In Bangkok a colonoscopy cost him the equivalent of HK$2,000. 'The very cheapest you'd pay in Hong Kong would be HK$10,000.'

Ruben Toral, the Bumrungrad's director of international programmes, said the hospital initially targeted countries in Southeast Asia where health-care facilities were below standard, but now saw patients from more than 140 countries around the globe. 'They come here for everything,' Mr Toral said. 'For simple routine check-ups, to neurosurgery and heart surgery.' Last year, only about 10,000 of the hospital's 264,000 overseas patients came from Hong Kong and the mainland, but Mr Toral saw southern China as a growth area and said the hospital planned to focus more resources on marketing its services to the region.

With a good public health-care system back home, Mr Toral said that in addition to check-ups, Hong Kong people generally travelled to the Bumrungrad for elective surgery including laser skin treatment, laser eye surgery, dental work and plastic surgery. 'These are things they would normally have to pay for out of their own pockets in the Hong Kong private health-care system,' Mr Toral said.

The advantages Thailand offers include a 50 to 70 per cent savings on the cost, immediate access to procedures and the chance to combine treatment with a holiday. Indeed, the Thai authorities emphasise the beaches and other tourist attractions in their efforts to entice people to come to the kingdom for health care. Officials are well aware they have to showcase Thailand's unique attributes, especially as it now faces tough competition from other nations trying to lure the health tourists.

In recent years both Malaysia and India have recognised the potential for foreign revenue earnings and are now marketing their medical sectors overseas. Malaysia, which promotes itself as the cheapest medical tourism destination in Southeast Asia, hosted about 85,000 overseas patients last year and is planning to further develop the sector. Initially, medical tourists in India consisted primarily of its nationals living overseas, but its hospitals are beginning to attract increasing numbers of foreigners, and the country is highlighting its medical services in tourism promotions worldwide.

Singapore's government began taking active steps to develop the island state as a health-care hub three years ago. Health care there is more expensive than in its three Asian rivals. A heart bypass in Singapore can cost around S$26,000 (HK$116,000) compared to about HK$54,000 in Malaysia. But the city state seeks to sell itself on the basis of its expertise in medical specialities, rather than the accompanying leisure experience. That's not to say it can't boast hotel-standard establishments. Opened just last year, the Raffles Hospital highlights its business centre facilities and assistance with air ticketing and local tourist information - as well as its heart and cancer centres.

Last year 200,000 foreigners were treated in Singapore hospitals, most from neighbouring Indonesia, but the government is now looking further afield for customers. 'We will also be targeting China as a potential market to promote Singapore's health-care services,' a government spokesman said. 'China has vast potential for economic growth, and its people are becoming better informed about higher standards of health-care services and medical needs.'

This fact hasn't escaped the notice of many in Hong Kong. Earlier this month, the Trade Development Council (TDC) hosted a 'brainstorming session' involving representatives of the medical sector to discuss promoting the city's health-care services on the mainland.

Dr Lo Wing-lok, the president of the Hong Kong Medical Association and a legislator, believes the recent easing of restrictions on mainlanders travelling to the territory as individuals opens up great opportunities. 'It's more and more likely that Hong Kong will become a medical tourism destination, especially for people from Guangdong and the Pearl River Delta region,' he said.

The Adventist Hospital in Happy Valley has seen the number of its mainland patients double since the rule change, albeit from a low base. Director of business development Jeremy Low said mainland patients now accounted for 8 per cent of all patients, up from 3 to 4 per cent before. He was keen to increase that number further, and believed the government had a role to play in helping to boost the sector.

Health-care providers from Singapore, for example, have just been on an eight-city tour of Indonesia promoting their services under the branding of 'Singapore Medicine' as part of a government tourism road show. Promotional materials talk of the road show 'taking Indonesia by storm'.

But the deputy medical superintendent of the Hong Kong Sanatorium and Hospital, Dr Walton Li, would not like to see Hong Kong adopt this approach to target patients from the mainland. He cautioned that Hong Kong's medical sector should be careful to avoid being viewed as 'invaders' of the China market. 'I don't want to just go in there without their involvement and advertise and canvass patients from China, just as the medical council wouldn't want to see [mainland] Chinese come over here.'

Dr Li reported a slight increase in the number of mainland patients at his hospital since the travel restrictions were eased. But he considered word of mouth as the most important marketing tool and said maintaining quality service is paramount. 'We'll have to make sure this first wave is properly taken care of, then they can go back and tell the others,' he said.

Dr Lo agreed that partnership was the key when it came to the China market and said co-operation with professionals on the mainland was also necessary for follow-up care. He would like to see reciprocal arrangements with hospitals in Guangdong. Dr Lo said while clinics there could refer patients to Hong Kong for treatment unavailable on the mainland, opportunities also existed for mainland health-care providers to treat Hong Kong people on the mainland. 'Definitely in the area of convalescence. China has a lot of land, and recently new hospitals have been built in pleasant settings in cities such as Zhuhai.' Dr Lo said these could serve Hong Kong people with chronic illnesses who would not be able to afford a long stay in a similar private hospital in Hong Kong.

But not all share the legislator's enthusiasm about Hong Kong's potential. Anthony May, vice-president of strategy consultants, the Monitor Group, doubted whether the SAR could really become a health-care destination in the same way as Singapore or Thailand. 'You have to think quite carefully about how you are going to compete for these patients,' he said. 'What's going to cause them to come to Hong Kong as opposed to sticking with some of the Guangzhou hospitals, for example?' And Singapore, Mr May said, had 'great facilities, great reputation, great quality, at a reasonable price', while Malaysia and Thailand could offer 'comparable quality at a much cheaper price'. However, Dr Lo insisted the city was well placed to compete because it wasn't just a question of price. 'Hong Kong has the rule of law, and an up-to-scratch consumer protection system and we also have the Medical Council, even though it's come in for criticism recently, it does serve a better function than its counterpart on the mainland and other parts of the world.'

Mr Low of the Adventist also pointed to Hong Kong's language advantage over Thailand and Malaysia, and he said it beat Singapore by its geographical location. Dr Raymond Yeung of the University of Hong Kong's Medical and Health Research Network believed mainlanders who could afford it would prefer to come here rather than use the facilities back home because of the quality of the treatment. But Dr Yeung, who earlier wrote a paper on the issue for the TDC, noted that Hong Kong's private sector was relatively small and, at least until recently, he said it didn't seem keen to market itself. 'Success depends on whether the local professional groups buy this idea or not,' he said.

Dr Lo agreed, but said the government needed a policy to encourage the private sector to grow. He submitted a plan to the administration about what the government and private sector could do to promote Hong Kong's medical services, including the proposal of a health services expo which could be moved to different areas of the mainland, particularly Guangdong.

The TDC said it was ready to help. But its spokesman Lawrence Yau said more discussions were needed before a plan could be formulated. 'We need to have a clearly defined product before we can map out a strategy to promote it,' he said. Mr May believed bringing in patients from the mainland would certainly help Hong Kong's private sector. But he cautioned that Hong Kong should guard against jumping on the health tourism bandwagon without giving the matter sufficient thought. 'Let's be skilful and strategic and smart about it and not just spend money, and hope,' Mr May said.