What can Google tell us about medical tourism?

Who knows what's going on in healthcare? Who knows what conditions and disorders are causing people problems? Who knows what's happening in medical tourism?

Google!

Google is a treasure chest of information about how people are behaving and what issues are concerning them. Google logs the online activity and search behaviour of hundreds of millions of users. It knows what you and I do on the web everyday. It knows where we are, most of the time. And from the data that Google collects, it can draw conclusions. And so can you.

A recent example of this in the healthcare sector is Google Flu Trends . Google has realised that certain search terms are good indicators of flu activity. Google Flu Trends uses aggregated Google search data to estimate flu activity in a US state up to two weeks faster than the federal centres for disease control and prevention.

Outside of healthcare, a UK web intelligence company was able to predict the winner of a TV talent show, based on the online activities of people who were watching the show and researching the contestants online.
So what does Google know about medical tourism....? Probably quite a lot more than most people in the business.

Let's take a simple example. Suppose I want to know which are the most popular countries for cosmetic surgery for UK patients who travel for treatment.

I can analyse the search activity of UK internet users by looking at the relative number of searches for cosmetic surgery and plastic surgery which also incorporate location or country names.

I then combine all of this data to create a search volume of country related cosmetic surgery related phrases. For each country, I can then calculate a share of the total volume of searches. And we get the table on the right.

Interesting stuff.... Now, it doesn't tell me which countries people are actually going to (in the same way that Google Flu Trends doesn't actually tell you that people have flu), but I'm willing to bet that it's not a bad indicator. And it's probably a far better indicator than the top of the head data that many "experts" toss around.

So, if your job is about marketing medical tourism, you need to consult the new medical tourism guru - Google Inc.

Medical tourism: Survival of the fittest?

No industry is immune from global recession, and that has to be the case for the growing medical tourism industry. In past recersions, businesses in the healthcare sector have perhaps suffered less than others; in a recession, people still get ill, and it's often difficult to delay expenditure on healthcare. But there are some indicators that medical tourism is begining to feel the pinch.

According to a recent article in BusinessWeek, "Medical Tourism: Surviving the Global Recession", the Bumrungrad Hospital in Bangkok, one of the world's leading centres of medical tourism is seeing a fall in overseas patient revenues. Similarly, the Association of Private Hospitals of Malaysia is reducing its forecast of overseas patient revenues, and some Indian medical tourism providers are reporting that "medical tourism is on the wane". The situation is further complicated in India and Thailand by the recent terrorist incidents and political protests.

If we think back to 9/ll and the subsequent Iraq involvement, these events had a major impact on travel related businesses and medical tourism flows from the Arab States to the Western World. Countries such as the UK saw a significant drop in inbound medical tourism, and Arabic patients transferred their loyalty to countries such as Germany.

The counter argument is that in times of economic hardship, people are going to be more inclined to go overseas to avoid high costs in their own country. i.e. they look to buy cheaper, so this is good news for the medical tourism industry.

What's going to happen? Here are my thoughts:
  • The speed and size of this global recession is such that it must have a negative impact on medical tourism; people are going to hang on to their cash, and delay treatment whether that is treatment within their own country or overseas.
  • It doesn't necessarily mean that less people are going to travel for treatment.It probably means that the growth in number of medical travellers which has been widely predicted is going to be much less than anticipated.
  • Many of the "new-born" medical tourism facilitation companies that have appeared in recent months are going to find it tough going.
  • Those businesses in the sector that have their marketing act together will do best. They'll focus on those marketing activities that deliver results, they'll have a clear idea of what their marketing and service strategy is, and they'll look to generate business and referrals from existing and past patients. See "Five Tips for Marketing in a Recession"

So....it's going to be survival of the fittest in the medical tourism sector. There's plenty of opportunities out there, but there will be fewer to go around. Which means that some businesses are going to find the going tough.

How to run a medical tourism conference...

Autumn is conference season, and it seems that medical tourism is becoming the most talked about subject on the conference platform. Three years ago, there was little interest in this area, but in 2008 it seems that every events company and association has jumped on the conference bandwagon.

In recent weeks, I've attended the World Health Tourism Congress in San Francisco, the Health Tourism Development Conference in Vienna, the Health Tourism Show in London, the Global Healthcare Conference in Dubai and spoken on medical tourism to a meeting of UK NHS management, and to a Cerner Healthcare Convention in Kansas. My colleague, Philip Archbold has spoken at the Indian Medical Tourism Congress in Chennai. Coming up...I'm off to address the International Medical Travel Conference in Korea, and speak at a meeting of the Cyprus Health Promotion Board.

