The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas must “knock down all the barriers that threaten the viability” of a medical tourism industry, a well-known surgeon warning there was a “disconnect” between rhetoric and reality.

Dr Duane Sands was speaking after the Bahamas, despite the much-trumpeted Stem Cell Therapy Bill and accompanying regulations, failed to merit a ranking in the 2014 Medical Tourism Index.

The Index, published by the Medical Tourism Association, assessed neighbouring destinations such as Jamaica, Costa Rica, Panama and the Dominican Republic.

Costa Rica ranked in the top five medical tourism destinations globally, alongside Canada, the UK, Israel and Singapore, with both itself and Jamaica topping the ‘destination attractiveness’ category.

Dr Sands, the Free National Movement’s (FNM) deputy chairman, told Tribune Business that the Bahamas needed to “embrace” medical tourism and “push it aggressively” to potential overseas clients/healthcare providers if it was to establish itself as a major player in the sector.

He added that the supporting infrastructure, particularly a timely and efficient approvals process, also required implementation.

Time is money, and with various approvals committees described in legislation yet to be appointed, Dr Sands said potential investors would likely head elsewhere than suffer inordinate delays in the Bahamas.

Despite Dr Perry Gomez, minister of health, stating that the Bahamas is poised to become a global ‘pacesetter’ in stem cell therapy and related practices, his fellow doctor - and political opponent - said the on-ground reality had yet to match the rhetoric .

“We’re still in the talk stage,” Dr Sands told Tribune Business. “It’s all well and good to talk about it and strategise about it. The difficulty is when you convert that into action.

“Let’s not hold our breath. We’ll see about the implementation, and whether we get one, two or three new medical tourism programmes by the Government, or the private sector with the support of government, to actively happen.

“I’m not terribly optimistic, but who knows?” added Dr Sands. “It threatens the viability of the industry if you create projects and business plans on a basis that assumes certain things will happen. Then they don’t happen, and you have got to go back and revise it and revise it again.

“It’s then that people start to look at other jurisdictions. I don’t know of many people who can afford a two-three year delay in a multi-million dollar project. I suspect it will be a while before we start climbing that Index’s rankings, unless we knock down all the barriers and make it happen.”

Dr Sands’ comments may be interpreted as a reference to Doctors Hospital, which said licensing and permit delays associated with its medical tourism programme cost it $1.275 million in its last financial year, helping to propel it to a collective $261,391 net loss

The BISX-listed healthcare provider’s annual report discloses how approvals delays meant its Bahamas Medical Centre on Blake Road hit just 53 per cent of its projected $2.64 million revenue target for the year to end-January 2014.

“Bahamas Medical Centre completed its first full year in operation,” the Doctors Hospital annual report said. “Total net revenue for the year was $1.399 million compared with $486,000 last fiscal.

“The revenue was $1.275 million below projection as the start of surgical programmes for international patients did not get off the ground due to licensing and permit delays.”

Doctors Hospital executives had previously complained about the impact extended permit delays were having on their business model and expansion plans. The point was again made forcefully in the annual report by chairman Joseph Krukowski, who wrote: “Delays in receiving the appropriate approvals for the projects to proceed continue to frustrate our intentions.

“Further delays could result in loss of these enterprises to other destinations, which appear more receptive to accommodating the operation. If this were to occur, it would be detrimental to the patient community, the medical profession, the hospitality industry and the country’s reputation in general.”

Dr Sands echoed these sentiments, adding that issues surrounding fiscal incentives for imported medical equipment and delays in obtaining the necessary approvals “make it very difficult to start up and maintain medical tourism programmes”.

This, the FNM deputy chairman, was epitomised by “the undeniable delay” between passing the Stem Cell Bill and its accompanying regulations.

“It’s one thing to say you’re committed to medical tourism, it’s another thing to allow it to happen,” Dr Sands told Tribune Business.

He suggested that what happened to the Freeport-based Okyanos Heart Institute was instructive. Embraced by the former Ingraham administration, Dr Sands said the investment become “the poster child for everything that was wrong” with the previous government’s approach after the Christie administration took office.

The latter had expressed concern that Okyanos was approved without the necessary regulatory regime being in place, but Dr Sands said: “If you remember they were throwing roadblocks at it left, right and centre.

“Now, it’s the only sustainable programme that has really taken root, apart from the smaller programmes at Doctors Hospital.”

Dr Sands said the Government’s approach to-date had been “a lot of hyperbole, a bit of rhetoric and business as usual”. He said the Bahamas needed to dedicate resources to “make it happen”, with the Ministry of Tourism, Ministry of Health and Ministry of Finance working in concert.

Arguing that the country needed to “jump in wholeheartedly” to become a medical tourism success, Dr Sands added that the fate of Princess Margaret Hospital’s Critical Care Block was another situation that would make investors question the Bahamas.

“How can you have medical tourism taking place in an unfinished building that’s 18 months behind schedule?” he asked. “There’s a disconnect, and if we’re going to embrace this, we need to push it, and push it aggressively.”

The Medical Tourism Index measures the attractiveness of a country for medical travel, examining three key categories and 34 underlying criteria. The 30 countries ranked this year cover 60 per cent of the world’s population.

“Many countries are touting their healthcare services, costs, safety and security, and locations to attract foreign patients,” said Marc Fetscherin, co-developer of the Medical Tourism Index and associate professor of international business and marketing at Rollins College.