Sustainable development is development that meets the needs of present without comprising the

ability of future generation to meet their own needs (W.C.E.D, 1987). 

Sustainable tourism development is an extraordinary confront for several nations. In simple

words sustainable tourism development can be explained as a tourism which is optimistic
socially, environmentally and culturally and ought to be able to produce revenue and communal
profit to the broad section of society. The environment as well as natural diversity has to be
sustained and the utilization of the natural wealth should be based on the finest sustainable yield.
Due to globalization and in addition to that the development which is been in technology has
made and developed people to travel for leisure time and has enhanced wealth. Therefore, the
number of travelers visiting various countries have increased and the number shows it and by
which the developing countries are facing challenge to sustain their tourism in optimistic and
collectively to be present for the upcoming generation.

“Medical tourism” is an important part of the Indian tourism industry and holds immense growth
potential. The medical tourism sector had experienced a phenomenal growth in the flow of
medical tourists - from10, 000 patients in 2000 to stupendous 180,000 by 2005 (RNCOS, 2007).
Medical tourism, which can be defined as “the provision of ‘cost effective’ private medical care
in collaboration with the tourism industry, for patients needing surgical and other forms of
specialized treatment (Gupta Sen, 2004). Medical tourism is an entire broad word which includes
various others marketplace. In this upcoming market tourism is considered as to tour from a
place to another where the treatment is available. It is has became the majority widespread
practice in the world. Medical tourism has been diversified into many other area of expertise
marketplace which has a considerable profit. Health tourism is to take a trip within a restorative
atmosphere by means of natural curative sources. It is being best known for the various kinds of
known treatment like offering yoga, massage, traditional ayurvedic medicine and spa resorts
(Conference on Tourism in India – Challenges Ahead, 2008). Medical tourism comprises of
three fundamental features such as hospital/health services, hotels and travel/leisure. For that
reason, the medical tourism industry is been looking for a noteworthy prospect for the economic
enlargement and infrastructure improvement for the developing nations like India and Singapore
and has gained a position of specialty market within business. In many developing countries it is
being actively promoted by the government's official policy.
India is been known a top performer in the medical tourism business. For the health measures an
extensive series is available in India and it is all the time more is raising as a destination of
preference. India with advanced medical services paired with exotic natural bounties has become
a heaven for medical tourists. The Medical Tourism Industry in India is poised to be the next big
success story after software. 'Medical Tourism' can contribute Rs. 50 to 100 bn additional
revenue for up market tertiary hospitals by 2012, and will account for 3-5 percent of the total
healthcare delivery market, says the Confederation of Indian Industry (CII)-McKinsey study on
healthcare. CII says that India has the potential to attract 1 million medical tourists per annum
and this could contribute around us $ 5 billion to the economy. India's national health policy
2002, says: "to capitalize on the comparative cost advantage enjoyed by domestic health
facilities in the secondary and tertiary sector, the policy will encourage the supply of services to
patients of foreign origin on payment. The rendering of such services on payment in foreign
exchange will be treated as 'deemed exports' and will be made eligible for all fiscal incentives
extended to export earnings". From 2002 to 2005 there was an increase of 350,000 foreigners
that traveled to India for care; this number is projected to increase by thirty-percent each year
(Hutchinson, 2005).By 2012, medical tourism is projected to increase in India to more than half a
million patients, while generating an astonishing $2.1 billion dollars in revenue (Passi,2004).
India is unique as it offers holistic healthcare addressing the mind, body and spirit, with yoga,
meditation, ayurvedic and other Indian systems of medicine. India offers a vast array of services
combined with the cultural warmth that is difficult to match by other countries. Moreover, India's
strong pharmaceutical sector has gained international recognition and contributed to the growth
of medical tourism (Conference on Tourism in India – Challenges Ahead, 2008).

Singapore is very well known and highly reputed as a technologically advanced, hygienic and
organized country. Singapore is considerably less expensive than the European countries and
more expensive than Asian countries. In 2000, Singapore attracted more than 150,000 tourists for
medical care which added 0.19 percent to its GDP. By 2012, this island is expected to treat more
than 1 million tourists. This figure will complement a 3 percent market share for health care
services, generate some $3 billion in revenue, add 1 percent to the GDP and lead to some 13,000
new jobs. The medical facilities available in Singapore are on higher side than that of India and
Thailand which helps them to give encouragement to the medical tourist. They offer hospitals
and medical treatment which is much more consistent than its competitors. For the European or
other tourist who would not like to visit developing countries, Singapore is much better option.
The ministry of tourism of Singapore has of late done a noteworthy effort to promote the
biotechnology division, which would help to tempt researchers to visit their country.  It helps to
keep track on the upcoming technologies, which has contributed to rim down many therapies for
various diseases which are not available somewhere besides.