So, I've become a bit of a medical tourism conference "groupie.....

But it prompts the question: Do we need all these events, and are they actually worthwhile?

In my previous company, one of the core activities was event planning and management; many of these events were within the healthcare sector. So, I do have some knowledge of what makes a good event and what can go wrong. Being an attendee/speaker/delegate at these medical tourism events has been an eye opener. Frankly, compared to other industries most of them aren't delivering the goods.

Where's it going wrong?

Here are my top ten recommendations for medical tourism event organisers:

1. Set some objectives....
Most of the medical tourism events that I have attended seem to have some kind of vague objective of "let's get a bunch of people together to "address some of the issues", and facilitate some networking (and we'll make a bunch of money while we do it.....).

2. ....and measure your success!
If you don't have SMART objectives, you can't measure your success. Sending out a post event "What did you think of the conference?" survey is the usual cop out in this respect..but what is it actually measuring? Most medical tourism conferences don't even bother with this most basic of measurement tools.

3. Plan the agenda
The current approach appears to be mainly along the lines of "who can we get to speak". Why not plan an agenda, and then identify those people who would be best to cover specific topics? Let's have some speakers from outside of the medical tourism fraternity who can give a different perspective!

4. Buy professional expertise
If events aren't your core expertise, buy some expert help. Get a professional event organiser in to plan, market and run the conference, The Medical Tourism Association did a great job of getting numbers to the San Francisco Congress, but in terms of structure, content and organisation ........

5. Abolish the all day plenary session
Different people have different information needs. The medical tourism industry is a melting pot of providers, purchasers, facilitators, insurers, etc etc. Run specific, smaller workshops or sessions that cover key issues for targeted groups of delegates. Start the day with a lively, thought provoking keynote presentation then break the audience into smaller sessions. The Cerner Healthcare Convention has cracked this one. A stimulating keynote address each day followed by 300 plus targeted workshops for the 5,000 plus attendees.

6. Fire some of the speakers
I've seen good, bad and just plain awful this year. My greatest gripe? Speakers who have been given a clear and very specific brief...and then ignore it completely, often making a "This is what we do in XXXX, aren't we wonderful" presentation. All speakers are guilty of promoting their own interest/business. That's part of why they are there, and it's to be expected. But, it shouldn't make up 100% of their presentation. If you want me to name names, I'll email
them to you....

7. Ban the "destination presentation"
The conference platform is not the place to run a 30 minute "advertisement" ..... "my country/destination/hospital/company has the "highest quality healthcare", "state of the art technology" etc etc

8. Organise
If you're going to attempt to run some structured networking or "buyer meets seller" sessions, plan it properly, match up the right people and run it like clockwork. Take a look at other industries and see how well they do this.

9. Keep to time
If there's one thing a conference must do, especially when it's based on parallel sessions is run to time. If speakers over run, turn off the mike. Dubai could learn a thing or two here.

10. Make it fun!
Liven it up! We're human beings. We're out of our regular job for a few days. We want to enjoy ourselves. Will someone please do something different.....!

Finally, one medical tourism conference not to miss in 2009; the 2nd European Congress on Health Tourism in Budapest. Why? Under the guidance of a medical tourism expert, Dr Uwe Klein, perhaps this one will hit the mark?

Medical tourism: The answer to the global healthcare problem?

A recent article from McKinsey International highlights the magnitude of the challenge that leaders of governments in the developed countries are going to have to deal with sooner rather than later. The article looks at the increasing proportion of a country's wealth that is going to be dedicated to the health of its citizens in future years.

In Europe currently around 9% of GDP is spent on healthcare; in the USA, it's higher, nearer 16% of GDP. For the last fifty years, the increase in health care spending in OECD countries has been 2% above the GDP...... which means that healthcare is taking an increasing proportion of the national wealth. But what happens if this continues? McKinsey says that "if current trends persist to 2050, most OECD countries will spend a fifth of GDP on healthcare. By 2080, Switzerland and the United States will devote more than half of GDP to it, and by 2100 most other OECD countries will reach this level of spending."

Those are pretty astonishing statistics! There's a decent analysis in the article, outlining the supply and demand factors that drive this growth, and offering some arguments as to why this trend will not or cannot continue at this rate. However, the harsh reality is that whatever governments do, they and their citizens will be faced by the burden of ever increasing healthcare costs.

