Cathy Rice had been in all-consuming ache for 18 months when she determined to fly to Lithuania. “I used to be going up the steps on my palms and knees. I couldn’t get to the store. I had no high quality of life,” she says.
Rice, 68, who has 4 grandchildren, had been informed she wanted a knee substitute for an harm attributable to osteoarthritis however – like hundreds of thousands of NHS sufferers – confronted a gruelling wait.
At a clinic in Kaunas, Lithuania’s second largest metropolis, the operation was organized inside weeks and price €6,800 (£5,967) – round half the fee within the UK. The worth included a pre-travel session, return flights, airport transfers, two nights in an en suite hospital room, pre-surgery check-ups and put up operative physio.
“I believed, ‘Simply take a look at your decisions. You’ll be able to keep right here and be in this type of ache for an additional couple of years or you may take a choice’,” Rice says.
The previous well being sector employee, from Glasgow, is one in all a rising variety of Britons going overseas for routine medical care. She had by no means gone non-public earlier than and by no means had a need to. However final week, a yr after the primary surgical procedure, she returned to Lithuania to have the identical process on her different knee. This time, she says the wait she confronted on the NHS was three years.
She explains tearfully that to cowl the prices of the surgical procedures in Lithuania, she bought her home. “Individuals assume that for those who’re doing this you’ve acquired a beautiful pension otherwise you’re very effectively off. However the driver right here is that persons are in ache,” she says. “This isn’t medical tourism; it’s medical desperation.”
Within the basement gymnasium of the identical hospital in Kaunas – a gleaming white clinic ignored by Soviet-era condominium buildings – one other affected person, William Grover, 79, is stepping on and off an cardio block.
The grandfather of eight, from Portsmouth, is 2 days post-surgery following a proper hip substitute that price €7,000 (£6,146). The previous development employee determined to fly the 2 and a half hours from Luton to Lithuania to have the process on the Nordorthopaedics clinic after going through an unsure wait on the NHS. He had been quoted £15,000 by a personal hospital within the UK.
“I all the time used the NHS. I by no means thought I would want to go non-public. However my hip was getting worse and worse and I acquired to the stage the place I used to be simply considering, ‘What am I going to do?’” he says.
Battered by the pandemic, workforce shortages and a persistent lack of social care capability, the UK’s well being programs are below acute pressure. The newest NHS figures present that 7.19 million individuals had been ready for remedy in England alone in November, with 406,575 ready over a yr. There have been greater than 600,000 sufferers ready in Scotland for deliberate procedures on the finish of final September and there have been greater than 750,000 ready to begin remedy in Wales in October.
A Division of Well being and Social Care spokesperson mentioned it was “working tirelessly” to make sure individuals get the care they want and that the NHS had “nearly eradicated waits of greater than two years for remedy”.
The Welsh authorities mentioned it had “formidable targets” to deal with delays for deliberate care whereas the Scottish authorities mentioned it was opening 4 nationwide remedy centres that would present capability for over “12,250 further procedures, depending on workforce”.
However a rising variety of persons are resorting to going non-public. Google traits information exhibits UK searches for “non-public healthcare” are at a file excessive whereas figures from the Personal Healthcare Data Community present the quantity self-paying for personal acute care has elevated by greater than a 3rd in contrast with earlier than the pandemic, with a 193% rise in these paying for hip replacements.
For individuals who can not afford non-public care in Britain, travelling overseas will be interesting. In some international locations in Europe, operations will be as little as half the worth of the equal remedy within the UK, even after factoring in extras like post-operative rehabilitation.
There isn’t any dependable supply of knowledge on outbound UK medical tourism, however the Workplace for Nationwide Statistics (ONS) has estimated that about 248,000 UK residents went overseas for medical remedy in 2019, in contrast with 120,000 in 2015.
For years, the medical tourism market has been dominated by individuals crossing borders for tummy tucks, dental work and different beauty therapies. However Keith Pollard, editor in chief of Worldwide Medical Journey Journal, says there may be proof of an elevated demand for core medical care, with NHS ready lists “driving enterprise”.
Clinics in Lithuania, Hungary and Spain are all reporting an increase in demand for elective procedures like hip operations, he says. “There are rising numbers of people who find themselves opting out of the NHS to self-pay and may afford non-public remedy within the UK. There may be one other group of sufferers who won’t have the ability to afford that, however might pay £3,000 or £4,000 for a process abroad.”
Lithuania, whose complete inhabitants is a 3rd of the scale of London’s, has turn out to be more and more common as a result of it’s simple to succeed in, comparatively cheap, and has developed an excellent status amongst worldwide sufferers.
This yr 500 sufferers are anticipated to go to Nordclinic in Kaunas for orthopaedic surgical procedures alone, together with hip and knee replacements, achilles tendon restore and foot and ankle surgical procedure, up from 392 final yr and in contrast with 150 earlier than Covid. The clinic additionally has a department providing common surgical procedure, together with hernia repairs and gallbladder surgical procedure. In January to date, 5 Britons have had their gallbladders eliminated.