The actual comparison is being based on the existing guidelines frameworks which are classified
into regionally, nationally and internationally. Internationally, the perception of medical tourism
is first and foremost in direction of support to take a trip by customers worldwide. For that
reason, there are many countries have acted out guidelines in a way which would be striking for
the customers on the grounds with the intention of if they are keen to travel and shell out the
essential sum they would be capable to obtain the healthcare facilities they wish for. Nationally
the Medical tourism is a kind of tourism where it is not necessary that the consumers should
travel from its nation.

Time and again, medical tourism is being marked as authority to authority or the difference in
state. Here, the guidelines would promote people to visit from one place to another for the
treatment as it may be more appealing or not as much of prevention. On Regional basis Medical
tourism is basically depended on the geographical areas through which it gains lots of benefit.
Therefore many countries have started to put together various guidelines on regional prospect.
The demography of Southeast Asia has become prime destination for the medical tourism for the
people. Therefore, the region which comes under this demography has started to formulate
various guidelines and policies because medical tourism has become the viable industry.

Speaking about social sustainability, medical tourism has different policies which brings into
various purpose. In India and Singapore the eminence guiding principle benefits both the country
and patrons as it allows various consumers to travel, to gain advantage from medical tourism and
the capability to disburse. In real meaning, course of action permits consumers usual and unusual
alternatives for their healthcare desires. Even this policy is able to enact and look after the
country and its consumers. As a result, the policy offers and look after the rights of consumers
added prospects and choices in treatment. The reflective impacts due to medical tourism lead to
rise in service creation in the country which automatically shows for enhancement in the
excellence of people’s life. It helps in developing infrastructure which includes roads, electricity
and water availability therefore adds on to the up gradation of people for social sustainability.
For e.g.:- When a tourist comes for medical treatment he stays in the local hotels and the hotel
give them a facility of a local guide to go along with them. Thus, social sustainability is being
achieved through local employment. Even, the hotel put into infrastructure of the tourist section
and the conveniences is also been benefited for the local inhabitant. And as a result, the
secondary employment and services enjoyed by the people in a straight line thrown in social
sustainability.

The fundamental assertion following medical tourism is that a consumer travels to a different
nation and state to fulfill the needs of healthcare preference which is responsible for the growth
or the promotion of tourism in that specific area or demography and has to focus on
environmental sustainability. Though the most important center of the medical tourism is to
provide proper treatment and to cheer consumers to be tourists. It acts as a way of making
available funds for the improvement and conservation of the ecological vicinity. Therefore the
Indian government has started National Commission for Quality Assurance, National
Accreditation Board to provide accreditation to all public and private hospitals to ensure quality.
This was necessary as there are many private hospitals presently unload their waste where no
appropriate arrangement for the waste. A big urban corporate hospital generates two million tons
of waste each year (Singh Ratna, 2004). The re-engineering of the water system was one part of
the clean and green policy which has now been further developed into a national policy of
environmental sustainability. The ministry of Singapore strictly manages the clearance of waste
through accredited companies by which they turn out electricity. They have even started National
Environmental Sustainability Fund to support industry to innovate new skills (Sidsnet, 2004).

This will help for the tourist to take up the tourism ethics and to think about the social, cultural
and environmental results would generate by their act when they take a trip to heritage places
with paper and soft drink cans etc. which heap in excess for years and tear down the good looks
of countryside. Still the practice in this tourism does not have need of any ample sum of
ecological resources. For that reason, nearby there is no main impact or outcomes of the medical
tourism resting on a nation’s environmental wealth. For e.g.:- The state governments are
focusing to reduce pollution caused because of vehicles by helping the travel agencies and the
local transporters to switch their vehicle to run on compressed natural gas or even on solar
batteries. Accordingly environment is benefited because of change in energy.

Medical tourism has an immense importance for the developing nations as its main aim is to
provide an economic motivation and sustainability plus through this business making available
occupation, source of revenue and a quality of life to the local habitants and thus helping nation
to gain a sustainable economy for it. So, the medical tourism will uphold the infrastructure
improvement which will help to sustain the industry. Even the revenue which will generate by
this industry will put in to nations GDP which is gross domestic product would be evaluated as a
success. Therefore to attract more tourists, the Indian Ministry of Tourism has started a new
category of visas for the medical tourists. These visas called the “M” or medical-visas are valid
for one year but can be extended up to three years and are issued for a patient along with a
companion (IBEF, 2006). It would be easier to consider the fiscal value through the tourism
related activity and the influence of the business by knowing the rise in number of tourists, new
employment and the healthcare earnings.

