BRITAIN'S "NATIONAL HEALTH" SO HOPELESS THAT PEOPLE GO TO INDIA FOR SURGERY INSTEAD!

Three months ago George Marshall fretted about the choice offered by his doctor in Britain. Diagnosed with coronary heart disease, the violin repairer from Bradford was told he could either wait up to six months for a heart bypass operation on the National Health Service or pay œ19,000 to go under the scalpel immediately.

In the end, Mr Marshall chose to outsource his operation to India. Last month he flew 5,000 miles to the southern Indian city of Bangalore where surgeons at the Wockhardt hospital and heart institute took a piece of vein from his arm to repair the thinning arteries of his heart. The cost was œ4,800, including the flight. "Everyone's been really great here. I have been in the NHS and gone private in Britain in the past, but I can say that the care and facilities in India are easily comparable," says Mr Marshall, sitting in hospital-blue pyjamas. "I'd have no problem coming again."

The 73-year-old found the hospital in Bangalore after a few hours surfing the internet. Mr Marshall decided to come after an email conversation with Wockhardt's vice-president and a chat with other "medical tourists" from Britain who had undergone surgery in the hospital. "Once I knew others had come I thought, why not? In Europe hospitals in Germany and Belgium would do the operation for less than doctors in Britain. But Europe was still more expensive than here. And the staff speak English in India."

With patients such as Mr Marshall willing to travel across the globe to get treatment sooner or more cheaply than they could at home, Indian hospital groups see a huge market for their services.....

Many say that it is not just cost but competency that is India's selling point. Naresh Trehan, who earned $2m (œ1.06m) a year as a heart surgeon in Manhattan but returned to start Escorts hospital group in India, said that his hospital in Delhi completed 4,200 heart operations last year. "That is more than anyone else in the world. The death rate for coronary bypass patients at Escorts is 0.8% and the infection rate is 0.3%. This is well below the first-world averages of 1.2% for the death rate and 1% for infections," says Dr Trehan. "Nobody questions the capability of an Indian doctor, because there isn't a big hospital in the United States or Britain where there isn't an Indian doctor working."

Most foreign patients who come to the subcontinent are from other developing countries in Africa, south-east Asia and the Middle East where western-trained doctors and western-quality hospitals are either hard to find or prohibitively expensive.

What little Mr Marshall knew about the country was not favourable and at first he was shocked by the organised chaos of India. "There are so many people here. When I was in the car coming from the airport we got stuck in really heavy traffic. It was hot, there were horns going off and people shouting. I thought, 'Oh hell, I've made a mistake.'" But once in his airconditioned room, with cable television and a personalised nursing service, the 73-year-old says that his stay has been "pretty relaxing. I go for a walk in the morning when it is cool but really I don't have to deal with what's outside".

How many patients will come from Britain ultimately will depend on the NHS, which has begun sending patients for treatment to Europe to cope with its backlog of cases. At present the NHS restricts referrals to hospitals within three hours' flying time - but Indian hospitals say this barrier will eventually be lifted. "It is inevitable. In the west you have rising healthcare costs and an ageing population," says Habil Khoraiwallah, chairman of Wockhardt, who plans to open five hospitals in India next year, including a new 350-bed hospital in Bangalore. "People are already discovering the benefits themselves. Governments will follow."

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I cannot help comparing the unfortunate Mr Marshall's experience with my own. I discoved a skin lump on my arm (probably a squamous cell carcinoma -- a dangerous form of skin cancer) a week ago and had it removed by a plastic surgeon yesterday. The hospital I went to is 10 minutes drive away from where I live and I went into surgery within 5 minutes of arriving. I was away from home for less than an hour in all!. I had surgery in less time that it takes many people to go to the supermarket. That is private medicine in Brisbane for you. Total cost: About $250 in U.S. dollars and I get a part of that back from insurance. Sure beats going to India!

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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