limited extant empirical work addressing domestic impacts of IMT is reviewed and a case study of Indonesian medical travel to Malaysia is presented. The case study material draws from 85 interviews undertaken in 2007-08 and 2012 with Indonesian and Malaysian respondents involved in IMT as care recipients, formal and informal care-providers, intermediaries, promoters and policy-makers. Evidence from the review and case study suggests that IMT may effect political and social change within medical travellers' home contexts at micro and macro levels by altering the perspectives, habits, expectations and accountability of, and complicity among, medical travellers, their families, communities, formal and informal intermediaries, and medical providers both within and beyond the container of the nation-state. Impacts are conditioned by the ideological foundations underpinning home political and social systems, the status of a medical traveller's ailment or therapy, and the existence of organised support for recognition and management of these in the home context.
  • Stan, Sabina - 'Transnational healthcare practices of Romanian migrants in Ireland: Inequalities of access and the privatisation of healthcare services in Europe'
    • This article deals with the transnational healthcare practices of Central and Eastern European migrants in Europe, taking the case of Romanian migrants in Ireland. It explores the implications of migrants’ transnational healthcare practices for the transformation of citizenship in Europe, more particularly in terms of access to free public healthcare. The article places these practices in the larger perspective of global care chains, seen as including transnational flows of healthcare seekers and healthcare workers that link distant healthcare systems in an emerging European healthcare assemblage. The study adopted a holistic perspective, taking into account both formal and informal practices, as well as the use of healthcare services in both the host and the origin countries of migrants. These were explored during multi-sited fieldwork in Romania and Ireland, conducted between 2012 and 2013, and combining a variety of sources and methods (semi-structured interviews, informal conversations, documentary analysis, etc.). The article explores the links between migrants’ transnational healthcare practices and two other important processes: 1) inequalities in access to healthcare services in migrants’ countries of origin and of destination; and 2) the contribution of healthcare privatisation to these inequalities. It shows that Romanian migrants’ transnational healthcare practices function as strategies of social mobility for migrants, while also reflecting the increasing privatisation of healthcare services in Ireland and Romania. The article argues that these processes are far from specific to Ireland, Romania, and the migration flows uniting them. Rather, they draw our attention to the rise of an unevenly developed European healthcare assemblage and citizenship regime in which patients’ movements across borders are closely interlinked with diminishing and increasingly unequal access to public healthcare services.
  • Volgger, Michael, Tomas Mainil, Harald Pechlaner and Ondrej Mitas - 'Health region development from the perspective of system theory – an empirical cross-regional case study' -
    • Governments are increasingly establishing health regions to deal with current challenges of public health service. These regions are seen as instruments to balance public and private stakeholders, and offer health care to regional citizens as well as to medical/health tourists. However, it is still unclear how the development of such health regions as well as their governance may be conceptualized. We apply Luhmann’s system theory approach in the context of a cross-regional case study that compares health region developments in the Autonomous Province of Bolzano-South Tyrol (Italy) with particular regard to the Eastern Dolomites and in the province of Zeeland (the Netherlands). We suggest that Luhmann’s system theory provides a useful set of criteria to evaluate and judge health region development. Fully developed health regions can be understood as auto-poietic systems. By emphasizing programs, personnel, and communication channels, these case studies illustrate the suitability of the system theory toolset to analyze the governance and spatial embeddedness of health regions. Additionally, the study contributes to literature by indicating that health regions are closely related to identity issues and to decision making in regions.
  • Walton-Roberts, Margaret - 'International migration of health professionals and the marketization and privatization of education in India: From push-pull to global political economy' -
    • Health worker migration theories have tended to focus on labour market conditions as principal push or pull factors. The role of education systems in producing internationally oriented health workers has been less explored. In place of the traditional conceptual approaches to understanding health worker, especially nurse, migration, I advocate global political economy (GPE) as a perspective that can highlight how educational investment and global migration tendencies are increasing interlinked. The Indian case illustrates the globally oriented nature of health care training, and informs a broader understanding of both the process of health worker migration, and how it reflects wider marketization tendencies evident in India's education and health systems. The Indian case also demonstrates how the global orientation of education systems in source regions is increasingly central to comprehending the place of health workers in the global and Asian rise in migration. The paper concludes that Indian corporate health care training systems are increasingly aligned with the production of professionals orientated to globally integrated health human resource labour markets, and our conceptual analysis of such processes must effectively reflect these tendencies.
  • Whittaker, Andrea and Chee Heng Leng - 'Perceptions of an "international" hospital in Thailand by medical travel patients: Cross-cultural tensions in a transnational space'
    • The growing trade in patients seeking health care in other countries, or medical travel, is changing the forms and experiences of health care seeking and producing changes to hospitals in terms of their design, organization and spaces. What is termed in marketing parlance in Thailand as an international hospital oriented to attracting foreign patients, is a hotel-hospital hybrid that is locally produced through the inflexion of local practices to make a therapeutic space for international patients. The paper reports on work undertaken within a Thai hospital in 2012 which included observations and interviews with thirty foreign in-patients and nine informal interviews with hospital staff. Although theorized as a culturally neutral transnational space of connectivity, we show how cross-cultural tensions affect the experience of the hospital with implications for the organization of the hospital and notions of cultural competence in care. There is no single universal experience of this space, instead, there are multiple experiences of the international hospital, depending on who patients are, where they are from, their expectations and relationships. Such hospitals straddle the expectations of both local patients and international clientele and present highly complex cross-cultural interactions between staff and patients but also between patients and other patients. Spatial organisation within such settings may either highlight cultural difference or help create culturally safe spaces.

