The Patients' Guide To Treatment Abroad 2017 by LaingBuisson

AUGUST 2017

WILL THE NHS FUND TREATMENT ABROAD? Why treatment abroad could be right for you Working out the cost Choosing a clinic or surgeon What if something goes wrong?

FOCUS ON... Fertility treatment abroad Cosmetic surgery abroad Destination Croatia Destination Dubai Destination Malaysia Destination Portugal Dentistry abroad

04 12

The Patients’ Guide to Treatment Abroad is published by Intuition Communication, 3 Churchgates, Wilderness, Berkhamsted HP4 2UB www.treatmentabroad.com Tel: 01442 817817 Fax: 01442 817818 Twitter: @treatmentabroad Facebook: TreatmentAbroad

CONTENTS

Considering treatment abroad

Page 4 – Will the NHS fund treatment abroad? Your rights to treatment as a citizen of a European Union state Page 6 - Is treatment abroad right for you? Weighing up the pros and cons Page 8 - Why choose dental treatment abroad? People are increasingly taking advantage of the low prices and high quality dental treatment available abroad, but is this option right for you? Page 18 – Considering cosmetic surgery abroad? A checklist of questions to ask your shortlisted clinics Page 22 – What if something goes wrong? What to do if you run into problems

Fertility treatment

Page 12 – Fertility treatment abroad A guide to choosing a fertility clinic abroad

Checking out the facilities

Welcome

Travelling to another country for medical treatment, dental procedures or cosmetic surgery is becoming increasingly popular. Private treatment in Western Europe and other developed countries is expensive and many patients now use the internet to search out less expensive, high quality healthcare abroad. Some patients combine their treatment with a holiday or a short break in traditional holiday destinations such as Greece, Spain, Cyprus or Croatia, or cities such as Budapest or Lisbon. Some UK medical tourists are looking further afield too, booking treatment in Malaysia, Thailand, USA or Dubai. The main areas for treatment abroad for UK patients are cosmetic surgery, obesity surgery and IVF treatment. Dentistry is also in high demand: the reduction in NHS dental services has forced many people to seek dental treatment abroad just so that they can afford the work that they need. Countries such as Croatia and Hungary offer significant savings on treatments such as dental implants and cosmetic dentistry. The cost of UK fertility treatment, and the restrictions on NHS provision, is also leading to many couples seeking fertility treatment as medical tourists. Despite the many obvious advantages of treatment abroad, there are still a number of concerns for patients travelling to another country for medical treatment, such as: • • • •

Page 23 – Checking out the clinic or hospital What to look for and what to ask Page 26 – Checking out the surgeon or dentist Doing your research on medical practitioners abroad

Working out the cost

What will the conditions be like in another country? Will the surgeon or dentist be suitably qualified? Where can I get the best deal without compromising my care? Is treatment abroad right for me and can it offer the treatment I need?

We’ve put together this Patients’ Guide to Treatment Abroad to answer all of these questions and more, taking you step by step through the medical tourism process using the experience gained through operating the Treatment Abroad website at www.treatmentabroad.com. The site provides extensive background information on popular healthcare destinations and details the healthcare services available, the standards of training and accreditation of medical personnel and provides a wealth of other useful information, such as travel availability, accommodation, local culture and places of interest to visit.

Page 27 - Comparing providers and costs Once you have decided on the treatment you need and selected your country, it is important to compare the different providers within that destination. Page 31 – Working out the cost of treatment abroad A guide to typical prices Page 30 – Medical travel insurance A check-list of things to consider before buying a medical travel policy to ensure you are covered.

Keith Pollard Managing Editor

Will the NHS fund treatment abroad? As a UK citizen and whilst the UK remains a member of the European Union, you have a right in certain circumstances and under certain conditions to seek treatment in other European states and for the cost of this treatment to be reimbursed by the NHS.

espite the Brexit vote, you will retain your right to seek treatment in another EU country, funded by the NHS, for some years ahead. The EU Cross Border Healthcare Directive gives you the right to be treated anywhere within the European Economic Area and have your care costs paid by the NHS, subject to certain conditions. More and more UK citizens are using their EU rights to avoid long waiting times on the NHS. No member state is obliged to fund treatment in another country if that same treatment is available at home within a medically justifiable period, or if that treatment is not normally funded by the local health service of the home state (apart from in exceptional circumstances). The Directive does not include cosmetic surgery or cosmetic dentistry, but may apply to other operations with a waiting list. You can have your treatment funded either using the S2 route, which is pre-agreed, or by paying for it yourself and claiming the money back under Article 56. The EU Directive does not give patients any rights to cross border healthcare that they don’t have already. It doesn’t introduce any new rights. These rights have already been established by the European Court of Justice. What the Directive aims to do is to establish a framework within which cross border healthcare will operate and to set the rules regarding how patients will access care and what kind of treatment they are entitled to outside of their own country. However, there are very few UK or EU citizens who understand what their rights are to treatment elsewhere within the EU and few know how to exercise those rights. In truth, most people are still not aware that they may choose treatment in another EU state. Mr S has been on the NHS waiting list for a hip replacement operation for osteoarthritis for eight months. His condition worsens after he slips at home, dislocating his hip. Emergency treatment restores his joint, but he is in agony afterwards, needing prescribed painkillers. His GP refers him for an urgent appointment with his orthopaedic surgeon, who says Mr S needs a hip replacement within four weeks. The local primary care trust cannot organise the surgery within this time, but they are prepared to reimburse his treatment in Hungary, as a hospital there is prepared to conduct the surgery in two weeks’ time. The estimated cost of the hip replacement is £2,000 less than the cost of the surgery done within the NHS but the primary care trust will only pay the cost of the Hungarian treatment, no more. Mr S is disappointed as he planned to use the difference to pay his travel expenses, but the

Mr G developed carpal tunnel syndrome in his right hand, and was put on a waiting list in his local primary care trust. He expected to receive surgical treatment within 18 weeks, but various delays and an administrative error meant that he still did not have a definite date for his surgery five months later and his condition had worsened to such an extent that he was now on long-term sick leave. He found a hospital in the Netherlands willing to do the surgery within 10 days and applied for authorisation under the Directive route. His treatment was authorised because he had experienced an ‘undue delay’ according to the judgement of his GP. rules of the Directive are clear on this point and he reluctantly accepts he will have to pay his air fare and hotel bills himself.

Cross border treatment is your choice The Directive has been created to support your rights to choose treatment anywhere in the EU, however it is not intended to encourage or to facilitate that decision. That means that although your local healthcare provider may fund your treatment, they will not arrange treatment or recommend providers in other countries. It is your decision to seek healthcare outside of your home state and therefore it is up to you to source that healthcare and make all the arrangements. While the Directive obliges EU states to provide a range of information for visitors, by establishing National Contact Points, states are not obliged to provide their own citizens with details of treatment options elsewhere.

How it works Choosing treatment in another EU state is entirely your own responsibility, and as such it is down to you to thoroughly research your chosen destination. You should consider factors such as local healthcare standards, language barriers and the overall quality of facilities. Remember, pre-approval does not mean that your chosen provider is approved, merely that your treatment there will be paid for. You have the right to apply for healthcare in any EEA state you choose, funded by the NHS, but you must comply with certain requirements to qualify for NHS funding of your treatment. These requirements include: • You must be a UK resident • You must be eligible for state funded healthcare services in the UK • The treatment must be medically necessary • The treatment must be funded in the UK under normal circumstances. (You cannot go abroad for a treatment that would not

normally be available under the NHS) • The treatment must be available to an acceptable and safe standard in the country of your choice • The treatment, clinic and trip must not pose an undue risk to your health Your local health commissioner has the right, on behalf of the NHS, to refuse to authorise treatment if these conditions are not met, although the grounds for refusal are limited and you have the right to appeal any decision that is made by your local commissioner. • In England, contact NHS England or your local CCG (clinical commissioning group) • In Wales, contact your local health board or the Health Commission Wales • In Scotland, contact your local NHS board • In Northern Ireland, contact the health and social services board

What if the treatment goes wrong? Since you have chosen to move outside of the NHS system, you have no legal redress in the UK, and if anything goes wrong you are on your own. You will be covered by the laws of the country you have been treated in, and you will need to make any compensation claims or sue for negligence under that legal system. You should always ensure that you thoroughly research your chosen treatment centre, as the onus is on you to select an appropriate provider. Under the Directive, prior authorisation will only be refused if there is a well-evidenced risk of unsafe treatment, or risk to public safety. However, even in the best facilities, things can go wrong. Naturally, if you suffer any problems following your treatment overseas, you can obtain treatment or emergency care under the NHS in exactly the same way as if you had been originally treated here in the UK. You will not be turned away as someone else’s problem.

