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The Rediff Business Interview/Dr Pratap Reddy

'We can earn $ 30 bn though our health care industry'

Dr Pratap Reddy, chairman, Apollo Group of Hospitals, is considered the pioneer in corporatising India's health care. That was way back in 1982 when he set up the Apollo Hospital in Madras. Today, Apollo has hospitals in Delhi, Hyderabad while new ones are coming up Lucknow, Visakhapatnam, Cochin, Ahmedabad, and Jaipur in India and also in Sri Lanka and Bangladesh. Shobha Warrier, who met him in Madras, came away with the impression that Dr Reddy looked and talked more like an articulate, friendly businessman than a doctor. Excerpts from the interview:

You are just back from a month-long trip abroad. What exactly was the purpose of your visit?

Apollo's goal is to constantly keep abreast with world standards, and for this reason, I visit Europe and the United States at least a couple of times a year to look at technology and also some amount of collaboration in certain areas. For example, I went to RSNA, which takes place every year in Chicago. Here you can see the latest equipment that are going to be sold next year.

I was impressed by a machine called Heart Scan which, in a matter of minutes, screens an individual's heart and grades the calcium. This calcium score will tell whether the individual is prone to a coronary risk or not. Its gradings are: no risk, minimum risk, moderate risk, severe risk, etc. It also depicts the coronary vessels. This makes it very simple for a cardiologist to manage medically and interventionally. It takes just two minutes -- one minute on the machine and one minute later, you come out with a coronary artery map.

In place of an angiogram?

Yes, we do angiograms, but that is an intravenal procedure. Anything interventional, even if we say there is no risk, causes inconvenience to the patient. Here, there is no inconvenience. I had it myself and I was there on the couch only for a minute. No removing one's shoes, no removing one's suit.

Would you say that there are hospitals in India which are on par with western hospitals?

We have extremes. We have certain hospitals which have no doctors and medicines, and these are the kinds that are famous. People all over the world think that Indian hospitals are infected and they give unsafe blood. They do not know the other extreme where we have hospitals like Apollo, Escorts, Hinduja, which give patients the highest possible care, comparable to any hospital in the world.

As far as Apollo is concerned, I am very confident that it can match the best hospitals in the world, not only in equipment and faculty standards, but in results also. The proof of the pudding is in the eating. Our results are on a par with the best in the world. If you take heart cases, we have done 22,500 heart surgeries in India, with a success rate of 99 per cent. And we are doing it for $ 3,000 compared to the $ 30,000 to $ 40,000 charged elsewhere.

Could you convey the message to your western counterparts that there are good hospitals in India?

People who do not know us think that all Indian hospitals are ill-equipped. Recently, doctors from our major hospitals in the United Kingdom and the US visited our hospitals. They were simply amazed and said, 'Dr Reddy, your hospitals are better than the best in the world'.

When we were in the States in the 1960s, people used to think that we used to sleep on the ground and snakes crawl all over us. That picture still exists, which I think is not their fault, but ours. When the plague broke out in India (Surat, 1994) we scared everybody and even small countries banned our aircraft. But in other countries, if something of this sort happened, we would hear about it only after it was controlled. This is where we falter.

The world must be told that in India we have hospitals which give quality service. We got the ISO 9002 for our cancer hospital and this (Madras) hospital too. In a matter of two months, we will have ISO standards for Hyderabad and probably by the end of next year, for Delhi too. When I started Apollo in Madras, everyone asked, 'Will you be able to maintain the standards?' We have not only maintained our standards but consistently improved too.

When you first started Apollo here in Madras, the corporate hospital concept was unheard of in India. What was the motivating force behind it?

I have to go back to answer that. I was in the US for 10 years, and came back due to my father's wish, I suppose. I started a good heart hospital, but I used to send those who needed heart surgery to the US. A young man of 37 came to me after a heart attack as he was suffering from severe pain. He needed a coronary bypass surgery. Unfortunately, his employer refused to pay $ 30,000 which was the hospital fee for the Texas Heart Institute. Before I could make any alternate arrangements, in front of my eyes he died. It shattered me. He shouldn't have died at all.

This was when I decided to create international standards in our country. I had seen in the US that professionally managed corporate hospitals were doing extremely well as far as quality of health care was concerned. Because of better management, they brought down the cost too. That was how Apollo, Madras, the first professionally run corporate hospital, was born.

How difficult was it to materialise your dream?

There are a million bricks in this building and there were a million problems too. At all levels we had problems; you name it and we had it. But all that are behind us now. The million problems have made our bricks very strong now, call it enforced bricks.

You want to bring international standards to India. To which section of society?

To all sections.

Can an ordinary person in India afford a hospital of these standards?

My desire is that no man should die for want of facilities in our country. But I know India. We have a small number of rich, a few upper middle class, and many middle class and poor people. We have beds to satisfy all these categories. We provide hospital facilities and doctor service free for poor people. Some organisations -- Lions, Rotarians, etc -- look after the medical consumable and disposables. If nothing else happens, we ourselves have a charitable society.

Then why is it that even now Apollo has the image of a five-star hospital which caters only to the rich?

People love talking. If they say Apollo provides high standards for care, unfortunately it doesn't make news. So they say Apollo is a five-star hospital. I tell them we are not five-star but seven-star. My first star is the hospital itself; second is today's technology; third, doctors par excellence; four, professionally run departments; five, value for money; the sixth star is for continuously upgrading our technology; and the seventh star is because we not only save foreign exchange, but bring it in too.

My mission is to make India a major health care destination for the world. All this happened because of the young man I lost. Now we have 5,000 people with the same mission.

The image I had of Apollo was that of a five-star hospital. Today I was surprised to see a mainly middle class crowd inside the hospital. Do you feel the attitude of the Indian middle class towards health care has changed?

I am very happy that today patients can have facilities which they never had before. Sometimes, I walk into the lobby and talk to some of the patients about where they came from, their opinion about the care here, and how they were able to raise the amount, etc. Their answers disturb me and make me very sad. At least 30 per cent of them cannot afford the charges. They borrow, they pledge and some even sell their properties to avail of these facilities.

My new mission is to create an opportunity or a situation so that people from all walks of life get access to a good quality health care system. For that we need to have two things. One, a high quality health care network not only in the cities but in rural areas too; and two, we need a mechanism through which all of them will have access to these facilities.

Health insurance is a necessity. I have been working at it for nearly three years. Anyway, the process has started and I don't think anyone can stop it because people at all levels, whether it is the bureaucrats or the policy-makers or the politicians and most important the public, have realised that it is essential to get high quality health care.

Do you think the ordinary people of India will understand the importance of medical insurance?

I think the understanding will come. Today, 75 per cent of Americans are covered by health insurance. That did not happen by magic one day. People in India also will realise that they have no choice but to be a member to get good health care. Let us pray that this happens soon.

Dr Reddy's interview continues

Interviews