Wednesday, 12 November 2014

CFP: 'International Medical Travel and the Politics of Transnational Mobility in Asia' Workshop - Singapore - 26-27 Aug. 2015


International Medical Travel and the Politics of Transnational Mobility in Asia

26-27 August 2015
Asia Research Institute, National University of Singapore

This workshop is organised by the Asia Research Institute, National University of Singapore; with support from the Monash University, Australia.
Although travelling across nations and crossing borders to seek medical care is not new, the rapidly increasing volume and velocity of medical travel at the turn of the 21st century soon raised its international profile and visibility. Especially with the emergence of the medical tourism industry, contemporary international medical travel expanded considerably as private hospitals stepped up their marketing to reach patient-consumers overseas and new businesses that sought to facilitate cross-country utilization of medical care proliferated.

In tandem with the growth of the phenomenon, medical travel/tourism as a field of research has also grown rapidly, with recent works encompassing ethnographic studies of patients’ experiences and subjectivities in the context of diverse types of medical travel as well as critical studies of international medical travel as a form of engagement embedded within struggles for access and rights to health care, as a reflection of shifting geographies of care and responsibility, and as forms of interactive encounter at the bodily, local and national scales, shaped by processes of globalization.

This workshop aims to provide a platform for discussing empirical and conceptual works on international medical travel in the context of the politics of transnational mobilities in Asia. Viewing Asia as a region of diverse and dynamic transnational mobilities, we are interested in papers that explore the ways in which international medical travel has developed in the region, the local, national and regional mechanisms that both impede and aid international medical travel, and the negotiations and contestations that accompany it.

We recognize that while international medical travel encompasses a range of different types of patient flows, and although the term ‘medical tourism’ often conjures up the idea of people travelling vast distances for medical care, the major flows are by and large intra-regional, often initiated because of the lack (or inaccessibility) of treatment facilities in the patients’ own countries. International medical travel therefore cross-cuts with people’s everyday realities, with different types of mobilities and bounded-ness, and with institutional processes in local, national, regional, as well as societal contexts.

While open to different theoretical approaches, we highlight the following which may provide useful starting points for empirical analysis:

1)   Transnational studies have fruitfully re-conceptualized migration and migrants’ realities within transnational social fields that do not coincide with national boundaries. While medical travelers are not conventionally regarded as migrants, conceptualizing international medical travel as a transnational social field may serve to reveal the depth and extent of social relations, networks and institutions that underpin this phenomenon.

2)   In modern life, access to health care is a crucial part of life and social security. The ways in which health care is accessed and utilized as part of everyday life constitute an important part of social reproduction. Are there ways in which international medical travel contribute to social reproduction that are distinct from, or that distorts, the social reproductive role of locally accessed and utilized health care? Conversely, how may international medical travel contribute to social transformation?

3)   Sustaining international medical travel as practice, as an industry, or even as a country export, involves processes of institutionalization that diverge from established conventions in healthcare provision and utilization. What are the ideas, practices, and processes that contribute to the institutionalizing of international medical travel and its cultural reproduction?

4)   Locating international medical travel in society necessarily calls for an examination of societal responses, from both host and sending societies. These societal responses range from solidarity and sympathy on the one hand, to resistance and hostility on the other. How do they play out in relations at various levels – individual, organizational, local, and national – and to what extent do they shape the shifting landscape of limits and opportunities in the provision of health and medical care?


Paper proposals should include a title, an abstract of 250 words maximum and a brief personal biography of 150 words for submission by 31 March 2015. Please send all proposals to Dr Chee Heng Leng at and Assoc Prof Andrea Whittaker at For a copy of the submission form, click here.