Further information See “A UK patient’s guide to the European Directive on Cross Border Healthcare” at www.treatmentabroad.com/eu for full details. See NHS Choices - Travelling to Europe for medical treatment at www.nhs.uk/NHSEngland/Healthcareabroad/plannedtreatment/Pages/Introduction.aspx

Is treatment abroad right for you?

edical tourism offers the advantages of saving money and getting the treatment you need without waiting, while at the same time giving you the opportunity to experience a different country. The medical tourism market is expanding all the time, as political and economic situations change across the world. New destinations often provide highly competitive prices to help them break into the market. However, it is not for everyone and you need to think carefully about the positives and negatives before you decide to go ahead. You need to consider a number of factors, including being away from your home and family at an especially vulnerable time. If you do feel it could be right for you, then there are a number of things to consider. To help you make an informed decision, you need to get as much information as possible. You can find out about treatment abroad in many different ways, including: • Read reviews of different countries and clinics on the internet, and on sites such as Treatment Abroad (www.treatmentabroad.com) and Medical Tourism Reviews (http://reviews.treatmentabroad.com). • Talk to people who have travelled abroad for treatment and ask about their experiences, both positive and negative. • Look out for reports in the media covering the experiences of the medical tourism patient.

What to consider when planning treatment abroad To make an informed decision, it is important to find out as much as you can about the treatment or surgery you are planning to have abroad. This will help you to understand the services on offer at different clinics, and how appropriate it is to travel to your chosen country for your treatment. To help you make the right choice, you should consider: • How long do you want to go away for and how far are you prepared to travel? • Will you be comfortable on a long flight with your condition, or with flying just a couple of weeks after surgery? Would your doctor deem you fit to travel and not running a high risk of DVT (Deep Vein Thrombosis)? • Will you have to go alone, or will a close friend or

And you do not have to restrict yourself to Europe. Even with the price of flights and accommodation in exotic places such as Malaysia and Thailand, the savings on your treatment costs can still be enough to make the whole trip cheaper than having the same procedure in the UK.

family member be able to accompany you? • Can you be flexible with your schedule if you have to stay longer due to complications? • Does your treatment normally require follow ups or further treatment, requiring further travel? Or is this follow up care available at home? • What are your personal priorities and is the lowest price more important than the highest quality?

Factors to consider when choosing your destination include: • Is your chosen procedure available in that country? • What are the safety standards like and how rigorously are they enforced? • How much does it cost to get there and how long is the flight? • What are the local costs, such as meals, transport and hotels? • How easy is it to travel around, and how safe is it to do so? • When is the country’s high season, and when is it cheaper to travel there? • What is the country’s weather like and when is it most comfortable to visit? • Is English widely spoken and are you likely to be understood?

Compare like for like Compare all providers on a like for like basis, looking at not only treatment costs and availability, but also the cost of travel and accommodation, the qualifications and experience of the staff and the standard of facilities at the clinic. You can compare prices and assess the services, treatments, costs and staff credentials of different providers in different countries by using the Treatment Abroad website at www.treatmentabroad.com. It is important to remember that however tantalising the idea of having your treatment in an exotic country like Thailand or South Africa may sound, you should never let the allure of a destination become more important than the quality and safety levels for your chosen treatment in that country.

Choosing a clinic Once you have chosen your country, there are two routes to finding a clinic. Either you can research the available clinics yourself, using the internet or by calling them directly, or you can use a medical tourism broker (or agency or facilitator), who may find the most appropriate clinics for you, as well as arranging all your travel and accommodation. If you are going directly to the hospitals and clinics, you need to find out as much information about the healthcare provider as possible. Ask for any literature and brochures they have, as well as details of the background and qualifications of the consultants, surgeons and medical staff. You should also find out as much as you can about the clinic from independent sources, such as online forums and independent review sites.

Choosing your medical tourism destination The medical tourism market has grown rapidly in recent years, giving you a huge number of countries and clinics to choose from, ranging from nearby European cities to more exotic destinations half way round the world. Each has its advantages and its drawbacks, so it is important that you do your research thoroughly before making your choice. Each country has different standards, costs and areas of expertise. For example, within Europe, Poland, Hungary and Croatia have an excellent reputation for low cost dentistry, Spain offers specialist fertility treatments, while Belgium is known for affordable obesity surgery.

Why choose dental treatment abroad? In the rapidly growing field of medical tourism, one area that is proving particularly popular is dental treatment abroad. With the limited availability of NHS dental treatment and the high cost of private dentistry in the UK, more and more people are taking advantage of the low prices and high quality dental treatment available abroad. Countries such as Hungary, Poland and Croatia have become a popular choice for dental tourists from the UK. So, is it something you should consider? Why do people travel for dental treatment abroad? The main reason people travel abroad for dentistry is to save money. Private dental treatment can be incredibly expensive in the UK, while countries such as Hungary, Poland and Croatia can offer similar standards of treatment for up to 70% less. The procedures involved in dental treatment rarely require significant recovery time. It is easy to combine a holiday or sightseeing with your low cost treatment. In many cases, you can enjoy a trip to a new city and get your dental treatment for less than the cost of the treatment alone in your home country.

Cost advantages Price is the biggest factor attracting people to dental treatment abroad. Root canal treatment and a crown can cost over ÂŁ1,000 at a private dentist in the UK. In Budapest, you can obtain the same treatment at less than half the cost. Just one Branemark dental implant can cost ÂŁ1,500 in the UK. A saving of 50% or more makes a big difference if you need several implants.

A wide choice of dental clinics abroad Private dental clinics across Europe are in a highly competitive market for international patients, and

will go out of their way to make you feel comfortable and confident. They will offer state of the art equipment and facilities with a highly trained clinical team in order to attract foreign business. They will often have specialist staff who understand the specific needs of international patients and their concerns about treatment in a strange land. Some will organise your whole trip - booking hotels and apartments, sending a chauffeur to the airport to collect you on arrival, arranging sightseeing trips, and providing a local mobile phone.

potential savings can be offset by the additional costs of multiple flights and hotel stay. Soâ&#x20AC;Ś do your sums beforehand. Clearly there are also concerns about aftercare when you have dental treatment abroad. If anything goes wrong with treatment from a local dentist, you can simply call in. This is not so easy if you have travelled hundreds of miles to a foreign country. Furthermore, in the worst-case scenario, you may find it much more difficult to pursue a claim for medical negligence against a dentist in another country.

Concerns about dental treatment abroad Despite the significant savings that can be made, there are still disadvantages to going abroad for dental treatment. The biggest of these is often the language barrier. Many people are apprehensive about dental treatment to begin with, and if you cannot communicate clearly with your dentist, you may not fully understand what to expect. For example, discomfort that is a perfectly normal part of your procedure can be very worrying if it has not been explained to you in advance. The other disadvantage of dental treatment abroad is the fact that many dental treatments, such as crowns and implants, require more than one visit, with several weeks healing time in between. The

Is dental treatment abroad right for you? Your choice as to whether dental treatment abroad is right for you will depend on a number of factors, including the dental problem you have, the budget you are prepared to spend and the length of time you are prepared to wait for your treatment. Your home dentist may be willing to advise you on whether treatment abroad is a good idea for you or not. You should always have a full clinical assessment before seeking treatment abroad. Consider taking advantage of the assessment services offered by some international dental clinics who offer assessment locally in the UK, before you decide to go for treatment abroad.

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MEDICAL MEDICAL TREATMENT, TREATMENT, CULTURE, CULTURE, LEISURE LEISURE AND AND SHOPPING SHOPPING IN IN THE THE SAME SAME VISIT VISIT Choose Lisbon for your medical tourism destination and Choose Lisbon your medical tourismyou destination and tailor your trip for to perfection, whether want to simply tailor your trip to want to simply relax and soak upperfection, the sun, orwhether enjoy a you round or two on relax and soak up the sun, or enjoy a round or two on some of Europe’s finest golf courses. some of Europe’s finest golf courses. Portugal’s capital has an intimate charm and is renowned Portugal’s capital has an intimate charm and renowned for its magnificent beaches, ideal climate, andisthriving for its magnificent beaches, ideal climate, and thriving city life, creating the perfect holiday destination. city life, creating the perfect holiday destination. Lisbon offers European standards of treatment at costLisbon offers European standards of treatment at costeffective prices, excellent infrastructure and clean, well effective prices, excellent infrastructure and clean, well equipped clinics with highly trained staff. equipped clinics with highly trained staff. The private hospitals and clinics offer a wide range of The private hospitals and clinics offerprocedures a wide range services extending beyond cosmetic to of services extending beyond cosmetic procedures to include routine surgery too. include routine surgery too.

