Gujarat, being an economically stable, industrially and agriculturally
developed state, has become one of the most favored medical destinations too
in the recent times. Sonal Shukla analyses the healthcare boom in the
a state which has achieved a stupendous 12.5 per cent industrial growth rate
from 2002 -2007, a GDP growth of 10.2 percent and a contribution of almost 20
per cent of Indian exports, has a similar success story to share when it comes
From Strength to Strength
This land of Mahatma has always played an important role in the economic history
of India. Today, Gujarat is believed to be fast transforming into a healthcare
hub with the focused Government-led healthcare initiatives with leading corporate
healthcare groups entering this market. The state currently has 13 medical colleges,
1,072 PHCs; 7,274 sub centres, 273 Community Health Centres (CHC) and 85 mobile
healthcare units. Experts agree to the fact that the healthcare landscape in
Gujarat has been changing rapidly. "The State Government has undertaken
several initiatives to make Gujarat a global healthcare destination. Gujarat
is fast evolving in terms of number of hospitals, healthcare centres and beds
and is expected to continue a positive trend in future," shares Pradip
Kanakia, Head of Healthcare, KPMG India.
The available medical infrastructure and easily accessible
healthcare facilities have remarkably improved the health index of the population
over the last few years. Well developed ports, roads, airports, rails are also
said to be responsible factors. Gujarat, being an economically stable, industrially
and agriculturally developed state, has therefore become one of the most favoured
medical destinations. From dominance of small nursing homes, 25-years back,
today Gujarat has made a rapid progression to the state-of-the-art tertiary
care corporate hospitals getting established in major as well as two and three
tier cities. Experts give credit for this rapid development to the changing
mindset of the patients who have become quality conscious and more aware of
their healthcare needs. Besides, growing per capita income and want of specialised
and sophisticated healthcare has given further impetus to this healthcare boom.
"Currently, Gujarat healthcare market is standing on a verge of great take
off. Medical tourism, enhancement of existing medical infrastructure, involvement
of state Government in improving other facilities has significantly boosted
healthcare market in Gujarat," says Dr Praful Pawar, CEO, Apollo Hospitals,
Sterling group is coming up with two more hospitals in Bhavnagar and Baroda
Shalby Hospitals is coming up with three new multi speciality hospitals-two
in Ahmedabad and one in Surat
Apollo is exploring opportunity to start Reach Hospitals in Gandhidham,
Kutch, Rajkot, Baroda and Surat
Land of Opportunities
Major corporate hospital groups such as Sterling, Apollo and Wockhardt have
made significant investments in setting up state-of-the-art hospitals in major
cities of Gujarat. The other major private players in this market are Shalby
Hospitals, SAL Hospital, Medisurge hospital, Krishna Heart Institute. Sterling
Addlife India Limited that owns and manages the largest chain of corporate hospitals
in Gujarat, in terms of bed strength and markets covered, under the brand name
of Sterling Hospitals, today boasts of 725 operational beds in Rajkot, Baroda,
Ahmedabad and Mundra SEZ. "We are coming up with three more hospitals in
Surat, Bhavnagar and Baroda, which will further ramp up the capacity to more
than 1,000 beds by the end of this year. We plan to build a chain of corporate
super-speciality hospitals in Gujarat. We strongly believe that we are operating
in an underserved market and outstanding opportunity for private healthcare
delivery exists in every city in Gujarat in which we have entered and planning
to enter to deliver best in class healthcare," according to Rajiv Sharma,
CEO, Sterling Addlife India Limited. Sterling Hospitals Group plans to invest
close to Rs 200 crore in various green field and O&Ms in the state. "We
are going to leverage our brand to workout a sustainable model by charging for
it," he adds further.
Ahmedabad-based 240-bed Shalby Hospitals, which started as
a single speciality hospital giving orthopaedic care, is also on an expansion
spree. The hospital is coming up with three new multi speciality hospitals
two in and around Ahmedabad and one in Surat. "We are planning to add 600-700
beds together in all these three hospitals. The construction will start in a
couple of months and we plan to complete it within 15-18 months," shares
Dr Vikram Shah, Chairman, Shalby Hospitals, Ahmedabad.
|The improved per capita income and rapid industrialisation
has made major cities like Ahmedabad and Surat instant hits amongst corporate
players. However, other prominent cities like Mundhra and Kutch region,
Saurashtra, Baroda and Bhavnagar have also grabbed attention of the market
leaders. "Baroda and Surat are emerging centres, especially Surat with
the overall boom in the business in this city as well as its close proximity
to Mumbai, which is a big advantage," shares Dr Anil Chadha, Hon Medical
Director and Consultant Plastic Surgeon, Rajasthan Hospital.
