The Term Tourism in the National Programme of Medical Tourism of Greece

We have been recently informed of policy initiatives and measures to support the inflow of patients in Greece. Jointly the Ministries of Health and Tourism announced a National Programme for Medical Tourism and presented parts of an action plan; rich information and details of which we are expecting by the end of January.

We are looking forward to further details and developments.

I would like to stand to a terminology issue, here. In particular, the emphasis of the National Programme on the term tourism. Tourism is a term and practice connected to joy, recreation, relaxation, cultural stimulation and vacation. Are all these characterising patients travelling abroad for medical treatment and care? Is the activity of tourism related in practice with the global provision of health services? To briefly touch upon these issues, I attempt a micro and a macro level approach.

A micro approach: While in few instances people who travel for medical reasons may take the opportunity to do sightseeing or other tourism-related activities, academic research suggests that the tourism component is either downgraded or non-existent. People feel fear, uncertainty, and anxiety; they often feel they are undergoing a small adventure. Why shall providers then rush to call them tourists? In fact there are cases of patients that refer to their travel as exile instead of tourism. Based on empirical research, scholars from universities as famous as Yale have repeatedly referred to this issue (please do not hesitate to contact me for the related academic literature.)

A strategic macro approach: Tourism is connected to business and profits as a leading industry in the services sector. Why bring in health care provision a term that connotes a business orientation and profit-maximisation? Is it profit and an improved trade balance that Greece aims to achieve? Or is it care for the citizens of other countries and support to health care systems that lack MDs, facilities, or reasonable prices for high quality care that Greece wishes to offer? Though a new source of revenue will support the economy of Greece, I would say that it is the latter that Greece and its people are committed to. Given the over-supply of highly qualified MDs and the overcapacity in health care facilities, the private sector in Greece may serve populations of other countries (potentially with minimal disruptions for the local community).

In Greece health care takes place in a beautiful natural environment with unique climate conditions. This is notable and worth of mention. It plays a more important role for non-intervention procedures, outpatient care and potentially day surgery. But again, to a great extent it misses the point of this form of travel. Patient travel is growing due to lack of accessible care at home. There is not so much to ‘celebrate’ in patient movement.

Consider the Libyan citizens that were hospitalised and offered treatment in Greece during and after the Libyan war. This has been the most recent example of large numbers of foreign patients being treated in Greece. Could that be included in the Medical Tourism framework/conceptualisation of the inflow of patients? Actually not. Why? Is it not support to our neighbouring country that has been offered? Was that not, at the same time, an important source of revenue? Yes, it was. Nevertheless, the value of offering help to war victims is much greater. Revenues are secondary in comparison to humanistic purposes (even when the problems that have been created in the process and have taken extensive attention by the press are considered).

I would briefly mention another example. The British NHS announced plans to expand its facilities in foreign countries. Is that because the government desires to create revenue so that the NHS becomes less depended on state funding? Or is it because the UK as a leader in medical research and innovation wishes to encourage knowledge exchange and to help other countries improve their own infrastructure and health care delivery processes? While revenue is always welcome, I would suggest that it is the latter that is put forward (‘Promoting Healthcare Excellence Globally’). Emphasis on an orientation to exports or on a new source of revenue of a public enterprise would give a monolithic impression. Similarly, emphasising the tourism aspect in the treatment of foreign patients through the term Medical Tourism is one-sided.

I agree that Greece is in a very difficult moment in its history. Once more it is heavily indebted, unemployment it strikingly high, and slow growth -if at all- is predicted for the years to come. Obviously, inflows of patients from foreign countries would give a new chance for the economy and the health care sector in particular. It could even contribute by reversing the migration trend of MDs to foreign countries. Nevertheless, there is another mission there for Greece. Despite the difficulties aforementioned, we are in the position to offer medical care to non-residents (potentially) without disadvantaging the local community. While the public sector lags behind due to amounting inefficiencies that call for improvement, the strong domestic demand has supported for long the growth of a strong private health care sector. Now the European Commission, the WTO, and other international regulatory bodies suggest that there are potential multifaceted and multilateral benefits in a globalised provision and the international movement of patients. Amidst such developments, Greece is in the fortunate position to be able to respond to the growing international demand.

To respond to this challenging call, however, we should not forget the real commitment. The revenues and the potential reversal of the outflows of MDs are really important but should not overshadow the humanistic mission of the endeavour. That is to service people and their medical needs. More so, as a member of the EU to actively support the right of EU citizens to timely, high quality, and affordable health care. I suggest that the term tourism unintentionally diverts attention from these goals.

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