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Treatment in Portugal When it comes to private treatment abroad there’s an overwhelming choice – so how about a country that offers a huge range of medical services in first class facilities? A destination with a sunny climate, plenty of year-round sunshine and award winning golf courses?

ortugal scores high, and if you add to the pot a fascinating, cultural capital city, some of the best seafood in the world and a stunning coastline for water-based activities from fishing to sailing, the decision

becomes easy. Portugal is situated on the south-western edge of Europe, beside Spain, and during the Golden Age of Discovery (fifteenth & sixteenth centuries), Lisbon was on top of the world with a vast empire including South America, Africa, Asia, and Oceania as valiant explorer Vasco da Gama, navigated his way to exciting, and continuing spice trade routes. And now, with a highly skilled workforce, cutting edge technology, and exemplary safety standards in its private hospitals, Portugal is becoming King of the Castle once more as health tourists are realising the realm of affordable medical possibilities here. Healthy living Portugal has a national healthcare system known as the Serviço Nacional de Saúde (SNS), which runs alongside special social health insurance and voluntary private health insurance, and the Portuguese enjoy high life expectancy. In this modern Western country you can expect first-rate private healthcare in a clean and cutting-edge environment with highly trained medical personnel (it takes six years of training with internships and residency in their specialty for doctors to register with the Portuguese Board of Physicians). A broad range of treatments is available from oncology to dermatology, cardiology to minimally invasive surgery. Many of the private hospitals are pioneering innovative state of the art diagnostic and treatment resources and attracting world-renowned specialists in their fields, for example, providing minimally invasive surgery with futuristic console and robotic arms. Best still, this medical expertise is more competitively priced than at home, and the hospitals have multilingual staff and provide communication support programs to counter any possible language problems, along with expert patient support services (IPS) ensuring that international patients are well looked after from start to finish.

Lisbon – the ‘feel better destination’ Lisbon is a great year round destination, boasting pleasant sunny temperatures even in the winter, and described as the ‘feel better destination’ it’s a top consideration for the medical tourist seeking first class private treatment just a few hours from the UK. Situated on the Rio Tejo (Tagus River) in the centre of Portugal, Lisbon has survived many an invasion and occupation (as well as a destructive earthquake in 1755) with several cultures leaving their mark on this enchanting city. In the Belem district the landmark Mosteiro dos Jeronimos overlooks Praca do Imperio (the city square), and nearby the imposing Gothic and Renaissance architecture of the 500 year-old Belem Tower, one of Portugal’s national symbols, stands tall and proud. From the beach here Vasco da Gama set sail en route to India, and many heritage sites and museums showcase Portugal’s maritime exploits. Although after the earthquake much of the city was rebuilt, many monuments remain, from the Sao Jorge Castle and the city’s triumphant arch, Rua Augusta, to the architectural delight of the Ajuda National Palace and Sintra, the World Heritage site palace. See the sights Take the vintage Tram (number 28) to view the Bairro Alto, Baixa and Alfama, the atmospheric Medieval quarters. Disembark at Alfalma to stroll its cobbled, hilly streets and immerse yourself in the ancient flavours, uneven rooftops, unexpected alleyways, and those ubiquitous decorative blue tiled buildings. Here you’ll find the Gothic/Romanesque Se Catedral (cathedral), the Moorish Castelo do Sao Jorge (castle), the Jewish Quarter - and outstanding city views. With fishing being a big industry you’ll experience what’s considered to be the best seafood in the world in Lisbon. Select a traditional restaurant in Bairro Alto, or nearby sophisticated Chiado, order grilled sardines or dried salt cod-caldeirada - served with peppers and tomatoes, wash it down with vinho verde (slightly sparkling white wine) then listen to some Fado, traditional Portuguese music formerly

sung by sailors, and now a massive tourist attraction performed by talented singers and musicians. Modern blends with old as the charm of the ancient facades in the cobbled Medieval Quarter give way to state-of-the-art architecture like the Gare do Oriente - no wonder Lisbon was nominated European Capital of Culture in 1994. The modernised Baixa district is the place to splash some cash, or in the designer shops of Avenida da Liberdade. To see more of contemporary Lisbon visit Parque das Nacoes, which was built for Expo ‘98, and demonstrates the city’s modern architecture with stylish bars, restaurants, shops, and leisure activities. Lisbon feels very Mediterranean despite being on the Atlantic Sea, and these water breezes cool visitors in the height of summer. The surrounding countryside, mountains, and Lisbon’s two superb beaches - cosmopolitan Cascais and sporty Estoril (under an hour by rail from the centre) offer solitude and relaxation. So why not combine private healthcare treatment with a fantastic holiday in a ground-breaking medical arena, where golfers can choose from many awardwinning courses, and relaxation seekers can locate a plot of sand on one of the Algarve’s 100 miles of Blue Flag beaches?

Fertility treatment abroad

Many factors are encouraging infertile couples to seek fertility treatment in another country. The high cost of infertility treatment, a shortage of donor eggs and donor sperm, restrictions on eligibility and legal issues are some of the reasons why the overseas option becomes attractive.

here are a growing number of destinations for wouldbe parents to consider. But choosing the one that is right for you is not easy. It is not wise to assume that standards and safety will be the same everywhere and it is vital that you thoroughly research how the fertility clinics are regulated in your chosen country.

the national organisation for the country of your choice. Within Europe, the European Society of Human Reproduction and Embryology (ESHRE) works with members to promote higher standards and safety in clinical practice, keeping fertility clinics informed of all the latest research and developments in the field. ESHRE publishes a Good Practice Guide for fertility clinics that treat patients from other countries.

Standards and safety in fertility treatment abroad Clinical standards and your safety are two of the most important factors to consider when thinking about fertility treatment abroad. You need to check out standards and safety both in your chosen country and in the individual fertility clinics. Any reputable fertility clinic should, at the very least, be registered with and/or licensed by their country’s department or ministry of health. You can easily find the details of the relevant ministry of health to verify the status of the fertility clinic you are considering. In some countries, private medicine and fertility treatment are licensed by a separate national government body (such as the Human Fertilisation and Embryology Authority in the UK). Licensing by such bodies will give you the reassurance that fertility clinics achieve certain standards and safety levels and that they are regularly checked and inspected to make sure those standards are maintained. Formal monitoring and licensing also gives you a route for complaints should anything go wrong during your fertility treatment. The national association may act as an independent arbiter between you and your fertility clinic in the event of a dispute. Without such support, you may struggle to pursue a complaint without resorting to expensive legal proceedings. In addition to government-run agencies, many countries have established national federations that work with their fertility clinics to promote high standards and safety in fertility treatment. These are represented by the International Federation of Fertility Societies (IFFS), who will help you find

Choosing a clinic In your initial decision-making process about the type and location of the fertility clinics you want to consider, you may find it useful to follow our general guidelines on comparing fertility clinics. An important part of this process involves deciding whether you will have fertility treatment close to home or whether you will travel abroad for treatment, either for cost reasons, or because you want to combine your treatment with a holiday. You may want to compare different clinics within one particular country, or to look at a range of fertility clinics in different locations abroad that offer the fertility treatments you want. Go with your gut feeling When comparing fertility clinics, your ‘gut feeling’ about a clinic can be as important as the technical or financial details. Feeling positive about a clinic will make your fertility treatment less stressful and easier to cope with – and if you are less stressed, your chances of conception will be maximised. When comparing fertility clinics abroad, speak directly to a member of the team that will be handling your treatment. In particular, you need to find out if there are any cultural or language barriers that may cause problems or that may leave you feeling isolated. You may not be able to visit but you can phone or email a fertility clinic, whether it is 300 or 3,000 miles away. The way the clinic deals with your enquiry will give a good indication of the approach you can expect when you arrive.

Essential checks In addition to comparing clinic credentials, you should also check the qualifications and experience of the specialists and other staff when comparing clinics. Many overseas gynaecologists will have trained in leading hospitals in the UK, USA or Europe and will have verifiable international qualifications. Staff should be happy to tell you about their qualifications and experience, as well as any specialist skills or training they have. Comparing fertility clinics by their success rates The success rates for fertility treatment vary according to the nature of the infertility problem, the procedure used and the age and health of the partners or donors. However, the skills and experience of the specialist and their team will also have an effect, so you should always look at success rates of individual treatments when comparing fertility clinics. Most clinics will publish their success rates for the different treatments they offer. You should always exercise caution when directly comparing fertility clinics on success rates to ensure you are comparing like with like. For example, a fertility clinic that treats only certain conditions, and limits treatment to younger women, will naturally have a higher success rate than one that tackles more challenging problems or serves a wider age range. Always check that the statistics quoted apply to your treatment and your age group. Success rates for fertility treatments are measured in a number of ways, and the more specific the data, the more useful it will be in helping you choose your fertility clinic. Most fertility clinics will have a headline success rate, usually expressed as the number or percentage of live births per fertility treatment cycle. This can then be broken down into success rates for individual treatments, such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI), and success rates for different client groups, such as age ranges or infertility problems. Another available measure of success rates may be that of clinical pregnancies achieved per fertility treatment cycle. This is a measure of the number of women who became pregnant, with a detectable fetal heartbeat. These data, however, do not always accurately represent the success rates for live births, as problems may occur later in the pregnancy. One of the biggest factors affecting success rates of fertility treatments is age. However, it is important to note that this is the age of the eggs, not the mother, so if you are using donor eggs, your own age is less relevant. Success rates will also be affected by the complexity of your infertility problems and the techniques used to overcome them. Fertility clinics that only perform simple treatments on selected age groups will have higher success rates than clinics who take on more challenging patients. Clinics that treat fertile women with donor sperm will have significantly higher success rates, for example, than fertility clinics that specialise in using surgical sperm retrieval techniques to treat male infertility, as there are far fewer obstacles to overcome. Even the most accurately calculated success rates are just a statistical average, and every client is an continued on page 14

