Turkish health sector hopes to serve 650 million people

Barçın Yinanç - barcin.yinanc@hdn.com.tr

With a know-how already well in advance of its neighbors, Turkey’s health sector is now aiming to attract 2 million patients and earn incomes of $20 billion by the country’s centenary in 2023, according to Meri İstiroti, the president of the Turkey Health Tourism Development Council.

“We have been telling the economy, tourism and health ministries that if we can make Turkey a brand, we will become a sector that can help decrease the current account deficit,” she said.

Give us an overview of Turkey’s place in the world health sector.

Globally, good health care and best practices were concentrated in the United States, in Europe or countries like Israel and the United Kingdom. In the last decade, it has been moving to the East and Far East.

Turkey is in a strategic position. We are in the center of a region covering the Balkans, Eurasia, Middle East and North Africa.

Now our know-how is far more advanced than our neighbors.

The surgeons’ capabilities, the physicians’ medical education status and the infrastructure has been promising in the interests of getting good medical for regional patients. We started with more elective cases, like plastic surgery, dental surgery and infertility. We have now moved to higher-risk patient treatments like colorectal cancers, brain tumors, robotic utilization, stem-cell applications and organ transplants. And we are making our investments not only for 80 million [people] but for 650 million in our region. 

What is the financial dimension?

In terms of per patient income, regular tourists bring around $700. The medical tourism income average is $8,000. This does not include the accompanying people’s income, but they come as a family. So from a 2,000-euro per excimer laser operation to a 150,000-euro cancer treatment or organ transplant, when we also include the outpatients, the average is $8,000. 

There has been a steady increase since 2005 when we received 126,000 international patients. In 2010, we reached $2.4 billion in income with 487,000 international patients. The numbers for 2014 were 727,000 patients and $5.5 billion. Our target is 2 million patients and $20 billion in income. We have been telling the economy, tourism and health ministries that if we can make Turkey a brand, we will become a sector that can help decrease the current account deficit.

The government at the beginning did not realize the significance of the contribution we can make. It said our responsibility is just to take care of our own nationals. But when they saw the numbers, they recognized the importance of the sector and they want to be in the game.

Currently, Turkey is internationally recognized as a medical destination. We have reached that point in 10 years’ time.

What has been the contribution of the state?

The Economy Ministry has put forward a lot of incentives regarding marketing capabilities abroad. These have helped us to move in the international marketing area more intensively.

Turkey’s touristic attractions must have been an additional advantage to lure international patients.

Indeed, Turkey is a country people like coming to as tourists. India is also a player in health tourism, but the moment you leave the hospital, you don’t see a hygienic environment. Turkey is a country where people are pleased to visit.

If we could maintain political stability, which has been done so for the past 10 years, that would bring with it economic stability. Health has become one of the sectors foreign investors want to invest in. That’s how our investment scales have changed and become bigger. The hospital chains have developed faster, and they have done what they would have in 10 years in the span of two-three years. And with increased investments, we started looking abroad.

Can you attract patients from the West? Europeans must still have prejudices against Turkey as a developing country.

The prejudices are down compared to the past. But I can’t say that all the Turkish medical facilities are making tremendous business in terms of good quality. The patient has to search for good care and good medical outcomes on the internet, but the internet does not show the reality all the time. As institutionalized corporations in health care, we have the responsibility of providing the correct information, helping intermediate institutions like insurance companies and digital marketing offices. We have to put forward the good data so they will have the means to compare the good and the bad.

Turkish hospitals not only compete with the world but also with each other. In 2002, there were 271 private hospitals; currently there are more than 600.

Our biggest competitors in the region are the Germans and the South Koreans. Actually, all have seen what needed to be done in the developing countries, but it was the Germans and the South Koreans who have been the most successful. We are just behind them. In a few years’ time we have made tremendous progress.

One of our advantages is that we are the number-one country with the highest number of hospitals accredited with the Joint Commission International (JCI), which measures and shares best practices and patient safety with the world. We have 56 institutions accredited with the JCI. 

The hospitals that receive patients are not just concentrated in Istanbul. Erzurum, Gaziantep and Diyarbakır receive patients from the east, while the [Black Sea province] of Samsun [receives patients] from the north. The Central Anatolian town of Afyon is another one. In the east busloads of patients come to the hospitals.

What are the problems you face as a sector?

There are not enough human recourses, from doctors in certain high-expertise areas, to nurses and support personnel for all these hospitals.

Another issue is the lack of a system whereby ethical work can be traced. Health is such an area that unless you have the necessary education, you can’t separate the good from the bad. In addition, there is never one type of treatment. We need a mechanism to register and monitor the medical results.

So what are your proposals for the development of the sector?

We need to have an independent accreditation institution which can keep the list of the medical results of all hospitals private and public, so you can trace the results in a transparent way.

Obviously, this requires a separate budget, measuring criteria, software and the like. But if we are to make progress in this sector, we can’t just do it by just investing in equipment, for instance.

We need to change the current vision.

The region wants to see us investing there, transferring know-how and training people. These are the issues for the future. Turkey can’t become a major player just by securing a certain number of patient transfers to the country.

But first we should not neglect the human resources dimension. We need to give the utmost importance to the training of good doctors by providing good education in medical faculties. The fundamental key to success lies in having good doctors. We should also give importance to learning foreign languages.