And that's the reason why healthcare is becoming global, and medical tourism is being talked about as one of the solutions. More and more, governments will not be able to provide and consumers will not be able to afford the healthcare that they need. The global market in healthcare provision will expand to meet the growing demand from both consumers and governments for low cost treatment overseas. And that's where medical tourism comes in.

Reference: Healthcare costs: A market based view: McKinsey International

Medical tourism ratings and reviews

It's been a couple of months since we launched medical tourism ratings and reviews. It's met with a variable response from the medical tourism industry, and from the patients themselves.

Medical tourism ratings and reviews at Treatment Abroad enables patients to provide feedback on their experience of travelling for treatment abroad. The Ratings and Reviews system is integral to our business philosophy of “helping patients to make the right choice”. It's run through Bazaarvoice, the US based world leader in reviews systems who operate similar systems for companies such as Dell, Sears, Argos and many others.

When a patient submits a review of a medical tourism agency, a hospital or a clinic, the review is checked by the Reviews Team to ensure that:
  • The review is valid, honest and fair comment.

  • It is not a spurious review that has been “invented” by a healthcare provider to promote their facility or to damage a competitor’s reputation.

  • The review does not bontain profanity or inappropriate content.

  • The review does not raise issues of legal liability.

Healthcare providers and agencies are given the opportunity to respond to any negative reviews.

So...what do the healthcare providers think of ratings and reviews?
It's interesting.... those medical tourism agencies and healthcare providers that are "marketing oriented" have adopted the approach with enthusiasm. They see it as a highly attractive way of generating "word of mouth" recommendation of their services and it doesn't cost them a penny.

Companies such as Gorgeous Getaways in South Africa and Vital Europe in Hungary are actively encouraging their patients to review their services:

Others are less enthusastic....and I'm not sure why! Is it because they are fearful of patients posting negative comments about their experience? Is it because they are just not switched on to the power of "word of mouth" and the way in whiuch consumers are using the web to influence product and service purchase?

Experience from other industries shows that:

  • 63% of consumers are more likely to purchase from a supplier, if it has ratings and reviews.
  • 77% of online shoppers use reviews and ratings when purchasing.
  • 82% of those who read reviews said that their purchasing decisions have been directly influenced by those reviews.

Asking people to record their experience of medical tourism should encourage more patients to travel for treatment abroad. And, Medical Tourism Ratings and Reviews should help healthcare providers to tune into the “patient’s voice”.

So...what do the patients think of it?
They love it! The feedback on their medical tourism experience is overwhelmingly positive, and it's helping to reassure other patients who are considering medical travel. Patients are healthcare consumers; and typical consumer behaviour is beginning to influence the way that they buy healthcare. If they can rate and review their hotel or holiday experience on TripAdvisor.... why not do the same for medical travel?

medicaltourism.com ......going, going gone?


What's a domain name worth? Especially in the growth business of medical tourism.

The Medical Tourism Association (of which my Company is a member) has recently announced that it is handling the sale of the domain name medicaltourism.com, on a commission basis. A reserve price of around $100,000 has been put on the sale.

Which raises the question of how you value a domain name and what is one actually worth?

The domain medicaltourism.com was originally owned by Sparrow Mahoney, who ventured into medical tourism after experiencing low cost surgery in Croatia after a car accident. Sparrow has now flown the medical tourism roost.The domain has been bought by a third party looking to make a fast buck.

Here’s a few recent domain sale prices in the health sector:
  • healthstore.com $27,500
  • healthcaresolutions.com $10,700
  • healthinsurer.com $4,595
  • healthglobal.com $2,700

So, would you pay $100,000 for medicaltourism.com?

There is certainly some value in the domain name.The words within a domain name can influence Google rankings, but it's certainly not a major factor. There's value in a domain name if it's associated with a strong brand or an existing web presence.

With regard to medicaltourism.com:

Bidding will take place at the World Medical Tourism and Global Health Congress in San Francisco in September.

Any offers?

EU Directive on cross border healthcare boosts health tourism

After a six month delay, the EU Proposal for a Directive on patient’s rights in cross border healthcare has finally been released. It provides an added stimulus to the already growing number of medical tourists who seek hospital treatment elsewhere in the European Union. Its aim is to create a formal framework for cross border healthcare and remove the obstacles that patients face if they wish to travel for treatment in other EU countries.