Successful applicants will be notified by 30 April 2015 and are required to send in a completed draft paper (5,000 - 8,000 words) by 31 July 2015. Based on the quality of proposals and availability of funds, partial or full funding will be granted to successful applicants. Participants are therefore encouraged to seek fund for travel from their home institutions. Full funding covers air travel to Singapore by the most economical means, plus board and lodging for the duration of the workshop.

Dr Chee Heng Leng Asia Research Institute, National University of Singapore

Professor Brenda SA Yeoh Asia Research Institute, Faculty of Arts and Social Sciences,
and Department of Geography, National University of Singapore

Associate Professor Andrea Whittaker School of Social Sciences, Monash University, Australia

Friday, 7 November 2014

New special issue: Transnational Reproductive Travel in International Journal of Feminist Approaches to Bioethics

This special issue of IJFAB makes a unique contribution, from an explicitly feminist perspective, to the ethical debates surrounding transnational reproductive travel. Specifically, it highlights some of the challenges with the cross-border movement of both reproductive material and people. This includes travel by reproductive laborers (i.e., women who provide eggs for third-party reproduction  and women who provide gestational services), and intended parents.

Introduction(pp. 1-9)  Free Content
Françoise Baylis and Jocelyn Downie
Stable URL:

Tuesday, 28 October 2014

New book: I. Glenn Cohen's Patients With Passports

The first two chapters of I. Glenn Cohen's new book (out in Dec. 2014 with Oxford Univ. Press), Patients With Passports, are available here:

Can your employer require you to travel to India for a hip replacement as a condition of insurance coverage? If injury results, can you sue the doctor, hospital or insurer for medical malpractice in the country where you live? Can a country prohibit its citizens from helping a relative travel to Switzerland for assisted suicide? What about travel for abortion? In his new book, Patients with Passports, just released by Oxford University Press, he tackles these important questions, and provide the first comprehensive legal and ethical analysis of medical tourism.

Medical tourism (or "medical travel") is a growing multi-billion dollar industry involving millions of patients who travel abroad each year to get health care. Some seek legitimate services like hip replacements and travel to avoid queues, save money, or because their insurer has given them an incentive to do so. Others seek to circumvent prohibitions on accessing services at home and go abroad to receive abortions, assisted suicide, commercial surrogacy, or experimental stem cell treatments.

This material the press has allowed him to upload to SSRN for distribution includes the front matter and the first two chapters of the book.

The "Preface" chapter introduces the book and the scope of medical tourism through the stories of six sets of medical tourists (some real persons, others composite) that sketch the very different needs, hopes, and experiences of patients traveling for care.

A second chapter, "An Introduction to the Medical Tourism Industry," introduces the industry at a more theoretical and data-centered level. It describes various ways of dividing the industry and brings together all the best existing available data to give a thick descriptive account of the industry and its major players: home country governments, destination country governments, destination country hospitals and their staffs, accreditors, facilitators, insurers, home country partner hospitals, and industry associations.

As these chapters and the book itself demonstrates, very different patients are traveling for very different reasons that raise very different legal and ethical issues. Some patients are traveling for cardiac bypass and other legal services to places like India, Thailand, and Mexico. He analyzes among other things issues of quality of care, disease transmission, liability, private and public health insurance, and the effects of this trade on foreign health care systems. Other patients are using medical tourism to attain services illegal in the patient's home country, such as organ purchase, abortion, assisted suicide, fertility services, and experimental stem cell treatments. Here, he examines issues such as extraterritorial criminalization, exploitation, immigration, and the protection of children.

Through compelling narratives, expert data, and industry explanations, his goal is to connect the reader to the most prevalent legal and ethical issues facing medical tourism today.

Friday, 26 September 2014

Upcoming: Medical Tourism Summit, Melbourne, Australia - 20-21 Nov. 2014

Medical Tourism Summit
Understanding medical tourism and how recent changes will impact Australia

20-21 November 2014 | Rendezvous Grand Hotel Melbourne

The Inaugural Medical Tourism Summit will examine the implications of recent changes within the medical tourism industry and the impact on the Australian market. In the last few years, Australia has begun to see more and more tourists arriving to receive medical treatments, including cancer treatment, heart surgery and IVF.
Meanwhile, NIB Health Funds has announced that they will offer insurance for Australian’s heading overseas for dental and cosmetic surgery, with plans to eventually expand this service to cover other forms of medical tourism.
The conference program will also address:
  • The current state of the industry
  • The risks
  • Australian services and marketing
  • Legislative challenges