Typical costs of IVF treatment abroad The cost of infertility treatment abroad varies widely across the world, from up to £5,000 per IVF cycle in the United States, to as low as £1,600 in the Czech Republic and Latvia. On average, IVF treatment in the major infertility treatment destinations costs between £2,000 to £4,000 per cycle. Typical cost of a single cycle of IVF: Country

GBP

Barbados

£3,800

Czech Republic

£1,180

Greece

£2,025

Hungary

£1,500

India

£2,500

Russia

£2,000

Spain

£3,500

Turkey

£1,875

Ukraine

£2,000

including consultation costs

In addition to this cost, you will normally have to pay for hormonal treatment that is used to promote the production of multiple eggs for in vitro fertilisation. Again, these will vary in price, from as little as £400 in Turkey to over £2,000 in Canada. If you are using donor eggs or sperm this will add extra costs to your treatment. Donor sperm is significantly cheaper than donor eggs, since the process of retrieval is so much simpler and does not require fertility drugs or complex harvesting techniques. Donor sperm can cost as little as £200 whereas donor eggs, including medication and treatment, can add upwards of £1,300 to your bill.

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individual with their own unique characteristics. A success rate of 20%, for example, does not automatically mean that you are guaranteed to get pregnant within five cycles; however it does mean that it is statistically likely that this will happen. You can compare rates on Fertility Treatment Abroad (www.fertilitytreatmentabroad.com) Comparing fertility clinics by their reputation Since fertility treatment is such a personal and emotive procedure, it can be difficult to compare clinics by raw statistics, qualifications and services alone. The experience you have at the clinic can be just as important as the treatment itself, so it is important to ask to see testimonials when comparing fertility clinics. The experiences of other women and couples, in similar situations to your own, can be invaluable in giving you an insight into the way the clinic operates and how they make their clients feel. Naturally, fertility clinics will only show you their positive feedback, but a few minutes’ searching online will soon tell you if there are any negative reviews too. Take a look at the fertility clinic reviews on Medical Tourism Reviews (reviews. treatmentabroad.com) and use forums such as those on Fertility Friends (www.fertilityfriends.co.uk/) and Fertility Zone (www.fertilityzone.co.uk/) to learn from other people’s experiences. Legal and ethical issues Fertility treatment can be a minefield of legal and ethical issues. These vary from country to country, but also by religious beliefs within those countries. Something that is permissible in one country may be banned outright in another. Once you have

decided on which fertility treatment you need, a good first step is to check which countries allow the process you require. Legislation comes into play at almost every stage, from whether you will be allowed fertility treatment in the first place, to how long frozen embryos may be stored following a successful treatment. For example, countries such as Turkey, China and Indonesia will only permit IVF treatment for married couples. Countries such as Spain, Sweden and the USA will allow IVF for single people and homosexual couples. Other legal and ethical issues that are regulated include: • The use of donor sperm and eggs: anonymity is guaranteed in law for donors in Greece, but no longer allowed in the UK. • The use and payment of surrogates: commercial surrogacy is banned in many countries but is completely legal in India. • The in-vitro development period allowed for embryos: in many countries, embryos are allowed to develop for several days to allow selection of the healthiest candidates but in others only early embryos can be implanted. • The selection process for embryos, including sex selection and genetic screening: preimplantation genetic diagnosis (PGD) is banned in some countries but allowed under strict regulations in others. • The maximum number of embryos that can be transferred: many countries have strict single embryo transfer policies, while others will leave the number of embryos implanted up to the discretion of the fertility specialist. • The maximum storage time for frozen embryos: Spain and Canada allow unlimited storage, whereas Brazil has a limit of just three years.

• The use of frozen sperm or embryos after the death of a partner: in Iceland, frozen sperm must be destroyed when the male partner dies, but in Belgium and The Netherlands, it can be retained with written permission for future use in fertility treatment. The cost of infertility treatment abroad The single biggest factor that drives people to seek infertility treatment abroad is the cost. The price of infertility treatment abroad can be less than half the cost of similar treatment in your home country, even when you include the price of flights and accommodation. There are many different aspects to the overall cost of infertility treatment, however, and it is important that you consider all of these when working out the final price and comparing infertility clinics on cost. These include: • Cost of your initial consultation with an infertility specialist. • Cost per cycle of in-vitro fertilisation (IVF). • Cost of donor sperm or donor eggs for use in IVF. • Cost of fertility drugs and hormone treatments required. • Cost of specialist infertility treatments such as intracytoplasmic sperm injection (ICSI). • Cost of frozen embryo storage for future frozen embryo transfer cycles. You will also need to include the additional costs of travelling abroad, such as: • Flights and internal transfers. • Specialist travel and infertility treatment insurance. • Accommodation. • Visas and other expenses.

HELPA means HEALTHCARE

mEDiCAL TEsTs

Destination Destination Cyprus Cyprus • Cosmetic Surgery CosmETiC suRgERy D E n TA L T R E AT m E n T s

• Dental Treatments • Hair Transplantation • Eye Surgery

H A i R T R A n s P L A n TAT i o n EyE suRgERy H EL PA C H EC k u P

Trust & reliability for over 100 years... HELPA HealthCare NICOS ROSSOS LTD

Specimen business letters of our family tradition dating back to the 1850’s.

Search... Compare... Enquire... Your online fertility travel guide

Fertility Treatment Abroad gives you what you need to make the right choice of infertility clinic. Explore leading infertility clinics in 80 countries. Find out what’s available, the costs, the success rates and get in touch with your selected clinics.

Please contact Nicos Rossos Ltd Your friend Constantia Klitou 3 Ioannis Polemis Street, 3021 Limassol, Cyprus Tel: +357 25 335073, x: +357 25 3 83739 Visit www.helpahealthcare.com forFamore information Email: reception@nicosrossos.com or call: +357 2533 6092 Web: www.helpahealthcare.com

Considering cosmetic surgery abroad?

Making the right choice of clinic or surgeon for cosmetic surgery abroad involves asking questions. Lots of them! The responses you receive will help you to make the right decision. If you’re not happy with the answers or the clinic avoids answering the questions below, go somewhere else. We have put together a checklist of questions to ask any clinic that is on your shortlist. The surgeon • Can you provide a detailed profile of the surgeon’s background and experience? • What qualifications does the surgeon hold? Where and when did he or she train? • To which national and international associations for plastic and cosmetic surgeons does the surgeon belong? • What papers on cosmetic surgery has the surgeon published in respected medical journals? • What is the level of fluency in English of the surgeon? • Does the surgeon have any videos available online, so that I can see what he/she is like? • Can I speak to the surgeon on the telephone or via a Skype video link? The clinic or hospital • What national or international accreditations does the clinic/hospital hold to allow it to operate as a clinic or hospital? • Will I or my primary care physician receive a report on the surgery in the appropriate language? • What is the level of fluency in English of the nurses and support staff? • What is the post-operative infection rate at your clinic/hospital? Quality and track record • How many operations of this specific type does the surgeon (and/or the clinic) carry out each year? (The best cosmetic surgeons specialise in specific areas of cosmetic surgery. So, if you are going abroad for breast enlargement, you want a surgeon who does lots of these). • What information can you provide regarding the surgeon’s or clinic’s success rates? • What information can you provide about complication rates such as postoperative infection? • Can I speak to any past patients from my country to find out about their experience of your clinic? • Can you provide me with any information on patient satisfaction levels at your clinic or hospital?

The operation • Do you have any advice sheets or literature available about the operation? • How long will the operation take? • Will I need to stay overnight or for several days in the clinic/hospital? • What pre-surgery checks are required? Are these included in the price of the surgery? • What post-surgery care is required? • How long does the clinic recommend staying abroad, before flying home? • What are the risks and complications associated with my operation? • How likely are these complications? If something goes wrong • What back up medical facilities are available, if something goes wrong during the operation and I become seriously ill? • What insurance does the clinic or the surgeon hold to cover malpractice or errors? Which company is it with and what is the level of cover? • If a complication arises during my surgery, which needs further treatment, is this covered in the price? • What kind of treatment guarantee do you provide? Pricing and payment arrangements • What is the total cost of the surgery, including all checks, aftercare, anaesthetics, drugs, nursing care, surgeon’s fees and clinic accommodation? • What do I have to pay up front? What payment methods do you accept? • What is not included in the price? • What happens if something goes wrong (e.g. a post operative infection, a ruptured implant) and I need further treatment or another operation, after I have returned home? Who pays for this? The implants (for breast enlargement patients) • For breast enlargement, which implants does the surgeon use? • Can you provide information on the rupture rate with this type of implant? • Do you have a choice of implant? • Does the cost vary depending on the type of implant that I choose?