I'll attempt to answer some of the questions that people are asking about this new Directive and its impact.

Why do we need a Directive on cross border healthcare?
The Directive has come about from a desire to create a European market in healthcare, and to some extent as a result of European Court judgements which have upheld the rights of patients to gain reimbursement for treatment in other countries where they have been subject to "undue delay" in their own country.

What does it cover?
The Directive proposes a number of developments in cross border healthcare, including reimbursement of medical tourists, patient safety and quality issues, European cooperation on healthcare, assessment of new medical technology and standards for e-health and transfer of patient information between member states.

How will it affect UK NHS patients?
In April this year, NHS patient choice in the UK was extended, giving patients the right to opt for treatment anywhere in the UK. The Directive, in effect, extends this patient choice to anywhere in the EU, provided that the treatment is available at a cost which is the same or lower than the NHS cost.

Under the Directive, the NHS will be requested to establish a direct payment or reimbursement system. This means that patients will not have to fund the treatment and then claim the cost back from the NHS. They will have to fund their travel and accommodation costs. No prior approval is required from the NHS or the patient's primary care trust.

It doesn't mean that patients in the UK or elsewhere in the EU can opt for treatments overseas that are not covered by the NHS. So, if a new drug or a new procedure is available in another country, the patient cannot obtain payment for this.

How many patients will opt for treatment abroad?
Who knows? Patients may decide to travel abroad because:

  • Surgeons and hospitals with better results for their treatment may be available elsewhere in Europe.
  • Hospital infection rates may be lower in other European countries.
  • Faster treatment may be available elsewhere.

It is worth noting that:

  • There is no requirement for the patient to be suffering "undue delay" in treatment.
  • The patient will need a referal from a GP.
  • Patients cannot jump the waiting list in other countries..... which is one reason why why we will not see large numbers of patients travelling to the UK for treatment. They will join the end of the queue of existing UK patients.
  • And since the UK is one of the most expensive healthcare providers in Europe, this will also discourage an inflow of patients from lower cost countries.

How will it affect the NHS?
It depends on how many UK patients opt for treatment abroad. If the NHS can prove that the number could be so large that it would affect the planning and funding of healthcare facilities in the UK, then it can make an application to set up a "Prior Approval" system which means that a patient would have to apply for treatment abroad. This is unlikely, I believe. It would be an admission of failure by the Government that the NHS cannot compete in a competitive European marketplace.

Overall the Directive has to be a good thing for both the NHS and UK patients. It could reduce the burden on NHS waiting lists, and offer cost savings where cheaper treatment is available elsewhere in the EU. It would also mean that NHS hospitals would face increased competition and would have to improve their performance relative to other European healthcare providers.

What else is covered by the Directive?
In addition to clarifying the position regarding medical tourism within the EU, the Directive also embraces:

  • The establishment of common principles in terms of guaranteeing patient safety and ensuring quality and continuity of care.
  • Stimulating greater European cooperation on healthcare including the establishment of “European Reference Networks” which would create a concentration of expertise, training and resources for specific diseases and health issues.
  • Establishment of a European network for the assessment of new medical technology.
  • Establishment of standards for e-health, in particular the transfer of patient information and treatment records between member states.

When will it take effect?
It's a draft directive, so it has to go through the EU mechanisms to be officially adopted as policy. But it's a part of a consultation process that's been going on for three years, so it's likely to become reality.

Good news or bad news for the medical tourism industry?
Undoubtedly, good news! It will add to the credibility of medical tourism, and will mean that people become more familiar with and confident about travelling for treatment. It will also reinforce the need for an improvement in standards and business practices in the industry. (See the Treatment Abroad Code of Practice for Medical Tourism).

Ultimately, it will result in greater patient choice and more people will choose to travel for treatment abroad.

For patients seeking treatment now who can't wait until the Directive comes into force, they can download Treatment Abroad's Guide to Medical Tourism or visit Treatment Abroad.

Helping patients make the right choice of medical tourism service

More and more people are using online reviews to make decisions about the products and service that they buy. Consumers worldwide want to hear from “people like me” before they make a decision about which product or service to buy. TripAdvisor has become the first place that many people visit when they are planning a holiday or booking a hotel.

So, would medical tourists benefit from hearing about the experiences of other people who have travelled abroad for treatment? Undoubtedly, Yes!.