Thursday 20th November 2014
The Current State of Medical Tourism
9.00      Medical tourism: Opportunities and threats in a Globalised world
With the availability of efficient modern transportation, it is possible to travel long distances in a short period of time in today's environment. As international tourism developed, so has the investment in infrastructure to cater for the tourism industry, from which medical tourism has had the opportunity to develop alongside on an international scale. This presentation examines the scope and challenges of medical tourism in a globalised world. The globalisation of markets and production, provide the medical tourism industry opportunities similar to those available to other service and manufacturing industries. Accordingly, the supply and demand create opportunities and threats to the industry. In addition, there are the ecological threats posed by the microbial world to manage in this industry. A holistic approach is necessary for the sustainability of this global industry.
Dr Christine Lee, Lecturer at the School of Business and Economics at Federation University
9.40      Why people travel for medical care: what we know and don't know
This presentation summarises the latest social science research on the reasons people seek medical treatment overseas. Patterns of travel differ for various groups and nationalities of people and by treatments sought, and appears to fluctuate. Research remains limited, due to the difficulties in accessing a mobile population, lack of consistent statistical enumeration and because much of the information is considered commercial in confidence. Although emphasis is placed upon individual decision-making, governments and regulations as well as insurers and tie-in contracts are important in shaping the trade in medical services.
Associate Professor Andrea Whittaker, ARC Future Fellow in Anthropology in the School of Social Sciences, Monash University
10.40      CASE STUDY: The Patient Experience
A patient's experience is broader than just the clinical aspects of care - all of the various non-clinical interactions impact their experience. Because patients are often at their most vulnerable while receiving health care services, each interaction takes on added significance. All of these interactions, or touch points, are the basis of 'The Patient Experience'. Each touch point offers the health care provider the opportunity to deliver unique benefits to the patient and to create a platform for differentiation and competitive advantage.
Cassandra Italia, Managing Director, Healthcare Hands and Global Health Travel, Thailand

The Risks

11.20      Medical tourism and bioethics: Imprints left by the global neoliberalisation of health
Internationally, healthcare has been intensively privatised and commercialised over the past 20 years. Medical tourism has emerged in this context as an economic development strategy for many developing nations, and provisional remedy to the rising costs and waiting lists for healthcare in developed nations. Through a focus on research carried out in India, this paper will explore how medical tourism provides a window through which to view some of the broader, exploitative economic practices occurring within and between nations. It will also discuss how national and international regulation can guard against predatory practices and promote social justice, or alternatively, exacerbate current inequalities.
Kristen Dawn Smith, Research Fellow for the Centre for Health and Society at the Melbourne School of Population and Global Health, University of Melbourne
1.00      CASE STUDY: Travails of hope and the real cost of stem cell tourism
Buoyed by the promise of regenerative medicine, Australians are pursuing 'stem cell' treatments - both abroad and within Australia - in increasing numbers. Often referred to as 'stem cell tourism', this emerging service industry is a discrete and worrying sub-set of the medical tourism sector. Rather than offering access to established techniques and medical procedures, the 'stem cell' tourist is being sold unproven interventions with little or no evidence to substantiate the claims made - and high fees charged - by providers. Indeed the potential cost extends far beyond financial considerations for the individual, with real implications for the biotechnology community.
Dr Megan Munsie, Head of Education, Ethics, Law and Community Awareness Unit at the University of Melbourne; Policy and Outreach Manager at Stem Cells Australia
1.40      Does medical tourism trivialise the severity of plastic surgery?
Dr Tim Papadopoulos, President of the Australasian Society for Aesthetic Plastic Surgery

Marketing and public relations

2.40:        The need for a systematic and integrated approach to develop the medical tourism industry
Dr Hemani Thukral, Director of Medical Tourism, Australia Indian Travel & Tourism Council; Managing Director, MyMedicalChoices
3.20      CASE STUDY: The difficulties of trying to develop a medical tourism market for Australia
  • Early attempts to define and establish the sector
  • Early conferences, their findings and resolutions
  • Attitudinal and structural hurdles
  • The "tourism" side of medical tourism
  • The ongoing opportunity
Matthew Hingerty, CEO and Managing Director, Barton Deakin
4.00       Measures to Develop and Promote “Down-Under Medical Tourism Hub”
Medical tourism is one of the fastest growing multi-million dollar global healthcare service industries. It is also  known as healthcare tourism, medical outsourcing, medical refugees, international medical travel, bio-tech pilgrims - where patients seek cost effective, first world quality of heath-care with latest medical technology in another country. It is a complex phenomenon influenced by interactions between medical, economic, social, legal, ethical, and political factors operating either singly or in combination, such as high health and insurance costs, globalisation, digitisation, regulation, long waiting periods, and non-availability of treatment. Medical tourism combines access to invasive, diagnostic, cosmetic and alternative lifestyle healthcare services with exotic locations, medical specialist and caring local staff, and travel itineraries. It incorporates the appeal of achieving positive health outcomes for improving once quality of life, with the adventure of heritage, spiritual, and cultural tourism. Therefore, in order to be competitive medical tourism development, information distribution and promotion should be of great interest to Australian marketers, medical profession, policy makers and medical tourism industry as a whole.
Anita Medhekar, Senior Lecturer in Economics, Central Queensland University
Friday 21st November 2014