The Dubai Health Experience Dubai is the fourth most visited city, one of the most popular tourism destinations in the world and is emerging as a strong global medical tourism destination.

uided by an ambitious initiative of His Highness Sheikh Hamdan Bin Mohammad Bin Rashid Al Maktoum, Crown Prince of Dubai and Chairman of The Executive Council of Dubai, medical tourism is playing a significant role in boosting Dubai’s economy, by attracting visitors from across the globe. Dubai aims to attract more than 500,000 medical tourists by 2021. Dubai generated over Dh1.4 billion from the medical tourism sector, with around 326,649 tourists visiting the Emirate last year. DXH Group DXH Group is a consortium of healthcare facilities within the Emirate of Dubai that are recognized and evaluated by Dubai Health Authority to promote comprehensive and competitive healthcare packages for in-bound medical tourists through the DXH Website/Mobile App. The group currently comprises of 45 healthcare providers offering a wide range of comprehensive healthcare services such as Orthopedics, Ophthalmology, Assisted Reproductive Techniques, Cosmetology, Dermatology, Bariatric and weight-loss surgeries, Dental care and wellness. Dubai Health Experience - www.dxh.ae Formulating Dubai’s health tourism strategy, Dubai Health Authority (DHA) has established the world’s first comprehensive electronic health tourism portal, www.DXH.ae. This provides medical tourists with access to premier accredited healthcare facilities, excellent medical experts, travel, hospitality, insurance and visa services at the click of a button in the iconic Emirate of Dubai. Medical tourists can compare and choose from over 400 healthcare packages designed to meet individual needs and aspirations.

accommodation and treatment. The policy is made available at the time of booking at a nominal cost of USD40.

What makes Dubai a global medical tourism destination? Dubai has around 3,000 private health facilities ranging from hospitals and specialised clinics to day surgery centers, with around 35,000 health specialists from over 110 different nationalities who speak the medical tourist’s language. These numbers are expected to grow to 40,000 specialists and 4,000 health centers by 2020. Dubai has a strong world class infrastructure, including internationally accredited healthcare institutions, modern and iconic tourist attractions, shopping malls and cultural and entertainment destinations and activities that attract tourists from around the world. Dubai also has some of the finest and most luxurious hotels in the world that are committed to meeting the demands of medical tourists by combining leisure activities with world-class treatments. The Emirate is also home to a world-class transportation network - including the metro, tram, buses and taxis - that enables visitors to commute conveniently across the city.

Health Bank In collaboration with Health bank, a global health management company Dubai health experience offers tourist seeking healthcare in Dubai a single point of contact for research and assistance, electronic consolidation of individual health record portfolio, 24/7 medical helpline, travel assistance , logistics and assistance in evaluating and understanding insurance options. By combining the services of Health bank with the health packages available on DXH.ae, medical tourist can get personalized assistance in planning and facilitating their trip along with continuity of care, from pre-arrival to post-departure. Wellness in Dubai The whole idea about getting away on a wellness holiday is to break your normal routine and enter a fresh space where you can realign what you want for your mind, body and life. Dubai offers an array of state of the art wellness program opportunities that combine annual health checkups, exercise, nutritional advice, outdoor activities and excursions that suit your lifestyle. The city offers the best healthcare and hospitality with luxury accommodation along with an expert health and lifestyle advice.

Comprehensive health insurance for Dubai’s medical tourists Dubai health Authority has a patient centric strategy for medical tourism where the patient’s interest is at its heart, Dubai launched the comprehensive Patient protection plan that includes an electronic medical complaint system, travel insurance plan designed for medical tourist and The Charter of patients’ rights and responsibilities. This extended travel insurance covers unforeseen complications that may arise from any treatment that is received in Dubai within 30 days of leaving the country. The insurance includes emergency medical expenses up to $50,000 including tickets,

DXH Mobile App The mobile app is known as DXH (which stands for Dubai Health Experience) is available on both Android and Apple stores and allows medical tourists from any part of the world access to information about hospitals and clinics, doctors and DXH medical packages at any time to start planning their journey to Dubai.

YOUR JOURNEY AS A MEDICAL TOURIST Verify your choice

from the members of the DXH group

Find your desired medical treatment available in Dubai through the DXH website

Search for the ideal doctor/healthcare facility/package on the DXH website

Contact the healthcare facility in Dubai and share your medical records with them

02 You arrive at the Dubai International Airport

DXH website by looking up the visa requirements (if needed) and booking: a. Tickets b. Stay at your preferred hotel c. Optional Marhaba pick-up service on arrival

fly to Dubai

treatment and cost

Plan your trip to Dubai through the

Prepare for the trip and

The healthcare facility advises you on the

05 Book an appointment.

You can choose to purchase travel insurance scheme to cover major travel risks and complications of eligible medical condition. This can be purchased from your HCF at the time of booking.

VISA

Meet your doctor

HOTEL

Check into your hotel and use the DXH website/app to confirm your appointment with the doctor

You receive medical advice for

and proceed with your treatment

follow-up and recuperation

either during your stay in Dubai or back at home. You can also read the Charter of Patient Rights and Responsibilities on the DXH website.

Dubai experience

Enjoy the

- explore the city and the various leisure and entertainment activities on offer

Return home satisfied with your treatment and your pleasant, bespoke experience in Dubai. In case of any complications, you can always file an e-complaint through the Patient Complaint Procedure on the DXH website.

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What if something goes wrong? All operations carry some risk and while most medical, dental, or cosmetic procedures go to plan, it is sensible to reduce your risks as far as possible.

If you are travelling to another country for treatment or an operation, you should consider purchasing specialist travel insurance cover.

To help things go to plan with your treatment, there are a number of simple measures you can take. These include: • Follow instructions from your surgeon about stopping medication (and smoking) for the appropriate period before you travel for surgery. • Plan for a suitable recovery period both while abroad and when you get home. Don’t risk your health in the rush to see the sights. • Allow some flexibility to your schedule, and your budget, just in case. You cannot always anticipate how you will feel about flying home having had surgery. • Know what to expect so that you understand what is normal and what is a sign that something is wrong. Your clinic should give you detailed aftercare instructions. • Buy complications insurance.

Problems while you are away Immediate post-op problems will usually be solved during your stay in the hospital or clinic. However, it is a very good idea to let your GP at home know that you are travelling abroad for treatment so that they can monitor your progress when you return.

Problems on your return If problems occur once you are back in the UK you should get in touch with the surgeon or clinic straight away and follow their advice. Some clinics have links with UK private healthcare providers and will tell you where to go for assistance or further treatment. If your clinic has no UK representatives, then you should visit your GP, or if you are having serious problems go to the Accident and Emergency department of your local hospital. After cosmetic surgery procedures you are more likely to deal with UK medical specialists post-op. Some medical tourism

providers include ongoing consultation with a UK specialist on your return to check that you are successfully healing and address any concerns you may have.

Buy medical travel insurance Insurance for medical travellers is a developing area within medical tourism. New medical travel insurance products have begun to appear, aimed at UK based medical travellers. Products may be available from the medical tourism agency or hospital that you

book with. Some medical tourism agencies and hospitals offer their own cost-over run insurance. If you are travelling to another country for treatment or an operation, you should consider purchasing specialist travel insurance cover. Treatment Abroad provides key information on medical travel insurance products offered to consumers seeking to insure their travel for treatment abroad at www.treatmentabroad.com/services/medicaltravel-insurance/

Checking out the clinic or hospital

It is important to make sure that your chosen hospital or clinic is formally regulated and inspected by the relevant authorities of their country – usually the government health ministry. If in doubt, check with the regulatory body to confirm the clinic’s status.

n the UK, the assessment of private clinics is the responsibility of the Care Quality Commission. Similar bodies will exist in your chosen country and they should be able to confirm your chosen clinic’s registration and the results of any recent inspections, as well as whether there have been any problems or complaints associated with the clinic.

Questions to ask a clinic or hospital • • • • • • •

Will the operation take place in a private hospital or at the doctor’s clinic? What are the back-up facilities in case of an emergency? What are their success rates? Do they have any clinical outcome data? What are their post-operative infection rates? What is the rate of unplanned readmissions after elective surgery? How long do patients usually stay in hospital? What happens on the first day after surgery — what aftercare and rehabilitation is provided?

•

Can they provide patient testimonials, or can you speak to past patients?

Inspection reports and references The best clinics will be proud to give you access to inspection reports and formal assessments, as they have nothing to hide. You will often find this kind of information on the clinic website, but you should always double check these claims for complete peace of mind. The clinic should also provide access to references from previous patients, or better still, put you in touch with satisfied customers that you can talk to directly. If your chosen clinic is unable or unwilling to share such information, you should move on to one that will.

