Mumbai’s healthcare sector is emerging from a period of stagnation and undergoing a transformation. Many of it’s old hospitals are shedding their personas for a new-age avataar By Raelene Kambli
In November 2012, Express Healthcare reviewed Mumbai’s hospital sector and found that the industry which was once a mecca for all kinds of medical aid had suddenly reached a plateau. Reasons for the stagnation being increasing real estates prices, disproportionate distribution of healthcare services within the city and lack of manpower to tackles epidemics and disasters. At that juncture, the sector needed a renaissance. Nevertheless, Mumbai is a city that possesses the valour to break all the possible jinxes and prove its ‘never say die’ attitude. The city’s healthcare sector has already started taking confident strikes towards reviving its lost glory.
The first move
The hospital sector in Mumbai is mainly dominated by multi-speciality institutes built during pre and post independence. Most of these centres of excellence are run by the Brihanmumbai Municipal Corporation (BMC) or various trusts and are structures that have stood for more than 50 years. However, it has been noted that these hospitals are soon reaching a dilapidated state and technologies used in these hospitals are very old and need to be changed or replaced. Hence, the first step to usher renaissance was to restore and revamp these structures which are the backbone of the healthcare sector in Mumbai. Earlier, in the year 2010, the BMC had announced the sanction of around Rs 750 crores for revamping civil run hospitals. However, the actual process started only in 2012.
The KEM effect
The first hospital to start off this trend was the King Edward Memorial (KEM) Hospital. The 82 year-old heritage structure built out of stones and teak wood has been associated with the history of modern medicine in India. The hospital is a Grade II heritage structure and is spread across approximately 5,23,400 sq ft, comprising two buildings. A sum of Rs 120 crores was allotted towards the entire restoration project and the contract was awarded to the Neev Group, a well-known construction and architecture company. Express Healthcare had also covered how the historic KEM Hospital was supposed to receive its new avtaar.
The then COO, Mayank Madhani, Neev Group had explained how restoring a heritage structure was a challenging task, especially if the restoration work had to be conducted while the hospital is fully functional. He had informed that when Neev began restoring the hospital, KEM’s building housed around 2000 beds with about 390 staff, physicians and 550 resident doctors, and about 1.8 million out-patients and 85,000 in-patients visiting the hospital on an annual basis . Here the challenge was to manage the functioning of the hospital without disturbing patients, visitors and whole staff as well as carry out the revamp while maintaining the essence of the heritage structure. In consequence to this, the whole project was divided in six phases. Each of the phase had a specific amount sanctioned to carry out the revamp. The restoration included increasing the strength of the structure and augmenting capacity of resources like water supply, and replacing the Medical Gas Pipeline System. The revamp included upgrading various wards and OTs, introducing new infrastructure for waste management etc and controlling HAIs. Also, where the interiors are concerned, every ward has been revamped with better flooring, plastering and tiling, painting as well as new beds and patient service furniture have been incorporated. Apart from this, the hospital also installed GRC domes instead of the conventional domes. GRC domes are lighter in weight, do not corrode and have substantial life. This revamp certainly gave a new lease of life to thousands of patients who commute to the hospital. Many departments which were not functional opened their doors to the patients increasing the capacity of the hospital. This landmark step urged the government to turn towards hospital like Bhagwati Hospital, Cooper Hospital, Nair Hospital, Lokmanya Tilak Hospital, Sion etc.
This revamp included increasing capacities of the hospitals and also upgrading them with newer technologies. Apart from this, the Corporation also introduced a new medical college attached to the Cooper Hospital that spreads over three acres, and will house additional 150 MBBS seats. BMC has also applied for essential approvals from Medical Council of India (MCI), New Delhi, to expedite the process. Dr Suhasini Nagda, Director, Major Hospitals in a press meet that happened this August had said that they would apply for the approval by August 31, 2014. The MCI team would eventually come to inspect the facilities.
The medical college will begin functioning with first-year MBBS courses, commencing from June 2015. Courses in anatomy, biochemistry, physiology and preventive social medicine will be offered, starting next year. The hospital will commence interviews for hiring teaching and non-teaching staff for the medical college from next year, January onwards.
The medical college in Cooper Hospital will be the first such institution in the Western suburbs. Currently, there are three functional medical colleges run by the BMC – Topiwala Medical National College run along with Nair Hospital in Mumbai Central, Seth Gordhandas Sunderdas Medical College run along with KEM Hospital in Parel and Lokmanya Tilak Medical College run along with Lokmanya Tilak Municipal General Hospital in Sion.
The Corporation took the first step, and the private sector followed suit. Revamp and restoration within the private sector took a different form. Most of the private hospitals in Mumbai are upgrading various departments within the hospital set-up to provide better services. On the other hand, hospitals like there are Sir Hurkisondas Nurrotumdas Hospital and Research Centre and Dr Balabhai Nanavati Hospital and Research Centre were taken over by organisations like Reliance Foundation and Radiant Life Care who completely transformed these hospitals into centres of excellence.
Reliance’s 19 storey swanky hospital
Sir Hurkisondas Nurrotumdas Hospital and Research Centre, now christened as Sir H N Reliance Foundation Hospital and Research Centre is a 19-storey buildging with around 345-beds. The earlier structure was built in 1925, and the hospital is one of Mumbai’s premium hospitals. It has witnessed the freedom struggle and the Second World War. One of its most frequent visitors then was Mahatma Gandhi. The hospital celebrated its Silver Jubilee with Sardar Vallabhbhai Patel as its Chief Guest and the Golden Jubilee celebrations was graced by Lok Nayak Jayaprakash Narayan. However, in the last eight years the hospital was battling with financial instability and so Reliance foundation acquired it to rebuilt its glory. Reliance began the hospital restoration project with a vision to make the hospital of the future.