8:00      Morning coffee and networking

8:50      Opening remarks from Chair

9:00      Issues associated with transnational reproductive treatment
Australians have been prolific users of assisted reproductive treatment in other countries, predominantly for surrogacy arrangements and donor treatment in Asia and the USA. Strong regulation and quality assurance mechanisms in Australia offer protection for all parties, minimising risks and looking after the interests of children born from assisted reproductive treatment. However, hundreds of Australian travel overseas for treatment. Current health, social and legal issues for all parties involved from transnational reproductive treatment arrangements and considerations for minimising risks will be explored. The interests of children born, the intending parents and surrogates will be explored.
Louise Johnson, CEO of the Victorian Assisted Reproductive Treatment Authority

9:40      The physiological effects of flying on the human body and the impacts of this on medical tourism - a discussion of the legal claims available in aviation against the airlines in domestic and international travel
  • A consideration of illnesses and injuries sustained aboard flights
  • A discussion of claims against the airlines
  • A comparison of physical injuries versus mental illness
  • An analysis of the effects of aviation injuries and illnesses on medical tourism
Dr Michael Spisto, Senior Lecturer in the College of Law & Justice, Victoria University

10.20      Morning tea

10:40      Controversies in Obstetric and Reproductive Medical Tourism
  • Accessibility - Examining Australians traveling overseas for IVF due to lower costs as well as access to services prohibited by Australian Law
  • When it all goes wrong - Case examples including evaluation of Baby Gammy's Case
  • Legal Considerations - Is the problem with our law?
  • Other matters - issues that you might not have thought of
Dr Vinay Rane, Medical Vice-President of the Medico-Legal Society of Victoria

11.20      Borderless healthcare
People worldwide are increasingly crossing borders for medical treatment driven by greater mobility, reduced trade barriers, competition and search for quality. Some emerging countries are likely to "outsource" their healthcare provision due to existing supply not being able to keep pace with rising "wealth" driven demand. NIB Options is seeking to take advantage of this thematic. Initial efforts are focusing upon cosmetic and dental treatment in Australian domestic market. This includes an option of being treated by Australian doctors. The ultimate goal will be to expand into medical treatment and sell cosmetic/dental/medical treatment products in foreign markets. Australian inbound opportunities for doctors, dentists and hospitals are enormous.
Mark Fitzgibbon, CEO of NIB Health Funds
What Australia Has To Offer

12.00      Why Australia's IVF programs are drawing international patients to Australia
Lyndon Hale, Medical Director of Melbourne IVF

12.40      Lunch

1.40      CASE STUDY: The difficulties of trying to develop a medical tourism market for Australia
  • Early attempts to define and establish the sector
  • Early conferences, their findings and resolutions
  • Attitudinal and structural hurdles
  • The "tourism" side of medical tourism
  • The ongoing opportunity
Matthew Hingerty, CEO and Managing Director, Barton Deakin

2.20      The impact facilitators make on the medical tourism industry
  • The evolution of facilitators
  • Why providers need facilitators
  • Why patients choose a facilitator
  • Responsible supply chain leverage
  • When things don't go to plan
  • The future for facilitators
Christyna Kruczaj, Director of CosMediTour

3.00      Afternoon tea
Medical Tourism in Australia

3.20      Challenges in providing low cost high quality cosmetic surgery performed by Australian trained fully qualified FRACS plastic surgeons in Australia
Dr Kim Chan, Medical Director of Breast Academy

4.00      The overseas market and what Australia can learn

Mr Daniel Donner, Medical Director of SkyGen

4.20        The future of medical tourism    
  • Where will Australia fit in the grand scheme
  • Specialisation 
  • Licensing
  • Packaging 
Christian Fletcher-Walker, Co-Founder and CEO of Wotmed

  5.20     Closing remarks from Chair

5.30      End of conference