How to compare different providers Once you have decided on your procedure and selected your country, it is time to compare the different providers within that market. You will often find a number of different providers within the country or city of your choice, with certain centres specialising in different fields, such as Budapest or Warsaw for

Hints and Tips

You can download one of our Hints and Tips guides for specific types of clinic: • Questions to ask a dental clinic abroad: www.treatmentabroad.com/cosmetic-dentistry-abroad/resources • Questions to ask a fertility clinic abroad: www.treatmentabroad.com/infertility-treatment-abroad/resources • Questions to ask a cosmetic surgery clinic abroad: www.treatmentabroad.com/cosmetic-abroad/resources

cosmetic dentistry, Spain for fertility treatment, or South Africa and South America for cosmetic surgery work. You can compare different providers within the same country using a number of practical criteria: • Price of the treatment • Reputation of the surgeons • Facilities of the clinic • Length of stay policy • Results of independent inspections and reports • Infection rates and return to theatre rates • Convenience (such as all-inclusive packages) • Feedback from previous patients • Personal comparisons While practical matters are important, you should not neglect your own gut instinct and feeling about a place. The way that they deal with your enquiry and their willingness to answer all your questions will tell you a great deal about the clinic and the treatment experience you will get there. If you have any reservations, or feel unsure about a clinic for any reason, then move on to the next one. Treatment abroad may be cheaper, but it will still cost a significant amount of money, so you need to choose somewhere that you trust and have confidence in. If any clinic tries hard sell techniques, move on straight away. Remember, the results of your procedure, whether it’s cosmetic dentistry or a nose job, will be with you for the rest of your life, so you need to do as much research as possible and be as sure as you can be about your choice.

Internationally competitive

Hea h Europe’s he ng gard

ou will find Kvarner where the mighty mountain meets the clear sea, attractive coast and islands, and where the air is enriched with therapeutic salt particles, and the climate is pleasant all year long. That area in the northern Adriatic has been attracting aristocracy from Vienna and Budapest since the 19th century for vacations, but also for medical treatments. The logical continuation of the long tradition of health tourism in the area was establishing the Kvarner Cluster of Health Tourism called Kvarner Health, the main promotor of health tourism in the area. Established in 2014, the cluster currently gathers 29 members, both public and private institutions from three different segments - health, tourism, and science and education, which makes it unique, not only in

Croatia, but also in Europe. Its goal is clear - to promote, develop, and advance services offered in health tourism in the region that Croatia, in its strategic documents, has called a key area in positioning the country as a renowned health tourism destination. In line with that, the main mission of the cluster is to offer superb health tourism services, based on modern trends and traditions, all year long and at affordable prices. Kvarner Region Tourism Board is one of the founders of the Kvarner Health Tourism Cluster. Opatija Tourist Board, in line with the long tradition of health tourism, is also a great support to this project as well as Rijeka Tourist Board, Crikvenica Tourist Board and Mali Lošinj Tourist board.

Wellness centers, located mostly in high-category hotels, are the dominant form of health tourism in that area. Hotels, and cluster members, which offer such services are Jadran Hotels, Lošinj Hotels&Villas and Milenij Hotels. Besides modern equipment and educated staff, the centers in Kvarner also offer an internationally competitive wellness offer, especially for medical wellness. Anti-stress and vital programs, massages, but also thalassotherapy (a treatment method with sea water and air), which was created in the 19th century by physician Claude La Bonnardiére, are all a part of the health & wellness offer in Kvarner. The pinnacle of the health and tourism offer in Kvarner are two special hospitals for medical rehabilitation - Thalassotherapia Opatija, with the modern Thalasso Wellness Center, which follows medical wellness trends, and Thalassotherapia Crikvenica. The Veli Lošinj Health Resort is famous for treating respiratory paths, asthma, and psoriasis, while the leading private health care provider in the region is the Special Hospital Medico, with outpatient services. The Terme Selce Polyclinic, where patients from six continents were treated, also gained global fame, and

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120 World and Olympic champions also received superb treatment there. The Special Hospital Dr. Nemec, specialized in treating injuries and ailments of the locomotor system, also has a great reputation. The Dr. Jelušić Dental Polyclinic and Smile Polyclinic from Opatija, Rident Polyclinic, which offers dental and tourism services in Rijeka and Poreč, as well as the Orto Nova Center for Dental Medicine in Rijeka, and Kalamar Implant Dentistry, which works in Rijeka and Dramalj, are all an important part of the dental offer in Kvarner. Public institutions also play an important role in the health and tourism story: the Clinical Hospital Center in Rijeka, the largest health care institution in the region, the Emergency Medical Institute of the Kvarner County, the Community Health Center of the Kvarner County, and the Teaching Institute for Public Health, while the Interdial Polyclinic for hemodialysis from Opatija also joined the cluster. Tour operator Mediteran Adria, better known as MedAdria, and Travelana travel agency take care of organizing accommodations in Kvarner. Other members of the cluster are the tourist boards of the Kvarner County and Opatija and the School of Medicine in Rijeka, Faculty of Tourism and Hospitality Management in Opatija, and the Wellness Academy in Lovran.

Health services:

Physical examinations, preventive examinations,diagnostics, check-ups, surgeries, rehabilitation • • • • • • • • • • • • • • • • • • • •

Aesthetic surgery Anaesthesiology Dermatology and venereology Endocrinology Physical therapy and rehabilitation Gastroenterology Gynaecology and obstetrics Haematology Cardiology Surgery (general and aesthetic) Nephrology Neurology Medical-biochemical laboratory Ophthalmology Orthopaedics Otorhinolaryngology Pulmonology Radiology Urology Hemodialysis

Dental medicine: • • • • •

Oral surgery and implantology Dental prosthetics Conservation Parodontology Smile design

Our region has a rich natural, cultural and historical heritage, a unique gastronomic offer and top equipped tourist and medical institutions to make your stay as enjoyable as possible, but the best way to expirience it is to come and see for yourself.

info@kvarnerhealth.hr www.kvarnerhealth.hr

Checking out the surgeon or dentist Putting your health in the hands of a medical practitioner in another country may seem like a daunting prospect, but every country will have its own standards and safeguards. You should check the qualifications and credentials of any doctor or dentist before you book with them.

his means doing your research. Firstly you should seek out the licensing, accreditations and professional associations that exist in your chosen country. For example, in the UK, we have the General Medical Council (GMC), the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) the General Dental Council (GDC) and the British Academy of Cosmetic Dentistry (BACD). You can find out the equivalent bodies in your chosen country by consulting the country specific pages at www.treatmentabroad.com. Your chosen doctor or dentist should be happy to show you their credentials, and you should be able to independently verify these with the national body. If they are unwilling to prove their qualifications, licences or memberships, you should move on to another practitioner who will. Look for professional memberships Often, surgeons and dentists working abroad will have trained and qualified in the UK, and will be listed as members of the appropriate UK associations, such as the GMC or BAPRAS.

Others may hold international memberships, such as the International Society of Aesthetic Plastic Surgery (ISAPS) or the European Association of Plastic Surgeons (EURAPS). Cosmetic surgeons trained in the USA may be members of the American Society of Plastic Surgeons (ASPS). While qualifications, registrations and association memberships do not guarantee the skill of your surgeon or dentist or the quality of their work, they do confirm a commitment to national and international standards and practices. You may only need to check out the qualifications and credentials of the main dentist, surgeon or consultant: high quality professionals will usually only work with good anaesthetists and staff in clean, safe, wellequipped clinics. Questions to ask a surgeon or dentist Wherever you are planning to have treatment, it is important that you understand your procedure in detail so that you know what to expect. You need to feel confident in the clinic and surgeon who will be treating you, so ask as many questions as you need to. Any high quality clinic will be pleased to help put your mind at rest. One question to ask is if initial consultations and follow up care can be provided in the UK. Some doctors come to the UK periodically to visit patients, while others have links with UK based clinics who will undertake consultations and aftercare.

Make sure that you meet your surgeon before the operation takes place. You may be in your destination by then, but you must have the chance to talk to them in advance to ask any questions you may have. It helps to write your questions down so that you don’t forget to ask anything on the day.

Don’t forget to ask •

What professional memberships, training and qualifications do they hold?

•

How can these be independently verified?

•

How often have the surgeon and anaesthetist worked together before?

•

How often do they perform this procedure?

•

Will the anaesthetist perform a pre-op and a post-op evaluation?

•

How much recovery time does the procedure entail?

•

How long will you be hospitalised?

•

Do they recommend that you are accompanied by a companion?

•

How soon after the operation can you fly home?

Comparing providers…. comparing costs How to compare different providers

Comparing costs

Once you have decided on the treatment you need and selected your country, it is time to compare the different providers within that destination. You will often find a variety of providers within the country or city of your choice, with certain centres specialising in different fields, such as Budapest for dentistry, Spain for fertility treatment, or Belgium for cosmetic surgery.

Low treatment costs are the main reason that most people travel abroad for treatment. With prices in some countries as low as 20% of the cost of treatment in the UK, there are significant savings to be made. However, you need to be careful to factor in all of the costs of your trip when making a comparison.

