North-East hospitals turning to care for people of eastern region

The journey began in 1987, when Nomal Chandra Borah, an AIIMS-Delhi trained neurologist, returned to his homeland to set up Guwahati Neurological Research Centre, arguably the first quality private healthcare facility in the North-East.

In 2018, the GNRC group set up an affordable multi-speciality hospital at Barasat in West Bengal. The ₹60-crore project ended the North-East’s dependence on Kolkata or other cities for quality healthcare.

Expansion plans

The ₹165-crore-turnover GNRC is planning to expand to other Tier-2 cities in the East.

Other players are also emerging out of the North-East to take care of health in the East. For instance, the ₹5-crore-turnover start-up ERC Eye Care, having vast operations in Assam, is mulling expansion to smaller towns of Odisha and Bengal.

Then, there is Ayursundra, a ₹26-crore-turnover NABH and NABL accredited diagnostic chain, which plans to expand to the North Bengal town of Siliguri soon.

This is just the starting point of the journey these outfits are embarking upon. For, all three, set up by first-generation Assamese doctor-turned-entrepreneurs, are aspiring to tap the potential in the neighbouring economies in South and South-East Asia, too.

World Bank, PE funding

Their aspirations are not misplaced. Each of them is profitable, backed by innovative models and finances. The affordable model of GNRC and ERC earned appreciation (and a grant of approximately ₹1 crore each) from the World Bank.

Having started with seed capital financing from Ankur Capital and Beyond Capital Fund, in 2015, ERC raised in 2017 ₹8 crore in Series-A from Ennovent India, North East Venture Fund of government-run North-Eastern Development Finance Corporation (NEDFi) and others.

GNRC raised private equity from Canbank Venture capital in 2013, which was bought back by Borah in 2018 riding on the ₹75-crore debt finance from Avendus Capital. Right now they have ₹200 crore loan on books from LIC and Avendus.

Ayursundra has the distinction of getting equity finance of ₹100 crore from abroad. “This is one of the largest FDI in North-East,” says Chief Executive Officer, Abhijit Hazarika.

A former medical practitioner in GNRC, Hazarika and his Amsterdam-based banker friend, Srimanta Das set up Ayursundra in 2007. In 2016, they started a 150-bed multi-speciality hospital in Guwahati. They also have an Oncology wing which is due for expansion into a super-speciality service.

Innovative approach

To understand what makes investors believe in such ventures, one must take a look at ERC, the smallest in turnover and most focussed of all. Having earned his medical degree in 2007, Parveez Ubed spent years in understanding the affordability of the rural population.

By 2012, he started organising camps in rural areas. And, in June 2015 when ERC opened its first hub hospital with World Bank money in Sivasagar in upper Assam, the business plan was ready. ERC focussed on refractive error and cataract — together constituting 80 per cent of eye problems — for the rural poor in a hub and spoke model.

Starting with vans and rural vision care centres — as spokes — ERC has four frill-free hub hospitals at the top. OPD services are offered at ₹50, small surgery packages are offered at ₹999, which includes the cost of transportation from villages and food. Lodging, if necessary, is provided free of cost.

He provides prescription glasses in partnership with Essilor and they are sold at a fraction of the market price. This is a completely disruptive model, which banks on volume. For example, his glass making unit recently started producing progressive lenses at 25 per cent the market price. “We are planning to scale it up as a separate venture,” Ubed said.

Affordability

GNRC has a similar model but on a larger scale. It, too, operates in the hub and spoke model starting from village level health workers. Packages are offered at a fraction of the market price. A CT scan of brain at ₹900, ₹2,500 for an MRI, ₹500 for an angiography and in emergency cases, free-of-cost treatment for the first 24 hours.

“Five per cent of the patients use the free window and take the patient out after 24 hours,” said Priyanka Borah, Deputy Managing Director. But she doesn’t find fault with the model. GNRC already had two hospitals in Guwahati when they introduced the affordable model in newly built GNRC Institute of Medical Sciences, also in Guwahati, in 2014.

Today the affordable hospital have better EBIDTA than the other hospitals. “We will expand in the affordable category only,” she said.

Rural kiosks

Ayursundra doesn’t make any claim on affordability. Its focus is on quality. “Diagnostic is the most critical aspect of treatment and we rate ourselves as one among the very best,” said Hazarika.

The company is now opening kiosks at rural centres, which serve the dual purpose of collecting samples for its lab network and extending the OPD of the Guwahati hospital through tele-medicine.

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