Investors brief St. Maarten MPs about plans for US $128Million medical tourism project

~ Cupecoy possible location for new hospital ~


PHILIPSBURG--A second group of investors under the name "Thukela" unveiled plans Monday to build a US $128.5-million hospital named International Medical Center (IMC) St. Maarten, "possibly" in the Cupecoy area, as part of plans to exploit medical tourism here.

Another group, the Florida-based Advanced Orthopedic Centre, had expressed earlier this year its desire to open a multi-disciplinary clinic to cater to residents and visitors.

Representatives of the two groups have met, but were unable to come to an agreement to work together, IMC Project Director Sandra "Sandy" Papale told Members of Parliament (MPs) in a meeting of the Central Committee of Parliament yesterday. She said IMC's intention was to create a "world-class medical centre" servicing world needs for first-class medical procedures with "top global surgeons and specialists."

Architect David Morrison also attended the Parliament meeting. The facility will combine medical facility and resort-type facilities for patients and their families to be able also to enjoy what St. Maarten has to offer.

News of the plans drew mixed reactions from MPs, some of whom said it would be beneficial to St. Maarten, while others questioned whether it would be competition for the existing St. Maarten Medical Center (SMMC) and sought clarity on issues such as provisions for local labour, liability insurance, etc.
IMC says its aim is to "bring the world to St. Maarten and introduce our island as the hub for medical tourism servicing the Americas, European and possibly the Asian and mid-Eastern markets."

Papale said the intention was for the facility to offer procedures and treatments based on what St. Maarten thinks is necessary and not any that would be in direct competition with SMMC.

However, in a feasibility study on the initiative, the group lists medical services to be offered as diagnostics, pre-operative care, cardiovascular care (invasive and non-invasive), oncology, radiology, orthopaedic treatment (spine work; hip and knee replacements), stem cell research/implementation, neurological evaluation, general/internal medicine, gastroenterological treatment, cosmetic/plastic surgery, urology, dentistry (including cosmetic), aqua therapy, physiotherapy and imaging (CT, MRI, EEG, etc.), as well as a hyperbaric facility and a pharmacy.

The centre also would address the needs of clients looking for preventive medical care, with attached residences to cater for post-treatment recovery and relaxation.

"The St. Maarten economy will benefit by the influx of visitors, who will often take much-needed vacations after their procedures. The neighbouring islands of Anguilla and St. Barths, who cater to the rich and famous, BVI, St. Kitts and Nevis, Antigua and Barbuda, as well as the existing mega-yacht community will also find the location of this world-class facility ideal and will partake in its services, bringing a further influx of monies to the local economy," it was stated in the feasibility study.

Papale told MPs that while Cupecoy was their first choice in terms of a venue, the group had a "plan B" to construct the hospital at another location if plans to acquire the Cupecoy venue were to fall through. She said that while the group's initiative was still in the early stages, financing to build the hospital would not be a problem.

"We won't want any financing from government," she said. Investment will come from multiple sources with which government would be happy, she said. She did not disclose the sources. However, she said local medical practitioners and associations representing medical practitioners would have an opportunity to invest and become shareholders in the facility. They also would be given an opportunity to work at the facility or to upgrade themselves to be able to work there, if their training is not up to par.

The intention of Monday's presentation, she said, was to secure a letter of support from Parliament, so that she could proceed with securing investment and move ahead with the project.

Papale said she had met and held discussions with Health Minister Cornelius de Weever and Independent MP Patrick Illidge. She said she had also given the former government a presentation on this project and on a hotel project with which she had been involved.

Papale, who said she had been the driver behind this initiative for the past three years, said many persons had died, been misdiagnosed or had lost a limb unnecessarily because of the timing of emergency services and the unavailability of equipment in St. Maarten.

She said that while she could not give any guarantees, she had never failed on any project in which she had been involved. Papale said locals also would be catered to at an affordable price, which she said would be determined by local insurance companies and medical practitioners.

Medical tourism
Papale, an Executive Vice President of Prudential Douglas Elliman, a New York-based residential real estate company, said research done by the group showed that there existed a real and distinct need for a "one-stop" medical, lifestyle and wellness facility in St. Maarten, which "will become a prime development initiative and market leader."

"The cost of medicine in the US is so high that people are desperately looking for alternatives. We will be fully inclusive and we hope to bring to this island the best surgeons and specialists in the world in each medical discipline, to cater to tourists and local people," she said.

In its feasibility study, the group said the cost of surgery in India, Thailand or South Africa could be as little as one-tenth the cost in the United States or Western Europe. A heart valve replacement that would cost $200,000 or more in the US could cost as little as $10,000 in India, including airfare and a brief vacation package.

Similarly, a metal-free dental bridge costing $5,500 in the US costs some $500 in India. A knee replacement in Thailand, including six days of physical therapy, costs almost one-fifth what it would in the United States. Laser eye surgery costing $3,700 in the US is available in many other countries for only $730.
"Therefore the financial savings benefit is one of the leading aspects of medical tourism that causes increasing interest from visitors," the study said.

According to the group's "low-range indicative financial projections," this project is likely to yield a 10-year internal rate of return (IRR) of 14.4 per cent for investments in St Maarten.

The study said the Caribbean had welcomed health and wellness travellers seeking out its warm climate, fresh air, soothing seas and mineral springs to prevent illness or aid in recovery. Now it is the medical tourism market segment involving those seeking curative treatment – with a bit of holiday on the side.
The major driving force is a growing demand in the Caribbean's traditional tourism markets of North America and Europe, where more and more people are opting to travel abroad for medical treatment sooner or less expensive than they can have it at home.

MPs present asked a number of questions on the initiative. However, Papale was unable to answer certain questions because she said the group had not yet met with any stakeholder and the plan was just in its preliminary stages and nothing was set in stone. She said once government endorsed the initiative, further discussions and plans for the facility could take place and more details on specifics could be ironed out. She said too that she did not want to create "false hopes" about the project.

Independent MP Frans Richardson said based on the questions asked and the responses given, the project had been brought to Parliament prematurely, because Papale had been unable to answer many of the questions posed.

Parliament President Gracita Arrindell's reaction to Richardson's comments promoted Richardson to say that his opinion as an MP should be respected and that Arrindell should be neutral as the Parliament President.
Arrindell later responded by saying that she was not neutral, because she had a vote as an MP. Some MPs of the governing coalition said the group had not wasted its time going to Parliament with its plans.
One of the questions asked by Democratic Party (DP) MP Leroy de Weever was how the group could assist SMMC, which needs $17 million. Papale said that while it would be easier for her to raise $150 million for a viable, world-class clinic than it would be to raise $17 million for a local St. Maarten clinic, the high-profile image of IMC would be the way to raise funds, as well as for the local hospital.

The proposed venue for the clinic was another issue raised by some MPs, who had concerns about the distance. Papale said this was the preferred venue for the hospital, the reasons for which would be disclosed at a later stage.

Based on other concerns raised by some MPs about the segment of the population without medical insurance and unable to pay, Papale said an agreement had been made with medical practitioners who would work at the facility that 10 per cent of their work would be pro bono.

On the issue of the Florida-based group that also is interested in setting up a hospital here, Papale said a member of her group had flown to Florida to discuss with that group the possibilities of working together. However, she said that while the vision of the two groups was primarily the same, they differed on certain issues and couldn't come to an agreement to work together.

Regarding concerns of possible competition by two groups, Papale said two medical facilities wouldn't be too much for St. Maarten. She said competition was healthy, that her group had confidence in the quality of its services and that government should ensure that any other facility at least provided the same level of services.