Collectively, now it is been able to decide of what is the influence of medical tourism on its
economy. Therefore government has started many corporate and international tie-ups for the
industry like Joint Commission for Accreditation of Healthcare Organizations (JCAHO) USA,
Parkway Group Healthcare PTE Ltd, Singapore in joint venture with Apollo Group for a hospital
in Kolkata, Pacific Healthcare Holdings, Singapore in a JV with Vitae Healthcare Pvt Ltd for a
hospital in Hyderabad, Columbia Asia, Malaysia, setting up a hospital in Bangalore (India Brand
Foundation Report, 2004). They have also created some policies such as Ministry of Tourism
will provide financial assistance to attend global medical fairs to promote India (Sauer Katherine,
2009). The policy aims at increasing the earnings from tourism inflow at the rate 10% annually
and seeks to promote sustainable tourism by encouraging a constructive and mutually beneficial
partnership between public and private sector for economic development and employment
generation. Eventually, these were some factors of medical tourism sector which should interact
synergistically among them which would result in economic sustainability. The Singapore
Government has recently renewed its support for the Biomedical Sciences (BMS) initiative,
which was first launched in mid-2000. As a key part of the 2nd phase of its Biomedical Sciences
Initiative from 2006-2010, the Government has earmarked S$1.4B to support translational and
clinical research (TCR) to bring basic BMS research discoveries into clinical application, from
“bench” to “bedside”(A Star,2006). Even, Singapore government provides subsidy for health
care and hospital services. For e.g.:- When a distant tourist comes to India produce a wholesome
and precious foreign exchange. It starts from the journey to tourist destination which is being set
either by hospital or tour operator who looks at entire medical tourism package. Thus, when
consumer reaches to the tourist spot it sets off a sequence of effect which results into run of
currency for the bottom troupe. Here the tour operators create considerable income by giving
various conveniences to the tourist for the period for visiting the beautiful places and using the
vehicles, guides etc. throughout sightseeing, and the tourist comes across to purchase artifacts or
items which would be the specialty of the area. This helps to gain a good amount of revenue for
the local habitants as they sell their goods at a higher price which foreigners do not mind.

The medical tourism industry is being able to offer a noteworthy economic incentive which is
very useful for the country’s income escalation and financial strength which is been done
through the policy proposition. Furthermore it motivates the infrastructure development in
addition to progress the excellence of the country’s citizens. On the other hand it helps the
country to position them for the profit. Therefore there are various striking policies found by
country to promote the medical tourism to exert a pull on consumers and time and again to make
obvious with a reduction of preventive guidelines than its opponent. By putting these policies in
an accurate position, the nation must use diverse and distinctive marketing tactic to endorse their
facilities to their end market. Some of the polices have recommended view such as expansion of
health care infrastructure; changes in health care seeking behavior; availability of newer
technologies for management; rising expectations of the population, escalating cost of health
care(National Health Policy, 2002).

The guidelines put up by the government are such as to promote tourism as a major engine of
economic growth and capitalize potential of sustainable tourism for economic and employment
generation. To acknowledge the critical role of private sector in development of tourism with
government working as proactive facilitator and catalyst. Clinical Establishment Act by 2006 to
make sure quality healthcare services, Amending Drug & Cosmetic Rules to Include medical
devices, National Rural Mission Launched in 2005 to provide effective healthcare to rural
population Government institutionalizing a mechanism of Public Private Partnership In
healthcare (IBEF,2006). There are also various national commissions formed by ministry such as
Federal Drugs Authority, Indian Medical Devices Regulatory Authority, Expanding Public
Procurement Systems of drugs, devices and vaccines, National Institute for Health Information
and Disease Surveillance, National Commission for Quality Assurance, National Institute for
Health Research (IBEF,2006). The free market system of Singapore has created an inclination of
private and public hospitals (sma, 1996).These policies have impacts on trade which is related
directly or indirectly to the product. It can be explained as the income generated by the tourists
coming to the nation for the treatment will help to construct nation’s healthcare structure and
infrastructure. For the reason that medical tourism come across a lot of various business
divisions for which it helps them to generate a handsome amount ultimately. This division
includes primary business such as lodging, and recreational. Even the outcome of the medical
tourism industry is been influential and not only benefits various trade division but also to
country’s GDP.