Sterling Hospitals is planning to increase its presence
substantially in Kutch area. "Sterling has started a hospital in
Mundra which is the largest SEZ in India and are in process of building
a Hospital at Bhavnagar", says Rajiv Sharma, CEO, Sterling Addlife.
Apollo Group is keen on tapping areas like Gandhidham, Kutch, Rajkot,
Baroda and Surat and is looking at opportunities to establish the concept
of Apollo Reach Hospitals in the region. "In Gandhidham, we are going
for 100-bed secondary and some tertiary care hospital," shares Dr
It has been reported that Artemis Health Science is planning to set up a Rs
500 crore medical education hub on the Baroda-Ahmedabad highway in Gujarat.
The medicity envisions a research centre, a medical college, nursing college,
pharmacy college, medical administration college and a hospital which will have
over 500 beds. Bombay Hospitals has signed an MoU to establish an Under Graduate
and Post Graduate Medical institute with MS Hospital. Twenty-five-year-old and
210-bed Rajasthan Hospitals, which is a major trust hospital, has plans to expand
its bed strength to 250 beds. The hospital is planning for a separate cardiac
wing, new ophthalmic centre, bone marrow transplant and stem cell unit. "Ahmedabad
is a big city and we would like to start two-three OPD and emergency management
city centres in Ahmedabad. We see a big opportunity in critical and emergency
care management," shares Dr Nitin Shah, Director, SAL Hospital, Ahmedabad.
The State Government is also reported to be joining hands with private players
to set up medical education facilities in the State. According to Dr MM Anchalia,
Medical Superintendent, Civil Hospital, investment is happening from both private
and Government. "Our State budget has doubled in the last two years for
healthcare sector. We are getting aid from Central Government and World Bank."
In the year 2009-10, the health department of Gujarat Government has planned
to extend the services and start new medical colleges. "One such college
is likely to come next year in Patan. The plans are on for four medical colleges
in Ahmedabad, Gandhinagar, Vadodara and Valsad. Hopefully one or two should
start next year," adds Dr Anchalia.
Civil Hospital, Ahmedabad is getting aid from the Central Government under Pradhanmantri
Swasthya Sudhar Yojana'. Started in 2005-06, the hospital has till date received
Rs 100 crore from the centre.
Under this scheme, a hospital is identified from each state and is given aid
by the Central Government to develop one AIIMS-like institution. The hospital
has also received aid of Rs 20 crore from the State Government of Gujarat to
develop it as Asia's largest medicity. Currently, the hospital is going for
a three-fold development which includes strengthening the existing infrastructure,
getting newer and advanced equipment and increasing existing capacity.
Narayana Hruduyalaya, Fortis Healthcare, and Artemis Group of Hospitals are
planning to set up medical colleges in the State. The Chiranjeevi Scheme, which
has been touted as one of the few PPP success stories in healthcare, has significantly
reduced the rate of maternal and infant mortality. As per the scheme, the Government
and private sector have collaborated successfully in providing safe child delivery
|Lifestyle diseases like diabetes and heart diseases
are on the rise in Gujarat region. The state is also said to be a big centre
for orthopaedic diseases. According to Dr Pawar, "Out of 14,000 knee
replacements done in Western India, almost 7,000 are done in Gujarat and
majority of them I am sure are done in Ahmedabad." Tapping this segment
Apollo has started the concept of 'Knee Clinic' in its Ahmedabad facility.
Experts also feel that there is an unmet need in the area of cancer and
radiation oncology. Medisurge super speciality hospital is planning for
a 100-120 bed new cancer hospitals in Ahmedabad, Baroda, Surat and Rajkot
which will provide medical, surgical and radiation oncology treatments.
The Ahmedabad Cancer Hospital by the group will be the first one to go on
the floor in another one year.
Care with Quality
It won't be an exaggeration to say that the healthcare sector in Gujarat has
come in the limelight by adopting global practices to deliver seamless patient
care of quality. "Gujarat's medical expertise and the strength of its facilities
are arguably better than those of some of the South - East Asian Nations and
Gujarat hospitals are trying to do a lot more hard selling abroad," says
Kanakia. They are seeking to achieve this by measures such as creating centre
of excellence in respective fields, developing a network, customising packages
and providing a stamp of quality through accreditation from global certification
agencies such as JCI. Not only corporate hospitals like Sterling, Medisurge,
Apollo, Shalby but also major trust hospitals like Rajasthan Hospital and 2,040-bed
Civil Hospital, which is also known as Asia's largest hospital, are in the process
of getting either NABH or JCI accreditations in the next one or two years span.