The web is now the first place that people look to research hospitals and clinics online before they decide where to go. Choosing a doctor, operation, or hospital, is a big decision, and the more opinions a patient can gather, the more secure they feel with their ultimate choice.

The philosophy of our online business is "helping patients to make the right choice". That's why we've just launched Treatment Abroad Ratings and Reviews to provide patients with the “word of mouth” that will help them to make the right choice of medical tourism service, hospital or clinic. We know from other areas of industry that:
  • 63% of consumers are more likely to purchase from a supplier, if it has ratings and reviews.
  • 77% of online shoppers use reviews and ratings when purchasing.
  • 82% of those who read reviews say that their purchasing decisions are directly influenced by those reviews.

But how much trust can people put in reviews of such services? A medical tourism agency, hospital or clinic, doctor or dentist may be tempted to either:

  • Create a fake review to promote their own service.
  • Create a fake review to damage a competitor’s reputation.

We have chosen BazaarVoice as the partner for our Ratings and Reviews system because of their ability to identify fake reviews through the algorithms they run on review submissions, the tracking of IP addresses of reviewers, the validation of email addresses, and BazaarVoice’s experience of moderating thousands of reviews for major clients every month.

We have also warned clients and healthcare providers that any attempt to bias our reviews service will result in immediate removal of all review content.

We'll see how Treatment Abroad Ratings and Reviews develops over the coming months. But we're sure it will help potential medical tourists to differentiate between the good and bad in terms of medical tourism service providers.

McKinsey and the medical tourism numbers game...

According to a new report on medical tourism from McKinsey (login required):
  • "Between 60,000 and 85,000 people annually travel abroad for inpatient hospital care, a number.....far lower than commonly assumed".

According to the Wall Street Journal:

  • ... the McKinsey report "contrasts sharply" with common assumptions and with figures often used by those who market medical tourism. "There's been an enormous amount of hype" regarding people traveling abroad to receive necessary procedures at a lower cost, Mango (from McKinsey) said.

So what are we to make of this "authoritative" report.....?

One industry insider who has compiled a comprehensive review of medical tourism suggests:

  • "The McKinsey figures are nonsensical......looking just at figures from Asia for travellers from Asia and the Gulf, they are way way out."

One problem with the McKinsey data is that it relies heavily on government statistics, and few governments record medical travel. Even where figures are collected then they do not include home nationals who work overseas going back for treatment, or US and other residents returning to a country of origin for treatment.

It's also a strange method of counting medical tourists, if you decide to leave out:

  • people travelling across borders for treatment, which would include UK to France or Belgium, Canada to the US, the US to Mexico, Mexico to the US , China to Taiwan or Hong Kong, central Africa to South Africa , Ireland to the UK, etc etc.
  • people travelling back to their homeland for treatment.
  • people travelling to the homeland of their parents/grandparents
  • expatriates working overseas
  • people who decide to mix travel and treatment eg UK travellers to Spain, South Africa
  • people who mix business travel and treatment
  • people who live in two countries eg UK and Spain
  • And..all outpatients

Other oddities...

If they reckon the number of medical tourists are 60,000 to 85,000 worldwide, how does this stack up against other reported data:

  • 70,000 - 100,000 UK medical tourists (from our own Treatment Abroad medical tourism research and the UK International Passenger Survey data)
  • Last year, 92,000 patients from the UAE visited the Philippines.
  • One dental clinic alone in Budapest that is treating over 4,000 patients from abroad each year.
  • 10,000 visitors to Korea last year for medical treatment, according to the Korean Tourism Organisation.
  • Singapore Tourism Board says 555,000 tourists received medical treatment in 2006.

And overall... it is a little strange to say that someone travelling overseas for a hip operation is a medical tourist, but someone travelling for a dental extraction or cosmetic surgery is not.

Whatever the real numbers are, McKinsey did conclude:

  • "Medical travel is a highly relevant market ........ The acceleration of unsustainable health care costs in many developed economies, the advent of advanced technologies in just a few locations, and the increasing concentration of wealth in developing economies are only a few of the factors fueling it. Over the next couple of decades, these trends may largely dispel the idea that health care is a purely local service"

So... good news for the medical travel industry!

A code of practice for medical tourism

At Treatment Abroad, we have introduced the first medical tourism code of practice for healthcare providers. The "Code of Practice for Medical Tourism" aims to encourage best practice in medical tourism through a commitment by healthcare providers overseas to a voluntary code of practice.

