CWhen athy Rice decided to fly to Lithuania, she had been in excruciating pain for 18 months. “I was going up the stairs on my hands and knees. I couldn’t go to the store. I had no quality of life,” she said.
Rice, 68 and mother of four grandchildren, was told she needed knee replacement surgery for damage caused by osteoarthritis but, like millions of NHS patients, faced a grueling wait.
At a clinic in Kaunas, Lithuania’s second-largest city, the surgery is arranged within weeks and costs €6,800 (£5,967) – about half the cost in the UK. Prices include pre-travel consultation, return flight, airport transfers, two nights’ accommodation in an en suite patient room, pre-operative check-ups and post-operative physiotherapy.
“I thought, ‘Look at your options. You can stay here and live with this pain for a few more years, or you can make a decision,'” Rice said.
The former health sector worker from Glasgow is one of a growing number of Britons traveling abroad for routine medical care. She had never been private before, nor had she ever thought of being private. But last week, a year after the first operation, she returned to Lithuania to have the same operation on her other knee. This time, she said the wait she faced on the NHS was three years.
She explained tearfully that she had sold her house to pay for surgery in Lithuania. “People think if you do that, you’re going to get a nice pension, or you’re well off. But the driver here is that people are in pain,” she said. “This is not medical tourism; this is medical hopelessness.”
In the basement gym of the same hospital in Kaunas — a gleaming white clinic neglected by Soviet-era apartment blocks — another patient, William Grover, 79, works out aerobics walking around.
The grandfather-of-eight, from Portsmouth, spent €7,000 (£6,146) two days after right hip replacement surgery. After facing uncertain NHS waiting times, the former construction worker decided to fly the two-and-a-half hours from Luton to Lithuania to have surgery at the Nordorthopaedics clinic. A private hospital in the UK quoted him £15,000.
“I used the NHS all the time. I never thought I needed to be privatized. But my hip was getting worse and I got to a stage where I was just thinking, ‘What do I do?'” he said.
Hit by the pandemic, workforce shortages and a chronic lack of social care capacity, the UK’s health system is under enormous pressure. The latest NHS figures show that in November alone, 7.19 million people were waiting for treatment in England, with 406,575 of them waiting for more than a year. At the end of September last year, more than 600,000 patients were waiting for planned surgeries in Scotland, and more than 750,000 patients were waiting to start treatment in Wales in October.
A Department of Health and Social Care spokesman said it was “working tirelessly” to ensure people got the care they needed and that the NHS had “virtually eliminated waiting times for treatment for more than two years”.
The Welsh government said it had “ambitious targets” to tackle delays in planned care, while the Scottish government said it would open four national treatment centers which could deliver more than “12,250 additional procedures, depending on the workforce”.
But more and more are resorting to privatization. Google Trends data shows UK searches for ‘private healthcare’ are at an all-time high, while data from the Private Healthcare Information Network shows more than a third more people paying for private acute care than before the pandemic, Up to 193 percent increase in paying for hip replacement surgery.
For those who cannot afford private care in the UK, traveling abroad may be attractive. In some countries in Europe, surgery can cost half as much as the equivalent treatment in the UK, even after accounting for additional costs such as post-operative rehabilitation.
There are no reliable sources of data on UK outbound medical tourism, but the Office for National Statistics (ONS) estimates that around 248,000 UK residents traveled abroad for medical treatment in 2019, compared to 120,000 in 2015.
For years, the medical tourism market has been dominated by people crossing borders for tummy tucks, dental procedures and other cosmetic treatments.But Keith Pollard’s editor-in-chief International Medical Travel Journalsaid there was evidence of increased demand for core healthcare, with NHS waiting lists “driving business”.
Clinics in Lithuania, Hungary and Spain have all reported increased demand for elective procedures such as hip surgery, he said. “More and more people are opting out of the NHS to pay out of pocket and afford private treatment in the UK. There is another group of patients who may not be able to afford it, but might pay £3,000 or £4,000 for an overseas procedure.”
Lithuania, with a total population one-third the size of London, is growing in popularity because it is easily accessible, relatively cheap and has a good reputation among international patients.
This year 500 patients are expected to visit the Nordclinic in Kaunas for only orthopedic procedures, including hip and knee replacements, Achilles tendon repairs, and foot and ankle surgery, up from 392 last year and 150 pre-Covid. The clinic also has a branch that provides general surgery, including hernia repair and gallbladder surgery. Since January, five Britons have had their gallbladders removed.
