One burning question, facing Governments everywhere, is choosing the right sectors to incentivise and facilitate, to promote economic recovery and growth. In Barbados, the two foreign exchange earning sectors that have recorded the most sustainable economic success, in the last 30 years, have been Tourism and International Business. Despite the OECD constantly moving the goalposts, International Business is still holding its own, and while various sub-sectors of Tourism have been actively developed as niches – e.g. Sports Tourism and Heritage Tourism – these have only had modest success to date, but still hold much promise.
Casino Tourism is a sector recently reported to be under (re)consideration by the Government of Barbados (GOB), and this sub-sector certainly has significant potential to grow the economy, not only through more foreign exchange earnings, but by attracting foreign investment, and providing that added inducement for investors to develop the several hotel properties that have been shuttered in the last 7 years. Arguments against Casino Tourism on moral grounds are somewhat hypocritical– the island already has many forms of gambling legally permitted, and Casinos surely can’t be any worse than the lotteries, which lure the most vulnerable income level of any society, selling dreams of instant wealth.
However, in terms of overall fit with the Island’s high-quality tourism and international business thrust, and in terms of global market growth, Medical Tourism has to be the Tourism sub-sector that could yield the greatest results for Barbados. In 2009, the American Medical Tourism Association estimated the worldwide industry to be worth about US$40 billion, and they predicted it would grow exponentially. The AMTA estimate the market in 2015 to be of the order of $100 billion – or 25% per annum average growth since 2009, and their prediction for future growth is in excess of that number.
Furthermore, the top ten destinations in the provision of medical tourism services are reported to be Brazil, India, Costa Rica, Mexico, Hungary, Malaysia, South Korea, Singapore, Thailand and Turkey. The Americas are far less developed than the Asia-Pacific region as regards this growing industry, and given Barbados’ familiarity and/or proximity to three major source markets (US, Canada and the UK) our common English language, westernized culture, reputation both as a leading tourism and international business destination, and the already established air links, we have a significant opportunity to take first mover advantage in the Caribbean in this industry. Geographically and developmentally, we are an ideal location for Medical Tourism!
Developing a Medical Tourism sector in Barbados also benefits both the existing Tourism sector and the International Business Sector, by enhancing the destination’s reputation as a safe place to visit – greater comfort of mind that a medical emergency could be promptly and professionally dealt with in modern state-of–the art facilities. The direct benefits to the economy are more obvious – foreign exchange earnings from not only the patients, but their accompanying family member(s); job (medical and administrative staff) and spin-off supporting business opportunities (e.g., laundry, transportation, and medical supplies); skill and technology transfer, including intern training and exposure of Barbadian doctors to state-of-the-art and cutting-edge equipment and techniques.
However one looks at it, Medical Tourism would be a rewarding sector to develop, the low-hanging fruit, so to speak, and we already have a golden example in the Barbados Fertility Centre. Dr. Juliet Skinner and her partner, Registered Nurse Anna Hosford, have built a professional fertility clinic practice of which all Barbadians can be proud, with astounding international success rates, and their accreditation by the Joint Commission International (JCI), the gold standard for international medical facilities, is testament the island’s ability to produce and maintain quality facilities and systems.
There has been some talk of Government support for this sector, but little action to date, which leads one to the inevitable conclusion that there may not be a very wide appreciation of the potential of the sector to contribute significantly to economic growth.
Much of what Medical Tourism projects (e.g. Hospitals, specialty treatment centres) would need from the GOB is already available to investors in other sectors, like duty-free concessions on construction materials, and on some operating consumables, low corporate tax, process facilitation assistance, etc. The main difference is that the business model most likely to succeed in attracting medical tourists from North America and the UK would see US board certified and other internationally certified surgeons and physicians doing repeated short-term rotations in Barbados alongside Barbadian doctors. Such rotations would require some streamlining of the licensure and work permit application and approval processes to improve response time, but both are achievable without lowering our existing quality standards.
Of course, what all investors need, in any sector, is certainty of process, simplified paperwork, definitive answers and speed of response from the GOB – whether at Cabinet level or from regulators and governing bodies. If Barbados can measure up to those criteria, we will be well placed to take a leading role in international medical tourism.
Examples of successful models of Government/Private Sector collaboration in Medical Tourism exist elsewhere – such as the Singapore and Costa Rica models – where quality of services, not price, is the focus – but Barbados must be ready and able to move quickly, as other Caribbean countries like the Cayman Islands, Jamaica, the Bahamas, Tobago and now Cuba, are already looking to stake their claim in this growth industry.