The standards of business practice and customer service in the medical tourism indutry are variable. But having said that ...they are probably much higher than many critics of the industry suggest. (In our recent survey of 650 medical tourists, 97 per cent of patients said they would be willing to travel abroad for treatment again).

The Code is an opportunity for agencies and healthcare providers to reassure patients considering overseas treatment that they are adopting best practice.

If the medical tourism industry continues to grow, it needs to adopt some common standards and best practices. Hence the Code of Practice for Medical Tourism. Healthcare providers and agencies who sign up to the Code will be identified as adopting a “best practice for medical tourism” and will be recognised on http://www.treatmentabroad.com/.

In addition providers who are approved will be able to display the Treatment Abroad accreditation mark on their website and patients will be able to access accreditation details online.
In order to receive accreditation, organisations are asked to demonstrate best practice in a number of areas covering provision of information, the patient experience and contractual terms, conditions and guarantees. The application will be reviewed by an independent consultant.
We believe that this is a positive step for the industry and offers a chance for providers to demonstrate their commitment to best practice in dealing with patients from overseas.

Further information about the Code of Practice for Medical Tourism is available at:www.treatmentabroad.com/medical-tourism/code-of-practice

Do concerns about MRSA and hospital infection drive patients abroad?

Medical tourists who travel abroad for treatment, don't just do it to save money. In our soon to be published "Medical Tourism Survey", 56% of the respondents who went for elective surgery abroad said that worries about the risk of MRSA/hospital infection in NHS hospitals were a "Very Important" or "Quite Important" factor.

According to the Health Protection Agency's latest data, there was an 18 per cent drop in cases of MRSA in England from July to September compared to the previous quarter (April to June). This is a drop of about 230 cases per quarter. however, there were still 1,072 cases reported in England during July to September 2007 .

The latest C. difficile figures show that there were 10,734 cases in patients aged 65 years and over in England, reported in the third quarter of 2007. This is a 21% decrease on the previous quarter. In patients between 2 and 64 years of age, 2,496 C. difficile cases were reported in the third quarter of 2007.

So.... there is some indication that the NHS is having some success in improving its poor reputation for hospital infection. But there's an awfully long way to go. The UK is way behind countries such as Norway, Sweden, the Netherlands, Czech Republic and Spain in controlling MRSA and hospital infection rates. (See MRSA statistics in UK and Europe).

Until the NHS can reduce hospital infection rates to a minimal level, patient concerns will continue to be a factor in why people choose treatment in private hospitals in the UK or treatment abroad.

EU Cross-border Healthcare Directive delayed

According to EurActiv, an independent media portal dedicated to EU affairs, the EU Cross-border Healthcare Directive which intends to lift restrictions on patients travelling for treatment in other EU countries could be either redrafted, withdrawn or downgraded.

The EU Cross-border Healthcare Directive has taken a couple of years to develop and was scheduled to go public on December 17th 2007. It became the main UK news story of the day (the EU had leaked early copies of the Directive to the media). But by midday, the EU had decided not to publish the Directive and announced a delay of 4 weeks or so in publication due to "agenda issues".

Methinks...that some governments including the UK were not too happy about the implications of the Directive and how it might place their own health system in a bad light as they became "exporters" of patients.

EurActiv believes that the Commission has been asked to redraft the Directive.

A representative of a medical stakeholders' organisation told EurActiv:

"This is an issue between the rich and poor EU member state. Health care costs vary widely across the EU, so it would be easier for rich countries to reimburse cheaper care abroad than for poor countries to reimburse their nationals seeking expensive care in wealthier countries."
According to a Commission spokeswoman, the proposal is still scheduled for publication at the "beginning of 2008".

High UK dental costs driving patients abroad

A new study has been published which compares the cost of providing dental treatment in nine European countries. The UK has the highest costs of dental treatment. (Note: the study compared the cost of providing dental treatment, not the prices that are charged to patients).

According to Siok Swan Tan of Erasmus University Rotterdam, the lead author of the study, differences in dentists' are the most important reason for the variation in costs. "They account for 70 per cent of total costs in England, and range from €0.09 per minute in Hungary to €2.88 a minute in England."

As a result prices for both NHS and private dental treatment in the UK are much higher than in other European countries. It's the main driver for the growth of dental tourism with Hungary the leading destination for UK patients.

The research is part of a wider European Commission study that compares the cost of medical procedure; the study was published in the journal Health Economics.

You can read a full report on the study on the Independent newspaper site. The story made front page news in the UK today.