Criteria for comparison You can compare different providers within the same destination using a number of criteria: • Price of the treatment. • Qualifications and reputation of the surgeons/dentists. • Facilities provided by the clinic. • Results of independent inspections and reports. • Clinical outcome data, infection rates and return to theatre rates. • Support services for international patients, provided during your stay. • Clarity on what you pay and when. • Feedback and testimonials from previous patients…. On patient forums, social media and review sites such as Medical Tourism Reviews (http://reviews.treatmentabroad.com).

Factor in the additional costs The full cost of your treatment overseas not only includes the cost of the treatment or operation, but also the other expenses related to your trip, including: • Flights and airport transfers. • Hotel accommodation and meals for you and a companion. • Insurance: standard travel insurance policies will not cover you when you travel for treatment overseas. You will need to purchase specialist medical travel insurance. You may also wish to consider buying specialist insurance to cover any complications that may arise from your surgery. Remember, if you decide to take a companion along many of these costs will double. You also need to factor in the same costs for repeat visits for further treatment if required.

Keeping flight costs down One advantage of treatment within Europe is the availability of low cost flights from budget operators such as Ryanair and easyJet. If you book well in advance, and can be flexible on your travel dates, you can often find flights to Europe for as little as £25 - £50 using comparison sites such as SkyScanner and Kayak. If you can book early and be flexible, you also significantly reduce the cost of long haul flights.

Gut instinct While practical matters are important, you should not neglect your own gut instinct and feeling about a place. The way that they deal with your initial enquiry and their willingness to answer all your questions, will tell you a great deal about the clinic and the treatment experience. If you have any reservations, or feel unsure about a clinic for any reason, then move on to the next one. Treatment abroad may be cheaper, but it will still cost a significant amount of money, so you need to choose somewhere that you trust and have confidence in. If any clinic adopts a “hard sell” approach, move on straight away. Remember, the results of your procedure, whether it’s cosmetic dentistry or a hip operation, will be with you for the rest of your life, so you need to do as much research as possible and be as sure as you can be about your choice.

Local cost of the stay The cost of accommodation, meals and transport can soon add up, so the local cost of living is an important factor. Hotel comparison websites will give you a good idea of local accommodation rates, while guides such as Lonely Planet will give you an idea of other local prices. While you may pay far more to get to India, local costs are much less than they are in Europe. Combine this with the low treatment prices and it could work out cheaper overall to have surgery in Mumbai than in Madrid.

Using a medical tourism facilitator or agency A medical tourism facilitator or agent will provide a complete package, including all the different elements listed above, making it much easier to directly compare total treatment costs. Despite the work that they do on your behalf, it may actually work out cheaper to use a facilitator than to arrange the package yourself, as they may have access to bulk deals and prices that are not available to the general public. Some facilitators will provide a complete package for an all-inclusive price, including airport transfers, accommodation and sightseeing trips.

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hiladelphia, the birthplace of American freedom, is known as a city of firsts, including the first American hospital. Philadelphia continues to lead the way in medical innovation, high-quality patient care and physician training. Home of the famous Independence Hall, Philadelphia is also home to many of the top hospitals, medical schools and research institutions in the world. You can access the medical excellence of Philadelphia with one-stop ease by becoming a patient through Philadelphia International Medicine (www.philadelphiamedicine.com), a network of academic medical centers, specialty hospitals and an impressive line-up of doctors. Philadelphia International Medicine has a track record of providing positive outcomes to thousands of patients, who travel from around the globe for the very best medical and surgical care. Cardiology, cardiothoracic surgery, orthopedics, neurology, eye care and cancer therapy are just a few of the many services offered. Each patient receives a personalised care plan and a care manager who tends to every detail to make sure the process is thorough and efficient, from scheduling to arrival to completion of

treatment. Our staff will nurture your well-being in a private, comfortable environment removed from the everyday demands and familiarities of life. Philadelphia International Medicine includes these centers of excellence: • Fox Chase Cancer Center - Designated as a Comprehensive Cancer Center by the National Cancer Institute. Expertise in radiation oncology, immunotherapy and genetics, cancers of the skin, women’s cancers and cancers of the lung, prostate, colon and blood. Fox Chase is also a center for cancer prevention. • Temple University Hospital - A leader in robotic surgery, cardiac care and surgery, organ transplants, lung care, emergency and trauma services and burn treatment. • Thomas Jefferson University Hospital Experts in neurology, oncology, orthopedics, hepatitis and other liver diseases and gastrointestinal (GI) disorders. Jefferson is also a center for liver and kidney transplants. • Will’s Eye Hospital - Ranked by U. S. News & World Report as one of the top two U.S. hospitals for clinical care, research and training in eye health. • The Rothman Institute - Internationally recognised orthopedics program offering advanced treatment methods and technologies. Sports medicine and joint replacement among its specialties. • Vincera Institute - Medical specialty center dedicated to core medicine, including

hip and pelvic pain in athletes. Vincera also specializes in the treatment of severe, chronic pain. • Magee Rehabilitation Hospital - Experts in treating spinal cord injury, brain injury and stroke. Cardiac and oncology rehabilitation services also offered. • The Renfrew Center - World-renowned center for treating women with eating disorders, including anorexia, bulimia and binge eating, and related behavioral health issues. Prevention is another key focus at Philadelphia International Medicine. You can choose to undergo a Personal Health Evaluation, a comprehensive package of services to measure your risk for heart disease, diabetes, cancer and other illnesses. You’ll gain insight into your health status and a plan for staying vital going forward. Philadelphia International Medicine should be your first choice for meeting your medical needs. While your priority will be on getting better and staying well, you will have the added bonus of discovering a city rich in history, culture, parks, restaurants and charming neighborhoods. U.S. News ranks Philadelphia as the second best city to visit in the USA. More details on Philadelphia International Medicine can be found at www. philadelphiamedicine.com. You can also get more information or schedule an appointment by calling 215-563-4473 or sending an email to physicians@philadelphiamedicine.com.

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Need complex care? Put Philadelphia first. Discover the advantages of getting your medical care in Philadelphia:  Access to leading physicians and surgeons  Personalized care plan and medical coordinator  A welcoming world heritage city

THE ONE SOURCE: Connecting patients and doctors around the globe to Philadelphia’s family of worldrenowned doctors, surgeons and hospitals.

To schedule an appointment or to learn more: www.philadelphiamedicine.com physicians@philadelphiamedicine.com +1-215-563-4733

Medical travel insurance – an overview

f you take out standard travel insurance (or use your annual multi-trip insurance) and the purpose of your trip is for some form of treatment or operation, then the travel insurer may refuse your claim, even if it is related to something non-medical such as the loss of your luggage. No travel insurance policy will cover the cost of planned treatment. Medical travel insurance is simply normal travel insurance designed for medical travellers. Many policies of all types may suggest they have worldwide cover, but that is almost always only for emergency medical treatment; it does not cover you for choosing to go overseas for treatment.

Legal aspects of medical travel insurance Insurance is a complex issue and subject to many laws, regulations and limitations. Insurance laws can depend on which country you live in, the country where treatment is taking place, and the country where the agency resides. Medical travel breaks country boundaries, and this can mean that different country regulations clash and are contradictory. The recent increase in medical travel is not something that laws or insurance regulations had in mind, so there is no case law that settles uncertainties. In some countries and states, there are rules on who can sell insurance, and this can

be complex. In others it is a “let the buyer beware” situation with little regulation on insurers or insurance sellers.

Are you covered for treatment abroad by your existing health insurance scheme? The vast majority of health insurance schemes do not allow treatment outside the country in which you are a subscriber. • The handful of private medical insurances that do allow treatment outside the home country rarely cover dental, cosmetic or lots of other treatments that people go overseas for. • Most travel insurance policies now have exclusions on going overseas for treatment. • Medical negligence policies only cover hospitals not the customer, but a special new policy has been launched. • International insurance policies are designed for people who are expatriates those working or living outside the UK,

not for UK residents. • International insurance policies only provide very limited cover for travelling between countries for treatment. • Cost over-run policies are available, but rare; and many are just uninsured guarantees. • Very few dental insurance policies cover non-emergency treatment outside the UK. • Policies will not pay your travel costs. There are some specialist medical travel insurance policies designed for the medical tourist.

Existing medical conditions and travel insurance If you are thinking of overseas treatment, this is often for an existing problem that you have. Many off-the-shelf travel insurance policies exclude pre-existing conditions and existing problems, so always check before travelling.

A few basic checks before buying a medical travel policy •

Does the insurance apply to the country you live in?

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Does the insurance apply to the country you are travelling to for treatment?

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Does the insurance apply to the hospital or surgery you are being treated in?

•

Never buy insurance if the person selling it refuses to provide details of who the insurers are, the price, what is covered, and what is not covered.

