Is pilfering patients from the developing world ever okay?
When a healthcare giant with deep pockets says it will enter an emerging market, the cynic’s reaction is to see an international referral stream. A non-profit once bemoaned to us that there is much truth in this. But what if it’s the only way they’ll agree to invest in the first place? And what if the good they do locally far outweighs the patients lost abroad?
The dilemma for policymakers was highlighted recently with hospital group Saudi German, active in Saudi Arabia, the UAE and Egypt, announcing plans to build facilities in Nigeria including a 100-bed hospital. Some in the medical community suggested they saw the move as nothing more than a patient grab – but local contacts we spoke to were more sanguine, welcoming investment in a country with a beds-per-1000-people ratio of less than a tenth that in the OECD countries.
It’s not just in Africa. Late last year, a massive Thai hospital group entered a JV with a Pakistani healthcare company to manage facilities there. Reports indicated definite potential for a referral stream to Thailand for more complex cases. But Pakistan, a country of almost 200 million like Nigeria, has an underdeveloped private healthcare market that could do with the management experience of one of the developing world’s most mature hospital sectors.
And it isn’t always just patients. Our non-profit contact says: “Pilfering patients can be for monetary purposes, but also for research. They might go to an area because it is an ideal research location, they go in and extract the data and then up and leave. Some groups are a bit cold that way.”
But as our Nigerian contacts said, if others aren’t making the investment – not exactly the case in Nigeria, there’s just not enough of it – then maybe it’s worth biting the bullet to win big investment in exchange for losing the very wealthiest who might go abroad regardless of what provision there is on home soil. When it comes to the world’s largest emerging market, HBI 2018 delegates agreed that the richest 1% of Chinese do just that.
So the answer to our question could be: so long as the promised long-term investments follow the initial entry. Every new hospital built, new medical professional trained and process-driven protocol enshrined is one step closer to a sustainable healthcare system that means patients don’t feel the need to go elsewhere for a hip replacement. But ensuring that investment happens relies on transparent governance, which is far from ubiquitous in some emerging markets.
We would welcome your thoughts on this story. Email your views to Cameron Murray or call 0207 183 3779.
