Private health sector in India has grown because of huge gap in healthcare delivery: Alok Roy, chairman, Medica group of hospitals

A nuclear cardiologist trained at the prestigious All India Institute of Medical Sciences, New Delhi, Dr Alok Roy helped set up various private hospitals such as Fortis hospital in Noida, B M Birla Heart Institute and Rabindranath Tagore International Institute of Cardiac Sciences in Kolkata and Manipal Heart Foundation and Narayana Hrudayalaya in Bengaluru. He founded Medica in 2008 as a clinic in Siliguri before starting a large multi-specialty hospital in Kolkata two years later. As a chairman of the group, Roy is now striving to make it the most formidable hospital brand in eastern India. In this chat with Moneycontrol, he talks about how he plans to achieve that and what support is needed from the government for the private healthcare sector in India to grow to its full potential. Here are the edited excerpts:

The journey so far has been very good. When we started in West Bengal, it was at the bottom of the healthcare delivery curve and people had trust issues with hospitals, especially the private ones. Though Apollo and Wockhardt — which was later acquired by Fortis — were there, they were yet to be established as good regional players. So the need for a regional player was felt in the eastern part of the country and I think Medica has fulfilled that part. We have certainly emerged as a key regional player. So the journey has been fulfilling and we have been accepted rather well. We are present in Odisha, Bihar, Jharkhand and Assam, apart from multiple locations in West Bengal; so we have our footprints across eastern India and that is a good thing. We feel that this part of the country needs us.

We have two ways of growing. First, we are kind of increasing our footprint wherever we are. We are widening our base because we feel that the return on the buck spent is maximum where we are. So wherever we are in Kolkata, Siliguri or any other place- we are increasing our size horizontally. That means we are adding facilities, more centres in our own facilities, more buildings, beds and disciplines. Then, we are also adding a few new areas. So our target states are currently Assam, Chhattisgarh and Odisha. These three are our focus areas where we want to grow. We want to stay in the east only and grow well here and we feel that the east has a need to provide such facilities. We don’t want to go pan-India.

I think the government has done nothing post-independence to help private healthcare grow. They have become more of an obstacle rather than being a very synergistic helpful. Somewhere there are sporadic instances where the government has offered help, but majorly the healthcare has grown in India because the need exists, mainly for tertiary and quaternary care. Secondly, the strength of India is its ability to produce a high number of doctors and specialists. Number three, the biggest advantage we have in India is that our training is in English. So our doctors get trained in the UK and the US as the language is common. So the learning is far better and many of these doctors come back. These are some of the reasons for the growth of healthcare in India and the role of the government could have been synergistic or would be synergistic if the government thinks like that. But now with the competitiveness with which the government has come in providing healthcare support to the masses, it does look like there will be an impetus for growth in India if they just get their costing right. Because they have not got their costing right, there is a big issue there. The Central Group Health Scheme rates, for example, have not been revised for the last decade or so properly; if they do their mathematics right and start supporting universal health care with the right mindset, payment and payment delivery, then there is nothing which can stop healthcare delivery in the country from growing.

The health sector will boom because the biggest pillar required for tertiary care, expertise, is available. People had accessibility problems because third-party payments were not available and people could not afford it. So with the third-party stepping in, either through insurance or assurance mode, it has given a huge boost to the sector.

There are two sets of Western healthcare models. One is completely insurance-based, which is the US model. Another is the state-controlled National Health Service (NHS) model of the UK- everything else shifts between these two. India has not made up its mind on which side it wants to sit. Once they make up their mind, on either side, we will grow and these are the golden next two decades for Indian healthcare delivery in India. We are extremely hopeful because the current central government is very bullish about setting up medical colleges, healthcare plans and reforming medical education. One of the major worries in the last 15-20 years has been that the quality of output from the medical colleges was uncertain. When you pay a huge amount of money to medical college, then they close their eyes on your attendance and your training program. Now, the government is planning to bring in one entrance and one exit, and once both happen everybody will have to have that minimum standard.

We are willing to play ball with the government. But the government needs to get the rules right. See, you go to any country — requirements such as 25 acres of land and all that huge buildings (for medical colleges) are unnecessary. How many people can invest in that? That means you encourage them to cheat. Knowledge is transferred not from the space but from people. Get the people right, get the system right. It will change and we will participate. The current norms need to be corrected and authorities are correcting them. There is a huge positive movement happening to reform medical education and the government is serious about that.

If you look at healthcare exclusively as it stands alone, then you are right. But people here come from the same society in which everyone exists. Do we have honest politicians, judiciary, IAS officers, cops or journalists? Then how do you expect healthcare to be different? There are good and bad people in every profession or sector and you need to choose your calling in life. We, at Medica, believe that we want to be an example for other healthcare settings to follow. So we are ethical, honest and upfront. But I can’t say the same thing for every hospital.