This hospital has collaboration with John Hopkins, MD Anderson Cancer Centre, Massachusetts General Hospital and University of Southern California and is currently a multi-speciality tertiary care hospital with six thrust areas: cardiac sciences, nephro-urology, neuro sciences, oncology, orthopaedics and spine, and woman & child health. The hospital also has a medical mall with progressive diagnostic services, including laboratories, radiology and imaging, and nuclear medicine.
The newly restored heritage building can easily be mistaken as the front of a hotel. The heritage wing of the hospital which is connected to the new tower by a sky bridge has an antique elevator excavated from the godown and reinstated. It reminds you of the bygone Victorian era that the Britishers brought to India. Well, while Reliance has maintained the old world charm of the heritage building, it has also fully digitised the hospital. It has a suite of operation rooms on every floor, some equipped with robotic arms for microscopic surgeries, and cutting edge hybrid cath-lab (a machine that does advanced imaging and allows doctors to perform interventional surgeries at the same time. The hospital has adopted technology in a big way with colour-coded floors and restricted passage ways covered by RFID tags for equipment management.
What’s more interesting is that, the charitable wing of the hospital, where under privileged patients will be treated also have the same set-up and technology as in the executive suite of the hospital. Additionally, the hospital has an outreach programme that currently covers over 310,000 individuals in the vicinity, providing preventive and primary healthcare on a digital platform virtually free of costs.
Also, it has initiated steps to adopt the nearby congested areas as part of Prime Minister’s call of Swachch Bharat Abhiyan. To make the hospital the greenest healthcare facility in India, Reliance has adopted methods like water recycling and rainwater harvesting.
Just as Reliance acquired Sir H N Hospital and transformed it into a healthcare centre, Radiant Life Care, promoted by former investment banker Abhay Soi has acquired Dr Balabhai Nanavati Hospital through an operations and management (O&M) alliance and has remodelled the hospital to make it into a preferred healthcare destination for Mumbai. The hospital is now named as Nanavati Super-speciality Hospital.
Radiant takes over Nanavati hospital
Nanavati Hospital has a legacy of service to the people of Maharashtra. The hospital has been a witness to the city’s effort in developing healthcare services. After experiencing a northward incline for many years, the hospital was faced with high operating costs, financial crunch and inability to compete with other private sector players, Nanavati Hospital, therefore decided to opt for a revamp. This July, the hospital entered into an O&M alliance with Radiant Life Care. The Nanavati Trust says that the brand Nanavati will remain intact.
As per the alliance, Radiant Life Care will help streamline operations of the hospital by bringing in global practices and introducing a wide range of medical services. The new design of the hospital is in line with Delhi’s BLK Hospital which is also transformed and managed by Radiant Life Care. The revamp has already began. As per the alliance, Radiant is looking to almost treble the capacity to 900 beds at a cost of over Rs 350 crores and upgrade the 64-year-old facility, inaugurated by the first PM Jawaharlal Nehru. The money will be used to add 600 more beds to the existing 350-odd beds. A good portion of the capex will be spent to add more super-speciality wings as well as to install state-of-the-art technology
The new management wishes to transform this hospital into a high-end quaternary care institute with world-class treatment facilities to provide healthcare solutions, like the the Mayo Clinic in the US.
Speaking about the vision and plan for the hospital, Soi, says, “The hospital has a very strong legacy of more than 50 years. Secondly, it is an iconic part of Mumbai’s landscape and the third important aspect is the academics. So it is inherent in developing Mumbai’s healthcare fabric of serving the people of Mumbai and North India.
Although it is not a heritage building, the art décor of the hospital does remind us of Mumbai’s old structures that you will find around the Marine Drive . So we decided to retain the old charisma, build upon the legacy and widen the ambit of healthcare services. So our vision for the hospital is that in a year or two we want Nanavati Super-speciality hospital to be the hospital of choice for Mumbai. Thereafter, we also have a 500-1000 sq feet of FAR, to build a new building where we will incorporate the 500 new beds. The hospital is also adjacent to the Mumbai airport and Juhu airport, so we intend to cater to the rest of the state. We also intend to build another IPD wing in the current premises while maintaining the current décor of the hospital.”
The interesting part of this transformation is that Radiant did not choose to stop the functioning of the hospital while conducting the revamp. Even more interesting is that the revamp work is carried out without any glitches, opines Soi. “We have been very careful in our work, as the hospital has been fully operational. We have maintained high standards of hygiene and other factors in order to keep dust and infections at bay. In fact, we have been receiving a good response, the hospital’s occupancy has increased by 60-70 per cent. This itself demonstrates that we have been able to carry on our work without any settlements on standards and practices.”
The initial focus of the revamp is the facet, lobby, the ground, upgrading the wards to modern standards, and upgrading the cath lab with Philips’ modern equipment. So, in the next two to three years time, the hospital will complete the entire revamp.
Sparking a trend
Radiant’s alliance with Nanavati also reflects that healthcare management firms are seeking avenues to enter Mumbai’s healthcare sector in the form of M&A, O&M and even complete buyouts.
On the other hand, hospital entrepreneurs who are battling with instability in their business are scouting for prospective buyers for their hospitals. For example, recently SevenHills Healthcare’s founder, Dr Jitendra Das Maganti and private equity investor JP Morgan mandated Goldman Sachs to find buyers for the over three-decade-old multi-speciality hospital chain. This serves an opportunity for the industry to acquire these hospitals and transform them for the better.
This is just a drop in the ocean, there is more to come in the forthcoming year. Mumbai’s healthcare scenario is witnessing the winds of change and we hope that they will usher prosperity to the sector in the times to come.