Healthcare Global Enterprises Ltd. (HCG), India’s largest provider of cancer care, believes that introduction of universal healthcare model like those of western countries can provide relief to cancer patients whose number is set to grow in the coming years. Chairman & CEO Dr. B.S. Ajai Kumar speaks about the challenges, and his vision to provide quality oncology healthcare across the country. Edited excerpts:
How serious is the cancer problem in India?
Very serious. It is increasing by the day. India reported 1.5 million cases but I think it will be 2.5 million or three million cases in a few years. Going forward China and India will have the highest numbers in incidence of cancer. So it is very important that we treat it properly. Prevention is always better. So we have taken up the issue of smoking, we have filed a case in Supreme Court and have sought a ban on smoking. We have taken up preventive measures like early screening. We want to focus on early detection and prevention. But not all cancers can be detected. So when they come in advanced stage, if treated properly, the patients can have a good quality of life.
Why will India and China have more cases?
Because of environmental and life style related issues. We have seen lot of people having style and dietary changes. Every one is eating outside and having junk and oily food. We are using herbicide, pesticides and all these will contribute. Smoking and pollution are adding to the problem. Cancer is something that does not happen overnight. Now even 25-year-olds are getting cancer and this is a matter of great concern.
What is your advise?
You must focus on lifestyle. Do good exercise, have proper diet and preferably organic food. If there is a family history we can look at the genomics criteria to see whether the patient will get cancer. One can predict. A saliva test can prove if someone has a higher chance of getting breast cancer. We are now getting more into genomics. So in future genomics will tell us who is likely to get cancer.
What is your growth plan?
Today we have 24 centres in India, Africa, Middle East and Vietnam. But most of them are in India. We have an opportunity to grow. Currently we are establishing a big centre in Delhi, possibly in Kerala. We have opportunity to grow in the Middle East and Africa. But right now we want to consolidate. Because we have grown too much, we want to consolidate first and then get into the growth phase again. We would like to go for the ‘asset light’ model. We don’t want to own real estate. And we are also coming with models wherein we will not own the equipments.
How about the treatment cost at your hospitals?
In India the problem is that we don’t have provision for universal healthcare. We have certain healthcare scheme for poor people. Today over 50% of the patients are paying from their own pocket. So naturally it becomes very expensive. In U.S. if you get a cancer treatment done it would cost $30,000 to $40,000. Here we are doing it in less than $8,000. The problem is that even if people are paying ₹5 lakh, they are paying from their pocket. But if you go to Singapore or Middle East the ₹5 lakh here is going to be ₹50 lakh. So it is very cheap here but people cannot afford that. That is why we have recommended universal healthcare.
How to make that possible?
The government has to be open and say let us create a universal healthcare model for the entire country. My frustration is that we have not done that yet. Unless we do that and measure the outcome, the existing schemes will not help. People are dying because they do not get the right kind of treatment. We have to bring that quality. Like I am a medicare recipient and have a medicare card in the U.S. When I was young I contributed for this. India has so many youngsters. Why can they not contribute? Their contribution can go towards universal healthcare pool. So billions of dollars will be there and people can benefit from that. There will be uniformity in care. When you become old you can benefit. That model has to be created. I don’t know what is coming in the way of that model.
What is the success rate for treatment of cancer?
Very good. For breast cancer the success rate is 90%, colon cancer is 80 to 90%. The only challenge is lung cancer, but with new treatment the patients are living longer. We can have better control on brain tumours, head and neck cancer if we can detect them at early stages. Late stages are also treatable. The cancer field has changed now. It is now more of a chronic disease.
What is the debt?
We have close to ₹650 crore debt. We are planning to reduce it. We have put an end to the capex cycle. We are now working on improving cash flow. Most centres are on the verge of breaking even. The whole idea is to improve the EBITDA and improve profitability. Then slowly we will reduce the debt.
What is your focus for company in the next five years?
All our centres should achieve full capacity utilisation. Then we will look at opportunity at asset light models. We are looking at operate and manage models and also areas where in we can provide our expertise. The entire Africa is a huge opportunity for us to provide good quality treatment. We have a centre in Nairobi and we want to build on this. We are looking at the partnership model like we have in Nashik and Ahmedabad. We want to grow through partnerships. Since we grew rapidly, I want to consolidate first.-The Hindu