Earlier than they journey, sufferers have a distant session, fill in a well being questionnaire and provide related scans and blood take a look at outcomes. After they return, they’re anticipated to have an x-ray after three months which is shipped again to the clinic. If one thing had been to go incorrect, sufferers can be entitled to additional free remedy to handle the problems. Different clinics, just like the close by Gijos Klinikos, a sprawling hospital with wards like resort rooms, make the identical promise.
Prof Sarunas Tarasevicius, an orthopaedic surgeon at Nord, says that when he started working there a decade in the past, nearly not one of the worldwide sufferers he handled had been from the UK. Now almost all of them are, largely from England. “Usually they’re aged and they need to be going to hospitals close to their house. However nonetheless, in some way they make the choice,” he says. “Some persons are borrowing cash from their children.”
Tarasevicius says that earlier than Brexit, sufferers may get the prices for surgical procedure like hip replacements overseas reimbursed if the NHS couldn’t present them in a “cheap” timeframe – often round six months. Funding for pre-planned care has now turn out to be tougher to entry, however nonetheless the sufferers come. “We had been anticipating a drop-off after Brexit, but it surely didn’t occur,” he says.
About 100km away within the capital, Vilnius, the Medical Diagnostic and Remedy Centre can also be in demand amongst Britons. The four-floor hospital treats round 150,000 sufferers a yr, about 5,000 of whom are from the UK. Most need well being check-ups – diagnostic checks like MRIs and scans. Others come for orthopaedic surgical procedure.
Deividas Praspaliauskas, the chief government, says UK requests have remained at an identical stage to earlier than the pandemic however demand from Lithuanian sufferers has spiked in the identical interval. “Individuals are planning visits from the UK and we don’t have sufficient capability to deal with all of them,” he says.
Maja Swinder, affected person co-ordinator at EuroTreatMed, a medical journey company, has noticed an identical pattern in Poland, with sufferers from the UK travelling for orthopaedic surgical procedure. “These sufferers had been thought of non-urgent instances below the NHS, and a few of them had their surgical procedures postponed a number of instances,” she says. “Individuals had been ready in ache [and] some grew to become wheelchair-bound.”
One non-public hospital, KCM clinic in Jelenia Góra in south-western Poland, says orthopaedic operations for UK sufferers had been 20% to 30% increased in 2022 versus 2019.
In France, Carine Briat-Hilaire, chief government and co-founder of France Surgical procedure, a medical journey facilitator in Toulouse, mentioned her firm was seeing excessive demand from UK sufferers looking for cardiology care in addition to orthopaedic surgical procedure. “Earlier than Brexit, English individuals got here to France for healthcare functions as a result of they had been reimbursed by the NHS. Now, they arrive to France due to the skyrocketing ready lists within the UK,” she says.
Recognizing a market, some clinics are ramping up their gross sales efforts. Acibadem, a number one healthcare group in Turkey, held an occasion on the Royal School of Surgeons in London final week to mark the opening of its UK workplace, which promotes its medical companies. On-line, clinics in Europe pay for advertisements that pop up when individuals google phrases like “hip substitute” whereas brokerages promote remedy packages providing to ship sufferers to Thailand and India for cut-price care.
The UK authorities advises sufferers to make sure any hospital or clinic they go to is correctly regulated and that they’ve insurance coverage that covers pre-planned medical care overseas. Sufferers also needs to contemplate potential language boundaries and any aftercare they’ll want on returning to the UK, the NHS says.
Sufferers who travelled overseas mentioned they thought of the dangers and determined they had been price taking.
“On the finish of the day it’s benefiting my high quality of life,” says Stuart Yeandle, 70, from Ceredigion, western Wales, who had a complete hip substitute in Lithuania final week after going through a “three or 4 yr wait” at house. He says that whereas he could have an appointment with an NHS nurse to take away the staples, the online profit to the well being service outweighs any perceived negatives. “It’s serving to the NHS in lowering numbers and permitting individuals who can’t afford it to get it achieved sooner,” he says.
For a lot of others who’re ready, paying for faster entry is an possibility that continues to be out of attain. The variety of Britons utilizing crowdfunding for personal medical bills has surged within the final 5 years. However whereas lots of of campaigns are reside – for therapies starting from hip operations to ACL restore and mind aneurysm surgical procedure – many by no means attain their goal.
Final yr, Samantha Barker, 25, launched a GoFundMe attraction to pay for surgical procedure at a specialist hospital in Romania after studying that the wait in Malvern, Worcestershire, can be no less than 65 weeks.
The gymnasium teacher says she was in agony resulting from endometriosis, a situation the place tissue grows on the surface of the womb or uterus which may trigger extreme ache and infertility. “I’d be screaming within the toilet at 2am on the ground, in a lot ache I couldn’t converse. They’d name an ambulance and say it’s essential to go to A&E, then give me morphine and inform me to return house,” she says. “There was simply no hope.”
Ultimately, she didn’t come near her £3,000 purpose, so couldn’t afford to go. As a substitute she had a much less most popular, non permanent remedy at a UK non-public clinic which gave her the choice of repaying the £4,022 over 24 months.
It has improved her high quality of life, however she has heard from others that for much less cash, the usual of care in Romania would have been “a lot greater than the UK”. “If I’ve to have surgical procedure once more I’d positively try to have it overseas,” she says.