India’s first successful PPP hospital turns 10

Adjudged second best civil hospital for its performance in Ayushman Bharat Yojana

India’s first successful experiment on Public-private Partnership (PPP) model in rural healthcare took shape on the aftermath of the devastating earthquake in Bhuj, Gujarat. What began as a challenging endeavour has now taken shape of a state-of-the-art hospital that caters to more than 1000 patients a day.

It was year 2009 when the Gujarat Adani Institute of Medical Sciences (GAIMS) and the G K General Hospital in Bhuj were brought into PPP model. GAIMS is a teaching hospital and the latter is a 750-bed multi-specialty hospital. Many corporate houses that were approached earlier by the government backed off at later stages citing lack of feasibility. Finally Adani Group, through its CSR arm Adani Foundation, joined hands with the Govt. of Gujarat and thus a new chapter in rural healthcare began.

The hospital has just been adjudged the second best civil hospital for its performance in the Ayushman Bharat Yojana.

One lesson learnt was that it will take long-term commitment, patience and sizeable investment for the partner to write a success story. Adani Foundation has so far invested around Rs. 100 crore in upgrading the infrastructure and developing top-line human resources among other things. A decade since then the cumulative operating deficit stands at Rs. 25 crores.

Over the years this successful PPP model in Kutch, India’s largest district, has led to create confidence in planning six brownfield self-financed medical colleges in Tapi, Dahod, Panchmahal, Banaskantha, Bharuch and Amreli districts by upgrading the government hospitals through PPP.

In October 2018, the NITI Aayog has accepted the merits of the model and invited private players to partner with government hospitals at the district levels across India. The central government has laid down guidelines for involving private sector in the healthcare area right at district levels through the Public Private Partnership (PPP) models.

Health is a state subject and each state can opt for a model of its choice proposed by the NITI Aayog with technical assistance from the World Bank. The four PPP models are Management of Contract, Purchasing of Services; Build, Operate and Transfer Model and a Co-location Model.

Broadly, four parameters make the PPP model in healthcare successful on the long term. It has to be affordable, cost-efficient, timely and feasible to all stakeholders. The World Bank, the World Economic Forum, many policymakers and think-tanks have also vouched for such an ideal approach.

Usually, governments across the globe have engaged the private sector in achieving six major objectives through PPP model. These are the areas of financing or co–financing of the project, designing of the infrastructure and care delivery model; in construction or renovation of facilities included in the project, maintenance of the facilities and the equipment, operating or supply of applicable equipment and delivery of nonclinical services, and lastly, in delivery and management of specified clinical and clinical support services.

Encouraged by the growing feasibility in India, the Govt. of Odisha has recently announced what would probably be the largest ever PPP programme in healthcare. Across the state 25 hospitals are planned to be developed. Each will be between 100 and 200 bed greenfield hospital.

G K General Hospital is the only referral hospital in Kutch, India’s largest district, and often considered the last resort by patients arriving from the farthest corner. Moreover, the expanse of Kutch district increases travel time for patients and thereby adversely impact the chances of recovery/survival. Further several cases referred to the hospital comprise terminally ill patients comprising critical infants and elderly patients. From Outdoor Patient Wards to the Operation Theatres and Labour Rooms to Intensive Care Units every critical aspect of the hospital infrastructure grew manifolds.

Looking ahead, the Indian healthcare scenes will go through a tremendous change revolving around the PPP model. With increasing demand for affordable, efficient and quality healthcare both in urban as well as rural areas, this area will evolve for the better, for sure.

A vision for healthier future

The G K General Hospital is in the process of filing for National Accreditation Board for Hospitals & Healthcare Providers. The GAIMS medical college will be acquiring simulation models for medical students to sharpen their skills and thus impart education at par with global standards.

“Adani G K General Hospital caters specifically to the healthcare needs of the poor and marginalized sections of the society. People from special and deserving categories receive further specialized and free IPD services. In addition, the hospital also connects people with various government schemes such as AyushmanYojana, MA Yojana, students’ healthcare programme etc.” said Mr. Vasant Gadhavi, Director Administration, GAIMS.