Amid increasing competition at home, leading private healthcare companies are looking overseas, and the Middle East is turning into their new battlefield.
Leading Thai hospitals Bumrungrad International and Bangkok Hospital are investing more heavily abroad, while at least two other operators are ratcheting up advertising in international markets.
In June, Bumrungrad signed a four-year agreement with the Abu Dhabi Health Authority to operate al-Mafraq Hospital in the United Arab Emirates.
Under the agreement, Bumrungrad will manage the popular hospital in the al-Mafraq region. It has 460 beds and sees 310,000 patients annually. Construction will start this year on a new modern hospital building, replacing the present facility by mid-2011.
Dennis Brown, chief executive officer of Bumrungrad International, said Dubai was an attractive market as "the UAE is shifting from a government-provided healthcare system to a private system funded by a national insurance plan. Secondly, there is significant economic and population growth occurring in the UAE."
The firm is optimistic that it can meet investment expectations within five years of opening the hospital in Dubai.
Group CEO Curtis Schroeder said his company had beaten many of the best healthcare-providers in the world in a highly competitive tender. Bumrungrad thus joins an elite group of international hospitals invited to manage facilities in the emirate, including Johns Hopkins Hospital and the Cleveland Clinic in the United States.
Bumrungrad has also entered into local joint investment to build hospitals in Dubai for the Dubai World Project. The first phase will feature a 250-bed facility opening next year.
Apart from the Middle East, the hospital has acquired all shares of Asia Renal Care (ARC), a privately owned regional provider of dialysis services based in Singapore.
While terms of the deal have not been disclosed, it marks the company's first acquisition outside its core acute hospital business.
ARC is a regional market leader, treating about 5,000 patients in more than 70 dialysis centres throughout Asia, primarily in Taiwan, Japan, South Korea, Singapore, Malaysia and the Philippines.
Bumrungrad also plans to invest US$20 million (Bt691 million) in Asian Hospital and Medical Centre, one of Manila's leading private facilities, in order to meet growing demand for high-quality private healthcare in the Philippines.
The phased expansion programme will include construction of a new 14-storey tower to accommodate more clinics, therapeutic services and in-patient rooms.
Bumrungrad assumed management control of Asian Hospital in February 2005.
The group is also interested in other investments in Southeast Asia, China and India.
The Economist reported that Bangkok's modern Bumrungrad Hospital had already seen tens of thousands of Americans each year and recently opened a new wing designed to handle 6,000 foreign patients, making it the world's largest private clinic.
Wallop Adhikomprapa, president of Bangkok Dusit Medical Services, which operates the Bangkok Hospital Group (BGH), said his company was reaching out to the Middle East in order to attract more international patients.
The group is negotiating with state agencies and private firms in Qatar, Bahrain, Abu Dhabi, Dubai and Saudi Arabia, hoping to sign cooperation contracts with them. Those contracts would entail BGH's partners sending their employees to BGH's hospital network in Thailand for medical services.
BGH has concluded similar contracts with Abu Dhabi's biggest oil firm, the Dubai Defence and Public Health ministries and the Qatari Public Health Ministry. It now operates 19 hospitals under the Bangkok, Samitivej, BNH and Royal International brands, the last one operating in Cambodia and Abu Dhabi.
Wallop said BGH was interested in entering Saudi Arabia, due to its large population.
"As everyone knows, Thailand has had troubled relations with Saudi Arabia, but if the situation recovers, that country will be a major market, one in which we are interested in doing business," he said.
BGH's second-quarter revenue from international patients rose 24 per cent year on year. Patients from the UAE, Japan, the UK, the US and Oman were in the top five internationally for that period, while the number of patients from Oman, Qatar and Ethiopia more than doubled year on year.
Chatree Duangnet, CEO of Bangkok Hospital Medical Centre, which is under BGH, said several agencies in the Middle East, including in Dubai, Abu Dhabi, Qatar and Oman, had approached the company about co-investing in the healthcare business.
Deals will be concluded this year, and they will represent big investments for BGH.
Chatree believes the Middle East will become established as a medical hub within five years.
BGH will open a new hospital in Abu Dhabi in the fourth quarter and a 100-bed hospital in Phnom Penh next year.
The Phyathai Hospital Group is also looking into expanding abroad. It is negotiating for the management of hospitals in the Middle East and China.
The group hopes to manage hospitals in Qatar, Bangladesh and Bahrain before moving into China. The first management deal should be signed this year.
It will take control of all management functions, including treatment, medical services, marketing, consultancy, information-technology systems and property care. Chief medical and international-business officer Surapong Ambhanwong said Thai hospitals were becoming more popular among foreign patients.
BNH Hospital director Dr Linda Kraivit said like other players, BNH was trying to attract more international customers by increasing its marketing activities instead of through added investment.
It is working with foreign insurance companies and organisations to send their staff to Thailand for treatment, because operations are much cheaper here than in many other countries.