a riskThe escort burden

What the person travelling beside the patient carries: a second fare and a second bed, unpaid leave, and the nursing after discharge that no package quotes. Three states have written the escort into an instrument - one capping how many may come, one paying them a daily allowance, one putting their charges on an invoice. None of the three measures the labour.

The hard number is a visa quota. India's Bureau of Immigration grants the e-Medical Attendant Visa alongside the patient's own, and caps it: "Only two e-Medical Attendant Visas will be granted against one e-Medical Visa (patient)". That is an immigration rule, not a clinical finding, and it is still the clearest published statement of how many people a state expects a treatment trip to involve.

The Gulf prices them. Dubai's Administrative Resolution No. (14) of 2017, the bylaw for sending patients for overseas medical treatment, entitles a patient aged 18 or over to one escort and a patient under 18 to two, named as both parents; two again for a patient of 65 or over, or paralysed, comatose or disabled. The allowance schedule sets the daily rate by destination: EUR 150 for the patient and EUR 150 for the first escort in European countries outside the United Kingdom with EUR 50 for the second, GBP 120 and GBP 50 in the United Kingdom, USD 150 and USD 50 in the United States, USD 130 and USD 50 in Singapore and South Korea, AED 300 and AED 100 in India, Thailand and Arab countries. Article 6 of the same bylaw pays for interpreting, medical devices, air ambulance where needed, and repatriation of the body if the patient dies.

Turkiye bills them. The 2017 regulation on international health travel defines the licensed intermediary as a group A travel agency authorised to supply accommodation, transport and transfer "to the patient and the accompanying companion and other relatives" (Article 4(1)(g)), and Article 11(1)(b)(1) requires that intermediary to hand over, free on request, an itemised breakdown of what it charged for accommodation, transport and transfer, interpreting and consultancy. The companion is a line item.

Inference - a per-diem schedule is a floor, not a measure. It prices a bed and a meal for a person a state has decided to send. It says nothing about the wage that person is not earning, the leave they are spending, or the hours of care they provide after discharge - and those three, not the airfare, are the bulk of what the escort carries. Nobody has measured any of them in this population.

What the job is, in the words of the one guidance that describes it: the Royal College of Anaesthetists asks that after a general or regional anaesthetic "a responsible adult should escort the patient home and provide support for the first 24 hours after surgery", by private car or taxi rather than public transport. Abroad, that single sentence expands. The companion is the second listener at a consent conversation run through an interpreter, the memory of what was said when the discharge summary is thin, the person who rebooks the flight when the patient cannot fly on the booked date, and the one who lifts.

The cost sits in places a price comparison does not reach: a second ticket bought on the same dates, a hotel room for the length of the stay rather than the length of the admission, days of unpaid leave, and, where the patient is a child or is over 65, a second escort at a second set of rates.

Trade practice - packages that name a companion usually name a bed, not a service - a second bed in the room, or a hotel night for the nights the package covers. Whether a relative may stay overnight on the ward, and at what charge, is set hospital by hospital.

As of 17 September 2026 the published figures attached to the companion are a cap and a set of per diems: two attendants per patient under India's e-Visa rules, and Dubai's daily allowance schedule by destination country. Both are what a state pays or permits. No survey, registry or study this project has found measures what a companion spends, how many patients travel with one, or what care they provide after discharge.