Medical tourism is an industry which is open for all countries and those who are able to analyze
and adapt the policies would emerge as a prosperous country. It has come up as a best sector
which callout for better economic sustainability by carrying capital to the tourist places and by
providing employment to the local habitants. It assists government to improve the infrastructure
and to carry on more development activities in the tourist destination which would be
transportation, street lights, hospitals and water supply which raise the standard of existing of
citizens. Finally, sustainability analysis can be accomplished by saying that the medical tourism
sector flourish on the accessibility of large number and multiplicity of tourist regions in country.
On the way to incorporate sustainability in the medical tourism both the countries India and
Singapore should build up a system which would act as an arrangement for the stakeholders to be
in well touch and work together. And by switching information with each other will lead to from
a barrier against the malpractice which is being followed against unsustainablity practice and it
will work more effectually and competently.
The Medical tourism fundamentally looks out for improved economic sustainability as it gets
revenue to the nation through tourism and at the same time providing work to the local habitants
which uplift their status. Environment emerges out as likely subject for the tourist and the other
factors such as hospitals and hotels because they seem to be very casual approach towards the
atmosphere. Consequently, it has become necessary for both the countries to concentrate on
hospitals and hotels to make them follow the healthcare guidelines setup by the government.
This would be achieved by coordination and collaboration among the guidelines maker,
government, local habitant and medical tourist.
References:-

1. Bruntland, G. (ed) (1987). “Our Common Future: The World Commission on Environment
and Development”, Oxford: Oxford University Press.

2. Chanda, R (2002). “Trade in Health Services: Bulletin of the World Health Organization”,
80(2):158-162.

3. Chinai R and Goswami R. (2007). “Medical visas mark growth of Indian medical tourism:
Bulletin of the World Health Organization”, 85 (3)

4. McKinsey–CII Study. (2002). “Healthcare in India – The Road Ahead”, published by

Mckinsey & Company.

5. National Coordination Committee. (2006). “Health System in India: Crisis & Alternatives”,
published by Jan Swasthya Abhiyan.

6. Passi, Gouri R. (2004) “East Meets West” by Indian Pediatrics 41: 757-758

7. Satpathy, S. and Venkatesh, S. (2006). “Human Resources for Health in India’s National
Rural Health Mission: Dimension and Challenges”. Regional Health Forum – Volume 10,
Number 1.

8. American, (2008) “Medical tourism” [Online] Available at:

<http://www1.american.edu/ted/medical-tourism.htm> Accessed on: 8th April, 2009.

9. Aaahrh, (2008) “The Potential Impact of Medical Tourism on Health Workforce and Health
Systems in India” [Online] Available at:
<http://www.aaahrh.org/3rd_conf_2008/paper_and_presentations/Indrajit_hazarika.doc>
Accessed on: 6th April, 2009.

10. Business in Asia, (2008) [Online] Available at:

<http://www.business-in-asia.com/asia/medical_tourism2.html> Accessed on: 8th April, 2009.

11. Expresshealthcaremgmt, (2008) [Online] Available at:
<http://expresshealthcaremgmt.com/20050228/medicaltourism02.shtml> Accessed on: 10th
April, 2009.
12. Fundsis, (2005) “India and health care” [online] Available at:
<http://www.fundsis.org/docs_act/1_RRavimohan_ (India).ppt> Accessed on: 6th April, 2009.

13. Ibef, (2006) “Healthcare” [Online] Available at:

<http://ibef.org/download/healthcare_2006.ppt> Accessed on: 10th April, 2009.

14. Indianmedicaltourism, (2006) [Online] Available at:

<http://www.indiamedicaltourism.net/medical_tourism_india_news/index.html> Accessed on:
11th April, 2009.

15. Psiru, (2008) “GlobalhealthcareMNCs” [Online] Available at:

<http://www.psiru.org/reports/2008-3-H-GlobalhealthcareMNCs.doc> Accessed on: 10th April,

2009.

16. Sidsnet (2006) “AIMS” [Online] Available at:

<www.sidsnet.org/docshare/other/20041109141045_AIMS_synthesis_report_final.doc>
Accessed on: 6th April, 2009.

17. SMA, (1996) “Medical ethics” [Online] Available at:

www.sma.org.sg/cmep/medical_ethics/MEA1A/1996.doc Accessed on: 6th April, 2009.

18. Sinetinfo, (2009) “Indian Medical/Health Tourism Service Sector Network Report” [Online]
Available at:
<http://www.sinetinfo.com/pdf/Reports/Medical3.pdf > Accessed on: 12th April, 2009.

19. The Times, (2007) “India’s rise in medical tourism” [Online] Available at:
<http://www.timesonline.co.uk/tol/travel/destinations/india/article2257994.ece> Accessed on: 6th
April, 2009.
20. Twin side, (2007) “Medical Tourism-Subsiding Healthcare for Developed Countries”
[Online] Available at: <http://www.twnside.org.sg/title2/resurgence/207-208/cover9.doc>
Accessed on: 8th April, 2009.
 ITM – IHM, NAVI MUMBAI
B.A. International Hospitality Management

Sustainable Hospitality Management in

Medical Tourism between

India and Singapore

2009
Module Code: B3117
Module coordinator: Ms. Vaishali Rajarshi

Matriculation No: 08006583

Word Count: 3054