Civil Hospital has done first round of accreditation for its blood bank and
is now going for final accreditation. It has plans to go for its lab accreditation
and finally accreditation of the entire hospital. Today, hospitals like Shalby
is known for its joint replacement surgeries and dental care. Krishna Heart
Care Centre has established its name in the area of cardiac care. After getting
a strong backing from HCG Global group, Medisurge group is trying to establish
its presence in cancer care by establishing three cancer care hospitals. HCG
Global acquired Medisurge Hospital, a local hospital in 2007.
of 14,000 knee replacements done in Western India, almost 7,000 are done
- Dr Praful Pawar
believe that opportunity exists in every city in Gujarat in which we have
entered and planning to enter"
- Rajiv Sharma
is fast evolving in terms of number of hospitals, healthcare centres and
beds and is expected to continue a positive trend in future"
- Pradip Kanakia
Head of Healthcare
In tune with the national goal to promote India as the most
favoured medical tourism destination, Gujarat has aggressively pushed the concept
of medical tourism by using its well known 'Vibrant Gujarat' annual event. Government
and private healthcare organisations have come together to attract patients
from abroad with measures such as creating accredited centres of excellence
in the respective fields and by aggressively promoting Indian systems of medicine
specifically, Ayurveda, naturopathy and yoga.
Apollo Hospitals, Ahmedabad attracts high number of foreign
tourists for various kinds of surgeries and health checkups. The hospital is
planning to ramp up its platinum wing meant for international patients by total
26 beds in the coming few months. "People are now aware of the quality
of health facilities being provided in Gujarat, helped by English-speaking doctors
and staff and an almost zero waiting period," says Kanakia. The major factor
for increasing medical tourists to the state is the low cost of cardiac surgery,
angiography, joint replacements, radiation and other medical services, which
is a fraction of what they would have to incur abroad.
Shalby Hospitals, known for its joint replacement, has witnessed
10-15 per cent increase in the medical tourism patients since its inception.
The hospital has an international patient co-ordinator especially roped in and
fully dedicated to its international clientele. Besides, the other major reason
for medical tourism in Gujarat to flourish is the increasing number of NRGs
or Non Resident Gujaratis settled abroad are preferring their homeland not just
as a treatment option but also for putting investments to establish hospitals.
Krisha Heart Care Centre is one prominent example of NRG-led
speciality care hospital. "Around 6.5 million Gujaratis are NRGs. They
visit their native place, especially in the month of November and December.
This is the period when besides vacationing, they also prefer getting treated.
However, the repeat cases only come through word-of-mouth publicity," says
Today, one of the key challenges faced by all the healthcare players wishing
to penetrate this market is the shortage of trained manpower especially when
they are planning to expand in tier two and tier three cities. Gujarat healthcare
is also believed to a 'doctor driven' market. Experts agree that physician is
a key link in the success of corporate healthcare in this market. Says Dr Shah,
"It is a 100 per cent doctor-driven market and is a difficult one to penetrate
and sustain if you have not involved the well known doctors." Agrees Dr
Pawar, "Gujarat is still a doctor- driven market and not institution driven
and this poses a huge challenge for corporates who are willing to enter this
market. Doctors also do not prefer to join as full-time consultants in the hospital."
The ever increasing real estate and electricity costs are the other major deterrents.
"We need to have deep pockets. As real estate prices will impact the per
bed cost, therefore the kind of infrastructure built and technology brought
in will impact the break even and profitability. One needs to invest prudently
and manage cost well and be prepared to invest for long term in this market,
The fledgling healthcare industry in the state of Gujarat is set to become a
leading sector, which other states can look up to replicate. "We are witnessing
a change in this market which will soon shift its focus from doctor-centric
to patient-centric healthcare. Gradually, we shall also see nursing homes disappearing
and corporates gaining a stronghold in this market," quips Dr Bharat Gadhavi,
CEO, HCG Medisurge Hospitals. Gujarat, thus, with all its right growth enablers
and strong building blocks can become a serious global healthcare hub in India.
However, this would call for serious continuing transformation efforts on the
part of the Government and private players to change mindsets of foreign investors
and patients in order to attract global capital, talent and business flow.