Now try the same sentence with a different noun. The UK will grow its healthcare exports to £40 billion a year by 2030.

Something in the British throat closes.

Services are roughly three-fifths of everything the UK sells abroad. Business services — law, accountancy, consultancy, R&D, advertising — are the single largest export category we have, at around £194bn. Financial services add another £104bn. We are, in trade terms, a country that has industrialised the export of clever people doing clever things in offices.

With one very large exception.

The patients are going the other way

The best available academic work on this is a study published in PLOS ONE, which did the unglamorous job of filing freedom-of-information requests to 28 NHS foundation trusts. Its finding: Britain is a net exporter of patients. Inbound international patients made up about 7% of private patient volume in the hospitals studied and generated close to a quarter of the private patient income. That is the segment you build a growth plan around.

Ankara’s business model

Between 2012 and 2024 the number of international patients travelling to Turkey from the UK rose roughly sixfold, to about 1.5 million a year, generating in the region of $3bn. The Trade Ministry has been explicit that this is an export industry, and treats it like one: in 2022 it extended export incentives that had previously gone to healthcare investors so that they also covered health tourism agencies, reaching more than 1,200 of them.

But the policy is only half the story. Turkey teeth packages are constructed with a clinical scope, a number of nights in a hotel, a written guarantee and a single number. A spokesperson at One Life Dental, a European agency specialized in full mouth dental implants in Turkey, stresses the importance of the holiday package for British patients: ‘there are daily flight to Turkey from over 12 UK airports, most of them to coastal holiday locations.’

Three things a service needs before it can leave the country

It has to be buyable by a stranger. Can someone 2,000 miles away work out what they are getting, what it costs, and what happens if it goes wrong, without speaking to a human first? We have convinced ourselves that bespoke and unpriced is a mark of quality. Abroad, it mostly reads as evasive.

Someone has to classify it as an export. Education got a strategy, a dedicated trade unit and a ministerial champion, and grew. Healthcare got a waiting list. The difference in outcomes is the UK’s clinical reputation is, if anything, more famous than its educational one –– but for the wrong motives.

Trust has to travel. Regulation, recourse and accreditation are the infrastructure of any cross-border service. We have world-respected versions of all three in Britain.

Who captures the value

“Exporting healthcare” sounds uncomfortably like selling the NHS. But we have already had this argument, in another sector, and resolved it. International students pay a premium that cross-subsidises domestic provision; that is the justification for treating universities as exporters. The PLOS ONE data suggests inbound patients are highly profitable in exactly the same way.

The delivery margin in dental tourism accrues to Turkey. The component margin — the implant systems themselves — accrues largely to Switzerland, Germany and Sweden, whose firms designed them. When the technology moves on, as with the newer cement-free and screwless dental implants now displacing older abutment designs, the engineering IP is once again continental European. Turkey sells the operation. Basel sells the part.

Britain sells neither.

That raises questions for an economy that keeps announcing it wants to be a science superpower. In any exportable service, there is a design layer and a delivery layer, and the money is in one or both. Deciding you will compete in neither is also a decision.

Somewhere in your business is a capability that nobody outside your postcode can buy. Because you have never converted it into something with edges: a scope, a price, a timeline, a guarantee.

That conversion is product design. Britain is extremely good at being excellent. We are oddly reluctant to be buyable.

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