Thailand's health tourism industry is coming under increasing pressure as competition from regional rivals, along with the effects of the global recession and domestic tensions, undermine the once-dominant position enjoyed by the country's medical travel segment.
Health tourism is a major contributor to the Thai economy, with an average of 1m foreigners coming to the country annually to receive medical treatment, generating revenue of more than $1bn a year.
The development of the medical tourism segment was driven, in part at least, by private hospitals needing to generate new revenue streams, according to Dr Chatree Duangnet, the chief executive officer of the Royal Bangkok Hospital.
When the state extended subsidised health coverage for nationals in 2001, many private hospitals moved into the medical tourism field to replace income lost due to the government initiative to charge around $1 for all medical procedures, he said in an interview with the Arabian Business news service on September 22.
"It resulted in everyone being far more health-conscious, but with the loss of their insurance payments many hospitals looked for alternative sources of income. One of the results was a boom in medical tourism," said Duangnet.
Though still a growth industry for Thailand, the potential held by health or wellness tourism has now been recognised by the country's neighbours. India has long been a rival for Thai medical tourism practitioners, while Indonesia, Malaysia and Singapore are now all making a concerted effort to promote their own health services, with varying degrees of success.
That success has prompted the establishment of the Health Travel Industry Research Society of Thailand (HTRIS), to both promote the sector and to monitor related developments in the media.
According to Chatree Niramitvijit, HTRIS's secretary-general, Thailand needs to do more to maintain its edge over its rivals, and ensure that the "increasingly aggressive promotion from competing nations in the region does not overshadow Thailand's primacy in the region as a favourite medical travel destination".
Efforts to maintain that primacy are not being helped by factors that are undermining the overall tourism industry in Thailand, with concerns over security and political unrest resulting in lower visitor confidence and arrival numbers.
Perhaps ironically, Thailand's health tourism segment may also have suffered something of a downturn due to the latest international health scare, with the spread of the H1N1 influenza virus serving to curb holiday travel in many regions. Thailand recorded some 165 deaths from the virus up to the end of September, and many hundreds of non-fatal cases, with fears over the pandemic keeping potential visitors at home.
According to figures released by the government in late September, tourism arrivals were down 14.1% for the first eight months of the year compared to the same period in 2008, with just 8.9m overseas visitors passing through passport control. While the figures do not give a direct breakdown of how many of those tourists came for medical reasons, if the drop in health tourists matches that of the broader sector, there will be far fewer beds occupied by foreigners at Thailand's hospitals this year.
While clear figures for the downturn in medical tourism numbers may not be available, the government is concerned enough at the potential loss to the economy to be considering providing support to the sector.
On September 3, the finance minister, Korn Chatikavanij, said his ministry was looking at a proposal to lower some taxes for spa operators so as to stimulate health tourism, with the government considering waiving some or all of the 10% excise duties imposed on spas.
Though Thailand's early lead in health tourism may have been reined in somewhat by its rivals, it still offers solid advantages to potential customers. Many surgical procedures conducted in Thai hospitals cost only a fraction of the price of those charged by hospitals in the West, while Thailand's medical facilities and professionals are generally seen as being of a higher quality than those in other countries in the region. The segment also has the benefit of longer experience in providing medical services, with many hospitals having a decade or more of tourist treatment behind them.
With health costs in many countries spiralling, obtaining treatment overseas is increasingly becoming an accepted option. Though Thailand faces challenges ahead, few are directly related to the medical tourism sector, which remains cost-effective and of high standard, and should retain its mantle as the regional leader for some years to come.