Working out the cost of treatment abroad

ow treatment costs are the main reason that most people travel abroad for treatment. With prices as low as 20% of the cost of treatment in the UK, there are significant savings to be made. However, you need to be careful to include all the costs of your trip when making a comparison. The full cost of your treatment overseas not only includes the cost of the treatment or operation, but also all of the other costs of your trip, including: • Flights and transfers • Hotel accommodation and meals • Insurance* *Standard travel insurance will not cover you for treatment overseas and so you will need to pay extra for specialist healthcare tourism insurance. The actual cost of treatment varies widely across the world, depending on the local economy. In developing countries, such as India, or emerging Eastern European states, the cost of living is still

very low. Clinics have lower operating costs and pay lower salaries than their Western European counterparts, which means they can charge less for private treatment.

Know what you’re paying for When shopping around, it is important to know what is included in any treatment costs quoted, as a low headline price can soon climb if extras are added. Always ask for an all-inclusive price and make sure that you understand what exactly is included. Set prices vary from provider to provider but they typically include surgeon fees, hospital fees, medical team, hospital meals, laboratory tests, anaesthesia, implants (if required), all consultations, transfers and take home medication. You should be clear who pays for what if something goes wrong. Will the clinic cover just the cost of further treatment, or will they pay your additional hotel and living expenses?

Using a medical tourism agency or facilitator A medical tourism broker or agent will provide

a complete package, including all the different elements listed, making it much easier to directly compare total treatment costs. Despite the work that they do on your behalf, it may actually work out cheaper to use a broker than to arrange the package yourself, as brokers have access to bulk deals and prices that are not available to the general public. Some brokers will provide a complete package for an all inclusive price, including airport transfers, accommodation and sightseeing trips.

Typical prices for treatment abroad The best prices for different treatments are often found in different locations. No single country has the best prices across the board. For example: • A single cycle of fertility treatment can cost over £4,000 in the UK, but as little as £1,500 in Hungary. • Rhinoplasty (a nose job) typically costs around £3,800 in the UK but just £1,200 in Poland. • Dental implants can cost over £2,000 in the UK but can be found using the same high quality materials in Eastern Europe for £500.

Featured clinics

We take a look at some of the leading clinics across Europe. Prices are highly competitive and can be considerably lower than those found at home, allowing any treatment to be combined with a relaxing and recuperative holiday in the destination of choice. These clinics are experienced in treating overseas patients, providing support with arrangements such as accommodation. Some are also able to offer initial consultation and follow-up appointments in the UK. Visit their website or give them a call to find out what they have to offer.

Medimall IVF center Budapest Medical Services www.budapestmedical.eu medical@budapestmedical.eu +36203258747 Telki, Hungary Budapest Medical Services is a private healthcare provider owned and operated by doctors. They offer surgery and hospital treatment from top specialists in a world-class healthcare system. Treatments available include all types of orthopaedic surgery, spinal surgery, general surgery (specialising in the treatment of abdominal, proctologic and endocrinological disorders), urology and gynaecology.The specialists at Budapest Medical Services offer a rapid evaluation of your needs, for which they can provide direct medical treatment. Being a private healthcare provider they deliver treatments that reduce or avoid normal waiting lists; for example, they can provide hip or knee replacements within a timescale as short as two weeks. The team at Budapest Medical Services offers personalised support throughout your treatment period: • Translation services • Travel and accommodation advice • Administrative services • Medical and moral support What can I expect from Budapest Medical Services? • Top specialists – hand-picked and renowned in their fields • Outstanding medical facilities – state-of-the-art equipment, stringent safety standards • Highly personalised service – end-to-end service and support, from initial enquiry to aftercare at home • A comprehensive treatment plan – efficient, costeffective and comfortable Treatments available at Budapest Medical Services • Orthopaedic surgery • Spinal surgery • General surgery • Urology • Gynaecology Contact Budapest Medical Services and within a few days you will receive a detailed proposition including prices, with • Hospital treatment and outpatient care information • Travel and accommodation recommendations

www.medimall.gr | info@medimall.gr | +30-210-7711600 Athens, Greece Medimall IVF center is located in Athens. Greece is considered one of the friendliest countries in the world in matters of IVF, Egg Donation and Surrogacy. Medimall is equipped with state-of-the-art technology and by constantly evolving its services, became one of the leading clinics in Europe in the field of reproductive medicine. Medimall is ISO 9001:2008 certified and licensed by the Greek National Authority for Medical Assisted Reproduction as an IVF clinic and cryopreservation bank. A highly experienced medical team will guide you through the fertility treatment process. The medical team has been thoroughly selected in accordance to high standards in order to provide optimal services to patients. Medimall offers IUI, IVF, Egg and Embryo Donation and Surrogacy services and a “Money Back Guarantee” scheme for IVF and Egg Donation, all with high success rates. Medimall visitors receive personalized treatment with no waiting list. They are provided with all the necessary information in a simplified, clear, and understandable manner. Dr. Xydias is the head of the IVF team. He received his medical degree in 1987 and became a certified Obstetrician - Surgeon – Gynecologist in 1996. He was a Research Fellow at Harris Birthright Research Center of King’s College Hospital in 1993. For 7 years he worked in the IVF department of the biggest maternity hospitals in Greece. He was the Director of Diagnosis IVF clinic from 2003 to 2007 before taking on the role of the Director at Medimall IVF. The senior embryologist of Medimall is ESHRE accredited and has 23 years of experience.

Wu Medical Center www.wumedicalcenter.com | inquiry@wumedicalcenter.com | +86108361-4932/4168 Beijing, China Wu Medical Center (WMC), located in the city of Beijing, China, is a medical organization offering leading stem cell therapies to treat numerous degenerative neurological diseases and disorders including Parkinson’s disease, Post-stroke, ALS, MS, MSA, SCI, Brain injuries, Batten’s disease, SMA and Eye diseases including optic nerve hypoplasia, optic nerve injuries, retinal pigment degeneration and macular degeneration that conventional medicine can’t do much for. WMC provides the safest and most effective individualized treatment program with our highly experienced medical team, advanced technology and world-class medical care. Since 2005, using neural and mesenchymal stem cells WMC has effectively treated thousands of these patients from all over the world with an excellent track record. Some of these cases were reported by well-known international news agencies such as the Washington Post, BBC and CNN, etc. We look forward to serving you.

Malaysia Healthcare Travel Council (MHTC) www.medicaltourism.com.my | callcentre@mhtc.org.my | + 603 2726 8688 Kuala Lumpur, Malaysia The Malaysia Healthcare Travel Council (MHTC) was established in 2009 as a dedicated, fully government-funded body to promote Malaysia as a leading global healthcare destination. MHTC facilitates collaboration between key public and private sector stakeholders such as governments, insurance companies, airlines, travel agents, health facilitators and the likes in further emerging and sustaining this industry. In unearthing Malaysia as the hidden gem in healthcare travel, MHTC acts as an enabler amongst industry patrons’ in promoting to the world on Malaysia’s offerings within this industry via various conduits both from the local and international arena. Private hospitals in Malaysia offer expertise in medical fields such as cardiology, oncology, orthopaedics, dental, in-vitro fertilisation, ophthalmology and neurology. Some medical facilities have attained accreditations such as the Joint Commission International (JCI), Malaysian Society for Quality in Health (MSQH) and the Australian Council on Healthcare Standards (ACHS) to advocate continuous quality improvement and safety in the arena of Malaysian healthcare. Malaysia is unique in that the government strongly supports the medical tourism initiatives and differentiates itself by offering patients hospitable end-toend quality care from the time a patient explores Malaysia as a healthcare destination, right through to post-operative recovery. MHTC was recently awarded International Medical Travel Journal’s (IMTJ) “Health and Medical Tourism: Cluster of the Year” at the Medical Travel Awards 2017.

Thanyapura Health & Sports Resort www.thanyapura.com | info@thanyapura.com | +66 (0)76 336 000 Phuket, Thailand Thanyapura Health & Sports Resort is located in a national park just fifteen minutes away from Phuket International Airport and presents a unique and inspiring destination for individuals, groups and families looking for a balanced approach to their lifestyle. Athletes of all levels train and prepare for global sporting events in the state-of-the-art facilities offered at Thanyapura while health conscious guests enjoy to rejuvenating health programs which edify the body and mind. Facilities include a dynamic 77-room Pool Wing, tranquil 37-room Garden Wing, award winning restaurant, holistic wellness centre, a clinic run by expert doctors and the renowned United World College Thailand International School. Sports facilities include a 50M Olympic pool, a 25M pool, athletic track, modern 900sqm gyms, indoor and outdoor tennis courts, Muay Thai training ring and a FIFA standard football pitch. Athletes of all levels train and prepare for global sporting events in the state-of-the-art facilities offered at Thanyapura.

Our guide is available to view online at www.treatmentabroad.com/patientsguide

helping you make the right choice

Helping you make the right choice of hospital, clinic or doctor abroad Treatment Abroad helps patients choose the right clinics, hospitals and medical specialists for a broad range of clinical, dental and cosmetic treatments. Visit www.treatmentabroad.com for access to: • • • • •

A market leading directory of treatments and clinics Quick price comparison facility Patient reviews Travel and country guides to help arrange your trip, accommodation and insurance Online version of the Patients' Guide to Treatment Abroad: www.treatmentabroad.com/patientsguide

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