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BOT: Panacea or Pandora’s box?

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With India dubbed as the diabetes capital, and growing evidence of the link between high insulin levels and certain types of cancer, the impact of a growing community of cancer survivors will be immense.

An industry contact at one of the overseas missions was sharing the news that they would soon be having a conference on cancer. In passing, I mentioned that this was one disease that was sure to leave its touch on most families and she responded that she had already lost one sibling to cancer and the another was a stage three survivor.

What struck me was that the latter, even though now battling obesity from the after effects of chemotherapy, still volunteers at the children’s wing of the local cancer institute. The petty problems we face in life are nothing compared to what people go through with this dreaded disease, especially children, commented my friend.

The good news is that many people have outflanked the big C and are now learning to live with cancer. The bad news is that we as a society still fear cancer and a cancer survivor often finds himself/herself fighting two battles: one is physiological but the more insidious struggle is psychological.

As our story in the Strategy section, ‘Life after cancer: Issues of cancer survivorship’ points out, we are looking at a steep increase in the number of cancer survivors but we as a society are clueless about our role. Barring a few shining examples, the medical fraternity also needs to develop more organised ways of supporting this community.

Our other major story in this issue is in the same spirit as our Anniversary issue in January where we featured 13 people who we felt could be game changers in India’s evolving healthcare industry.

Moving from individuals to potentially game changing business models, in this issue we analyse the pros and cons of the Build-Operate-Transfer (BOT) model. Its application to healthcare is still being debated and some argue that its old-wine-in-a-new-bottle: just another hybrid variation of PPPs.

Will BOT be able to eliminate the ills bogging down the sector? As GP-led practice gives way to or grows into neighbourhood clinics, then nursing homes, and later on into larger (70-100 bedded) facilities and finally into franchisees of national multi-speciality corporate chain hospitals, doctor-entrepreneurs who want to leapfrog to the next level during their life time rather than leaving it to the next generation, need to find the right model to suit their vision. Maybe BOT could be the answer to these entrepreneurs.

In the same vein, a hospital architect at the HBII 2012 commented on the potential of Tier III and IV cities in India’s hinterland as future healthcare hubs. There are doctors from the hinterland who have inherited huge tracts of ancestral land which they’d like to transform into a healthcare facility which bears their name, she said. They could find some answers in the BOT route. Will BOT be the panacea or just another Pandora’s box?

Viveka Roychowdhury
Editor

[email protected]

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