Setting up of Super-specialty / Multi-specialty Hospitals. Healthcare Government of Gujarat

Transcription

1 Setting up of Super-specialty / Multi-specialty Hospitals Healthcare Government of Gujarat

2 Contents Project Concept 3 Market Potential 5 Growth Drivers 6 Gujarat Competitive Advantage 7 Project Information 8 - Location - Connectivity - Manpower - Key Private Players Project Financials 10 Approvals & Clearances 11 Key Department Contacts 12 Page 2

3 Project Concept Healthcare Industry- An overview The Indian healthcare industry size was USD 100 b in 2015 While the healthcare sector is expected to expand from USD 160 b in 2017 to USD 280 b by 2020, India lags behind on healthcare outcomes when compared to similar nations (peers) Gujarat is rapidly developing into a healthcare hub with the favourable Government-led healthcare initiatives with leading private healthcare groups entering this market Gujarat s health care facilities attend patients from all over the state including neighboring states of Rajasthan, Maharashtra and the Union territory Daman & Diu The state has a mix of Private and Public facilities rendering healthcare services across various specialties and the private sector s market is expected to grow with state adding to the purchasing power through assurance model of healthcare delivery There is also a potential for the state to be a pioneer in healthcare tourism Background Government of Gujarat (GoG) is contemplating of setting up a multi-specialty hospital on PPP basis The private player would be required to design, finance, construct, equip the hospital with necessary medical and non-medical infrastructures, run and maintain the hospital for the concession period Project Facets Hospital is expected to be developed as per Indian Public Health Standards and minimum Standards laid down by the National Accreditation Board for Hospitals & Healthcare Providers (NABH) It is envisioned to provide health care facilities in selected disciplines The broad scope of work is to develop a two hundred and fifty (250) bedded Hospital. The hospital may be developed in a phased manner as agreed in the Concession Agreement The private partner would design, build, finance, and operate and maintain the hospital during the concession period, after which the project, all its assets would be transferred to the concessioning authority free from all liabilities and encumbrances The scope includes deployment of adequate number and mix of qualified clinical and non-clinical staff for operation and management of the hospital and providing the health care services Page 3

4 Project Concept Role of Private Party Construction of facility The private party is expected to construct, equip, staff and operate the core and support facilities at the Hospital and get all the relevant approvals 250 bedded hospital The private partner is expected to construct a two hundred and fifty (250) bedded hospital as per the IPHS and the minimum standard laid down by the NABH Super specialty Out of the two hundred and fifty (250) beds, at least one hundred and twenty five (125) beds may be reserved for Super speciality in relation to cardiology and cardiac surgery and at least such number of beds as may be required to start operations of the other Super Speciality department (as identified by the Medical Council of India) Medical infrastructure All associated clinical and non-clinical services including pathology laboratories, emergency units, diagnostics centre, radiology, pharmacy, kitchen, etc. to support the proposed hospital Accommodation Accommodation should be provided for the clinical and nonclinical staff as well as for the attendants of the patients Support services Pharmacy, ATMs, car parking, telephone booths, e-suvidha counter / jan suvidha Kendra etc may be permitted with prior approval in accordance with the provisions of the Concession. In addition, restaurants, and canteens may be allowed Page 4

5 Indicators Healthcare industry size n USD b Year Market Potential Per capita healthcare expenditure in India Over the period per capita healthcare expenditure has increased at a CAGR of 5% This is on account of increasing income, easier access to healthcare facilities and greater awareness Per capita expenditure n USD Source: India Brand Equity Foundation, Healthcare Sector Report, January 2016 Healthcare sector growth trend in India E Year F E: Estimate, F: Forecast, CAGR: Compound annual growth rate Source: India Brand Equity Foundation, Healthcare Sector Report, January 2016 Health Indicators in Gujarat vis-a-vis India During , the market is expected to grow at a CAGR of 16.5 % The total industry size is expected to touch USD 160 billion by 2017 and USD 280 billion by 2020 As per the Ministry of Health, development of 50 technologies has been targeted in the FY16, for the treatment of disease like Cancer and TB Total Fertility Rate (SRS 2012) Maternal Mortality Rate (SRS ) Infant Mortality Rate (SRS 2013) Infant Mortality Rate Maternal Mortality Rate Total Fertility Rate (SRS (SRS 2013) (SRS ) 2012) India Gujarat India Gujarat Page 5 Source: Sample Registration System 2013, 2014

