voxy.co.nz – A University of Canterbury (UC) lecturer is concerned about the booming medial tourism industry, combining cosmetic or dental surgery with an overseas holiday, because of the future of medical services and health security. UC Professor Michael Hall, editor of a recently released book on international medical tourism, said that the lack of accurate data on the international flow of medical tourists, along with some governments promoting medical tourism was creating substantial challenges to national and global public health delivery. The Wall Street Journal has reported the international medical tourism industry would reach $US100 billion this year. The way medical tourism has evolved is the result of deliberate decisions by governments as to their spending, economic, welfare and taxation priorities and shed a substantial light on their commitment to public health provision,” Professor Hall said. In many western countries the growth of medical tourism is the result of the failure of some governments to respond to increasing demands for public health services. Some governments see medical tourism as a means of not only raising revenue but also as a way of subsidizing their ailing health systems.” He said medical tourism was raising substantial questions about equity to medical and healthcare access as well as the long-term implications of medical tourism. Some governments might even feel relief when people travel overseas for medical treatment as it would potentially take the pressure off local services. Growth in international medical tourism was a reflection of globalization and changing political philosophies on health provision. But he said not all medical tourism was bad. In some cases for cultural or language reasons travelling internationally for medical treatment made a lot of sense. Similarly, cross-border medical treatment in the European Union provided opportunities for economic efficiencies while still being in a high quality medical environment. Nevertheless, he said there was also a dark side to medical tourism. There are major issues with respect to quality of treatment, liability if things go wrong, as well as the ethical dimensions of medical practices in some cases. Medical tourism also reinforces the current mind-set of some governments and medical institutions that changes the perspective from that of a patient to that of a consumer. How does this affect the traditional patient and medical services provider relationship? What are the obligations to treat if things go wrong, and who should pay?” Perhaps the most concerning aspects of international medical tourism is the potential danger it poses to public health. Medical tourism can only further globalize the growing drug resistance of some medical diseases and conditions while also being a potential vector of future pandemics. Unfortunately, even the best bio-security arrangements make it very difficult to intercept people returning from medical treatment overseas who are carrying either antibiotic-resistant bacterial infections or a disease as the symptoms may not show up immediately. Such events or outbreaks are then a major cost on the public health fund in their own right. We need to get a much more rigorous assessment of the potential longer term effects of medical tourism not only on people who decide that they want to travel abroad for treatment but also because of the effects on health services and public health.”