GLOBALISATION OF MEDICAL

TOURISM AND THE NEED FOR

CLINICAL GOVERNANCE

DATO DR. SIVAMOHAN.N DSNS DPMP

FAMM MBBS FRCOG MSc FICS Fellowship (Gynae-Oncology)

CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST

KPJ DAMANSARA SPECIALIST HOSPITAL/
MEDICAL DIRECTOR KPJ KLANG SPECIALIST HOSPITAL

MEDICAL TOURISM
Emergence as a Global Medical
Business Challenging the Dominance
of Health in Developed Countries
Emergence as a Threat Pushing
Health Disparities in Developing
Countries

Era of Globalization
Healthcare Has Become A
Commodity - Production
Outsourced

The Organized Travel Outside Ones

Natural Healthcare Jurisdiction for
the Enhancement or Restoration of
the Individual's Health Through
Medical Intervention Using but Not
Limited to Invasive Technology
Carrera & Bridges (2006)

GROWTH OF MEDICAL
TOURISM

SPENDING ON MEDICAL
TOURISM

ENABLING FACTORS FOR GROWTH

Cost and Affordability

Health Insurance Coverage

Choice
Access to Information Technology
Reputation of Innovative Services
Cost of Production of Services
Restrictions on Travel

ENABLING FACTORS FOR GROWTH

Quality of Care
Waiting Time

CONCEPTUAL FRAMEWORK OF
GLOBALIZATION & MEDICAL TOURISM

AGENDA FOR MEDICAL

TOURISM GOVERNANCE
Government May Allow Health
Insurers and Employers to Extend
Their Coverage Abroad
Expansion of Medical Tourism
inevitable new global economic
order

AGENDA FOR MEDICAL

TOURISM GOVERNANCE
Medical Tourism Accepted Part of the
Solution for High Costs and Long
Waiting Lists
Reconciling the Aims of Economic
Growth with Equitable Health Services
& Access-Challenging and Contradictory

MEDICAL TOURISM
Governance in Separate Domains of
Trade & Health
Trade by Definition is International
but Health Systems (Financing,
Delivery & Regulation) is Nationally
Bound
The Question of Equity

TRADE & HEALTH GOVERNANCE

1. International

World Trade Organization (WTO) & World Health

Organization (WHO)

2. Regional
Association of South East Asian Nations (ASEAN)

3. National (Government Ministries)

COMPETITION & COST

CONTAINMENT

AREAS OF CONTENTION
Reproductive Tourism
Cosmetic Tourism
Medical Transplant Tourism

SAFETY OF PATIENTS TRAVELLING

ABROAD
Carrying Infectious Diseases
Violation of Human Rights-illicit
Activities Notably Organ
Transplantation, Surrogacy,
Aesthetic Surgeries

MEDICAL GOVERNANCE BY
KEY STAKE HOLDERS
A. Representatives from the Government
B. Medical Care Providers
C. Employer Group
D. Pharmaceutical Companies
E. Health Insurers
F. International Medical Brokers
G. Patients

 Medical Tourism Audit

Regulations & Policy Options

EXPERIENCE & ACHIEVEMENTS OF

MEDICAL TOURISM
Expectations from Extended Medical Tourism
Identification of Existing Problems and
Potential Obstacles of Reaching Targets
Impact of Health System of Provider
Countries
Equity of Healthcare
Clinical Governance & Regulatory Framework