The Health City Cayman Islands project represents a new phase in the Caribbean’s medical tourism ambitions. While it seems that every country in the region is claiming to have pans in the fire, the envisioned 2,000-bed hospital and supporting development in the district of East End in Grand Cayman dwarfs the schemes imagined elsewhere in the region.
The medical tourism project, locally known as the Shetty hospital, has caught the attention of international researchers interested in the feasibility of large-scale medical tourism in the Caribbean and the potential effects of such a large development on a small territory like Cayman.
Simon Fraser University professor Jeremy Snyder said, “One of the big key differences for the Health City development in Cayman is the scope of it. If they really spool it up to the size they’re talking about, they will be a massive player globally.
It will certainly be the largest such development in the Caribbean targeting international patients.”
Health City is a joint venture between Dr. Devi Shetty’s Narayana Hrudalaya group and Ascension Health Alliance, which runs the largest Catholic and nonprofit health system in the United States.
Another distinguishing characteristic of Cayman’s project is its reliance on foreign-trained medical professionals who will live on island full-time, said Mr. Snyder, a health sciences faculty member who participates in the university’s medical tourism research group, which has studied the sector in different countries, such as Barbados, India, Jamaica and Mongolia.
Mr. Snyder said he was putting together a grant application to look at several sites in the Caribbean, including Cayman, as the region seems “a little bit more realistic for Canadian patients” than, say, flying to Asia.
The Simon Fraser group is one of a relative few dedicated to studying the topic of medical tourism. Mr. Snyder said it’s difficult to predict if particular projects will work out or what their precise impacts – positive and negative – might be.
“There’s a lot of speculation out there, and not a lot of good empirical research. We’re trying to contribute to that now,” he said.
Good signs for Health City are that it is backed by Dr. Shetty’s group and Ascension, its apparently solid financing and the fact that construction is well under way.
Caribbean medical tourism
Existing medical tourism projects in the Caribbean are relatively small. As an example of a successful initiative, Mr. Snyder referred to the Barbados Fertility Clinic, a Joint Commission International-accredited facility established in 2002. The clinic attracted 260 medical tourists, mostly from the Caribbean, U.K. and U.S., in 2011, according to a September 2012 report, which Mr. Snyder co-authored.
“They’re very good, but they’re very small,” he said. “That tends to be what we see now in Caribbean countries.”
Existing medical tourism in Caribbean countries tends to involve elective procedures like fertility treatment or cosmetic surgery, or else offer services not available in the patient’s home country, such as stem cell therapy or, for example in Bermuda, a new prostate cancer treatment. Cuba offers a variety of services, including treatments for eye diseases.
On the other hand, Health City’s initial 140-bed hospital will focus on cardiac, cardiologic and orthopedic services, with costs 40 to 50 percent of U.S. rates. When all phases of the US$2 billion development are complete, all specialties will be available. Health City also will include a medical university. Dr. Shetty has predicted that one in seven Caymanian graduates (out of about 700 per year total) would enter the medical field if the medical university were available.
Mr. Snyder described the project as indicative of a “maturing sector in the Caribbean.”
“Cayman, because they’ve gotten in early, may be one of those success stories,” he said.
Time-share vs. resident
A company called American World Clinics has proposed creating a US$200 million hospital with 50 beds in Barbados, signing a government lease for a former private hospital in June 2011. According to April 2013 Barbadian news reports, the hospital’s projected opening date had been pushed back from summer 2013 to 2015, as developers awaited financing and final government approval. In June, the company was preparing to start construction, according to reports.
The group also has explored opportunities in the Canary Islands, Uruguay and Asia, and visited the Bahamas in April to pitch a plan for a US$200 million-US$250 million hospital.
Unlike Health City, the American World Clinics group has talked about having North American physicians participate and sign up for more of a “time-share style membership,” as well as take their patients abroad for surgery.
In Cayman, Dr. Shetty has said Health City will be attractive to physicians from different countries, including the U.S. and India, looking to settle down.
The magnitude of Health City raises some concerns, such as if there will be enough housing to accommodate large numbers of health care workers. Another human resources-related concern is if the medical tourism hospital will soak up technicians, nurses and orderlies from the public system, Mr. Snyder said.
“Relative to the population, it can have such a distorting effect if human resources issues are not planned well,” he added.
Other concerns about any major development, including Health City, are their possible negative impacts on the natural environment. Health City developers have repeatedly attested to the sustainable features built into the project.
The unknowns are what make new and proposed medical tourism projects of interest to researchers.
“On the one hand, there’s a lot of upside. There are a lot of incredibly talented Indian doctors. I imagine Shetty, as a big player, will be able to pull it off,” Mr. Snyder said. “There are a lot of risks involved. It’s not a proven concept in the Caribbean.”