6 Growth Drivers 1 Favorable demographics According to 2011 census, the population of Gujarat was 6.03 crore, at an annual growth rate of 1.9 percent the population by the end of year 2016 would be 6.63 crore Rising population and increasing per capital income would lead to an increase in requirement of healthcare services 2 Growth in lifestyle diseases As per Public Health Foundation of India (PHFI), traditional diseases in India are increasingly being replaced by lifestyle diseases in the past two decades High blood pressure, stroke, diabetes, diseases associated with smoking and drinking are mainly lifestyle diseases 3 Rising healthcare consumption by middle class As per Euromonitor, between period, the Indian median income per household is expected to increase by 89.8% to reach USD 10,073 (in constant 2014 prices) by 2030 Rise in income coupled with lifestyle diseases leads to increasing consumption of healthcare services 4 Growing penetration of health insurance The insurance industry intends to increase penetration levels to 5% by the year 2020* With about 360 m policies which are expected to grow at a CAGR of 12-15% over the next five years, India has the largest life insurance sector* Gujarat in particular has been focusing on an assurance led model to increase the purchasing power of the population for health related services 5 Private Equity in Indian Healthcare Sector As per World Health Organisation, the total expenditure on healthcare in India is about 4.1% of GDP, in which government contribution is less than 1% of GDP Also the 12th Plan has envisaged rise in healthcare expenditure to about 2.5% of GDP by the end of 2017, apparently the private sector investment is going to play a major role # Source: *IBEF, Insurance sector of India, 2016 # Kalyani B.G. Private Equity in India: A Special Reference to Healthcare Sector, 2015 Page 6

7 Gujarat Competitive Advantage Highlights from Budget Government of Gujarat has made a provision of INR crore under plan and non plan for health and family welfare department A provision of INR crore for the construction of 50 Sub-Centres in rural areas, establishment of 63 Primary Health Centres and 15 community health centres A provision of INR crore to upgrade 32 PHCs to provide higher medical services including gynaecologist and paediatrician in health centres in Urban areas A provision of INR 15 crore to provide Haemodialysis centres in 10 hospitals A provision of INR 100 crore to create Diagnosis Centres, Speciality and Super Speciality hospitals in remote and needy areas under PPP A provision of INR 82 crore for expansion of Cancer Hospital, Ahmedabad Source: Page -14, Government of Gujarat, Details of Budget , Speech-Formatted1.pdf Actual expenditure in plan & non plan under Family Welfare Linked Health Insurance Plan during was 1.22 crore* Source: * Annual report , department of health and family welfare, Government of India Health facility summary in Gujarat 19% Primary Health Centre Sub-District Hospital 2% 2% 77% Community Health Centre District Hospital Mukhyamantri Amrutam MA & MA Vatsalya Yojana provides tertiary care treatment to Below Poverty Line (BPL) population & to the families having an annual income INR 1.20 lakh or below INR 1.20 lakh per annum The Sum assured is up to INR 2,00,000/- per family per annum on a family floater basis Source: National health mission, State health society, health & family welfare department, Gujarat Other Advantages Flourishing Economy Gujarat contributes 7.2% of the Nation GDP and shows leadership in many areas of manufacturing and infrastructure sectors Gujarat s SDP (State Domestic Product) at current price registered a growth of 11% during the year Source: Statisticstimes Page 7

8 Project Information Location Multiple Locations across Gujarat Possible locations could be tier II cities e.g. Rajkot, Vapi, Valsad, Vadodara Infrastructure Availability & Connectivity Gujarat is well connected to all major locations such as Delhi, Mumbai and other nearby states from where Broad gauge railway line passes through. Gujarat is well connected to all major locations such as Delhi and Mumbai through Delhi-Mumbai Industrial Corridor ( DMIC) and neighbouring states. Gujarat has an international airport in Ahmedabad 8 domestic airports in Surat Vadodara, Rajkot, Bhavnagar, Junagadh, Jamnagar, Porbandar & Kachchh which is well connected with metro cities in India Gujarat has a major seaport in Kandla and around 40 non major seaports. Page 8

