British care homes in India and the Philippines
The Independent, 14 February 2012

telephone booth

Come and spend your autumn years in an Indian palace,” a seductive voice beckons at the beginning of The Best Exotic Marigold Hotel. In the new film, Judy Dench and Bill Nighy lead a veteran cast of characters to Bangalore in the hope of spending their retirement in sunnier – and cheaper – climes.

Based on a book by Deborah Moggach, the premise is simple: faced with a growing number of old people and the daunting cost of care, couldn’t we outsource the problem of ageing to Asia at a fraction of the price?

It’s certainly a topical question. Britain’s impending care crisis is headline news. The trouble is, we’re living longer than we’d planned for and ageing has become an expensive process. The cost of residential care is now upwards of £30,000 a year.

It’s now no longer a hypothetical one either, I discover, talking to Dennis Carpenter, an Englishman who is eyeing a small snake from his bedroom window.

“There’s all sorts of wildlife further uphill,” he mutters. “Monkeys, mongooses… and there’s talk of a leopard, but we’re quite safe here.”

He’s speaking to me from Dignity Lifestyle, a “Retirement Township” 50 miles east of Mumbai. A former engineer from Cambridge, he sounds younger than his 74 years. “It costs me about £130 a month to live here, including my internet connection. I spend another £250 on general supplies and £190 on medicine.” Dennis has chronic problems with his lungs and eyesight, although things are stable at the moment. There are nurses and a doctor on hand for all residents, but he prefers to take a train or a taxi to Mumbai to see two specialists. “I get to see two of the best doctors in the country. To me, they’re gods.”

The community is made up of 56 residents, about half of whom live independently in a small cluster of bungalows. The other half, most with some form of dementia, require more regular assistance and are housed in a purpose-built block where they are cared for by local nurses.

There are now more than 5,000 people living in India claiming a British state pension, up 28 per cent compared with 10 years ago, although strict rules on residency visas suggest that most are likely to have some former connection with the country. The same figures show an increase across all Asian countries, however, many of them actively marketing themselves to British retirees.

Malaysia’s “My Second Home” programme, which offers tax breaks for foreign pensioners, has seen the number of Brits retiring there quadruple in a decade. More striking still is the Philippines, which of all Asian countries offers the most intriguing proposition.

A short drive from the capital, Manila, on neat roads lined with mango orchards and banana plants, sits Indang Village. Billed as “The British Village in the Philippines”, Indang is a curious mixture of Pacific tropicana and English nostalgia, loosely modelled on London’s Regent’s Park. Vintage parking meters appear next to manicured lawns, as does a 159 bus stop and a red phone box in Gilbert Scott’s classic design. There’s a pub, too, whose walls are decorated with replica medieval swords.

The village was created from scratch by Filipino businessman Gil Zarcilla, specifically to cater to Brits who balk at the cost of care in their own country. A marketing film for prospective customers asks: “Does your care home have a problem with increasing costs, lack of qualified staff and diminishing quality of care?” then answers: “Let us help by providing the ideal care home environment in the Philippines.”

Indang is home to more than 60 British pensioners at different stages in their retirement. Professor Kenneth Evans, 73, used to teach social sciences at Goldsmiths College in London and met Gil at a party in Hounslow. He says the decision was a simple one. “I can live here for about a fifth of the cost of living the UK and outside of the rainy season, it’s like springtime all year round: sunny and temperate, so perfect for older people.”

Set on 74 acres, Indang is a gated community with a mixture of detached houses and live-in care facilities. A large house costs around £20,000, and for those who need constant care, two full-time nurses can be hired for £280 a week. “It works well,” Kenneth tells me, “because there’s a more gentle and caring culture here. Even outside of the village, people are attentive and concerned.” There are local doctors, but most residents have private healthcare insurance, which provides access to “world-class” hospitals in Manila.

Another resident, Raymond Humphreys, 81 and originally from Lewisham, is also positive about the village, but says he’s troubled by the poverty outside Indang. “The unemployment rate here is three times higher than in the UK and for those in work, wages are very poor. £65 a week would be a good wage, which is difficult to understand if you’re from Britain.” This hasn’t prevented a growing stream of retirees, though. Rising from 630 in 2002, almost 2,000 people now claim their UK state pension in the Philippines. The trend looks set to continue, and not just amongst the British.

German and Japanese care home operators have bought up large swathes of land in the Philippines and Japanese companies have started building “what look to us like huge Butlins holiday camps”, says Kenneth.

There is a scene towards the end of The Best Exotic Marigold Hotel in which Dev Patel, playing an unlikely care home manager, proclaims: “I have a dream to create a home for the elderly so wonderful that they simply refuse to die.”

It isn’t goodwill driving this surprising trend, though – it’s good economics and, as our material expectations and our ability to pay for them continue on divergent paths, it could be an option that we all need to take more seriously.

Additional reporting by Nasfim Haque