Before their trip, patients undergo remote consultations, fill out health questionnaires and provide relevant scans and blood test results. When they come back, they are expected to have X-rays in three months and then return them to the clinic. If a problem arises, the patient will be entitled to further free treatment to resolve the problem. Other clinics, like nearby Gijos Klinikos, a sprawling hospital with wards like hotel rooms, have made the same promise.
Professor Sarunas Tarasevicius, a plastic surgeon at Nord, said that when he started working there a decade ago, almost none of the international patients he treated were from the UK. Almost all of them are now from England. “They’re usually old enough to go to a hospital near their home. But somehow they still make up their minds,” he said. “Some people borrow money from their children.”
Before Brexit, patients could be reimbursed for procedures such as hip replacements abroad if the NHS could not offer the procedure within a “reasonable” timeframe, usually around six months, Tarasevicius said. Funding for pre-planned care is now more difficult to come by, but patients come anyway. “We thought there would be a drop after Brexit, but it didn’t happen,” he said.
The British also need a medical diagnosis and treatment center about 100 kilometers away in the capital Vilnius. The four-storey hospital treats around 150,000 patients a year, around 5,000 of whom are from the UK. Most people want health checks — diagnostic tests like MRIs and scans. Others come for orthopedic surgery.
Chief executive Deividas Praspaliauskas said requests in the UK remained similar to pre-pandemic levels, but demand from Lithuanian patients surged during the same period. “People are planning to visit from the UK and we don’t have enough capacity to treat everyone,” he said.
Maja Swinder, patient coordinator at medical travel agency EuroTreatMed, observed a similar trend in Poland, with patients from the UK traveling to orthopedic surgery. “These patients were considered non-urgent cases under the NHS and some of them had their operations delayed several times,” she said. “People wait in pain [and] Some people can only use wheelchairs. “
The KCM Clinic, a private hospital in Jelenia Góra in southwestern Poland, said the number of patients undergoing orthopedic surgery in the UK would increase by 20% to 30% in 2022 compared with 2019.
In France, Carine Briat-Hilaire, chief executive and co-founder of Toulouse-based medical travel provider France Surgery, said her company saw high demand for cardiac and orthopedic procedures from British patients. “Before Brexit, Britons came to France for healthcare purposes because they were reimbursed by the NHS. Now they come to France because of the surge in waiting lists in the UK,” she said.
After discovering the market, some clinics are increasing their sales efforts. Acibadem, Turkey’s leading healthcare group, held an event at the Royal College of Surgeons in London last week to mark the opening of its UK office, which aims to promote its medical services. Online, clinics in Europe pay to pop up ads when people search for terms like “hip replacement” on Google, while brokerages sell treatment packages offering to send patients to Thailand and India for reduced-price care. Serve.
The UK government advises patients to ensure that any hospital or clinic they visit is properly regulated and that they have insurance that covers pre-planned medical care abroad. Patients should also consider potential language barriers and any aftercare required upon return to the UK, the NHS said.
Patients who have traveled abroad said they considered the risks and decided it was worth a try.
“At the end of the day it has improved my quality of life,” said Stuart Yeandle, 70, from Ceredigion, west Wales, who had a total hip replacement in Lithuania last week after “three or four years of waiting at home” “. He said that while he would book an appointment with an NHS nurse to have the staples removed, the net benefit to the health service outweighed any perceived negative impact. “It’s helping the NHS with fewer people and getting those who can’t afford it done faster,” he said.
For many others who are waiting, paying for faster access is a distant option. The number of Brits using crowdfunding to pay for private healthcare has exploded in the past five years. But while hundreds of activities are underway—from hip surgery to treatments like ACL repair and brain aneurysm surgery—many never reach their goals.
Last year, Samantha Barker, 25, launched a GoFundMe appeal to pay for surgery at a specialist hospital in Romania after learning the waiting time was at least 65 weeks in Malvern, Worcestershire cost.
The fitness trainer said she was suffering from endometriosis, a condition in which tissue grows in or outside the uterus, causing severe pain and infertility. “I’d be screaming on the floor in the bathroom at 2 a.m. in such pain that I couldn’t speak. They’d call an ambulance and say you needed to go to A&E and give me morphine and send me home,” she said. “There is no hope.”
In the end, she wasn’t close to her £3,000 target and couldn’t afford to go there. Instead, she received less popular temporary treatment at a private UK clinic, which gave her the option to pay back £4,022 over 24 months.
This has improved her quality of life, but she has heard from others that, for less money, Romania has “much better” healthcare than the UK. “If I had to have surgery again, I would definitely try to do it abroad,” she said.