9 Project Information Minimum Manpower Requirement for 250-Bedded Hospital Indicative Minimum Manpower Requirement Sl. No. Specialists For 250 bedded 1 Medical Specialist 3 2 Surgeon 3 3 Obstetrician & Gynaecologist 4 4 Paediatrician 4 5 Anaesthetist 3 6 Ophthalmologist 2 7 Orthopaedic Surgeon 2 8 Radiologist 2 9 Pathologist 3 10 ENT Specialist 2 11 Dentist 2 12 Medical Officer Dermatologist 1 14 Psychiatrist 1 15 Microbiologist 1 16 AYUSH Doctors 1 17 Visiting Doctors (for major operations) 5 18 Nurses & paramedical Administrative Staff 21 TOTAL 276 Source: Indian public health standards, guidelines for district hospitals, revised 2012 Key Private Players in Gujarat HCG Hospitals Zydus Hospitals Sterling Hospitals Indus Health plus Bankers Heart Institute Narayana Hrudayalaya Charusat Hospitals Global Hospitals Apollo Hospitals Page 9

10 Project Financials The estimated cost of setting up of a new super-specialty hospital is approximately INR crore Description of Work Area in sq. meter Rate INR crore Land cost would vary depending on the size and location of the site. Approximate land requirement for the project would be around 10 acre Civil Works: Area requirement for 250 bedded hospital, minimum required area per bed (1,076 sq ft. per bed for all hospitals)* Therefore built up area requirement is 25,000 sq meter INR 25,000/ sq meter, (Escalated rate for Hospital, RCC framed structure upto 6 storeys from INR 23,500/ sq meter, Plinth Area Rates-2012 Central PWD, Government of India) Plant & Machinery/ Engineering Services 24.0 Medical Equipment 26.0 Medical & Non Medical Furniture, Signage etc 5.0 Ambulance & Automobiles 0.6 Site Development Total % 12.2 Total Project Cost Estimated annual Human resource cost Source: * Number of Beds 250 No of OPD Rooms 15 Number of Operation Theatres Minor: 3 Major: 6 Estimated Project Cost ~146.5 crore Note: Above cost is indicative and may vary subject to the scale and facilities in the Project. Page 10

11 Approvals & Clearances Approvals Minimum Standards & Accreditation While undertaking the development of the Project, the private party shall adhere to the latest amended National Building Code of India, other relevant IS Codes and practices, Development Control Rules, FAR Limits, statutory requirements, guidelines and approvals of the Nodal Agency, Applicable Laws of land, the principles of Good Industry Practices, the IPHS and the minimum standard laid down by the NABH, and any other norms as applicable from time to time They shall also take into account the guidelines issued by the Government of Gujarat and the State Health Department and obtain the necessary approvals Keeping in view that the hospital services should be world class, the Hospital shall apply to the NABH for accreditation and obtain the same within five (5) years from the Date of Commercial Operations Clearances The private party shall be responsible for all the clearances and all other approvals as may be required for the construction, development and operations of the Project under the Applicable Law. They may apply to the Nodal Agency for single window clearances for obtaining No Objection for the establishment of the Hospital. Page 11

12 Health & Family Welfare Department, Government of Gujarat National Health Mission, Government of Gujarat Medical Council of India Industries Commissionerate National Accreditation Board for Testing and Calibration Laboratories This project profile is based on preliminary study to facilitate prospective entrepreneurs to assess a prima facie scope. It is, however, advisable to get a detailed feasibility study prepared before taking a final investment decision. Commissionerate of Health, Medical Services & Medical Education (Health) Office Address :Block No. 5, Dr. Jivraj Mehta Bhawan, Gandhinagar. Phone No. : cohealth@gujarat.gov.in